Euthanasia - update - it's not Wildfire's time yet

kflei

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I wasn't sure where to post this, so I'll post it here, but if a Mod knows a better place, please feel free to move it.  Thank you.

My cat Wildfire is 20 1/2.  We knew her teeth weren't great, but at her age, there's not much we can do about it, other than she is on pulsing antibiotics (Clindamyacin for 10 days every two months).  She just came off her last round (her 2nd one) about 2 weeks ago.  Within the last few days she's been caterwauling a lot more than usual, can't seem to settle down peacefully.  I've had a nagging feeling that her time is coming to a close.  Then, this morning, I had the realization that her teeth are bothering her.  I watched her eat (she has her own room where the other cats won't bother her when she eats, so I don't typically see her eat.  When she's hungry, I put her food down and shut the door, then pick the food back up and open the door when she's done), and sure enough she had a hard time eating- did the 'grinding' thing with her teeth, pawed at her mouth.  This is the first I've seen her do this.  I have a vet appointment tomorrow morning at 8:30 (the soonest I could get in).   I gave her some watered-down wet food, and she did eat some of that.  Within that room she has a very large tote with a 'doorway' cut into it that has padding and blankets inside and over the top, so that she feels warm and safe, and that's where she spends most of her time, and where she went after she ate a little.

She is still using the litter box, still wants to eat, is still social, can still move around the house fairly freely, meaning she is walking okay for her age.  If she was a human, she wouldn't need a walker, but it might take her ten minutes to get from A to B, so, not too bad.  Her hearing is pretty much gone, but her eyesight is still very sharp.

Within a day of each other in 2012 I had a cat go naturally from cancer (Mau Mau), and the next day one euthanized (Romeo) for a myriad of reasons.  I felt like I waited too long with Pallet, and euthanized Romeo too soon.  So my thoughts here are: what if the vet recommends euthanasia tomorrow morning?  The booger of the timing is it's a holiday weekend, so they are closing at noon, and won't be open again until Monday.  Do I go ahead because it's their schedule, or get her pain meds and wait until Monday when they open again, and spend the weekend with her?  Neither option sounds fair at all.  Sure, we can put her on pain meds, but she sleeps most of the time anyway.  Am I delaying for me?  And taking the rest of her into consideration, it feels premature.  She has a heart murmur, and her kidneys have all but shut down, and there's no way they could put her under anesthesia.

I know nobody else can make the decision for me, and I know a lot depends on what the vet says tomorrow.  I guess I'm asking for advice/guidance based on other peoples' experiences.  We had to euthanize our cat Leo the end of July, and I knew without a shadow of a doubt the time was right.  I just can't say that here, but I know cats hide their pain, her quality of life isn't fantastic, she's clearly feeling unrest because she's hungry, and I feel like I should free her from her body, but am scared it might be too soon.  Sigh.
 

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This is a tough one. I guess, ultimately, if she is in pain and nothing can be done to alleviate that, then it is time.

Based on your description, I am guessing she has stomatitis? If not, what exactly is wrong with her teeth?

If stomatitis, perhaps the addition of a low dose of steroids (there's new information out regarding the use of steroids in cats with kidney disease) and Buprenex for pain might make her more comfortable and improve her quality of life?
 

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kflei

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I, too, wondered about stomatitis.  She is a very tiny cat with a tiny mouth, and they did their best to look at her teeth earlier this year, but she is a fighter, and they didn't get a good look, other than saying that they are in bad shape.  I take extra-special care not to let any of the other cats get into her food, just in case.

After her most reason round of antibiotics, her breath improved 110%, only to return very quickly to its previous noxious state.

Medicating her is very, very difficult, as well as traumatizing to her.  That's another factor I didn't mention...
 

donutte

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Can you try liquefying food for her? Unfortunately that won't help with general pain but it will help with pain associated with eating. There is also something called Clinicare, it's basically kitty Ensure (meal replacement). Can be used on its own, or can be used to help thin down food for pureeing purposes without sacrificing calories, like you would if you used water.

I'm guessing she probably doesn't do pill pockets?
 
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kflei

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She's actually choosing dry food over wet.  I don't get it, but that's how it's been for a while.  Once in a great while she'll eat the wet (I keep offering it to her), but I think it's easier for her to swallow the dry...  We got our appointment moved up to tonight at 9:00, and it's with the owner of the clinic, so there's absolutely, positively no better vet to get, not just at the clinic itself, but in this entire quarter-of-a-million-people city, and my husband is taking me, versus me going alone in the morning (when he has to be at work).  I'm still so scared- my husband thinks the 'choice' is clear, but it's not so clear to me.  She's led a good, long life.  I guess the biggest dilemma for me is do you wait until it's so bad that it's crystal clear, or do you let them go when they still have some dignity...  I know what I'd choose for myself, and for my human loved ones if the blankety-blank powers that be would grant us that choice.
 

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This is so hard. I hope whatever happens tonight that you take comfort in knowing you gave your girl a wonderful life. Sending best wishes your way. [emoji]128149[/emoji]
 

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Let us know what happened. Whatever you decided tonight, I feel from what you explained you couldn't make a wrong decision. Choosing to bring her home on some pain meds for the weekend seems a reasonable thing to do given her state. Gives you time to say goodbye and she's still comfortable. Euthansia this evening would also be fair if the vet recommended it. I personally am of the opinion that you can't really euthanize too early if you've tried all the methods you can emotionally and financially afford and the prognosis is imminent. 

Here are a couple links that I found helpful during my decision making and grieving: 

http://www.pet-loss.net/

http://www.pet-loss.net/euthanasia.shtml
 

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My heart goes out to you, when we have to decide something like this, there truly seems no right and wrong, and no matter what we do we agonize over the decision. Your sweet baby has given you over twenty years of unconditional love, I wish we all had that long with our little ones! I have given Kitten Replacement milk to those who need a little boost, you might ask your vet if that would help to build her up. Ask if her meds, and pain meds , can be crushed and disguised in something like tuna juice, or Gerber meat baby food. I've had good luck with that. If the vet says she truly is failing and that she is in great pain, then you know what has to be done. You would not want her to suffer for one moment. You might want to bring her home and have the vet come there, it may comfort you both. No matter what, just keep telling her how much she is loved, she may not want to leave because she knows how much you will hurt, but remember, the love and the bond she has with you will never leave, her love for you will never die, she will reside in your heart and your precious memories forever, a queen for eternity. 
 
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kflei

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Let me start by saying Wildfire is still with us.

After spending much time in deep confusion and fear yesterday, I decided to take a hot bath last evening and connect with her.  She told me she's not afraid of living, and not afraid of dying.  She doesn't want a bunch of pills shoved down her throat until she dies, she doesn't want surgery, and she actually didn't even want to go to the vet, but was willing to do it for me.  She arranged a meeting with the best vet in town, because she knew I wouldn't believe what anyone with less experience told me.  I realized that she's not ready to go yet, and my bubble of doom and gloom burst, and I was able to pull myself together.

In a nutshell, the vet said her teeth are indeed crusted, and it's probably irritating to her, but that's not the big issue: she has hyperactive thyroid.  She was borderline several years ago, and even though we didn't run any tests last night, he could tell just by feeling that she has a greatly enlarged thyroid.  She's down a pound (weighed in at 5 pounds even) from her last visit earlier this year.  He said that we can't give her pain meds because she's already toxic (? Need to read up on hyperactive thyroid).  He recommended surgery to remove her thyroid(s) and scale her teeth, but that would only be possible if her kidneys are still functional, which he couldn't even find them with his hands.

I took the Quality of Life quiz posted by AbbysMom (thank you for those links), and she still has quite a bit.  Now that I've moved beyond the 'freak-out' phase, I can look at things more realistically.  The day is coming, I know that for sure, but it's not today, and for that I'm grateful.  Now I'm off to post in the main forum about good low-protein foods for cats with kidney issues.  Thanks everyone, for taking the time to respond.  Happy New Year to everyone.
 

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:hugs: :hugs: I'm happy to read your update. As Di and Bob said, there really would have been no bad decision at this point. I'm really glad that we were able to help you come to terms with this. You know it's coming, you know it's not today, but you have a better idea what to look for.

As I've mentioned, I've been through this, and the "freak-out" stage can be incapacitating. Just talking it out can help so much. You may get to the freak out stage again at some point, and if you do, we're here. :hugs:
 

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So sorry. That is such a tough decision. I will be facing soon with my Birdie and it is keeping me up at night. I wish you and kitty the best.
 

donutte

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I'm so glad Wildfire is with you for another day :) And sounds like you had some great bonding time with you baby.

Just some thoughts now. I didn't know they could diagnose hyperthyroidism (or the severity of it) with just feeling. Surgery seems kinda extreme, plus she may end up having to be on medication after that for hypothyoidism. Hyperthyroidism also tends to make cats eat a lot more to the point of being ravenous, unless they are like my Sara, who have the opposite when the numbers are really high (she's not typical though). Did they not want to do the blood work for some reason? They could also check kidney function then.

They have transdermal medication to treat hyperthyroidism that you can put in the ear. I've never used it personally, but many others here have successfully.
 
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kflei

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The vet said based on her appearance and the description of her behavior, in addition to her numbers from a few years ago, as well as the palpable size of her thyroid, he said without running any additional tests he's fairly certain it's hyperthyroid.  I trust him- he's the best vet in our city, and has been practicing longer than my 40 years on this planet.  I do remember him saying something about the medication being somewhere around $200 a month, or there's the option of radioactive iodine.  So much of what he said I felt like I was hearing from outer space.  She doesn't have long, she's doing better than what he described are the typical effects of hyperthyroidism, so I think we're going to leave it at that.  As soon as she takes a noticeable turn, we will euthanize, which I know could be next week, or next month.  Right now I'm just grateful for every day we have with her.  At 20 1/2 years I think she deserves to live the rest of her life free of poking and prodding and meds and such.  I know a lot of people don't agree, but...  Of the three cats we lost, two were 18 and one 16.  Of our living cats, we have:  20, 19, 15, 11, 10, 4, 3, 2, and 2 years.

As long as she has food in her stomach she doesn't vomit.  I can't leave her food down because all of the other cats will eat it, so she just lets me know and I close her in her room with her food.  She eats a little throughout the day, and typically quite a bit overnight.  I used to give her Cerenia, but she hated it and vomited more than when I didn't give it to her because she'd get herself all worked up.  She haaaaaaaates taking meds.  We almost lost her in 2008, and I had to syringe feed her for days until she was ready to eat again on her own, and since then she hates having her mouth touched.

Her BM's are pretty normal and regular, and she does urinate quite a bit because of her kidneys.  I'm going to scout out some low phosphorus food for her today and see if she'll eat it (fingers crossed).  And she's calling me right now for food, so I'd better get, lol!
 

donutte

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That's completely understandable, and if I had a cat live to 20 I'd be overjoyed to have them be around also. Pilling a cat that really hates it definitely is no fun so I get not wanting to do that, or put her through the stress of it.

As far as looking for low phos food, we're in the same boat! Been obsessing over it for the last two days. The lowest I could find commercially (that would appeal to my cats) was Science Diet canned food at .7% phos. I think the lowest phos for any commercial food is Weruva Steak Frites (not sure I'm spelling that right) at .57% phos, but it's pricey.
 

donutte

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Not sure if you've seen this list, but I found it this morning and am taking it with me when I shop for food:  http://felinecrf.org/canned_food_usa.htm
I have seen it, probably more times than I can count, but thank you! Tanya's website is like the feline CKD bible. I've probably looked at that site every single day for the last month and a half. And that particular page has been open on my browser non-stop the last three days


There are two more I found that have other foods on it as well (like Canidae), that aren't on Tanya's list just yet. Although Tanya's list is a bit more comprehensive so I still prefer that.

http://www.catinfo.org/docs/FoodChartPhosphorus9-22-12.pdf

http://www.catinfo.org/docs/SortableCatFoodChartCatinfo.org2-22-13.htm
 
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kflei

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Those are good lists.  Looking them over, though, after pouring over the first one, I felt something pop in my brain and smoke started coming out of my ears, lol.  I ended up buying her a good variety, fed her one when I got home, and she loved it.  Yay!
 

birdie1953

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What did you get? Birdie is nt eating the low protein presciption food.
 
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