Crappy News at wellness exam today :(

[Alldara]

*sorry admins if this is the wrong forum. Please move if needed.

Nobel went for his geriatric exam today and they found he likely has HTC. 8 months ago was his last exam, with no murmur heard, but periodically over his life it has been noted on his file. They said a level 4 heart murmur.

He also has more dental. His arthritis is bad and she suggested the new medication everyone has been trying but they had none left. Metacam is also hard on the body over time.

We've made the sad decision to schedule a final appointment next month. We will call at the end of January, when February appointments begin. We took a quality of life check with the vet and she agreed it was time to begin discussion for him.

We really worry about the younger boys. Calcifer especially was upset about Nobel leaving the home today. He tried to break him out of the carrier and grabbed my leg to stop me from leaving.

Has anyone's vets suggested anything in particular for remaining cat family members? I want to be prepared to bring it up if needed. The younger boys will do their wellness exam and vaccines in March.

Photo of holiday treats with the boys.

 

[neely]

I'm sorry you are going through this with Nobel. I don't have any personal experience with this particular situation but when our dog passed away our cat, Neely, was affected. They were best friends and in his final days she sensed something was different. She was normally mischievous and baited him into playing but she suddenly became patient and sat by him. One thing we did was to leave his crate, bed and all his toys out. We didn't want to change anything even though he was gone. This may not work for some people but it kept things stable for Neely. I'm sure the situation is different for other people and their pets. Thinking of you and sending special thoughts.

 

[MeezeIfYouPlz]

I'm sorry for your bad news. We lost two dogs in 2022 and our eldest cat (who died suddenly at home). We thought we would get bad news today with our 16 year old cat but it turned out to be something treatable. Anyhow, when we did have to put our two shepherds down the vets never said anything about helping our other pets cope. We just lavished even more attention on them, which is alot since we are retired and have lots of time for spoiling. We left them alone to grieve when they showed us that's what they wanted and were there for them every minute when they needed us to be. All but our 16 year old cat have seemingly adjusted well to the new dynamics of the house. She is still very much grieving for "her" dog three months on.

 

[OopsyDaisy]

Such sad news about Nobel, I'm so sorry.

Unfortunately, I don't have experience with this situation either. My cats who passed on were basically loners. They weren't close like Lulu and Ash are...each did their own thing. That's such a beautiful photo of the three of them together, you can see how close they are. My heart goes out to you, having done the palliative thing, it isn't easy. I hope others can give some insight.

Love and hugs.

 

[Meowmee]

I am so sorry about Nobel. It is always devastating to get that kind of news. If you want to and are able to, I would do an echo with a cardiologist to confirm that your dvm is correct and then decide what to do.

I have never done anything specific for my other kitties when one was ill and was going to pass etc. Sadly it was often some thing that happened very dramatically at the end, with some of my cats while others were chronically ill for quite a while before they left, but some also had a dramatic event at the end.

I always chose to try and give them whatever care I could to extend their life as long as they were not suffering terribly. I’ve kind of been debating about that with my cats now, having five cats… I’m not going to be able to afford to do that kind of care and I’m going to have to end things sooner, so quality of life is going to come in to play more than before maybe.

With my Wizard I waited until the very end because I knew he wanted to stay with me, it was clear, and it was his decision. In fact none of my cats ever wanted to die so it was always very painful to let them go. They all made it clear even at the end.

When they passed we would bring them home and set them up in a little wake before cremation so the other cats could see them. That seems to give them some closure however I think Quinn got very upset by seeing Sybil and hissed at her, I can’t remember the specifics now.

It’s so hard to decide what to do. But at least your younger boys will have each other when Nobel leaves so they won’t be totally alone. And they will give you comfort as well.

 

[Alldara]

Thank you everyone for your kind words neely M MeezeIfYouPlz OopsyDaisy and Meowmee .

 

[Alldara]

I am so sorry about Nobel. It is always devastating to get that kind of news. If you want to and are able to, I would do an echo with a cardiologist to confirm that your dvm is correct and then decide what to do.

I have never done anything specific for my other kitties when one was ill and was going to pass etc. Sadly it was often some thing that happened very dramatically at the end, with some of my cats while others were chronically ill for quite a while before they left, but some also had a dramatic event at the end.

I always chose to try and give them whatever care I could to extend their life as long as they were not suffering terribly. I’ve kind of been debating about that with my cats now, having five cats… I’m not going to be able to afford to do that kind of care and I’m going to have to end things sooner, so quality of life is going to come in to play more than before may be.

With my Wizard I waited until the very end because I knew he wanted to stay with me, it was clear, and it was his decision. In fact none of my cats ever wanted to die so it was always very painful to let them go. They all made it clear even at the end.

When they passed we would bring them home and set them up in a little wake before cremation so the other cats could see them. That seems to give them some closure however I think Quinn got very upset by seeing Sybil and hissed at her, I can’t remember the specifics now.

It’s so hard to decide what to do. But at least your younger boys will have each other when Nobel leaves so they won’t be totally alone. And they will give you comfort as well.

Yes it certainly is different by each pet isn't it? Something going in to the decision, is how much Nobel hates to be handled. He was trembling at the vet just today and how stressed appointments in general make him. He has FLUTD, so each appointment comes with a risk. He doesn't deserve his last few months to be stressful, just to buy him some time.
He's been enjoying his late years, and we want to continue that and have him rest peacefully.

You sound like you made such hard choices for your floofs too! You did what they needed. Totally right, when you know, you know.

 

[catloverfromwayback]

I’m so sorry you’re going through this.

I’ve never had a cat react to others going to the vet other than disappearing under the bed in case it’s them. The only one who’s shown distress at another’s death (or at least, not coming back) was Phoebe two years ago with Maddie. In her case I adopted Daisy within a week of Maddie’s passing, because she obviously needed feline company (and I wanted another cat, too).

 

[silent meowlook]

Hi. If you hadn’t talked to the vet today, how would you think he was doing? Does he seem unhappy or unwell? Metacam can be hard on kidneys and fluid therapy for kidney disease is tricky, but possible for a cat with heart disease.

The most important thing is that you know your cat and know if he is suffering.

There are further diagnostics like an echocardiogram, with a cardiologist, the only way to diagnose hypertrophic cardiomyopathy. There are heart medications depending on what is found.

Arthritis can be treated with Adequan.

Dental issues, I wouldn’t mess with. But obviously, like I said, you know what’s best for your cat.

Heartbreaking regarding your cat trying to keep you from leaving with his friend.

When I euthanized my 17 year old best cat in the world, Rusty, Cheetah was devastated. She stayed in his carrier, I think because that was the last place she had seen him. She looked for him and walked the house crying for him. It was so sad. I did what I could to occupy her time with new toys and extra attention. It took about a month, then the behavior became less over the next few months with her spending less time in the carrier and less time looking for him. Probably about 3 to 4 months till it stopped completely.

I have seen people bring in cats before to see their cat in the final end of life and I wouldn’t do that with mine. I don’t think they understand and seemed confused. I might feel different if it was done at home.

I am very sorry for what you and your kitty are facing.

Trust your gut with what you do and how you handle the young ones grief.

 

[Furballsmom]

Hello I'm so sorry

If I understand your question right, you want to know how to help a tightly knit feline crew cope when one will be passing?

They need to see/smell the body, but I agree with silent meowlook, not at the vet.

Also, I think Cat Music can be surprisingly helpful, either RelaxMyCat, Musicforcats or cat music with purrs in it.

 

[Alldara]

Ugh. I had a crap sleep because my crap brain has decided to try and work through our lousy options.

In 8 months since his last appointment he developed periodontal disease and needs most teeth (fangs and small baby teeth remaining) removed. It's not a joke when people say geriatric conditions advance FAST. IF, and this is a big IF, he can have an operation, we run the serious risk that he goes on hunger strike two days after surgery like he did after his last tooth removal and then he needs emergency intervention (again), as he won't be able to have dry food anymore.

Either HTC is caused by his congenital heart murmur worsening, or hyperthyroid. We do bloodwork next month and confirm the former and he's not viable for surgery (says our vet and this is a specialty clinic). We confirm hyperthyroid and pray we can get his heart ready for surgery. We couldn't with Lily and she kept catching infections and it was a miserable last year.

Both of those options involve monthly vet visits and more handling than he would ever want, in which will make him miserable and stressed. They couldn't even get the bloodwork off him yesterday to confirm as he was so, so miserable about being handled (he has been since he was young, and the vet tech made his nail bleed).

Or we take the win. We caught it early enough that he's still comfortable. We get a month spoiling him with everything he loves. He's had us home for almost 3 years now and enjoyed his seniorhood with enrichment and extra attention.

My mother in law will come stay with Magnus and Calcifer while we go to the appointment and we will bring the blanket he was pts on home. I'm just very frightened that they'll think we gave him away, but being COVID born kittens, if I have someone come to the house to have Nobel pts, I think they'll be frightened that any guest will come do that to them.

Magnus's transfers often happened through the vet office (colony to foster, foster to foster), and it took a few vet trips to have him believe we were coming back for him. I'm scared of regression.

Anyway I informed both Magnus and Calcifer last night that they should healthily live to 30. They seemed agreeable

 

[Kflowers]

Since he loves his dry food and it's getting hard for him to eat, rather than wet it down, I would put some between two paper towels and smack it with a hammer to make the pieces smaller. Many cats don't actually chew dry food and the ones that do usually just break each piece in half before swallowing. You would be breaking each piece for him and he could avoid chewing it and still have it. This would work even if you get the dentistry done.

 

[silent meowlook]

If he is hyperthyroid, he can be treated with medication. There is a transdermal Methimazole. You just put a tiny amount of gel on the ear twice a day.
Sometimes you can find a cat only hospital that is better at dealing with cats that don’t want to be there.

There are medications that can be given before his appointment to help keep him happy. Gabapentin is a good one.

Sometimes you can find a housecall vet that is good with cats to pull blood etc.

 

[Alldara]

S silent meowlook We are at a cat-only vet He has BAD white coat syndrome. She gave him a treat yesterday and he wanted it so bad he drooled on it. Wouldn't eat it. I picked it up and tried and he wouldn't. Then I told him it was from me and not the vet and he ate it immediately. They did suggest Gabapentin, but it would still be an appointment a month either way the diagnosis goes, to *maybe* extend life 6 to 12 months.


I've contacted the two house call vets twice each and had no responses from their office. I even made an appointment at one point and no one showed. The third is only for euthanasia appointments but are very responsive.

My late cat Lily was hyperthyroid. We treated her with medication. Then she developed an issue and needed a tooth removal. We could NOT get her heart rate down enough to do it, so she had URI after URI after URI. I will not do that to another pet. It's a miserable end of life and she didn't mind being handled or vet visits. She would go on harness and come when the vet called her to follow him to the exam room. Nobel had 2 teeth removed in 2021 Jan. Unfortunately, two more have gone downhill despite brushing and dental gel. They will need removed 100%.

It's also a big IF that even if he is hyperthyroid, that because he had a congenital heart murmur that hyperthyroid medication would get it down enough to operate safely.

 

[Alldara]

Since he loves his dry food and it's getting hard for him to eat, rather than wet it down, I would put some between two paper towels and smack it with a hammer to make the pieces smaller. Many cats don't actually chew dry food and the ones that do usually just break each piece in half before swallowing. You would be breaking each piece for him and he could avoid chewing it and still have it. This would work even if you get the dentistry done.

Thank you for the suggestion. We did try that and he won't eat it crushed or wet.

 

[Alldara]

Hi. If you hadn’t talked to the vet today, how would you think he was doing? Does he seem unhappy or unwell? Metacam can be hard on kidneys and fluid therapy for kidney disease is tricky, but possible for a cat with heart disease.

The most important thing is that you know your cat and know if he is suffering.

There are further diagnostics like an echocardiogram, with a cardiologist, the only way to diagnose hypertrophic cardiomyopathy. There are heart medications depending on what is found.

Arthritis can be treated with Adequan.

Dental issues, I wouldn’t mess with. But obviously, like I said, you know what’s best for your cat.

Heartbreaking regarding your cat trying to keep you from leaving with his friend.

When I euthanized my 17 year old best cat in the world, Rusty, Cheetah was devastated. She stayed in his carrier, I think because that was the last place she had seen him. She looked for him and walked the house crying for him. It was so sad. I did what I could to occupy her time with new toys and extra attention. It took about a month, then the behavior became less over the next few months with her spending less time in the carrier and less time looking for him. Probably about 3 to 4 months till it stopped completely.

I have seen people bring in cats before to see their cat in the final end of life and I wouldn’t do that with mine. I don’t think they understand and seemed confused. I might feel different if it was done at home.

I am very sorry for what you and your kitty are facing.

Trust your gut with what you do and how you handle the young ones grief.

Thanks yes. We did have some concerns enough to bring the conversation up with the vet and book his wellness before the younger boys in March.

We did the quality of life chart and he is smack on the number for time to consider euthanasia from pain/mobility etc.

We just want him to enjoy his time.

 

[Alldara]

Hello I'm so sorry

If I understand your question right, you want to know how to help a tightly knit feline crew cope when one will be passing?

They need to see/smell the body, but I agree with silent meowlook, not at the vet.

Also, I think Cat Music can be surprisingly helpful, either RelaxMyCat, Musicforcats or cat music with purrs in it.

I'll bring the blanket home then. I did that for Nobel when Lily passed.

I don't know if I should ask for anxiety medication for the younger two. I'm not sure what signs to watch for with them other than the usual.

We have Feliway and cat calming music with purrs

 

[Meowmee]

Ugh. I had a crap sleep because my crap brain has decided to try and work through our lousy options.

In 8 months since his last appointment he developed periodontal disease and needs most teeth (fangs and small baby teeth remaining) removed. It's not a joke when people say geriatric conditions advance FAST. IF, and this is a big IF, he can have an operation, we run the serious risk that he goes on hunger strike two days after surgery like he did after his last tooth removal and then he needs emergency intervention (again), as he won't be able to have dry food anymore.

Either HTC is caused by his congenital heart murmur worsening, or hyperthyroid. We do bloodwork next month and confirm the former and he's not viable for surgery (says our vet and this is a specialty clinic). We confirm hyperthyroid and pray we can get his heart ready for surgery. We couldn't with Lily and she kept catching infections and it was a miserable last year.

Both of those options involve monthly vet visits and more handling than he would ever want, in which will make him miserable and stressed. They couldn't even get the bloodwork off him yesterday to confirm as he was so, so miserable about being handled (he has been since he was young, and the vet tech made his nail bleed).

Or we take the win. We caught it early enough that he's still comfortable. We get a month spoiling him with everything he loves. He's had us home for almost 3 years now and enjoyed his seniorhood with enrichment and extra attention.

My mother in law will come stay with Magnus and Calcifer while we go to the appointment and we will bring the blanket he was pts on home. I'm just very frightened that they'll think we gave him away, but being COVID born kittens, if I have someone come to the house to have Nobel pts, I think they'll be frightened that any guest will come do that to them.

Magnus's transfers often happened through the vet office (colony to foster, foster to foster), and it took a few vet trips to have him believe we were coming back for him. I'm scared of regression.

Anyway I informed both Magnus and Calcifer last night that they should healthily live to 30. They seemed agreeable

You have so much to deal with here it’s not easy … hugs to you.

I have had two cats who had HCM. Tess lived for three years with it and she was on medication and she did very well- she was about 8 when it was diagnosed. Eventually it all caused kidney disease and then anemia for which she received epogen but everything kind of fell apart about six months after that… she was able to receive fluids even having HCM.

Sybil also had HCM but it was not diagnosed until the end of her life. She was in an advanced stage when a cardiologist confirmed it. You can’t diagnose HCM with a blood test, so I’m not sure if that’s what you mean here? It has to be confirmed by a cat cardiologist with an echo cardiogram. The thing that caused Sybil to go into heart failure was that she was already being treated for mild kidney disease, and they overdid the fluids.

I will always regret that. You should never give large amounts of fluids to a cat that has HCM because it puts them into congestive heart failure. In fact it can do that to any cat if you give too much fluid. I would never do large amounts of fluids ever again.

anyway if he has HCM that is not advanced it’s possible he could just take medication for that. And then you can decide what to do about all of the other issues.

HCM is a hereditary congenital condition, Sybil was part Norwegian forest cat and it was hereditary for her. For Tess I don’t know, she was a domestic short hair tortoiseshell but obviously there was some hereditary thing going on because she was even younger when she developed heart failure.

Also having a heart murmur is not always present with cats with HCM- Tess never had any heart murmur, Sybil seemed to have one on and off but it was never confirmed and at diagnosis when she had gone into congestive heart failure there was no murmur present. Determining if there is a heart murmur is not easy, you have to have someone who is an expert who is listening to it. A lot of people think they hear one and it’s not really there, so again a cardiologist can tell what’s really going on.
My doctor once said I had a heart murmur and sent me for an echo. This was a long time ago… but when I went to a cardiologist to confirm all of this they said there was no heart murmur. Now I actually do have some issues going on with my heart post Covid. However I do not have a heart murmur fortunately.

For the dental surgery that is a really touchy thing in an older cat. When my wizard was very ill first with kidney disease and then with Gastro lymphoma he had some teeth problems- infection etc. but we just treated it with antibiotics. A crazy ER veterinarian was insisting that I do teeth extractions on him and I said no way, are you kidding me, he is very ill and he’s not going to live much longer. His regular vet said that she is bat s ‍

 

[Alldara]

Meowmee that's definitely a lot.

My understanding is that they can diagnose heart disease with bloodwork. They did heart bloodwork for Magnus when he had a heart murmur.

Yeah the vet says he likely cannot get his teeth done, which will lead to chronic URIs, and eventually kidney and liver issues.

I know we could prolong life, it's more a matter of should. We can always push back his appointment date if he's doing well

I hope your heart issues are well managed for you. It's hard to manage a new diagnosis and treatment until you work all the kinks out.

 

[Meowmee]

If he is doing ok if it were me I would do the echo and see what is really going on. He may not even have heart disease or hcm at all.
Heart disease cannot be diagnosed with blood work alone in a cat or specifically at all. There is a test they do for bnp, a hormone level but that doesn’t tell you what type of heart disease a cat has. Of course they would probably do a full blood work anyway to see what else is going on if your cat goes into a heart failure. I don’t think Sybil or Tess ever had BNP testing.

For a real diagnosis you have to have a cardiologist do an echocardiogram- they look at the heart and they see what parts are functioning and not functioning, they measure the size of the different parts of the heart etc., output etc. And they can stage the disease by how bad the enlargement, degrading and function of the heart is. They can also look at fluid build up in the case of congestive heart failure.

First usually a primary dvm will have done an xray. When both Tess and Sybil went into congestive heart failure which was a very sudden event, they first did an x-ray and they knew it was that probably from fluid build up and an enlarged heart, symptoms etc., but an echo needed to be done to confirm that.

Of course they were both symptomatic in a very severe way. Sometimes there are no symptoms and a cat just dies from a clot, Sybil had a saddle embolism at the end and her hind legs were paralyzed.

Before Tess went into heart failure there were only mild symptoms- she had some fast breathing on and off that I noticed. The idiot dvm made fun of me when I brought her in and said I was crazy. Then a few days later she was suddenly in congestive heart failure. Needless to say I took her somewhere else immediately which was the Bobst Animal Medical Center and they saved her life- she was there for about three days and she lived for about 3 1/2 years quite happliy after that on medication. I will never forget that DVM there, she was an angel, she loved Tess, and she let us come and visit her every day. Which was over an hour drive.

For Sybil there really were not any heart specific symptoms it just happened very suddenly also, although I noticed she had been feeling a little bit tired for a few weeks before that. Being that she was 17, I was not alarmed. But we know things can crash really badly quickly with cats….they are so strong but sometimes also so fragile.
Thanks, my symptoms are milder things showing up on echo, but I am on meds now too as a protective measure.


Hugs to you and Nobel