To manage or not to manage?

New years eve we took our 12 year old cat Cream Puff to an emergency vet

because she threw up 9 times in 7 hours that night. There she was had IVs

for antibiotics and pain control while they waited to give her an ultrasound.

She showed enlarged kindey, liver, pancreas as well as some intestinal abnormalities.

Her BUN and CREA were pretty high that night, 62 BUN and 3.7 CREA.

She also showed signs of increased liver values.

ALT 221

GGT 7

four days later she returned to her normal vet for more blood work

and her BUN/CREA values dropped significantly, 38 BUN, 2.6 CREA. Still high but better.

However this newer test showed her liver values where significantly higher.

ALT 403

ALKP 151

GGT 5

AMYL 1,804

The vet believes the elevated kidney values could have been a kidney stone passing

as her urine culture showed no UTI of any kind, which is a good sign.

In order to diagnose the liver problems a biopsy would be needed, but I feel that is a bit too

invasive, especially when she has all these other underlying issues.

At this point the only thing we are doing is managing her pain as she has some pain in her

kidneys still, she would fight back when being examined.

The vet suggested all sorts of medication for nausea, intestine, liver, and pain.

We were also instructed to giver her SubQs at home, 100cc a day for a week, which I think I am gonna

lower that as it seems waaaaaay too high. What would be appropriate? 100cc every other day? 80 every other day?

She sleeps most of the day, which is normal for her I suppose. Eats well. Drinks, urinates.

We started giving her some Wet Prescription K/D which she seems to like, for now at least.

Has some diarrhea but that could be from the recent antibiotics she was given.

My question is, because she has so many problems that will only get progressively worse, when do you draw the line?

I'd hate to put her through all the drugs, especially the side effects, only to keep her comfortable.

I know this is a difficult choice, I don't want to be guilty about forcing her to go through all this just to delay her illness for another day.

*HUG!!!*

That is such a crappy situation and a horrible choice to make And only you can know when the time is right. I guess this is something we all face eventually, that's what we get for sharing our lives with things that don't live as long as we do...

I guess my opinion on this kind of matter is - whatever you do, do it for the cat. Of course she's your family member and you want to do everything you can to preserve her life, of course that's natural. But animals don't really understand the concept of longevity, all they know is how they feel in the now. If it's something that you can reasonably expect to fix until it isn't a quality of life issue anymore, continuing to treat is the obvious choice. If its likely to continue to progress, as you say... then you have to think about when it stops being about her and starts being about you not wanting to lose your pet. And truly, only you can say when that is. <3

Before I had cats, I had pet rats. People have different opinions on pet rats but I think they have the personality of something that should live far, far longer than their measly 2-3 yrs. And they are prone to many progressive illnesses with treatments of varying efficacy. So the "when is it about the animal and when is it about me?" dilemma was something I had to deal with it a lot. It is really sucky and all I can offer you are internet hugs.

When did this illness start?

hexiesfriend said:

When did this illness start?

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This began about 6 months ago when we took her in for sudden weight loss and appetite, she lost about 5 pounds.

They got blood work but nothing significant showed, in the end they gave her SubQs twice and sent her home.

She eventually began eating again after trying a ton of different brands of food, both wet and dry.

Then last week, it flared up to the point where she vomited those 9 times in 7 hours.

It was bad. While she seems stable now, eating/drinking/urinating, she hides in the closet for most of the day.

Pebble said:

 
*HUG!!!*

That is such a crappy situation and a horrible choice to make And only you can know when the time is right. I guess this is something we all face eventually, that's what we get for sharing our lives with things that don't live as long as we do...

I guess my opinion on this kind of matter is - whatever you do, do it for the cat. Of course she's your family member and you want to do everything you can to preserve her life, of course that's natural. But animals don't really understand the concept of longevity, all they know is how they feel in the now. If it's something that you can reasonably expect to fix until it isn't a quality of life issue anymore, continuing to treat is the obvious choice. If its likely to continue to progress, as you say... then you have to think about when it stops being about her and starts being about you not wanting to lose your pet. And truly, only you can say when that is. <3

Before I had cats, I had pet rats. People have different opinions on pet rats but I think they have the personality of something that should live far, far longer than their measly 2-3 yrs. And they are prone to many progressive illnesses with treatments of varying efficacy. So the "when is it about the animal and when is it about me?" dilemma was something I had to deal with it a lot. It is really sucky and all I can offer you are internet hugs.

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Thanks for the kind words pebble! It is indeed a bad time for our family. The vets seem very focused on keeping

her medicated in order to manage her symptoms but we're not really comfortable giving her SubQs daily, or even weekly

as well as all the other medication she has been recommended. Its tough

Yep this is tough. The fact that she is eating and drinking is a very good sign, her hiding in the closet isnt. I had a very kind vet give me some good advice after he found a huge tumor on my cat Sam's liver. Sam had lost some weight but he still ate like a horse and acted happy but there was no hope for him with the tumor he had and the vet said within weeks it will hit. The vet knew what was going on in my mind and told me "if you wait until Sam can't eat anymore you waited too long. " I took Sam home and spent a nice week with him and then let him go. I knew what was in store for him ahead of time and I didn't want that for him. You seem to be in a position of not necessarily having to wait until your kitty stops eating to make a decision. But I am not hearing that you and the vet think there is no hope for her. Now this is a very personal decision for everyone and you and others may not agree with what I did with my cat Sam, some say "if they are still eating it's not time." I was just offering how I handled my situation. It may be too early for you to make this decision.

Honestly I think my opinion is that a little "too early" is better than a little "too late", and leaving it a lot too late is horrible for all involved. So it is a very personal decision and everyone's personal guidelines are different, but I don't think anyone could fault you for opting out of  treatments if you are not comfortable with administering them, in order to ensure your cat goes out on a better note before it gets worse. She has no concept of dying sooner or later, all she knows is how she is feeling.

<3

Quote:

hexiesfriend said:

Yep this is tough. The fact that she is eating and drinking is a very good sign, her hiding in the closet isnt. I had a very kind vet give me some good advice after he found a huge tumor on my cat Sam's liver. Sam had lost some weight but he still ate like a horse and acted happy but there was no hope for him with the tumor he had and the vet said within weeks it will hit. The vet knew what was going on in my mind and told me "if you wait until Sam can't eat anymore you waited too long. " I took Sam home and spent a nice week with him and then let him go. I knew what was in store for him ahead of time and I didn't want that for him. You seem to be in a position of not necessarily having to wait until your kitty stops eating to make a decision. But I am not hearing that you and the vet think there is no hope for her. Now this is a very personal decision for everyone and you and others may not agree with what I did with my cat Sam, some say "if they are still eating it's not time." I was just offering how I handled my situation. It may be too early for you to make this decision.

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Yes, this is exactly where we are coming from. The vet said that without more invasive tests, there is no way of finding the underlying cause.

At this point we are just managing her symptoms(nausea, dehydration, etc). I was told to not put her through another ER visit. Which is another thing we fear as the last one came out of nowhere.

Like you said, we don't want to wait until it is too late and she is in such pain/discomfort that she is vomiting constantly or worse.

We have discussed euthanasia with the vet, they agree that there is not much they can do for her without tests but the decision is obviously on us.

Thank you for your words Hexiesfriend! We appreciate it

All of us are here if you need us....

Thank you all for the support and kind words, we are glad we found this website.

we'll treasure these last few days we have together while she is still well.