Is it time to let my CRF cat go?

hb1993

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Hi everyone, I'm new on the forum and looking for some advice. 

My cat Kiara is 15 years old, she's been my furry little friend since I was 7 and since she was a kitten (along with her sister who was sadly knocked down on the road about 6 years ago). She has been diagnosed with chronic renal failure- first diagnosed around a year ago. We had her on a special kidney diet and a medicine called semintra, which seemed to do the trick until around 2 weeks ago, when she started eating a lot less and drinking a lot more. She also lost around 20% of her body weight, and has lost more by now, and she was a very small cat to begin with- when the vet weighed her last week she was 2.9kg, and I suspect she is even lighter now, she is very bony :( 

When we initially brought her to the vet 2 weeks ago they were very concerned that it was her kidney disease playing up and hospitalised her for 2 and a half days to administer IV fluids and to run tests. Tests confirmed our fears and the vet basically said that things weren't looking good and that her levels were high and that the fluids did not seem to help the levels. They gave a very poor prognosis. When we got her home she was so tired and lethargic and just wanted to sleep all the time, she was a lot worse than before she was hospitalised. I know this may be due to her being stressed in the unfamiliar environment and not getting much sleep whilst she was there, but I think maybe she just didn't respond to the treatment. She did eat more that she had been in the days after her treatment but I think only because we were feeding her wet canned food which was a treat compared to her usual dry food. 

Basically, since the initial trip to the vet, she has just kept going downhill. At times I had hope that she felt better as she was eating well, using the litter tray and seeking out comfy spots and purring a lot, but today has been a bad day. She is very, very weak and wobbles a lot when she walks. She even fell over which broke my heart. She wet the bed last night and is drinking an awful lot. She didn't or maybe can't get out of bed much. She barely ate anything yesterday or today, today she only ate a morsel of tuna, 1/2 a prawn and a little bit of yoghurt. Her gaze is different too, she may not be able to see very well but it's hard to know. She is still purring when I pet her but she just doesn't seem to feel well at all and basically, I want to know if it is time to let her go? In the past few days I have read a lot online about sub-q fluids but my vet said something to the effect of "some people give fluids at home but I wouldn't recommend doing anything further as it is just going to slightly prolong the inevitable at this stage" and basically said that after trying the IV fluids and them not having much effect that there's not much that can be done for her, other than putting her to sleep. Another vet at the same practice said something along the same lines. I definitely want to trust my vet(s) and I know they know best, I guess I just want to be 100% sure.  

Do you think it's too late? Should I have pushed harder about the sub-q's when they mentioned them instead of just accepting that there wasn't anything more we could do? I don't think I fancy the idea of pricking her with needles or giving her pills when she is in such a poorly state. I just don't know what to do. Please help. I feel like although I knew she had kidney disease this came on so suddenly and I just wish that I could have done something more for her. 

As I type this I think I already know the answer to my question, but I'm agonising over this and I don't want to make the wrong decision and just wanted to ask some advice. I love Kiara to bits and don't want her to suffer unnecessarily, I just want to know what is best for her.

Many thanks in advance to any one who answers, and sorry if this was very rambly and long. 
 

shurples

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First of all don't start thinking shoulda woulda coulda. That will eat you up. Secondly every cat handles kidney disease differently. Only you can make the decision but look at her quality of life. Is she telling you it is time?

Hugs.
 

margd

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I'm so sorry about what you're going through right now.  In my opinion, you're right in your thinking that it's time to let dear little Kiara go.  I think your vet is right in advising you not to try to prolong things.  In trying to make this decision it's important to think in terms of quality of life, not quantity of life and it sounds like Kiara's quality of life is going downhill quickly.  There are several points I look at when trying to decide if it's time.

Can your cat still walk and move around easily?

Does your cat still use the litter box or is she sometimes losing control of her bladder? 

Has her appetite decreased?

Is she lethargic?

Does she show interest in her surroundings?

Is she in pain?

It sounds like Kiera is having problems in all of those areas except possibly pain.  Cats also get a look in their eyes when they are ready to go and that might be the change you are seeing in Kiera's.  They have a way of letting us know when it's time.

This is one of the most difficult, and the most loving things you can ever do for your girl.   It is possible to get a vet come to the house so she doesn't have the stress of going to the vet, so you might look into that.

When you are ready, please consider posting a tribute to her in our Crossing the Bridge forum:  http://www.thecatsite.com/f/19/crossing-the-bridge  Many people find it very comforting.

Again, I am so sorry.

Edited to add:  no, I don't think pushing for the sub-q fluid would have helped much.  You made the right decision there. The collapse was just moving too fast.   
 
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DreamerRose

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I am so sorry you are in this situation, too. My son went through the same thing with his cat. He couldn't let her go and continued to give her the sub-q liquids at home. She didn't get any better, just declined to the point where she could not get out of her bed, just peed there and laid there. He finally realized it was time and let her go.

It's a decision you have to make, but I think my son could have said goodbye sooner. He hung on to every last hope until there weren't any more.
 
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hb1993

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First of all don't start thinking shoulda woulda coulda. That will eat you up. Secondly every cat handles kidney disease differently. Only you can make the decision but look at her quality of life. Is she telling you it is time?

Hugs.
Hi Shurples, thanks for your response. You're right, that's a dangerous line of thinking to go down. I think she is, however much I wish it weren't true. Thank you for your help. 
 
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hb1993

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I'm so sorry about what you're going through right now.  In my opinion, you're right in your thinking that it's time to let dear little Kiara go.  I think your vet is right in advising you not to try to prolong things.  In trying to make this decision it's important to think in terms of quality of life, not quantity of life and it sounds like Kiara's quality of life is going downhill quickly.  There are several points I look at when trying to decide if it's time.

Can your cat still walk and move around easily?

Does your cat still use the litter box or is she sometimes losing control of her bladder? 

Has her appetite decreased?

Is she lethargic?

Does she show interest in her surroundings?

Is she in pain?

It sounds like Kiera is having problems in all of those areas except possibly pain.  Cats also get a look in their eyes when they are ready to go and that might be the change you are seeing in Kiera's.  They have a way of letting us know when it's time.

This is one of the most difficult, and the most loving things you can ever do for your girl.   It is possible to get a vet come to the house so she doesn't have the stress of going to the vet, so you might look into that.

When you are ready, please consider posting a tribute to her in our Crossing the Bridge forum:  http://www.thecatsite.com/f/19/crossing-the-bridge  Many people find it very comforting.

Again, I am so sorry.

Edited to add:  no, I don't think pushing for the sub-q fluid would have helped much.  You made the right decision there. The collapse was just moving too fast.   
Hi Margd, thank you for your kind words and advice. 

You're right about her having problems in most of those areas. She doesn't seem to be in pain but I know cats are good at hiding discomfort. I'm sure she must be very nauseous though and if she's refusing tuna which she usually devours then she must be feeling pretty awful :( I don't want to let her feel like that any longer. 

It is extremely difficult but I think it is what I have to do for her. A house call would definitely be preferable as she gets very stressed out at the vets- thank you for pointing that out. Hopefully there is someone in my area and hopefully my dad will be agreeable. I'll see about that in the morning (it's 3.15am here in N.Ireland).

That sounds like a lovely idea, thank you. 

Glad you think I made the right call with the fluids- thanks for saying so, that has been eating at me. This is all very difficult.

Many thanks for your response. 
 
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hb1993

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I am so sorry you are in this situation, too. My son went through the same thing with his cat. He couldn't let her go and continued to give her the sub-q liquids at home. She didn't get any better, just declined to the point where she could not get out of her bed, just peed there and laid there. He finally realized it was time and let her go.

It's a decision you have to make, but I think my son could have said goodbye sooner. He hung on to every last hope until there weren't any more.
Hi DreamerRose, thank you also for your response. I'm sorry to hear that :( I'd be scared to let her hang on too long until she was miserable, I think she is already getting to that stage, although she still purrs so loudly when I talk to her and pet her which I think lulls me into falsely believing that she feels OK. I think it's time to really face up to it and realise that letting her go is the right thing to do and that hanging on won't help either of us. 

Thanks for your advice. 
 

sweetdz99

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There are tears running down my face for you. I can feel your anguish and heartache because all you want to do is the right thing for your girl. I don't know if it is because I lost my Kiara last July and I remember asking the same questions to everyone or if it is my heart ache for the decision you have to make. You already know what you have to do. I am crying as I type this but when you make the decision make sure they allow you to be there with her, loving her as she passes on. I kissed my Kiara's paws as she took her last breath and I was there for a while after that. Kissing and loving her. Losing her broke my heart so make sure you set aside proper grieving time for yourself. Some people will tell you that "she was just a cat"... but our pets are more to us than that.

I am so sorry
 
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hb1993

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There are tears running down my face for you. I can feel your anguish and heartache because all you want to do is the right thing for your girl. I don't know if it is because I lost my Kiara last July and I remember asking the same questions to everyone or if it is my heart ache for the decision you have to make. You already know what you have to do. I am crying as I type this but when you make the decision make sure they allow you to be there with her, loving her as she passes on. I kissed my Kiara's paws as she took her last breath and I was there for a while after that. Kissing and loving her. Losing her broke my heart so make sure you set aside proper grieving time for yourself. Some people will tell you that "she was just a cat"... but our pets are more to us than that.

I am so sorry
I'm so sorry to have made you cry, and I'm so, so sorry to hear of the loss of your Kiara :( it is so hard to lose our fluffy little companions, especially when we have to make the call on when exactly that will be. It is such a hard decision to make, I'm scared of doing the wrong thing and keep second guessing myself, thinking "oh maybe it's just a tooth problem" and "maybe it's something else and it will clear up" but the vet told us the diagnosis and the prognosis so I'm just lying to myself and I think now it is clear that her quality of life is not good any more and I don't want to let her suffer. It's so hard :( I will miss little Kiara so so much, she's been part of the family for so long, and after my mum passed away last year she has been such a comfort to me and has given me so many little pick-me-up moments, she's been a constant little companion. It's making me even more sad because my mum loved Kiara so much too and I feel almost like that's a connection between me and my mum that will be gone once Kiara has passed away. This is so, so hard. She is so much more than "just a cat". I'm crying (again) now too. Thank you for your kind words and your advice sweetdz99. I am waiting for my dad to get up so we can discuss this and arrange hopefully for a vet to come out to the house.

Thank you, and again I am sorry for your loss of your Kiara. :( :( 
 
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hb1993

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Are tooth problems a complication of kidney disease? I have noticed yesterday and today with the small morsels Kiara has eaten, there is a very worrying and loud sounding grinding/clacking kind of noise, like 2 teeth are hitting or grinding together. Does anyone know what this is? This doesn't seem to be distressing her but it sounds horrible and sounds like it would be very sore. She is lapping up yoghurt with enthusiasm but after a small bite of tuna she turns her nose up at everything else. When we brought her to the vets last time I thought she had a tooth problem as her dry food had kept falling out of her mouth even though she was trying to eat it, and the same with her wet food- bits would fall out and she would excessively try to chew it, but after a quick check the vet said her teeth were ok. 

Basically- are tooth/mouth problems an issue with end stage kidney disease or is this something that could have added to her problems that should have been addressed earlier? I know it is too late by now so I'm not even sure why I'm asking, I guess I just wanted to know what this is.

Thanks. 
 

sweetdz99

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My kiara had that too. It was tartar build up. She didn't have kidney disease so I think its just something that happens. She never ate hard food and I didn't brush her teeth. She would paw at her mouth too when I knew she needed a cleaning.
 
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hb1993

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Ok, thank you. I know it is too late to do anything now anyway :( I was just concerned about what it was.

My dad and I looked into getting our vets to do an at home euthanasia but they are unavailable until Thursday or Friday which I think is much too long to wait, considering how poorly she has become in the past couple of days. I don't want to see her get any worse. So we are bringing her to the vets tonight for the last appointment of the day when it will be quiet and hopefully less stressful. Kiara seems quite unaware of her surroundings at this stage and is only interested in sleeping so I hope she'll not be too stressed by having to go to the vet clinic.

Thank you all so much for your help, support and advice on making this difficult decision, I really do appreciate it, and I know I'm making the best choice for Kiara. Hugs to you all.
 
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hb1993

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So it's getting near the time to bring Kiara to the vets, this is horrible :( I hope she doesn't get too stressed out. She keeps turning around and looking at me and I just wish I knew what she were thinking. I know this is the best thing to do for her, I just wish it didn't have to be this way :(
 

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 HB1993.  I am so sorry, this is such a terribly difficult thing to do.  My heart goes with you.  
 

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I'm reading this with tears forming in my eyes. I'm so very sorry. Just let her know she is loved, pet her, talk to her, say your goodbyes. I know your heart is breaking, but you are doing what you have to do to end her suffering. Love her. She'll be okay soon (not okay in the way you want her to be, but by passing on). Sorry, I hope I'm making sense.
 

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I refused to put my kiara in the box.  I wrapped her in a towel and held her the whole ride crying then walked her into the room.  I was not going to stuff her into a box waiting for what I was about to do.  I couldn't sleep last night, as if it was me making this decision today.  I have been anxious and sad all day.  It reminds me so much of mine and Although it is closing in on a year ago it feels like yesterday.  

I am so sorry.  Hugs to you and kisses to her.
 
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hb1993

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Thank you all so much for your kindness and support, I wanted to reply to your messages last night but I was too distraught. Tears are still blurring my vision but I just wanted to let you all know that I really appreciate your help throughout this horrible time.

Thankfully the process was all very peaceful and little Kiara seemed quite relaxed, or maybe just extremely tired. She was really sleepy so we had her in her bed wrapped in her blanket and I didn't want to move her as she looked content. My dad thought it best to bring her in her carrier, but we kept her comfy and cosy in her bed inside the carrier and then took the top off when we got to the vets. I kissed her and stroked her and spoke to her and said goodbye. I had told her how much I loved her at home before we left and said goodbye from my brother who is living in a different country and was heartbroken not to be there. I told her we all loved her so much and that she had been an amazing cat. I know she didn't understand but I'm glad I got to tell her all of those things.

I feel so, so guilty but I know it was the kindest thing to do. I'm glad I got to spend all day with her yesterday too, and it was sunny so we sat outside for a little while too and she seemed quite content, but so tired and weak. She just wanted to sleep the rest of the day. I couldn't let her get any worse. I just wish I could have done more for her. And I wish she didn't have to spend her last moments in the vets, but at least I could be there with her. I miss her so much and it's going to be so strange around the house without her. :( 

Thank you all, you're all such lovely and kind people, and although I'm not really the hugging type (with people anyway) I wish I could give you all a hug.
 
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DreamerRose

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Bless you and hugs. This has been so hard for you, and I know it doesn't help, but you made the best decision you could for Kiara. You spent her last day with her and told her you loved her. She understands. Take care of yourself, and let yourself grieve. Don't let anyone tell you it's silly; we all understand here what our kitties mean to us. Hugs.
 

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Oh sweetie.....
  

You did an amazing thing: ending your baby's suffering...she is not in pain anymore....


Kiara is now basking in the sun, playing, in the Rainbow Bridge....she will be there for you, when it is your time....

Her spirit will never leave you. She will always be in your heart...
 

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Sending hugs as well. There's always guilt (not to mention unbearable heartache) that comes with a decision like this, but if she could thank you, I'm sure she would. You ended her suffering, it's what was best for her. Now you're the one left to suffer, I know. Just allow yourself to grieve and cry as many tears as you need to cry. One of these days, that pain will ease. It will never truly go away and you'll always miss her, but it'll at least get better.
 
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