Background: I grew up in a large city without a ton of money. Our family cats were all either killed by cars or died “naturally,” which really meant wasting away without medical care. My spouse grew up quite poor in a rural area and, to quote: “when the animals got old we just put them outside for nature to do its work.” It all sounds pretty awful to me these days, but that’s just how it was for both of us. Basically, neither of us had had to deal with end-of-life medical care for a cat. Fast forward...
My cat is 17 (possibly older) and we have had 15 wonderful years together. The spouse came into our lives about seven years ago.
The cat has had a very healthy, happy life without any health problems; her only procedures have been a spay and two dentals. A year ago, the vet said her pre-anesthesia labs for a dental looked like those of a five year old cat. Within the last few months she has started to develop high urine output and thirst. Labs last month revealed CKD (now stage 2) and the problems that go along with it, including anemia. All of this is manageable. However, her platelets have dropped well below the normal range and are now 70. There has been a downward trend — too much lower and she is at risk for spontaneous bleeding. We also suspect she has a nasal polyp due to sneezing and scratching at her ear (both of which result in bleeding due to the thrombocytopenia), some head shaking and newish onset snoring. She has been in a cone for over a month to let the wounds on the side of her head heal, one of which required some stitches.
I am well aware that all of these issues can be treated. Her CKD is well controlled by diet changes and a dose of subcutaneous LR here and there. Most polyps can be removed surgically. And there can be underlying causes for thrombocytopenia to treat. My vet of course sees all of her issues as “fixable” and would like to treat everything. I’m considering if and when to get a second opinion.
I want to look at the bigger picture and take whatever action is in the cat’s best interest. She is a pretty old lady. She has some joint pain for which I give glucosamine and CBD. She doesn’t get around as easily as she used to. She hasn’t played in a year or two. Now the health problems that have come on quite suddenly (within the last month, but most of this news came just this week). She is at such a high risk of bleeding from polyp removal due to the platelet issue. She might not even be able to have it removed at all. Polyps also recur quite frequently, so even if it were removed and she survived another year or two, we could be looking at exactly the same problem again. Vet trips stress her out so a big work up including multiple trips for serial labs, xrays, and possibly a CT becomes a quality of life issue. She also has been living in a cone, which just sucks.
It seems like all things are pointing to the fact that she’s aging rapidly, nearing what would naturally be her time, and I should focus on comfort. I am a PICU and NICU nurse and regularly see unethical heroics done to patients for very selfish reasons. Just because we can treat doesn’t mean that we should. I know cats and humans are different (!), but my background as an ICU RN is informing my decision making to a large extent.
The thing is, she is still herself. Pretty happy, very interactive, loves to eat, snuggle, and sit in her sunny spots, and so on. I see no signs of pain or respiratory distress. It seems so odd to be considering a palliative care route for a cat who looks pretty darn good considering her age. She may not even decline rapidly — no one knows. She also wouldn’t know the difference if we euthanized her, I get that. I’m not saying I’d do anything now, but I would much rather error on too soon.
There are multiple vets and in-home euthanasia folks in my area, so waiting would not necessarily mean a painful or traumatic death. Someone can be to her within a couple of hours, around the clock.
I guess I’m just looking for some validation. I have a pretty good idea of what is going on medically, and I want to consider the ethical, compassionate side before talking to the vet again and developing a plan. As a cat parent, is it okay just to focus on comfort, while knowing that medicine can still work some miracles for some pets? Is it worth causing her stress to seek treatment for this stuff? Possibly death by hemorrhage while under anesthesia? Can a cat just live in a cone? Should she? Are there other considerations I may not have looked into yet?
She has had such a happy and healthy 17+ years, why should death look any different?
I know there is not one clear answer and am okay living in the grey. This just seems like a very compassionate little community with a lot of experience, so I would love some input. Most of the posts I have seen, and the situations I always considered for my cat, involve a terminal diagnosis or some very obvious signs of pain or distress. That is clearly not our situation so a little guidance would be very much appreciated.
My cat is 17 (possibly older) and we have had 15 wonderful years together. The spouse came into our lives about seven years ago.
The cat has had a very healthy, happy life without any health problems; her only procedures have been a spay and two dentals. A year ago, the vet said her pre-anesthesia labs for a dental looked like those of a five year old cat. Within the last few months she has started to develop high urine output and thirst. Labs last month revealed CKD (now stage 2) and the problems that go along with it, including anemia. All of this is manageable. However, her platelets have dropped well below the normal range and are now 70. There has been a downward trend — too much lower and she is at risk for spontaneous bleeding. We also suspect she has a nasal polyp due to sneezing and scratching at her ear (both of which result in bleeding due to the thrombocytopenia), some head shaking and newish onset snoring. She has been in a cone for over a month to let the wounds on the side of her head heal, one of which required some stitches.I am well aware that all of these issues can be treated. Her CKD is well controlled by diet changes and a dose of subcutaneous LR here and there. Most polyps can be removed surgically. And there can be underlying causes for thrombocytopenia to treat. My vet of course sees all of her issues as “fixable” and would like to treat everything. I’m considering if and when to get a second opinion.
I want to look at the bigger picture and take whatever action is in the cat’s best interest. She is a pretty old lady. She has some joint pain for which I give glucosamine and CBD. She doesn’t get around as easily as she used to. She hasn’t played in a year or two. Now the health problems that have come on quite suddenly (within the last month, but most of this news came just this week). She is at such a high risk of bleeding from polyp removal due to the platelet issue. She might not even be able to have it removed at all. Polyps also recur quite frequently, so even if it were removed and she survived another year or two, we could be looking at exactly the same problem again. Vet trips stress her out so a big work up including multiple trips for serial labs, xrays, and possibly a CT becomes a quality of life issue. She also has been living in a cone, which just sucks.
It seems like all things are pointing to the fact that she’s aging rapidly, nearing what would naturally be her time, and I should focus on comfort. I am a PICU and NICU nurse and regularly see unethical heroics done to patients for very selfish reasons. Just because we can treat doesn’t mean that we should. I know cats and humans are different (!), but my background as an ICU RN is informing my decision making to a large extent.
The thing is, she is still herself. Pretty happy, very interactive, loves to eat, snuggle, and sit in her sunny spots, and so on. I see no signs of pain or respiratory distress. It seems so odd to be considering a palliative care route for a cat who looks pretty darn good considering her age. She may not even decline rapidly — no one knows. She also wouldn’t know the difference if we euthanized her, I get that. I’m not saying I’d do anything now, but I would much rather error on too soon.
There are multiple vets and in-home euthanasia folks in my area, so waiting would not necessarily mean a painful or traumatic death. Someone can be to her within a couple of hours, around the clock.
I guess I’m just looking for some validation. I have a pretty good idea of what is going on medically, and I want to consider the ethical, compassionate side before talking to the vet again and developing a plan. As a cat parent, is it okay just to focus on comfort, while knowing that medicine can still work some miracles for some pets? Is it worth causing her stress to seek treatment for this stuff? Possibly death by hemorrhage while under anesthesia? Can a cat just live in a cone? Should she? Are there other considerations I may not have looked into yet?
She has had such a happy and healthy 17+ years, why should death look any different?
I know there is not one clear answer and am okay living in the grey. This just seems like a very compassionate little community with a lot of experience, so I would love some input. Most of the posts I have seen, and the situations I always considered for my cat, involve a terminal diagnosis or some very obvious signs of pain or distress. That is clearly not our situation so a little guidance would be very much appreciated.
