Knowing when it's "time"

I apologize in advance if this is rambly and incoherent... but I am trying to be prepared to make decisions for our geriatric Grumpus. You guys were a huge help to us when he came to live with us, so I figure who better to ask, right?

Quick backstory- Grumpus showed up on our porch a year and half ago as a stray who was pretty much emaciated and not that far from death's door. Blood tests at the time showed nothing seriously wrong but dehydration, so he has been on the mend with us and doing well. He is pretty old, the vet said at least 11, but compared to our 12 year old, I would say he's probably closer to 15. (eyes are completely covered in cataracts, including a few tears, wobbly gait, etc.) He has always been unsteady on his feet, and not the most active of guys, but he has been getting around pretty well the last few months and even climbing onto the lower furniture.

However, the last month or so has not been great. He decided the litterbox was entirely optional, which earned him a trip to the vet. Unfortunately, he is not an easy cat to examine and so we did a urine test and that's about it. He got a shot of antibiotics just in case, but no signs of infection from the urinalysis. (they gave the shot at the vet because we couldn't get a sample from him at the time and I had to bring that in later) He is using the litterbox sometimes, but not always (Note- we would never consider his litterbox issues as a reason to send him home over the bridge)

He is also having a lot of issues with his legs. His hind legs have always been weak, but recently he is having a lot of trouble getting them underneath him. Occasionally, they seem to not work at all and he will pull himself across the floor with just his front legs (only on the hardwood, he seems to be okay on the carpet) He is stumbling a lot more, and falling over at times. He is not climbing on the furniture anymore, and is now sleeping on the floor. He climbed onto the couch on Saturday for the first time in a couple weeks right after his bath, but has otherwise only been on the floor.

I've started giving him cosequin the last few days, and we have moved his litterbox, food, and water all into the front room where he likes to be. I am reading some reviews on heated cat beds since he likes being near the heater vent and he's been sleeping on the floor.

From what we can tell, he doesn't seem to be in pain, and seems quite happy most of the time. But his hind legs have me worried quite a bit. The last time they went out on him (generally if he is trying to move quickly while on the hardwood) was entirely awful and heartbreaking, though he was walking fine a few minutes later.

Any advice? How will we know when it's time? Should we take him back to the vet for another exam, keeping in mind that he can be difficult to handle, and doesn't care for the 30 minute drive there?

My kitty started having litter box problems as well in hindsight I think it was she was having the same issues with her legs. She never tripped but she too would pick herself up by the arms dragged the legs around to get up. She started completely missing the litter box. I started using adult XL incontinence pad and strated to put them in front of the litter box and my kitty started using those to pee. Getting in and out of the litter box was too much she chose to poop in the litter box only. You may want to try that. Lay it down and then let him see the texture and maybe he will squat to at least pee there and not anywhere else. I noticed my cat could barely squat and essentially peed standing up with a tiny squat. It's good he is still active and happy that's how you know it isn't time yet. Mine lived for 4 years using the pads.The vet can give you pain meds to make him comfortable if he is in pain. Did they take blood and run a test last time?

Sadly there are many threads in this forum that discuss this very topic.  Not an easy subject.  It's been a month since we made this decision for our cat. 

He was 17 years, had bladder cancer, renal failure and hyper-t.   Two and a half years ago, the vets thought he might live a year.  These last few months he exhibited similar health to what you describe...bad legs, not eating, peeing everywhere, significant weight loss.  Those items were not enough for us to put him to sleep, so we slept under waterproof sheets (in case he hopped up on the bed), we put waterproof sheets on top of the carpet where he lay, we put a litter box in the family room, I syringe fed when he wouldn't eat on his own.  The deciding factor was his demeanor.  Despite his difficulties, he continued to show spunk and interest. 

There were a few times that I made an appointment with the vet, thinking it was his time.  But that day he'd wake up and suddenly start eating, or trot down the hallway...and I would cancel the appointment. 

His last day, I could tell he was in acute pain despite a dose of Buprenex.  I sat with him that afternoon and let him rest his head on my hand.  He still wanted love, but he couldn't do anything more.  It was different than on any other day.  I don't know if it was a "look in his eyes" like others have described, but I certainly knew and accepted it was time.  I am still teary-eyed when I think of him, which is often, but I have no doubt we made the right decision when we did. 

Our over-riding theme these last couple years was to do whatever we could for him, as long as he was good with it.  There were certainly heart wrenching moments for us along the way as we watched him decline, but heart warming moments as he would rally. 

We did not take him to the vet for his last few months, but the vet would call to check up on him.  We all decided there wasn't any need for renewed bloodwork as there really wasn't anything she could do for him and it wouldn't change the care given.  We gave him daily sub-q fluids and doses of pain medication as needed, which the vet filled as necessary. 

Most of our family (outside immediate family) thought we should have put him down months ago, because he was taking up so much of our time and energy.  That wasn't our criteria.  My advice is you should have a conversation with your vet, to tell him/her how you want to approach your cat's last days, so that he's on board with that.  See if he's okay with phone calls and prescribing needed pain meds without seeing the cat.  Then I would love and enjoy your cat as much and as long as he's willing.  Best wishes!

Southlake seems to be describing old age in a cat that seems to be happy and liking life. Absent any health conditions that are not related to age I think your kitty has some good years ahead of him. Like in humans there are supplements and pain meds to deal with aging. I would look into that. I would also make sure he does get a trip to the vet for checkups so you know what's ahead.

I was wrong above. I thought of this after I posted and am changing my suggestion.

Our decision to not physically take our cat to the vet at the end was made after two years of taking him to very specialized vets, an oncologist and internist. We stopped when he was known to be in a terminal health situation and at that point nothing was going to change.

Until I knew exactly what was wrong, to determine if it can be fixed, I'd go back to the vet.

As long as your cat is not in pain, then you have time. Enjoy your little one. Make every day special.

Here is a video of a veterinarian going through much the same of what you are going through: 

Well, as of last night, Grumpus could barely walk. Still didn't seem to be in pain, but also couldn't use his hind legs effectively. So, we went to the vet today.

The vet is confident that it is something neurological. Not a surprise, as he has had neurological issues the entire time we've had him. (Odd head tilts, twitching, balance issues, etc.) She says these issues are most likely caused by something affecting his spine, be that an old injury, disc issues, spinal tumor, etc. If we wanted her to, she would make a referral to a neurologist, who may or may not be able to get a full exam since we would need to sedate him for them to be able to truly handle him. However, he is 15+, doesn't care for being handled, and ultimately, it's not likely that they would find anything treatable.

On the other end of the spectrum, we could say our goodbyes to him today. We weren't quite ready for that.

We opted for the middle of the road treatment. The vet administered a cortisone injection and we are giving it a few days to see if that helps or not. She said we could see anywhere from 0-100% improvement, but she's not particularly optimistic. If this doesn't work, we know that we have tried everything we can, and that this would be the best that it would get for him. and only getting worse in the future. He isn't in pain now, but if he can't even get up to get his food and water, I don't want to wait until he is suffering.

Does anyone have any experience with steroid injections for something like this? Our other cat has gotten them for allergies, but never anything like this. How long before we should see an effect?

My husband took him home after the visit and said he went straight for his food in the old place (about 30 feet from his bed). He doesn't seem to recognize the food in the new place, so we moved it back. DH gave him a snack, and then he went back to his bed and went to sleep. He says Grumpus seemed to struggle a little less, but he still isn't super hopeful. Being able to get to his food seems like improvement to me, so I want to hope for good things for him, but I'm unfortunately not certain that will be the case. But, if he can continue getting himself to food and water and doesn't seem to be hurting any, we should be good to go. Fingers crossed.

Keeping our fingers crossed it works!! He may have suffered a stroke a well. Another one of Mine did, but they are hard to diagnose after thinking it was arthritis it ended up being a stroke. Mine couldn't walk at all though and permanently looked to the side. Hopefully not, keep your chin up!!

My grumpy old cat, Chase, gets steroid injections in her hips 1-2x a year. It usually take a week or two to notice any difference. For her, the difference is that she doesn't walk as crouched over after the shots. She's still going strong up until now. We don't know her exact age either, but guess at about 16-17.