13 y.o. cat has intestinal cancer; need help deciding when to put him to sleep...

Background:

  I've been lurking these forums for several weeks, since my cat TC got sick. He's 13 years old and is co-owned by my mom and myself; we live together. Mid July I took him into the vet because he had lost several pounds and had finally stopped eating and drinking & was very lethargic. They were very slow to really diagnose him with anything; all they would tell us at first was that he had non-regenerative anemia, and did not test positive for FeLV and FIV. He got a blood transfusion, some prednisolone & antibiotic, and they sent him home. A week later, his blood counts were still low & he hadn't gained or lost weight. (He went from 16 to 12 lbs in a couple of weeks.) They gave him more prednisolone, a different antibiotic, some stomach stuff, and some vitamin b12 & told us to come back in 10 days. We gave him his meds & tried to keep him fed, but by the end of the 10 days he was getting violently sick, incontinent, with uncontrollable diarrhea, and he was even more anemic. When we took him to the vet the 3rd time, a week ago, we got a different vet. She finally gave him an ultrasound (as well as another blood transfusion, etc.) and when the results came in told us that he has intestinal cancer which has metastasized into his spleen at least and into his stomach; he has several masses in his stomach as well. 

We can't afford chemotherapy or a specialist, not to mention that the closest oncologist is a 6-hour drive away, which would be torture on TC who hates traveling and gets very carsick. The vet told us that it didn't look like a good prognosis even with the chemo, so we chose palliative care. 1 week ago, She gave him a shot of prednisolone that is to last a month, daily anti-nausea medicine, and antidepressant/appetite stimulant every 3rd day, and said that the blood transfusion would probably last only a week. He's very sick, in other words.

He did really great the first couple of days after this last visit & was back to eating & drinking, but gradually over the past week has degenerated a lot, to the point where he was actively refusing even syringed food/water. He was actually fighting me off when I was trying to feed him. We were going to go ahead and make an appointment for Monday to put him to sleep; read on this site & the forums about pain management, and thanks to you guys realized TC's in a lot of pain, and yesterday we called the vet and pretty much demanded pain meds, to try to see if helping the pain would help him start eating again. She gave him a shot of ... that stuff. I can't remember, but it's an opiate, very commonly used for cancer patient cats. Anyhow, he came home and immediately went to his food bowl, then went to the bathtub & got a drink. The problem is, that's the last time he willingly ate or drank, and we're just trying to figure out if it's time. 

Question:       

TC has intestinal cancer which has metastasized into his stomach and spleen. He's on palliative care & is now refusing food and water, and seems in pain. He is restless but lethargic, is shaky when he walks, and his eyes stay extremely dilated most of the time. He can't seem to fix on one spot but wanders around the house a lot. He'll go to his food bowl and wait (there's hard food there just in case, but he's been on a wet diet since this mostly), but when you put food down he won't eat it. 

We had basically decided that tomorrow we would make the appointment to have him put down, and then this evening all of a sudden he started eating again & acting more like his old self, where a couple of hours before I was actually wondering if he would even make it alive to the vet tomorrow, he was acting so puny and weak and just sick. 

We don't want to make him suffer, but we don't want to jump the gun if he's still got a few more days to live a good life. Does anyone have any advice/experiences with this decision? Ultimately it's up to us ( my mom and I), I know, but any advice would help. 

Also, is it weird that the vet didn't proactively prescribe pain meds for him or even let us know that he's likely in a lot of pain? Should we look at another vet? I want to have a house call for the euthanization, but is that prohibitively expensive? I live in Texas, U.S., western part of the state, if that helps. 

Thanks in advance for any advice, opinions, input, encouragement, or help, you guys. 

TLR: My cat is dying of cancer. Need help and input on when to euthanize, signs he's ready to go, tips on tempting him to eat and drink, etc. 


TC at the vet last week.

I am so sorry you and your gorgeous little boy are going through this.

You ask when you know if it's time. The fact your cat may have had one good day doesn't change the fact that most of the time he's in pain. I'm sorry, but that seems to be how things have progressed.

If this was my cat, I'd love him up for a day or to--at most--then if possible, have the vet come to the house.

I let a cat go too long once. She had cancer at age 7. By the time I realized how bad it was, she bled out into her lungs and was that way for the longest 4 hours of my life. Please do not put it off until your cat is in agony.

I wish I had something better to offer, but my experience was a painful one. I'd not wish it on any cat.

Don't be sorry; I'm just glad someone replied so quickly. And that is exactly what I was looking for: just some outside input, because I'm right in the middle of all this for the first time ever. I think my initial instincts were right; his eyes have been just hugely dilated since this afternoon, which I've read can be a sign of impending death, and in spite of his burst of energy/appetite, still seems actually a little confused and out of it. I just got a brief burst of hope that I might have another day or two with him. It's so hard to look at him and know that he's not going to be here this time tomorrow. So hard to comprehend.    

Anyhow, thank you so much for your reply and well-wishes.    

P.S. I'm so, so sorry that you had to go through that with your cat. I can't even imagine. Thank you for sharing that. 

We have had to put several of our beloved babies down over the past few years do to various things, the latest being 4 weeks ago due to urinary problems that could not be fixed (your TC looks just like our Pumpkin).  I truly believe that you will know when that time comes.  Each time a point would be reached that you "just know", maybe a look in their eyes (showing how tired they are) or signs that they are suffering or maybe that they have no quality of life left.  I guess I sort of put myself in their place and try to imagine what I would want my owner to do.  I guess what I am saying is don't rush into anything if TC does not look like he is in pain, enjoy the good days while they last.   My heart goes out to you, your mom and TC, .

PS.  We have made a "wall" in our home where when one of our sweet babies pass, we put up their picture along with a saying.  It is our way to always keep their memory alive and with us each day!

My Vet told me that because cats are so good at hiding problems by the time you notice it their discomfort has increased significantly.  It's difficult I know, I just put one of my cats asleep a little over a week ago, but to be honest it's the one last gesture of kindness that you can give your pet.

It's better to be a little early than too late.

Mary Podgorny said:

 

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Sorry for the late reply.  Buprenorphine is probably what he got and you could try injecting it yourself to see if he continues eating, but basically i agree its time.  If he refuses to eat, and is in pain there is no point in continuing his life, and even if more bupe worked, you're probably looking at very little time.  I'm so sorry, but the best gift you can give him is the gist of sending him to his next home so to speak. 

I am sorry you are struggling with this.  It's making me cry bc it is very much like the process I went through with my dog (RIP Sierra).  It took a 4th vet to finally do an ultrasound and diagnose abdominal Lymphoma.  I was going to do palliative care for the weekend and P (her) TS Monday but that Saturday, she wouldn't get up to go to the bathroom and I knew it was time.  I found a vet who could come to my house and I made the hardest and worst decision for myself but the best decision for her.  I now know that my Sierra was dying for 2 weeks (she stopped eating on her own on Valentines Day 2014)  

I watched my dad die at home with hospice support and I know the stages of pre-death.  Once a being stops willingly eating, death is on the doorstep.  Even my dad had a rallying day on day 2 of the 5 day vigil but it was just that - one last burst of energy for this life.  I believe he did it more for us than for him.  

Anyway, my thoughts and prayers are with you and your mom as you go through this inevitable stage in loving a pet.

PeacE, Maria B

Maria: Thank you for sharing about your dad. I'm so very sorry for your loss, and for that of your Sierra as well. 

Update: 

Thank you all for your helpful input and stories and encouragement. We've made the decision to have him put to rest at 5:30 today at the vet's office.  Will try to reply individually later, but am too upset right now to do so. Thanks to you all; you have been a huge help to myself and my mom. 

You are doing the right thing as hard as the decision is.  I am so very sorry....hugs to all of you!

So sorry to hear about your cat. My rule for my animals has always been if they stop eating and have a terminal illness it is time. It is so hard to let them go. Glad to hear you have made this difficult decision to put him out of his misery. Once he is gone and you feel up to it, please feel free to post a tribute to him in our Crossing The Bridge forum.

Sending you positive energy for this difficult time.

Mary Podgorny said:

Background:

  I've been lurking these forums for several weeks, since my cat TC got sick. He's 13 years old and is co-owned by my mom and myself; we live together. ...

TC has intestinal cancer which has metastasized into his stomach and spleen. He's on palliative care & is now refusing food and water, and seems in pain. He is restless but lethargic, is shaky when he walks, and his eyes stay extremely dilated most of the time. He can't seem to fix on one spot but wanders around the house a lot. ... 

We don't want to make him suffer, but we don't want to jump the gun if he's still got a few more days to live a good life. Does anyone have any advice/experiences with this decision? Ultimately it's up to us ( my mom and I), I know, but any advice would help. 

..

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Mary Podgorny said:

Update: 

Thank you all for your helpful input and stories and encouragement. We've made the decision to have him put to rest at 5:30 today at the vet's office.  Will try to reply individually later, but am too upset right now to do so. Thanks to you all; you have been a huge help to myself and my mom. 

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So sorry to hear of your cat, and I can recognize your grief - I went through a similar experience a year ago. It feels like your heart is being ripped out, and you will second-guess yourself... but please know that your TC is so lucky that you care for him and can know when he is suffering and struggling. Having intestinal cancer that has metastasized into stomach, and beyond, is very serious. It is a hard life for him right now, and a few more "good" days may be a day too many. As another poster said, better too soon than too late, when at this stage of illness. This is a very difficult time; sending hugs to you.

NewYork1303 said:

 
So sorry to hear about your cat. My rule for my animals has always been if they stop eating and have a terminal illness it is time. It is so hard to let them go. Glad to hear you have made this difficult decision to put him out of his misery. Once he is gone and you feel up to it, please feel free to post a tribute to him in our Crossing The Bridge forum.

Sending you positive energy for this difficult time. 

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Thank you so much. I really just needed some confirmation that I was doing the right thing; several people kept saying that you just "know" and that your cat will just "tell you" but I was back-and-forth until the very end. Even in the office, I told the doctor that if she looked at him and thought he was doing relatively all right, then I would just take him back home again... but after it was over, I looked into his eyes and that's when I knew for sure. It was the right thing to do. Thanks for your encouragement. I will probably post in that forum in a day or two. It helps to share memories. 

Update 2: 

TC was put to rest at around 6:15 p.m. yesterday. It was very peaceful on his part. Myself and my mom and my dad were all there with him; they gave him a sedative, which put him in la-la land (don't know if this is normal, but he was already really out of it, which I wasn't expecting), we all loved on him and gave him kisses and said his name a lot, then the doctor came in and gave the shot and he was gone within 10 seconds. It was very, very fast, and then I completely fell apart and was inconsolable for the rest of the day and night. I'm calmer today. 

One amazing thing that happened, and I think I already alluded to it briefly before: The night before we put him to sleep, I was trying to find a favorite video of TC to post on Facebook. He was next to me, kind of in his own world & in pain & a little out of it, and unresponsive so I was just leaving him alone. I started playing this video of him playing a cat game on my tablet, and he perked up and looked at my laptop. I moved the laptop to face him a little more, and he meowed (he's been VERY quiet since he got sick so that was a big thing) and got up and got up on my laptop, as close to the screen as possible, and watched the video(s) of himself for a couple of minutes, purring the entire time. I actually started videoing him with my phone & can post if anyone wants to see. I was just in the moment, but afterwards I realized how special that was. It was like we shared a couple of minutes reminiscing about the good times. 

Some things/thoughts I want to put out there for the benefit of others who may be going through this or a similar process:

I was very back-and-forth until the very end, which was why I was questioning the decision so much. I kept hearing people say that you just know, and that your pet will let you know when it's time, and I (and my mom) didn't have that experience. So I'm posting this so that people who are trying to figure this out & have the same experience as I did, can see. TC didn't really "tell" me that it was time; I just had to figure it out myself. I think he would have just hung in there till the very end, enduring and hiding the pain as best as he could, trying to do his normal routines as best as possible, because that's all he knew, was to just keep going. The only thing that he did that was maybe an indication that it was time, was actively refuse to eat or drink, and by this, I mean, even physically fighting me when I was trying to hand-feed and give him water with a syringe...

It wasn't till after he was gone that I realized. I looked into his eyes after he was gone, and I realized that I had been seeing that look in his eyes several times for the past several days, and that he had been on the verge of passing. 

So sometimes it's not super-clear, and maybe that's just because I'm inexperienced; I don't know. But I just want to encourage people out there to trust yourself & don't beat yourself up for doing the right thing. 

Thanks for everything, y'all. You've been a huge, huge help. 

@Mary Podgorny

Thank you for your insights and the photos, greatly appreciated and it will help others.  I'm glad he had a great life with you and your family. 

StephenQ said:

 
@Mary Podgorny

Thank you for your insights and the photos, greatly appreciated and it will help others.  I'm glad he had a great life with you and your family. 

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Thank you so much. Your input was especially helpful; I just needed to know I was doing the right thing, and your earlier reply helped. I was too overwhelmed to reply specifically then (plus I didn't realize I needed to quote to notify a specific person that they had been replied to!), but thank you so very, very much, both from myself and on behalf of TC. 

I'm happy to help although i think i did very little.  Another way you can reach someone is like this, you put the @ sign up and then you type there name until it appears and select it and that well also notify them without having to quote them.   Like this: @Mary Podgorny

Again I'm so very sorry for your loss.  We've all been there, and its just so hard.  But you gave hi nthe best life and then you did the right thing at the right time. 

kellie90 said:

 
PS.  We have made a "wall" in our home where when one of our sweet babies pass, we put up their picture along with a saying.  It is our way to always keep their memory alive and with us each day!

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Thanks for your advice, and for sharing your "wall." We put him to sleep yesterday around 6 pm and will be receiving a clay heart with his paw imprints & name plus his ashes in a few days. The wall thing is a good idea. Thank you!

@StephenQ: Thanks again, and thanks for volunteering as an advisor. You do more than you probably realize. I think it's great that this site has people who specifically show up in each thread & make sure they at least have one answer. I haven't been involved in cat sites & forums a whole lot in the past so I don't know if I will continue to be active in the future here, but I'm very appreciative of it right now. Blessings for all that you do. :-)