Hospice Care For An Old Cat

[melaq]

I posted in the "Crossing the Bridge" forum a few weeks ago because I was told by my vet that we should euthanize our twenty year old cat. That thread is here in case anyone wants to read it (link).

The run down:

• Thaddeus is twenty years old. I've had him all of his life.
• When he was about 16-17, a vet told me he had weak kidneys. I didn't have a lot of money to treat him, so I watched his diet
• He behaves well except for his weight loss. He's eating normally, drinking, going to the litterbox, cleaning himself and being social
• About a year and half ago, Thaddeus has had about three grand mal seizures days apart of each other. He hasn't had any since, but he is 'twitching' a lot, which has to do I'm told with potassium imbalance due to kidney failure.
• We took him in a few weeks ago because an abscess in his gums started to drain. By the time he was at the vet, he was weak, and dehydrated. The vet noted how seriously underweight and dehydrated he was and his outlook was grim.
• He's now prescribed antibiotics (antirobe) and painkillers (tramadol, administered transdermally) I've been consistent with this except since a few days ago when he started to get worse
• He's been doing great since the vet visit, gaining a little bit of weight and eating three cans of Fancy Feast a day. I give him treats of a small spoonful of yoghurt after his meds or when I think he'd like a treat.
• Follow up visit to the vet went well, with vet proclaiming how amazed she was at his recovery. There is no longer any inflammation in his gums, he's gained a little bit of weight and he had more energy at the office (looking around, exploring) since the last visit. But because of his age and his overall issues, that this may be his last reprieve. She suggested keeping him on painkillers and antibiotics.

He started having trouble jumping onto furniture, starting with his favourite chair, a two days ago (Friday). We noticed throughout the weekend, that he's wobbly, and he's dragging his back legs slightly - he can still use them, but he doesn't seem to pick up his feet and it looks like a breeze could knock him down. He doesn't seem to be in pain, as we pick him up and rub his legs and he doesn't react. He just seems weak. He was still eating a bit, but much less than what he ate last week. He eats better when I mash up the stuff with warm water. He drinks a little bit too, but I'm worried that he isn't drinking as much as he should. His voice is very weak and 'whiny'.

Sometimes he makes it onto the couch, sometimes, he fails and flops over. He's still using the litter box and he isn't hiding. Because of his age, me and my partner has agreed to not treat him and to make him as comfortable as he can. If we feel that he is suffering, we will take him to the vet for a peaceful end, but as much as possible we hope he will find his way here at home where he's not stressed out and comfortable. I feel like he's still with us, looking at us and wanting to be close. I don't think he's in a lot of pain, but then again, I don't know. He's okay with being touched and held.

I'm not sure if I should continue giving him his antibiotics. Administering it stresses him out, and I'm not sure if the medicine is good for his weak kidneys. I'm half thinking it's aggravated his kidney, even though it stopped the inflammation in his mouth. I'm giving him the tramadol though. But I don't know what to do. Should I keep him on the antibiotics?

I just want everyone's opinions about home care for a cat who may be at the end. I'm not sure what else to do. His last two vet visits have literally broke me (I'm living paycheck to paycheck, that sucks but it is as it is). Even if I do go back to the doctor, she's given me her opinions and options, and she's leaning on euthanasia. This, as you understand, is an option I'm considering, but only if it really seems like he's given up and is suffering.

Thank you for reading.

 

[laura mae]

I'm sorry that you are looking at the end of your friend's life. It's especially hard when they have been such a huge part of your life for so long. It is evidence that you and your cat have a good bond that he's been here as long as he has and recovered from some challenging health issues.

If I could take away the medicating part of my last girl's last month, I would. I wouldn't have forced it on her.

Way back in 2003, my 19 year old cat passed. Her last days were not good ones. She had kidney issues as elderly cats usually do and in her second to last day, she seemed extremely stressed. Panting, drooling---so clearly uncomfortable. I have heard that there are cats that pass quietly with no obvious pain or fear, but I've never witnessed that.

What I have witnessed with the euthanasia is that the vet first gave my girls a shot, very similar to a vaccination for very heavy sedation. They relax and are asleep. When the vet was sure they were completely out, she finished the process. I of course, was so sad, but also relieved that their ends were not faced with confusion because they couldn't do what they had always done. I was relieved that they weren't panicked and afraid from pain.

With little Charlie, I felt I waited too long because she was doing okay on pain meds and then the last day she couldn't swallow and just drooled. It was hours before the vet could fit her in. I don't wish that sort of "I waited too long" on anyone or any cat. But I know that every kitty and person is different.

 

[ginny]

I'm so sorry for you and Thaddeus. It's always a sad time when you know your pet is declining. So many of us understand what you're going through, so this is a good place for support.

I'd ask if there was another way to give the antibioitc since it stresses him out, and just focus on the meds that keep him comfortable. From what you're saying, it sounds like he's very weak but he may not be "there" just yet. But you know him better than any of us could. Since he's eating, can you hide the antibiotic in his food somehow? Probably not, cats are smart. Or maybe the vet will let you give him a bit of a break from the antibiotics since his gums aren't red right now.

 

[melaq]

laura mae Thank you very much. I'm sorry to hear about your Charlie, but I appreciate it. I feel bad overstressing him with antibiotics right now. He's so weak, it's hard for him to walk far now. He's started flopping over in the middle of the floor, or by his food bowl. He hardly eats or drinks anymore.

I've also lost kitties in the past too. I had to put down a very sweet, affectionate five year old tabby because he had diabetes which became unmanageable. When he started hiding and not responding, I made the decision to bring him to the emergency vet. I have so much guilt over that. I've also watched another kitty die at home...but because she was also young, I made the mistake of hoping she would pull out of her illness.

I just want to do the right thing for Thaddeus this time. I know bringing him to the vet stresses him out, but I'm hoping he's a little bit used to it now that he's gone a few times this month already. Hopefully it won't be too stressful. I'm also hoping he'll go peacefully at home, but every day, it doesn't seem like it. But it just seems like he's trying so hard to do the stuff he used to do... go to the litterbox (which he's managing to do), jump up on furniture, beg for food he never eats...

ginny thank you. I've tried in the past giving him the medicine in his yogurt, but he won't eat it. I think I'll just make his last days as stressfree as possible and give him his painkillers at least.

 

[mrsgreenjeens]

Can you help him get up on the couch, etc. by placing something a little bit lower in front of it, say a step stool, maybe even a little box tht is weighted down so it doesn't wobble or get knocked over. That's what we've done for our cats as they've aged and gotten arthritic over the years. I even padded the tops of the boxes with towels and then covered the whole thing with fabric to match our drapes (in days gone by )

As to the antibiotics, I would call the Vet ans ask just how essential they are at this point, when Thaddeus may not have that much time left, and just explain that you want his time to be less stressful. Did they run any new bloodwork this time around? How is his potassium now? From what you describe it sounds like it may be low again, and this can be fixed so easily with potassium supplements. Might make him feel quite well again. It's amazing what a little hydration and the rights Vitamins and minerals can do. Plus many meds can be given in ways that don't require pilling...transdermally or via injections, which normally they don't even notice. Or sometimes they can be compounded into tuna or chicken flavored liquids.

My chronically ill cats (kidney disease also) have let me know when they were ready ti go. They definitely give signs...withdrawing is one of them. Doesn't sound like your guy is ready to go yet if he is spending quality time with you

 

[melaq]

mrsgreenjeens Thank you so much for your reply. We're doing all we can to make him comfortable, including making it easy for him to get up and down on furniture.

We decided for a number of reasons that after the issue with his abscess, we will not do any tests or treat, and will do our best to keep him happy and comfortable. Though he may ask for food, he's all but stopped eating. He drank some canned salmon water and licked up his yogurt happily though. He hasn't pooped in days.

I thought long and hard about "what if it's a simple treatment", but with him being 20, and his kidneys potentially not being his only issue, I asked myself where will it end? Not only am I flat broke (I'm taking out a small loan to deal with this as it is), because of both me and my partner's hours, we may not spend as much time with him as he deserves. As much as I hate to lose him, we've been waiting for this moment for a long time, but Thaddeus is a funny, but stubborn kitty. I want him to go with peace and dignity rather than risk even an hour of suffering down the line because that's what I did with my last two cats, and they deserved better.

Right now, I want to concentrate on his comfort, and what I can do for him until the inevitable. I don't want to inadvertently cause anymore pain, and I don't know how to measure it with him. He's been so stoic and stubborn for so long. We no longer think it's wise to expect him to pass peacefully while he sleeps, as much as we'd like that for him. This makes me so sad, though, I just want to know that he isn't suffering too much now.

 

[mrsgreenjeens]

Well, if it helps, here is a quality of life scale you can use: Quality Of Life Scale

 

[melaq]

In the end, I guess it didn't matter how much I put into this. I spoke to our vet about it, he said with cats that have the same issues as Thaddy, it goes up and down and sometimes managing it doesn't help. I didn't want to get into the cycle, so as Thaddeus deteriorated further, we made the sad decision to go to the vet. Maybe he wasn't in physical pain, but he was so weak, he wasn't able to move much at all. I couldn't watch him waste away.

And as ready I was to do that, it still hits hard and I still feel guilty about it. I'm sorry this post might not be any help to anyone. I guess if anything, when you know your cat is sick and dying, just try to be there for him. Give him his space if he wants, bring his food to him, handle him gently and talk to him with love. I've posted more in the Crossing The Bridge thread.

Thank you everyone.

 

[mrsgreenjeens]

I'm so sorry for your loss