Please help me make a very difficult decision

Dear Friends:
Please help. I need all the help working this out that I can get.
Thank you.
My beloved kitty Max, aged 12-15? years, has bone cancer in his right hind foot. He has what they call a pathological fracture in his toe, too. Pathological means it was caused by illness, in this case the cancer. Max is in pain because of the fracture and the swelling of his paw (it looks like he has a golf ball under his skin). But otherwise, he's in great shape. His eyes and teeth are great. His blood work came back fine except for one elevated liver level (probably due to age-the vet says if there were no cancer, she'd just keep an eye on it). He's purring, playing, cuddling, eating, drinking, and sleeping normally.
Here's the hard part: The vet has given me a choice. (By the way, my vet is WONDERFUL! Super compassionate, great at explaining things, takes her time with me, and has fallen in love with Max. Well, really, who hasn't fallen in love with Max? He's pretty amazing.) I can have his right leg amputated at the hip or euthanize him fairly soon (like in the next week or so). Apparently the pathological fracture is too much to bear and the pain medication available (opiates or non-steroidals) have bad side effects when used long term.
My entire focus is on doing what's best for Max. I'm going through a breakup right now and have to move out, but I don't want to make a choice for myself. I would much rather not lose Max right now, but if that's the most humane thing to do, that's what I want to do.
Here are the pros and cons of each option:
Amputation will take all the cancer with margins. With amputation alone, Max could live 2 more years. Or, if the cancer is more aggressive, he might only have 2-6 months. The cancer is spindle cell (which the vet says is good. It doesn't spread easily. The cancer seems to be totally localized to the paw. There doesn't seem to be any lung involvement). Many sites on the internet say that cats respond well to amputation, although Max is older and a little heavy making the adjustment potentially harder. I'm almost positive he wouldn't have to have chemo or radiation. If so, I wouldn't opt for amputation.
Euthanasia...What can I say? It feels too soon to put him to sleep because he's so well other than the foot, but maybe putting him down now while he's still happy would be the most compassionate option. He would die a "whole" cat, without the trauma of amputation. He also would have only another week to live.
Some other things you should know: The amputation is $2000. To do a biopsy to determine the exact kind of cancer (whether he'd have 2 years or 2-6 months to live after amputation) and an abdominal ultrasound (to make SURE there's no cancer in his lower half-the vet says she doubts it since his blood work is so good) is $800. If I do the biopsy/ultrasound first, then the amputation, that's $2800. Too much for me and my family. But I don't want that to be the overriding consideration.
Also, you should know my mom, with whom Max lived the first 8 years of his life, is ADAMANTLY opposed to amputation. She thinks it's cruel and doesn't want me to do it.
Sophie's choice, no?
I'd love to hear any thoughts you have. I'm just trying to consider as many points of view as possible. One minute I'm set on the amputation. The next I can't bear the thought and want to put him down.
Thanks so much! Max thanks you, too. ^..^ Purr. Purr.
Amy and Maxie

Amy,

Cats do fine with amputation, usually. I recently had to put Tazzy down, but not because of the amputation solely, but because she had brain damage as well from the accident. But Tazzy was only 6 years old.

You have several weighty factors to consider- first off the cancer. If it has spread, will the vet see it during the surgery and if it has spread, what do you do then?

Your cat is in his senior years and when they reach their double digits, their body just starts to wear down. It's a given, and yes, you can buy some time, but at what cost?

If you are going through a change in your life, then if you are having to move residences, then your cat will have to deal with the stress of moving.If you are staying put, then at least he will still have stability.

Honestly, the day after surgery, Tazzy was moving like there was no problem. Her front leg was amputated above the shoulder. But again, if she had been older, I believe we would have just had her put to sleep. Just to let her escape the stress, the pain and the whole vet experience.

If it were me I would probably amputate, but I very admittedly have trouble with loss and it may be the selfish thing to do. I'm sorry you have to make this tough choice.

We have done a few amputations on cats and dogs, they all bounce back great.

Grrr... I just wrote a big long response and lost it.

Amy,

First let me say I'm so sorry you have to go through all this with Max, and the fact you are going through a break-up and life change now doesn't make it any easier. I had to put my Comere to sleep at the beginning of March, so I know how hard it is.... if you ever need an ear to listen, feel free to PM me.

That said, if it were me and mine I would probably make the decision to put my cat to sleep. You're not sure of his age which makes it a little more difficult. 15 is closer to an elderly cat, while 12 is more like retirement age. If Max is 15, extending his life another 2 years might not even be realistic (even if he didn't have cancer).

Money should never be the deciding factor, but of course it plays a role in the decision. Of course Max is worth the money... but is only maybe extending his life a possible 2 more years, and risking that he won't adjust or that he'll have complications or end up sicker worth paying $2800 for? If you KNEW the outcome was going to be good, then sure you might be able to say "we'll go for it!" -- but with the future so shakey you have to weigh the cost vs. benefits (especially if you don't easily have the money).

For me there would be too many potentials for an unhappy kitty... and I would hate to have my guy spend the last few days, weeks or months of his life confused and trying to adjust, unhappy and sick (if it's the worst outcome).

If it's an option in your area, and if it were me, I'd find a vet that will come to you home to put him to sleep, where he's most comfortable. Stay with him and tell him you love him every minute and that he's a good boy, so the last thing he hears is your voice. Let him cross to the other side with his dignity intact and KNOW that you gave him an awesome life.

And nurture YOURSELF -- get a lot of support from people in real life and here. My offer stands... I know we don't know each other, but if you ever just need an ear I'll listen (from one Amy to another )

Please do take care of yourself

You are all so kind! It is really wonderful to have found a place to talk about this and get differing opinions, as well as compassionate understanding. I know I will figure this out with enough support and love from friends. I'm leaning towards euthanasia tonight. Because of his age and weight, I'm afraid that Max might be really thrown for a loop with an amputation. He is a sensitive, though hardy cat. He has a tendancy to get the herpes virus in his eye, respiratory infections, and stomach upsets. He's been through intestinal surgery, a debulking of a previous, benign tumor in the same hind paw (same place the cancer has shown up), and came to us declawed (CRUEL!) so he's a tough one, but it's been two years since a surgery and he's older now. I don't think I could bear it if he experienced much pain and complications from an amputation.
Still, it's so hard to put a lively, alert, loving pet to sleep. Still thinking...
Thank you. Amy and Maxie

Oh dear, I am so sorry to hear of this. I can only imagine what you are going through right now. Not sure if this will help but let me share something with you. My mom had a greyhound she rescued. When he turned 8 years old, he was suddenly diagnosed with bone cancer and it was effecting his back leg. She could amputate or put him to sleep. She decided to put him to sleep because she felt that it would be too hard on him to try to readjust and he already had kidney problems.
My jessie just crossed rainbow bridge on March 19th. In a matter of two weeks, I found out that she had cancer because suddenly her stomach began to get big. It was fluid. I did not want to put her through an intensive surgery to do a biopsy or try to give her chemotherapy so I had to put her to sleep. I am crying right now writing this but I feel that this was the most loving thing I could have done for her. I miss her more than I can explain but I had to do what was best for her. She was 17 years old and had a very beautiful life.
What you are going through is so difficult and I am so sorry. My heart goes out to you. You will find the right decision in your heart, let that guide you.
Here for you if you need to talk...

in a way i would say go for the amputation....cats usually adjust great to only having 3 legs and there is little chance of it going wrong and i understand that you want to do everything possible for max...however on the other hand.....
there is going to come a day when max has to leave you and maybe it would be better for him to have his last days feeling great and being well rather than leaving it til he is already feeling ill and he has to spend his last days in pain....
my cat had a tumour in her ear, we decided against the idea of removing the ear since she was an old cat and fortunately she had many more years left in her....however when we did finally decide to have her put to sleep she had gone off her legs and had a constant pain ......looking back now i wish i had had her euthanazed while she was still well so she didnt have to go through all that pain

Just a couple of thoughts to add to all the quality posts already written on this subject.

Your mom may voice her opinion - *once* - and then she needs to step back and let you make what you think is the best choice, preferably with her active support if possible, and if that isn't possible, then she should remain quiet on the subject without making "faces" at you. The purpose of her opinion *should* be to help you make an informed decision - not force your hand.

Despite all the help from friends and family, sometimes its helpful to shut yourself in a room by yourself and just search your heart, and your head. Don't force anything. Just meditate on the idea, "what seems best?" and listen to your inner voice - if you listen closely you should hear the answer.

Another way at the problem is, for the sake of argument, to pretend money is no object and then ask yourself what you would do. If the answer is still to euthanize, then you've just made a stronger case for that. If on the other hand the answer is to amputate - then clearly you've discovered what you *want* to do, the new questions can be focused on "Is this financially reasonable and/or possible"? "Will this put my family at financial risk or will I simply loose perks and vacation time, and how do I feel about that?" "If I spend the money am I going to be criticised by my mom, both for a medical decision and for a financial one, and how do I deal with that"? "is that influencing my decision?"

All food for thought.

Either decision can be the right choice so long as you make it for the right reasons.

First, sorry you are in this tough dilemma but at least you are a loving pet owner thinking about what is best for your cat.

Second, this is the internet and what a random stranger thinks is no substitute for what you -- as the cat's primary caretaker -- thinks of the situation. It is your decision.

But speaking in generalities...if a pet makes it out of infancy, I would do everything in my power and within my resources to make sure they reach the human equivalent of 50 years of age. That's about 8.5 years old for a cat. After that...it depends on the specific pet and it's overall quality of life. But once they've reached ~50 year old in human years, I wouldn't go to great extremes or painful procedures or anything really unusual or speculative to extend life. If they have an infected claw -- sure, no problem, let's get it fixed. But kindey stones on a 17 year old cat? Well...that cat has probably gotten most of the fun they can out of life and now an owner should gracefully make the humane decision.

Anyway, based on the suspected diagnosis and the age of the cat, I would seriously consider euthanasia.

i don't know that this is the right answer, but if it was me i wound amputate the leg, animals adapt very well, and if he isn't in any pain i see no reason to euthanize, in fact i think unless the animal is in a lot of pain and there's no other alternative whatsoever i wouldn't euthanize, i think that should only be done in extreme conditions good luck

Oh Amy...my heart aches for you.
Here is how I decided, when the time was right, to let my baby go home.

Five years ago, when my beloved furbaby, at age 16, became very ill...I decided to not let him go. With the help of painful treatments, I kept him alive for 3 months. Finally, I became aware that I was being selfish. He was miserable with no quality of life. I put myself in his place...what would I want if I were him? I decided that I would want to be set free. I held my sweet baby while he was put to sleep.

It was the most difficult decision I have ever made...but for my furbaby it was the right one.

I don't know what the right decision is for you. If you can...put yourself in your furbabies place.
What would you want if your were sweet Max?
That process might help you decide what to do.
I will pray for you both.

For the people advising amputation, did you notice the part where amputating the leg is speculative? The cancer might have already spread. So amputation does not equal guaranteed survival...it means a hope for survival. The leg could be amputated and the cat could end up dead in two months anyway.

I honestly can't believe the majority of people are saying they would put a 12-15 year old cat through all of that.

Nano, there are people who love their cats so much they will go to any extreme to keep the cat in their world. It is the hardest thing for anyone who loves- to let go of that love and make the ultimate decision. It means that you must be selfless, realistic and have all the facts in front of you to make the decision. Years ago we rescued a kitty who had been a near drowning victim. She lived a long life with us, she had limitations in her life based on the abuse she suffered at such a young age. Then she became riddled with cancer, and we had the option of keeping her alive with chemo, repeated vet visits, blood transfusions and surgery. We could have done this, we loved her enough, the money wasn't an issue, and we wanted her with us. But one night as I lay with her stroking her, she raised her head and she just looked at me. The look was blank, it was pleading, she was tired, it was time. My tears fell for her that night and the next day we took her in and put her to sleep. We could have bought her a few more years, but as I asked the poster above- at what cost? Not the financial aspect, but the cost to her-to the disruption of her comfortable life, to the stress, to the confusion..

But it is a personal decision and although I sometimes feel like the grim reaper when it comes to this subject, my decisons are based solely on how many cats I have been with that have been abused, injured, sick. If it was only one cat in my life instead of many, I believe I would be among the masses that say- do anything and everything you can to keep this cat in your moment. But again, I see many, I see great suffering and I am wise enough to understand that sometimes, it is ME wanting them to live. They are finished, they are done- they look to me for understanding this and ending their pain early if possible.

So don't fault those who love one with such a passion that being without their cat is something they can't even begin to imagine. Just take care of your own, just as you are, and hope that if you ever have to make this very difficult choice, you do so wisely, understanding all that is involved, and your pet comes out better in the end-

The cat I spoke of was Dunkin- you can read her story here if you like:

Dunkin- A Cat of Courage

That was a beautiful story about Dunkin. Thank you for sharing that. It helps me reinforce in my mind that the choice I had made for Jessie was right.

Originally Posted by Nano

For the people advising amputation, did you notice the part where amputating the leg is speculative? The cancer might have already spread. So amputation does not equal guaranteed survival...it means a hope for survival. The leg could be amputated and the cat could end up dead in two months anyway.

I honestly can't believe the majority of people are saying they would put a 12-15 year old cat through all of that.

Click to expand...

Nothing is guaranteed in life. It's possible the cancer hasn't spread, and the cat will have several good years left. In fact, since the cat has energy and otherwise healthy, even the vet doesn't think the cancer spread, according to the original poster.

Amy, I am so sorry to hear that you are going thru this. I have had cats and dogs with cancers (included a greyhound with bone cancer in his leg where the choice was amputate or euthanize). For some I have pushed medical procedures to the limit to give them a longer life and for others have let them go without extreme intervention. The choice to euthanize is never easy and as others have said, you need to consider all the factors in your situation - Max's age, chances of recovery, your changing lifestyle....

I will say that in the case of my greyhound, prognosis was about 6 months post amputation. We chose to keep him on pain medication until it would no longer work. I couldn't see him going thru the amputation and having to adjust to a short life without a leg (he was 95 pounds and loved to run).

In the case of my first cat love of my life Hippocrates, we chose radical surgery and he lived for about 6 weeks afterwards. Even though that was 15 years ago, I still kick myself for putting him thru the trauma of surgery so close to his death. His prognosis was better than that and we thought we had more time.

As my vet so succinctly said to me years ago: are you keeping him alive for yourself or are you keeping him alive for his sake? You know Max best, and I will send positive vibes that you can reach a decision.

Originally Posted by Nano

For the people advising amputation, did you notice the part where amputating the leg is speculative? The cancer might have already spread. So amputation does not equal guaranteed survival...it means a hope for survival. The leg could be amputated and the cat could end up dead in two months anyway.

I honestly can't believe the majority of people are saying they would put a 12-15 year old cat through all of that.

Click to expand...

no i hadn't caught that part...i wouldn't selfishly keep the cat alive if it was in pain, i'm thinking from what i would want done, if i had cancer and they thought they might be able to save me by removing my leg then take the leg! i wouldn't want you to kill me! however...if i was in an extreme amount of pain and there was nothing that could be done, i wouldn't want you to put me on life support either...cats are very amazing creatures, and i had a friend who had her cat for 13 years and had to have his leg amputated and he adjusted fine, and is still alive and happy and healthy...it's a tough decision...i'm sure you will in the end decide what's best for your baby

The vet already diagnosed it as a spindle cell tumor and the lungs were clear, so if the blood shows good organ funtion there is no reason why the cat couldn't do fine with the surgery.

Thank you, everyone for your thoughtful, compassionate input. I've almost come to a decision. I think I'm going to put Max to sleep. I've read all your postings, investigated an internet site dedicated to "tripod" kitties, talked many times and at length with my vet, and heard from my most trusted friends. Although amputation is compelling, I simply don't want to put Max through it. He's had a wonderful, adventurous life...lived in SF, Colorado, and now NYC...he's been very well loved, fed, and played with. I think I want him to go now, when he's still happy and not in excruciating pain.
I called my vet today to see if she knew someone who would come to my home and put him to sleep. If she doesn't, I'll probably take him to my old vet (very sweet man with a private practice and a rather quiet waiting room). My current vet works at a noisy, chaotic hospital and I don't want Max to have to be in such a place for his last moments.
Any advice about how to handle this horrible event? For him. For me. What about what happens to his body afterwards? I'd like to have him cremated and mix his ashes with the dirt in the garden. He loved to play in the garden.
Thanks, all. You are very, very kind. Amy and Maxie