When is the right time?

Richard Gee

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I'll start with a thank you to the regular posters on here. I've been visiting this site for five years or so getting info on how to help out the many abandoned kittens that we encounter here in Thailand. I'm originally from the U.K by the way.
Due to the language barrier and the cultural differences I find myself needing to post for the first time to ask a question, when should be a suitable time to say goodbye to our 9 year old Tabby, Thanwah?
About two months ago we noticed she did sometimes vomit. This normally happened after eating in the morning and running around in the garden after being let out of the house. She's quite a big girl, 7kg or so and loves her food. We thought that eating well like she did along with exercise playing with our other three cats were causing this.
About a week ago she didn't seem herself and was hiding. We took her to a vet who sent us to another larger vet located at the veterinary teaching dept and the local university.
Some tests and scans revealed a tumor in her stomach along with some tartar issues on her teeth. Over the last three or four days she hasn't been eating and we've been feeding her goats milk with a syringe. She will drink water but not an amount comparable with the healthy cats. She has probably lost about a kilo in weight but is now similar sized to our other cats,
The vet made it known that there was the option of treatment with no guarantees of positive outcomes or if we decide to there is is option of euthanasia. From what I gathered from my wife it seems the vet was indicating we should probably prepare to do the latter.
We've had loads of cats down the years, there is quite a problem with strays here in Thailand and there are more animals than folks willing to take them in. We always have 4 or 5 cats around which we care for and some have passed on naturally but we've never been in this position before where we are at a crossroads.
Thanwah hasn't eaten any solid food for three or four days, she hasn't eliminated normally for at least three days. She pees a little bit sometimes. She sits alone staring into space and doesn't seem to be sleeping well other than a few minute naps. She doesn't interact with the other cats or even walk around much. She will get up and move so she can lie next to us for an extended head massage and chin rub session though. She doesn't appear to be in pain when walking but I guess there must be some pain or discomfort in her stomach and mouth other wise she would be eating.
Please advise me what I should do, the vet will not say to us "you should do this now" due to cultural differences within the buddhist religion surrounding topic like euthanasia. So it seems I'm tasked with asking the good people of this forum for help deciding what happens next.
 
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Richard Gee

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Richard Gee

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I would go for further treatment. Kirsten, one of my girls, had kidney disease but she wasn't
suffering. She passed away in the cabinet on top of towels. :hugs:
We haven't ruled out further treatment, it's not expensive here so there are no financial constraints. But just looking at her now I wonder if she would survive anaesthetics and operations and the stress / anxiety etc.
 

Mia6

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My Lena had anxiety at times and doc prescribed Valium. Only you will know when it's time. Over here we
have hospice at home.
 

mrsgreenjeens

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Do you have anyone there that can assist you with having a detailed conversation with the Vet. It's really important that you have all the information in order to make this critical decision. IF they feel the tumor can be removed and it's not cancer, or even it it IS cancer but a treatable type, then perhaps it's not too late to treat if you want to go that route. BUT I need to also let you know that when overweight cats suddenly stop eating, that in itself can be very dangerous for them as they can develop something called Fatty Liver, which can be deadly all by itself, without that tumor even existing. And it only takes a few days for Fatty Liver to develop. So time is really of the essence here unless you can get her to eat. If you can get someone to help you talk to the Vet, have them ask them "what would you do if this was your cat?".

The tartar issue can be resolved with a dental (yes, cats get dentals just like humans), but I would think that is for a future date.

The most important thing here is that you don't want her to suffer, and clearly you don't as you have said it doesn't appear she is in pain. I think the problem is, as this progresses (her not eating), her organs will begin to shut down, and in the end, that could be painful, or at the very least, not comfortable. If she stops coming to you for head rubs and totally withdraws, to me that is a clear sign that she is "done".

:alright:
 

di and bob

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I agree, when they totally withdraw it usually indicates pain and defeat. Get some lickable treats and see if she will eat that, but you can't let her be overcome with pain. starving is relatively painless as it progresses, i have talked to many dying patients who have told me they feel nothing, even after weeks. Water is helpful though, it should be encouraged. i had a beloved boy with almost the same thing. He was happy up until the end. never indicated any anxiety or discomfort until the day he died. He was SO skinny though, it broke your heart. He was so scared of teh vets though, i had promised him he would die at home. But on that day there was a huge emergency with an overturned cattle truck and every vet was called. so i would suggest having an injection or an oral liquid pain medication that could be put in her cheek. It would help the passing......my heart goes out to you, I will pray for a peaceful passing in the night......
 
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Richard Gee

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Thanks for replies guys. I got an email from the vet outlining the conversation with my wife and I was able to translate that. I didn't really learn anything new. They think she is too old to progress with treatment. She's 9 which doesn't seem that old compared with cats in the west but both humans and animals here have lower life expectancy.
Thanwah still won't eat so we're pretty much forcing her to drink 75-100 ml of goats milk per day. Sh'e really not happy about having that done but seems content afterwards. She hasn't been hiding as much, seems brighter than she was a couple of days ago, seeks us out for attention and I got a couple of firm headbutts from her yesterday which is always nice.
She's losing weight but has a lot of fat in reserve being that she was always a bit chubby.
It's my intention to visit the vet today / tomorrow with the idea to progress having this tumor removed. I believe she is not in pain as she is quite mobile. Obviously there is discomfort and a reluctance to eat due to the tumor. Given that she seems happy to starve herself to death because of that tumor the logical thing would be to have it removed on a "nothing to lose" basis. Thanks again for all your input.
 

Mamanyt1953

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This is, without a doubt, the hardest decision we ever have to make as pet guardians, and be sure that no matter what you decide, you are going to second guess yourself about that decision. Since she seems to be doing better, your decision is the right one for YOUR cat at THIS time, given what YOU know...and that is the best that any of us can do.

I'm lighting a candle for her right now.
00LitCandle.jpeg
 
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Richard Gee

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Visited the vet today and got to speak in English with staff there about Thanwah. They showed me ultrasound and x-rays of what they believe is a tumor in her stomach. Asked what the next steps might be for treatment the suggestion is CT scan followed by operation to investigate if tumor has spread to lymph nodes and to take a sample for testing and perhaps removal. After that it would be chemotherapy. I asked about the chances of returning to a normal life for Thanwah was possible if everything went well and his response was a 20% chance at most given her age. Blood test reveal she is also anemic and would firstly need to undergo a transfusion, they said we would have to provide a donor animal, possibly one of ours to source the blood from.
She seems fine today, we tried her with one of those treat snack things that are gel like in the tube shaped sachet and she lapped up half of it which was very encouraging. Over the last 5 days her weight has remained the same at 4.95 kilos.
Vets gave us some anti inflammatory pills and we're going to have a think about the situation over the weekend.
Seems like treatment would be quite the ordeal for her especially the chemo.
 

skylerlark

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Visited the vet today and got to speak in English with staff there about Thanwah. They showed me ultrasound and x-rays of what they believe is a tumor in her stomach. Asked what the next steps might be for treatment the suggestion is CT scan followed by operation to investigate if tumor has spread to lymph nodes and to take a sample for testing and perhaps removal. After that it would be chemotherapy. I asked about the chances of returning to a normal life for Thanwah was possible if everything went well and his response was a 20% chance at most given her age. Blood test reveal she is also anemic and would firstly need to undergo a transfusion, they said we would have to provide a donor animal, possibly one of ours to source the blood from.
She seems fine today, we tried her with one of those treat snack things that are gel like in the tube shaped sachet and she lapped up half of it which was very encouraging. Over the last 5 days her weight has remained the same at 4.95 kilos.
Vets gave us some anti inflammatory pills and we're going to have a think about the situation over the weekend.
Seems like treatment would be quite the ordeal for her especially the chemo.
Hi. I too have had to go through what passes for veterinary care here in Thailand owing to my cat's CKD. I visited practically every vet on the island (Phuket) and some are good at some things but useless on others. It's a 'face' thing. If I were in your position I'd go with the 'nothing to lose' option. They don't even know if it's cancerous and as a former poster said, they don't suffer chemo (if needed) like humans do.

In my case my poor cat became terribly constipated quite often and the last but one vet cleared his bowels and kept him overnight on 'fluids' which turned out to be Acetar and not Lactate. I knew Acetar was very harsh on coursing through a cat's system as another vet had sold me a bag telling me it was the same as Lactate'. I knew straight after I'd subq'd him it wasn't. He was obviously in pain and growled (never growled) so took it back and exchanged for Lactate. Anyhow, when I'd called this idiot vet to ask if it were Acetar she flat out lied and told me it was Lactate, even though I sent her a copy of the bill with Acetar clearly marked. Next day he wouldn't eat anything, took him to local clinic who gave him a pain pill for 'his sore throat' and instructed me to take him home and administer Lactate before he let out a yowl and promptly died.

Your vet is just guessing at the 20%. I was told by one vet he had 3-4 years, turned out to be 6 months. They really don't know everything and you've nothing to lose by going ahead with surgery have you? As you say, it's relatively cheap here.

Btw, there's an alternative to valium - Semintra, but halve the dose they tell you or cat will be sleeping it's life away. Good luck!
 
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Richard Gee

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Bear in mind as you think that chemo does not affect most cats as adversely as it does humans.
That's good to know thanks.

Today Thanwah has been visiting her bowl and eating a little bit of wet food with a drink of water also. She hasn't done that for a week or so. She's been jumping up and down off my bed and the sofa today, roaming about the place and hanging out with the other cats like normal. That's three days in a row that she has visibly improved.
I too have had to go through what passes for veterinary care here in Thailand
I'm glad you came here and said this. I don't have much confidence in professionals here at all and that's across the board, lawyers, vets, car repairs, whatever. It's why I'm on here asking all these questions!
Will make a decision on what to do next after observing her tomorrow.
 

di and bob

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Prednisone, a steroid, helps a lot to shrink tumors and help the cat be more comfortable. I had a boy with advanced mouth cancer live for two years on steroids. I did lower the amount after the first year. Really, with all that is involved with cancer treatment, i just couldn't put him through that. He was about that age too, a stray someone abandoned because he was drooling so much. He was even shot with pellets, probably by someone trying to keep him away. He was so thankful fro any kind of kindness......
 
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