14 yo cat with HyperT...is it OK to let her go?

About a month ago kitty was diagnosed with Hyperthroidism.  I should've taken her to the vet sooner, perhaps months sooner.  She had lost a lot of weight, was walking a bit odd, and seemed a bit scruffy.  We did a relatively low dose of medication (felimazole) for 3 weeks.  Her T4 counts went down but she was still hyperT.  And she is worse now.  She weighs under 6 lbs, is very weak, very scruffy.  Her latest blood work suggests she might be reacting badly to the medication.  (I'm currently in discussions with the vet about that.)

If she is in fact reacting badly to the medication, the last option for her is the Radioiodine treatment.  But I have a hard time justifying the cost and she may not even be healthy enough for that.  My husband and I make good salaries but I'm already in debt.  Part of me says its not that big of a deal to add on another $1000 or so of debt.  But honestly, I'm not sure what the point of that would be except to ease my conscience.  She has had a heart condition for years and for which I decided not to medicate.  And since having my children (the last one 5 years ago) my kitties have really become second class citizens in our home.  They get little attention from me.  So, I feel guilty already.

She's dying.  I see it.  The vet sees it.  He calls her condition "guarded" and they didn't even want to schedule a follow up visit for 2 weeks from now - probably assuming she was going to get worse instead of better.  But she may be getting a tiny bit better, slowly.  She pretty much stopped eating on Thursday but has eaten a little bit more eat day.  This morning was the first morning in 5 days that she anxiously went to the food I put out.  So maybe I thinking prematurely about letting her go.  The wait and see approach is quickly adding up in terms of expenses for vet appointments and blood work.

Perhaps my conversation with the vet tomorrow will help give me a clearer path.  Up to this point, I haven't had the nerve to ask the vet about just putting her down.

I don't know what I'm asking for here.  But thanks for reading.

Is she on special food?

I know it's frustrating, I've got a 13 year old that was just diagnosed with an enlarged heart, and you DO wonder how far you will go. I guess the thing you have to ask yourself: is there quality to her life now, or am I just prolonging the inevitable? You love her dearly and we all feel guilty that we can't spend as much time as we would like with our loved ones. I talked to my vet about that radio iodine tx. too, when we thought my Burt had hyperthyroidism, but he ended up testing OK. The vet said that sometimes taking out the thyroid can have it's own problems, too. I guess what I'm trying to say is I feel for you having to go through this and want you to know you are not alone. I'll pray for you both and lets all hope for a peaceful, natural end for a wonderful cat. Good luck, I'll keep you in my thoughts.

The vet did give me a couple of cans of the Hill's "critical care" food.  Hoping that if she would at least eat a little of that, it would be better than regular food because it apparently has a higher calorie level.  Other than that, she's been on a ultra-low carb diet of mostly canned food for a while now (years).  I don't really consider the special HyperT food an option because I have 2 cats and the research on that says its low quality food.

Thank you Di.

It's such a difficult call.  We recently lost a kitty to kidney failure.  We were debating, too, wondering if we should keep trying to keep her going and getting her to eat, or whether to let her go.  She had heart problems too and in the end developed a saddle thrombus and we had to have her put to sleep.  It's agonizing and I think Di has a good point--does she have any quality of life now?

Here's a quality of life scale that some people use to help decide:  http://www.pawspice.com/downloads/QualityofLifeScale.pdf

My heart goes out to you.  

I'm sorry you are going through this. I had to make the decision once myself and even when it is obvious what the right choice is, it is never, ever easy. In my case my vet broached the subject with me and said "I wouldn't question you if you decide it is time". We choose to wait to get a few more test results back, but her condition deteriorated to the point when we had no choice but to let her go.

Talk to your vet. Get their honest opinion. What would they do if it were their cat? Look over the link betsygee provided. What is her quality of life at this point?

Good luck.

aww big hugs....as we were in that position 5 weeks ago but chose to put Min down...for her it was the rough road we saw ahead if we wanted to drag her through it in hopes of a cure (chylothorax) but the percentages weren't that great and we could afford surgery...but it was open chest surgery that would be a pretty rough thing for her to endure, also it still wasn't a "for sure" cure. She was only 10 . Incredibly sad for everyone who has to make that decision but I felt totally at peace as I didn't want her to go through suffering at all.

I am so sorry you are going through this.  The best resource for this decision is your vet, I would have an honest conversation with him or her.  I think often vets kind of hang back when it comes to this discussion because they aren't really sure where the owner is at with it.

Always a hard time and always loads of things we beat ourselves up about too when we get there, and even more later on.  I think @betsygee  has given a great reference for you to look at and think over for your cat as each situation is different and only you know exactly what your cat's life is like just now along side the advice your vet gives you.  If you can, spend time thinking over the quality of life scale and use the thoughts you have from that to talk more with your vet.  I have only had to do this twice and with older cats but each decision stays with me.  It is important you are comfortable with what you decide and for me that is most likely if I can put my own emotions and confusion in to the background as much as possible, and focus on the cat's health and her quality of life.   

There is a food that is specific for this and is an alternative when it is hard to medicate, Hill's Y/D.

I use y/d dry with my slightly hyperthyroid cat (she has tons of other problems as well). The switch to y/d stopped her legs from twitching and stopped her from falling during jumps.

I am thinking you will have seen the vet by now, how have things gone today?  I hope you are doing OK @maurene  .

Thank you, everyone! 

The vet was supposed to call me back today but she didn't.  So, I will try again tomorrow.  (We were just in the office on Monday.)

I stopped the felimazole a couple of days ago and she is like a different cat today. I could tell last night that she was feeling much better and she's even better today.  Her appetite is back but I suspect that has mostly to do with her T4 levels shooting back up after being off the medication.  She's being more social and not hiding in the corner anymore.  Kitty gave me real good scare last week - she was in terrible shape! 

I want to talk to the vet about possibly starting the felimazole again but this time splitting the original dose into AM/PM instead of one pill a-day.  Some have suggested that 1x a day may have upset her stomach and/or caused her metabolism to swing wildly as the dose wore off throughout the day.  If that works OK, then trying gradually up the dose to get her T4 levels into normal range.  (The vet on Monday wanted to double her dose right away.)  But, if this other vet at the practice is concerned that the felimazole caused her white blood cells to go down then maybe I'll try the special food -- if it is OK for my other cat to eat too.

Thanks, again!

I am glad she is feeling a little better. I can sympathize wit her as I was diagnosed as hyperthyroid 6 weeks ago and yesterdays testing show I am still hyperthyroid. I feel awful so I can imagine what your cat has been feeling.

I think all of us struggle with deciding what is best to do for our cats and what we can afford to do. in July I had to make that decision for my Leo.The night before I was sure that I would have to say good-bye. We had been told more than a year before that it was a matter of quality over quantity. I thought I had made the best decision as he was suffering and the medication was no longer working. For whatever reason that evening I started searching for other peoples experience with Leo's condition and I came across something written that gave me false hope. That night I went to sleep determined to try again.I was stunned when my vet looked at me and said that there was nothing left to do for him and that he needed me to let him go.It is so hard and I hope that your kitty continues to get better.

StephenQ said:

There is a food that is specific for this and is an alternative when it is hard to medicate, Hill's Y/D

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has anybody tried recovery?

What about surgery to remiove the thyroid? My 13 year old cat got an enlarged thyroid and while the vet suggested Radiocat as the premier treatment I couldn't at the time and so he removed it. She is great today (6 months later) and has gained weight.

It's good to hear she is doing better today, not hiding away, and has started eating more.   It is so hard when a cat's health changes to dramatically, especially when they stop eating or drinking causing so many more health complications.   I hope you manage to have a full discussion with your vet about what has been happening, and also that you will see her condition pick up and stabilize some more.  Fingers crossed for you.

I've assumed surgery isn't really an option for with her heart condition. Her heart may also may mean she's not a good candidate for the radioiodine either. I think l need to get more definative info on my options and their cost. I am thinking about seeing a new vet, maybe.

Sometimes a second opinion can be useful, though it can also result in feeling even more confused.  If you are not comfortable with what your vet says though it can be very helpful.  Did you manage to speak with your vet to get more information?