19-yr-old diagnosed w/kidney failure - vets wants euthanasia??????

Anyone who's read a little about Phoebe on one of my other posts has heard this. Over the weekend while my husband & I were out of town, our cat sitter informed us Phoebe hadn't eaten or drank or used the box at all for her. And seemed lethargic. Sure enough - it was very, very serious. I'd had little signs that week before, but I'd been preoccupied  with my current foster kitten, Olaf (who had corners of his eyes grafted to his eyes to make new eyelids -- cats been through hell!!!!!!0. Needless to say I feel awful I didn't think more about the behavior that now adds up from Phoebe the week before.

But we got her to the vet Monday soon as we were back. She'd gone from 6 1/2 lb to 5 1/2 pounds in less than a year (and, if she didn't have Maine coon like fur - she'd look like an Auschwitz victim - awful)..

No change - lethargic - barely stumbling to the litterbox, and even then standing front feet in, back feet out and peeing on the carpet. No drinking or eating on her own. Not even interested in american cheese- - love of her life. Wouldn't even lift her head. So took her back for blood work Wednesday. 

I  didn't end up actually seeing the blood work itself - and think Monday I'm going to call to get it sent to us. I don't want to drive myself nuts with the numbers - obviously she's at the tail end of all of this - whether it's days or weeks (I won't even think it could be longer - but there's always hope!). The vet passed along to the receptionist (he was with a patient and couldn't come to the phone -so consequently all I heard was "Tell her it's the kidney's. I think they should put her down whenever they can and Phoebe's ready." So I'm trying to decide if I drive myself crazy and get the numbers - knowing it'll touch off a "what more can I do to change this number' panic. Obviously it's kidney disease, so I know it's not reversing. I just don't want to put her down until she's ready.

Well, I don't think any of us is ready! Phoebe included!!! Phoebe's been perking up over the past few days - don't know if it's shoving 140 ml of blendered AD down her throat throughout the day, or the antibiotic, or a combination. But she's back to (as my hubby puts it) "Bitchy ol' Phoebe". She gets up when we enter the room, meows at us, jumps down and THINKS about food, for about 5 minutes. Drinks on her own. Begs for little pieces of American Cheese (she's up to eating about 2 quarter sized pieces 3 x a day?!?!? Using litterbox for pee and very normal poop. Even purrs, walks across the room to headbutt my leg. So now....if she'd just eat. Syringe feedings truly aren't bad, she growls a little, but she'd do that if my husband were holding her anyway. Without pushing hard or fast, we generally do 7 syringes of 6 ml of canned AD in a sitting, which equals about 42 ml of food per sitting. We're doing it 4 times a day, with the aim of working her up to 185. (which is what one website I saw said she should have....but that's alot...maybe we;l lwork up to it tomorrow). But she hasn't even vomited a bit yet - so TRULY hoping she may be headed for a plateau. Am I stupid to think so? Is it possible that she could like another few weeks - a month even - being syringe fed if she's happy otherwise? Tell me I'm not nuts to keep this going.....she almost doesn't seem to mind the feedings. 

How do you put a cat to sleep that seems happy about life (except for the eating part)? Any thoughts? Tips? I only want to do what's right for her. She's been with me since just before my husband....both are great loves of my life,

Lastly - a euthanasia question. I found that we may have a vet who will drive over for housecalls, and it's possible I could have phoebe euthanized at home. If it's affordable in the slightest, I'm really thinking about it. It's how I had 3 of 5 of the last pets I had euthanized done - and they seemed so much less stressed out. Now the positive thing of going to the vet is that he's a vet I've been with for 20 years, very kind and gentle. So I know he'll make every effort for it to be as pleasant as possible (a it can be in a little 5 x 7 ft room with a metal table and clinical tiles and other animals yelping and whining all around). I know he's very competent and likely will help the euthanasia go smoothly (I've gone to several that DIDN'T and it was AWFUL). Obviously the housecall vet would be a crapshoot as far as competency and personality. But is that more for me? If I'm doing what's best for her - is it better to ride to the vets and get it done there? It is a long car ride (that she hate) - - about 35 minutes. 

I just don't know!!! (obviously money could solve it). So I'm asking about the home vs vet euthanasia, the how long to keep syringe feeding (& if she is now a "kidney cat" do I need to syringe feed something other than AD???), whether or not to get Phoebe's blood numbers, and how much to beat myself up over. 

Lots of crying here......

I'm so sorry to hear about this.. what a difficult time.

I'd just like to share with you my feelings about euthanasia at home.. I am absolutely all for it.  When my beloved Woozie needed to be PTS my vet told me that she just didn't do house calls.  I found a vet who would and I'm so glad I did.  Woosie didn't mind the car, but I still didn't want her to go in a place she didn't know.  I was able to sit with her until he arrived and hold her while she went, lying on her favourite blanket.  I think it's worth the small risk of having a vet you didn't like. 

As for when to let her go, I think it is at the slightest sign of suffering... We're blessed that we can do this for our feline companions.  If she doesn't mind the syringe feedings too much and it seems to help, I'd keep going.  But the nausea of this disease it just awful, so if she looks like she's not coping, you know to stop.  As the vet said: 'When Phoebe's ready'.

I really do feel for you.. sending you

and love to the beautiful Phoebe.

kittychick said:

......
 Obviously the housecall vet would be a crapshoot as far as competency and personality. But is that more for me? If I'm doing what's best for her - is it better to ride to the vets and get it done there? It is a long car ride (that she hate) - - about 35 minutes. 

I just don't know!!! (obviously money could solve it). So I'm asking about the home vs vet euthanasia, the how long to keep syringe feeding (& if she is now a "kidney cat" do I need to syringe feed something other than AD???), whether or not to get Phoebe's blood numbers, and how much to beat myself up over. 

Lots of crying here......

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All the decisions you are making, are with your Phoebe's comfort at heart, so I think you are an awesome owner.

I , too, would choose the home euthanasia option, if affordable to you, because you said Phoebe does not like  that car ride.  No matter what you do, she will be surrounded by her family, but being at home, may make the transition smoother.  It should not matter if the vet is a stranger, since this final act of love is all about you and Phoebe, and Phoebe will know this.

I think I would want to know the blood counts, not because there is anything more to do to keep her comfortable, but because it would give myself a record, so that I could look at it after.

I'm not sure how long you should continue to syringe feed, but it sounds like she does not mind it so much, so as long as she is still able to take in nutrition, I would continue.

But I would follow @Mani's advice, and if she seems to get worse, then its time.

I am also crying, but not because of your cat care, only because of the suffering you will have to go through.

Read this post, the first one only,  by Gareth.  In it he talks about how all us pet people transfer the pain that an animal is experiencing to ourselves, because of the commitment made when we first met the animal.  We just never really knew it at the time.

It helped me with my cat Sparky, may be it will help you.  It will also cause you to cry more.  so I don't know. Please stay strong, and don't beat yourself up over anything, you are a great owner.

http://www.thecatsite.com/t/237066/when-the-moment-comes

Our first cat, a female lynx point siamese was with us for 19 years, 6 months and 6 days. We had her PTS because she refused to eat or drink anymore.

Our first cat didn't like going to the vet clinic, but this time she wasn't alarmed making this trip to the clinic because she was in bad shape. But, I will not take our present cat, a male manx who is getting close to 17 years of age (June 13th) and still in very good health PTS like this.

Our old vet retired after 30 years of practice and closed his vet clinic three years ago. We searched for and found a new veterinary clinic with 3 vets in it. Two females and one male. The owner of the vet clinic is one of the females and she said she does make PTS home visits since I specifically asked about this service when we were looking for a new vet clinic.

If we have to have this procedure done with our present (my) cat, it will be done at our home. In my mind and since he's my cat (he chose me as his favorite person), I owe him this. The last thing I want his eyes to see is me comforting and petting him when he passes.

I know what you're going through since we've already been there. It's not easy to make this decision, but our first cat let us know it was her time.

My heart goes out to you....it's one of the hardest decisions you'll ever have to make for your kitty. And it never gets any easier.

Our vet will come to the house to euthanize the cats. It is a bit more expensive, but it's easier on the cat in the long run. Our cats don't like car rides and they don't like the waiting in the office in the carrier. And they don't like the exam. I don't like to put them through it all, so whenever we can, we have the vet come to the house.

When Hydrox, The Old Coot, passed away, the vet came to the house. Hydrox was put to sleep at the foot of our bed. Right before he passed, Whisper (who loved him dearly) jumped up on the bed, nosed around him, cleaned his face for him, and then jumped back down. I think he died peacefully, in the place he loved. Da Pumpkin Boy died at home, in our bed, curled up in my arms.

As Mani, said, if your kitty starts to show signs of suffering, then it's time. It does sound like Phoebe, in her own way, is telling you that it's not quite time yet.

And please, do not beat yourself up over letting her go. While it's difficult (and sweetie, we all know how hard it is....honest we do), one of the best things you can do for your Phoebe is to let her go when it's time. 

Sending you many, many 

Are you giving her sub Q fluids?  This would be standard for ad*****d renal failure to improve her quality of life and delay the end.

Stephen

I am so sorry you are going through this - it is the hardest, and the kindest, decision you can make for someone you love.

All I can say is that she will let you know when it is time. They just get a look in their eye, maybe after they find they cannot do something, they can't jump. or there is a disaster at the litterbox, but they know, And you will know. And if you can, I woul opt for for a home visit. even if it a bit of a lottery, most vets who offer that service are likely to be caring and gentle, and she will be much less stressed. AS will you, knowing you have not put her through any more pain or stress than absolutely necessary.

It is a sad time for all, but you may still be able to enjoy a few weeks with her during which you can spoil her and cuddle her until she tells you she wants to go.

Thanks for so much advice and good thoughts! Phoebe's still making it just fine to the box, to both pee and poo. and although a tiny bit wobbly, is all over the room. snifing this, rubbing on that. She still purrs, and gets up and declares "MEOW" like "you're here!" like she has for years when we come in the bedroom. She grooms herself, etc. I just know she's not ready. She came up to me in the middle of the night and meowed, and then licked my nose and headbutted it. Then settled down and purred. So I know it's not time yet. She'll eat cheese...and drink a few sips of a Cat Aid, but that's about it. Otherwise it's syringe feed.....which still goes beyond well. One - 1 1/4 can a day of Hills AD, no struggling, no vomitting. So....guess it's day by day if no one thinks I"m boing overly cruel?!?! She seems so happy! And comes right back to us after the syringe feeding, so there must not be too much hate there....

I will look at the page regarding passing. And I'm going to start calling around to see if I can get someone to come to the house. Affording it may be another issue.

So the thought is I should get the numbers? I don't want to drive myself bonkers.....since I'm sure we're at the end of the road....or as close as you can get without stepping off of it.....but every bit helps.

Thanks all

kittychick said:

 
Thanks for so much advice and good thoughts! Phoebe's still making it just fine to the box, to both pee and poo. and although a tiny bit wobbly, is all over the room. snifing this, rubbing on that. She still purrs, and gets up and declares "MEOW" like "you're here!" like she has for years when we come in the bedroom. She grooms herself, etc. I just know she's not ready. She came up to me in the middle of the night and meowed, and then licked my nose and headbutted it. Then settled down and purred. So I know it's not time yet. She'll eat cheese...and drink a few sips of a Cat Aid, but that's about it. Otherwise it's syringe feed.....which still goes beyond well. One - 1 1/4 can a day of Hills AD, no struggling, no vomitting. So....guess it's day by day if no one thinks I"m boing overly cruel?!?! She seems so happy! And comes right back to us after the syringe feeding, so there must not be too much hate there....

I will look at the page regarding passing. And I'm going to start calling around to see if I can get someone to come to the house. Affording it may be another issue.

So the thought is I should get the numbers? I don't want to drive myself bonkers.....since I'm sure we're at the end of the road....or as close as you can get without stepping off of it.....but every bit helps.

Thanks all

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You're not in the least cruel.....that word does not exist here.  If I were a cat, I would so want you as an owner.

As others have said, do what you can afford, since you will be with her regardless, and the way she is acting, she knows that without any doubt.

If getting a copy of the numbers will bother you, then you don't really need them.  But if you want them later, I am sure the vet will give them.  For me, it was just that I appreciated the science, and the decision was easier to make when my vet showed me how off the numbers were.

For you it is different, because Phoebe is still having good days, so she will tell you when its time. Stay strong, cat friend and Phoebe.

ps. I forgot to mention, that my vet told me that bloodwork was only a  "snapshot" of that particular day, and that the numbers could change in a week's time, maybe even sooner, idk., so vets use the counts to help them diagnose and give a prognosis or treatment plan for the animal.   He said that it changes as the condition changes. and that sometimes the animals look bad, but the counts are good, so they use an overall assessment of the animal, temp, losing weight, teeth, gums,  not just the counts. hope this helps.

Of course there's no hate there!!  She loves you and knows you love her.  

If you want the numbers, by all means get them.  But after 19 years, you, and Phoebe, will not need them.  She'll tell you when it's time and you'll know what she's telling you.  

Oh--we had a home euthanasia for our baby, and am glad we were able to do that.  But had we needed to take her to the vet's, as cat nap said, we still would have been with her, so that's the important part.

My heart goes out to you--this is the most difficult time to go through.  

i'm sorry to hear you're going through this.  i would ask about subq fluids - if her kidneys are bad enough that your vet is thinking you should consider euthanasia, subq fluids may help keep her hydrated and help her flush her body of toxins and stuff.  and re: euthanasia, cats let you know.  it sounds like phoebe isn't ready from the way she's acting!  enjoy every minute.

she seems very hydrated ' i saw no signs of dehydration, and neither did he. I'm off to talk to "the vet i like in the practice" and ask about ivs & numbers. 

And in other cat news - the foster Olaf (pictured - pre surgery) love all of our cats - except Bowie, My smudge faced black and white who had been abused. Olaf wants to play and chase and to chase - Bowie's terrified. SO as much as I though Olaf was the cat to come in as Phoebe sliips the tethers of earth, I can't do it if it upsets Bowie. Why can't it be easy?!?! (Bow Dow's (Olaf does have a young girl and interested - so he won't go homeless - but we love the little dorkO 

Kittychick,

Sub Q fluids in renal failure cats isn't about hydration per se, its about forcing the body to flush toxins that are accumulating by sending in more water, and having the kidneys then flush the fluids out along with toxins.  When kidneys fail, the urine becomes more dilute by virtue of the kidneys not working as well, more dilute means the toxins stay in the body. 

Sending in the fluids helps to compensate for the fact that the kidneys cant flush all the toxins with a normally hydrated cat.

Cats with renal failure routinely have both their lives extended and their comfort increased by sub Q hydration.  It's easy to do at home, is usually done once every few days to start with, and with more advanced cases once a day.  There are easy to find youtube videos that will show you how to do it, and your vet can show you too.  It's not even costly.

Stephen

It's funny , in all of the time I've spent working (don't currently) at humane societies...and gave subq fluids - I thought it was about rehydrating the dehydrated, and flushing out toxins as a secondary benefit. Granted I didn't ask, but the vet certainly didn't propose. I showed him the video of her syringe eating and he thougth she sounded peeved. I reminded him it's the sound she makes if you pick her up, move her bowl, tell her goats don't fly-----in other words, anything. Both the nice vet and stern vet seem to think "it's over." Well - she seems darn perky to me today! Ate 7 ml of AD all on her own, plus about 2 teaspoons of her normal Fancy feast, about 4 inches square of her favorite (american cheese slices)....plus what we gave her by syringe. Call me crazy - but I think she's got plenty of fight in her. She actually ran from DH when he went to get her to help syringe feed! Of course, I just called "Phoebe Dee} and she jumped right up on the feeding towel. But I think - don't you - that she still wants to be hear??@?

Meant to say - I WILL be asking about subq. I used to hate giving it even when it wasn't my cat - so this should be fun

I am so glad she is having this time with you and enjoying it. Give her everything she likes.

Hey there,

Two things really surprise me.  1) i'm not used to vets suggesting euthansia before its ready and based on your description, its sounds like they are wrong to suggest this.  But having two vets suggest this is even stranger.  2) Sub Q fluids is such a completely standard treatment for kidney failure - seriously there is no debate in the veterinary community on the benefit of this treatment that when you say that your vet has never suggested this - it's very odd and a bit disturbing.

Is there something about your vets and their practice that I don't see or understand?

Stephen

 ~~How do you put a cat to sleep that seems happy about life (except for the eating part)? Any thoughts? Tips? I only want to do what's right for her. She's been with me since just before my husband....both are great loves of my life,

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Simple answer: you don't!

I have had at 3 cats euthanized - 2 were very old and, according to the vet, they were more dead than alive. The third had kidney failure. It came on suddenly - treatment was force feeding and Sub Q fluids. We did most of this at home before the lab results came through. At this time there was some hope and nobody mentioned putting Lucy to sleep. However, the results showed that we had a difficult task ahead. Lucy seemed to be blind - not seeing the litter tray I'd put next to my bed but struggling to get down into the cellar where the other litter boxes were. I had to carry her down only for her to produce a few drops of urine. An X-ray showed that one kidney was huge, her intestines were empty. A few days later it became apparent that we were pushing far more solids and fluids into her than her body could deal with. She started vomiting - a horrible black vomit and her whole body was bloated. We stopped treatment and decided to wait 24 hours before making a decision. No bowel movement and little urination. Since becoming ill she had not eaten or drunk anything on her own. Force feeding was a torture and it was dangerous for me to try to carry this poor shapeless cat down the stone steps into the cellar whenever she needed to use the litter box.

We decided to have Lucy put to sleep. If my memory serves me right, her illness had lasted about 6 days. You will know when it's time to say - enough is enough! But as long as she is coping well with the situation there's no reason to even consider euthanasia.,   

Stephenq- I think in -happily!- this case that now we know they were both wrong in saying so quickly it was "time." But I will say in their defense, she's 19 and was almost dead years ago. She'd stopped eating/drinking/using the box & was generally miserable, until our one vet (the "nice one") suggested putting her into our master bedroom suite 24/7 (litterbox, food, etc) & she blossomed! But this past year she's gotten down to 5 1/2 pounds and basically stopped grooming, so both myself & my husband have talked with each other & with both vets about how we weren't going to go to any painful, heroic measures at this point. (Plus, sadly to say -we did at least talk & come to an understand about how far we can go, sadly. And she'd all but shut down 100% when we took her in. So I really do understand why subq/meds/etc weren't pushed.because she truly was on death's door.

But of course NOW thinking about her actually leaving me makes me panic & rethink everything. I did go ahead & start her on an antinauseau & an appetite stimulant since those seemed like non-stressful things to try. But we're still struggling so much over the syringe feeding (not strugglingfeeings-but w/mental concept of how long can it BBEdit done -we hope we haven't put ourselves & her into some awful endless loop that's going to be hard (in every way) to keep up. And while she's definitely not dehydrated, I do get that putting her on subq's and flushing toxins can provide a big benefit--but we also know how stressful it could be to her too. So for right now-and know some people will criticize but she's so happy!!! How long do people syringe fed? Can't bear to do it to a cat who will "dig" to find a way to avoid, but she sure seems to alf
So since last night & this am she ate 47 ml on her own, we're cutting back a little on syringe meals(hoping it'll switch over coml). Think we're doing ok -any though suggestions so appreciate it!!! Here' a pic of phoebe 2 years ago posing (she was tolerating getting ready for our first group shot Xmas card (& our last).

Thanks again -support is invaluable!!!

Thanks for so much positive encouragement---greatly

All you can do is take one day at a time and monitor her quality of life.  At this stage, it isn't likely to get better but as long as she's happy and not suffering, let her have those days.  When he starts going downhill and losing that happiness, spare her the hard times.  And if you have not had a cat euthanized before, be sure to go over the process your vet uses in order to spare her any trauma.  The accepted Best Practices now, at least for cats, is to premedicate them with anesthesia (i.e. a quick shot of ketamine in the butt), no struggle to find a vein, stings for a second but then they are happy and purry and can drift off to sleep happily in your arms, no struggle, about 10 minute or so before the intravenous shot  is given, which they do not struggle against or feel because they are totally anesthetized by then.  Not all vets do this, and we've had a few sad stories on this site abut the end being not perfectly peaceful as it should be.  Do your research and communicate with your vet.  You are your cat's only advocate.  Here is a link to a local group called Sweet Dreams who do in home euthanasia locally and are very highly respected.  It is ever so much easier when you know what to expect ahead of time.  In the meantime, enjoy every loving minute with your beloved old girl.  You have given her a wonderful life, and I know you will make sure she has a peaceful passing as well.

http://www.sweetdreamsgeorgia.com/expectations.php