Lisa at Home Posted April 9, 2009 Share Posted April 9, 2009 I tried to post this on the pet group, but it was just way too long so I just copied and pasted it and put it here. Plus, I only have until morning to think about this, and I wasn't sure if Soph would see it be then (I haven't been able to be here much lately...there were no new posts on that group since March). I not only value Soph's opinion on the matter, but all you kitty lovers, too. I have posted about my kitty Sasha in the past, but not for quite a while. In August, we discovered her kidneys and thyroid weren't doing to well. She was put on Methimazole for the thyroid, and gets 100 (ml? cc?) sub cutaneous fluids twice a week. She had a six month check up yesterday, and I was a little concerned because in the last two weeks we have seen her kind of stagger around a bit once or twice. Well, the bloodwork came back, and her kidneys were seriously worse. She is down to 25% function. She also has elevated liver enzymes, her calcium is below 1 (!!!) and her potassium is outrageously high. She has a slightly elevated WBC. The vet wanted me to bring her in and give her IV fluids and IV calcium. It's going to cost about $550 dollars. Yesterday's bill was $250. I wish I could say money was no object, but it isn't so, and must be considered. The cat is 18 years old. The vet feels like the cat is in crisis. Today I told her I just couldn't afford all that. This afternoon, a check came in that was late. It's enough to cover the bill, but things may still be tight and I'm just not sure at this point that it's a prudent thing to do. I could end up needing to pay another $1,000 at any moment. Because I told her I couldn't do the $550 route, she sent me home with some other meds to help the liver, and to help the vomitting that she says is going to start happening. :o( She sent me home with Denosyl, Marin, Metoclopramide, and Famotidine. She also wants the fluids increased to 150 (whatevers) and done every other day. Half of me wants to just pitch all the meds into the trash and forget it, because this is all becoming very unnatural feeling and her body is old and ready to go to sleep. The other half of me would spend the family's food money and never bat an eye. I really need an objective second opinion. Thanks. ~Lisa Quote Link to comment Share on other sites More sharing options...
elise1mds Posted April 9, 2009 Share Posted April 9, 2009 I have four cats (have had others in the past), and my heart aches for you. It is so hard to watch anything, especially a beloved animal, be in pain, KNOW you can do something about it, and have that horrible guilt about not wanting to spend the money for fixing it. At the same time, if you feel that it's time to let go, it probably is. You know how much your baby is suffering, and even doing the $550 treatment isn't going to fix the problem permanently. You might get a few more months, but at what cost to the cat? It's just prolonging the situation, and if you're in a place right now where you feel the ability to let go, it might be time. What does your family say about it? I'd have a family meeting about it and explain the situation and see what input you get. (HUGS) to you all. Quote Link to comment Share on other sites More sharing options...
Remudamom Posted April 9, 2009 Share Posted April 9, 2009 Bless your heart, that's a very old kitty. I understand about the money, I would be considering having her PTS. Why do you have to decide by morning? I wouldn't make a decision that quickly. Quote Link to comment Share on other sites More sharing options...
Catwoman Posted April 9, 2009 Share Posted April 9, 2009 :grouphug::grouphug::grouphug: I'm so sorry you're going through this -- I have had to deal with similar situations in the past, and it never gets any easier to make the necessary decisions. I think elise1mds has given you some excellent ideas to consider. Personally, I think it all comes down to one thing -- what is best for your cat? If you decide to treat her illness, what will her quality of life be like, and for how long? We spent thousands of dollars on surgery and treatment for our cat, Max, a few years ago, and although he only lived another 3 months, they were three really good months, so I don't regret having done what we did. Also, he was only 8 years old, and it was very clear to us that he wanted to hang around for as long as he could. In another case, though, we opted not to treat our cat Sasha, because she was much older and the prognosis was very bad. She would have suffered all sorts of horrible side effects from the medications, and I swear to you, she looked at me that night and I just knew she was done fighting. I'm so sorry you have to make this decision, but I'm sure that, whatever you decide, you will have done the right thing. Cat Quote Link to comment Share on other sites More sharing options...
Lisa at Home Posted April 10, 2009 Author Share Posted April 10, 2009 Although, having thought about this for several hours already, I don't see how it would really make a drastic difference. The cat is not behaving a bit differently from yesterday when we didn't have any of this information. This is partly why I am considering not giving her any of the meds at all, and letting nature take it's course- unless/until she is uncomfortable. Thanks, ~Lisa Quote Link to comment Share on other sites More sharing options...
Guest Alte Veste Academy Posted April 10, 2009 Share Posted April 10, 2009 Bless your heart, that's a very old kitty. I understand about the money, I would be considering having her PTS. Why do you have to decide by morning? I wouldn't make a decision that quickly. :grouphug: I agree. I know from personal experience how hard this is. However, given the age of your dear kitty, I'm surprised that your vet wouldn't be gently talking to you about options. I think vets are in a difficult place at times because they are faced with people who are deeply grieving and they want to do everything they can to help. It's just so, so hard to make a decision to let go. I sometimes wonder if they offer more treatment as a way to give people the feeling that they've done all they can as an owner. We lost our 14 year old kitty Sydney to cancer in 2007 after three surgeries and thousands of dollars. Same thing with our 14 year old yellow lab just last July--$2300 and, in the end, a devastating outcome due to osteosarcoma. I know what it's like to feel guilty about not wanting to spend more money but, gently, the prognosis can't possibly be favorable. :grouphug: You shouldn't feel any guilt. Your kitty has lived a long and happy life thanks to you. I would encourage you to ask the vet what he/she would do in your shoes. Two out of two times, my vet has looked almost relieved to be able to tell me the hard truth about saying goodbye to my dear pets. My heart hurts for you. Even after this long, I'm still pretty tender about it all. Quote Link to comment Share on other sites More sharing options...
Lisa at Home Posted April 10, 2009 Author Share Posted April 10, 2009 But she never did. I had to do it. Only then did she admit that we could be back in the very same spot next week. Because of her age, no matter what I do, she could simply die from old age tonight. Of course, I have no way to predict how long she would live if we followed vet recommendations. Actually, I think this would be easier on me if the vet would have talked about the options. Only recommending to treat, treat, treat, has me feeling like the bad guy for bringing it up. Thank you, ~Lisa Quote Link to comment Share on other sites More sharing options...
vettechmomof2 Posted April 10, 2009 Share Posted April 10, 2009 So sorry that you are having to deal with this Lisa but it sounds like her time might be near. YOu need to decide what things in life make her happy. I normally choose 3 things and as those start to go or do not make my critter happy or excited anymore then I know it is time to help them the best way that I can. Only you can decide this though and it is a really hard thing. My thoughts are with you. Good luck. Quote Link to comment Share on other sites More sharing options...
Catwoman Posted April 10, 2009 Share Posted April 10, 2009 (edited) This is partly why I am considering not giving her any of the meds at all, and letting nature take it's course- unless/until she is uncomfortable. I think that is the best decision you could possibly make at this time. We took our dog to the vet in early December with what I believed to be a minor infection in her gums, combined with her usual allergy symptoms. After hundreds of dollars worth of tests, the vet informed us that our dog was dying and needed to be put to sleep that day. If we wanted her to live for a few more days, they said they could give her some IV fluids, but there was nothing else they could do. We were devastated, but our dog didn't seem to be at the point where we would feel comfortable putting her to sleep, so we said we were taking her home. They said she would probably die relatively peacefully at home within a day or so, but if she seemed to be suffering too much, we could call them and bring her right in. Perhaps now is the best time to mention that this same dog is sitting here next to me right now -- over 4 months later -- hoping I'll share my chicken with her (and I thank God for her every night!) She made a complete recovery within days. I still nearly throw up every time I think about how, for just a few minutes and in my panic, I considered taking the vet's advice and putting her to sleep. The vets aren't always right. You have to do what you believe is best for your pet. I mean, I'm sure your cat is very ill, but no one really knows for sure how much good time she has left, and maybe she'll do a lot better than the vet thinks she will. :grouphug::grouphug::grouphug: Cat Edited April 10, 2009 by Catwoman typos Quote Link to comment Share on other sites More sharing options...
Guest Alte Veste Academy Posted April 10, 2009 Share Posted April 10, 2009 Actually, I think this would be easier on me if the vet would have talked about the options. Only recommending to treat, treat, treat, has me feeling like the bad guy for bringing it up. Exactly. And that's not fair. We're here to tell you you're not the bad guy. I truly believe it's the right thing to let a suffering animal pass as humanely as possible. Prolonging the almost inevitable passing of such an elderly kitty with stressful (and potentially painful?) treatment is something I don't think your vet should be encouraging. That just makes your grief harder to endure. :grouphug: You're getting wise counsel from some serious cat lovers here though. Take heart. Quote Link to comment Share on other sites More sharing options...
Lisa at Home Posted April 10, 2009 Author Share Posted April 10, 2009 But it never seems to come. And it won't if we keep interfering medically. She sleeps pretty much all of the time, but seems pretty peaceful. She doesn't really seem to be in pain. Today she ate really well, but that could change at any moment. She goes through spells where she doesn't want to eat. But then she starts again! Sometimes she responds to catnip, sometimes not. This is part of the problem!!! I can't feel really sure I know what's best for her because she slows down, and then perks up. My greatest wish for her is that she would just pass peacefully in her sleep, but it seems like we're going to have to walk a harder path than that. Thanks, ~Lisa Quote Link to comment Share on other sites More sharing options...
Lisa at Home Posted April 10, 2009 Author Share Posted April 10, 2009 Intuitivley, this is the kind of support I need right now. It's very difficult to make the choice to do something differently from what any medical professional suggests. Thank you! Quote Link to comment Share on other sites More sharing options...
Paula in PA Posted April 10, 2009 Share Posted April 10, 2009 :grouphug::grouphug::grouphug::grouphug::grouphug: My sister just went through something similar with her 10yo cat. She was going to go the whole fluids and meds route, trying to prolong her life, but then decided that, in the end, it just wasn't fair to her cat. She chose to let her go. I was sort of facing this same thing with one of our cats and our dog. Both have cancer. We had to decide if we were going to do some very expensive things that may prolong their lives, but for an unknown length of time and quality of life, or do the minimum (pain relief) and let them live as long as the cancer allows. We chose the latter. It was a really hard decision to make, because like your cat, sometimes it's almost like there's hardly anything wrong. But other times, it becomes painfully clear that neither of them will make it through the summer. My heart goes out to you at such a difficult time. :grouphug: Quote Link to comment Share on other sites More sharing options...
Starr Posted April 10, 2009 Share Posted April 10, 2009 It is truly difficult. We let our 18 year old cat die. I think if I were you I'd leave her be unless she was in pain and then work with pain meds or send her on her way to the happy hunting grounds. Poor little thing. Quote Link to comment Share on other sites More sharing options...
Jenny in Florida Posted April 10, 2009 Share Posted April 10, 2009 Of course, I have no way to predict how long she would live if we followed vet recommendations. Actually, I think this would be easier on me if the vet would have talked about the options. Only recommending to treat, treat, treat, has me feeling like the bad guy for bringing it up. I went through that "bad guy" feeling with my second cat, who died a few years ago. He was 17 and seriously ill. And we were not in a good place financially. Every time I took him in, it was a whole new course of treatment and a couple hundred more dollars. Eventually, the vet said the only remaining option was surgery. I asked several times what the odds were that an older cat, whose health was already compromised, would come through surgery with any quality of life. I never got a straight answer and felt I was being pushed into spending money I didn't have to put the cat through an aggressive course of treatment I had no faith would work. I had hours of tearful phone calls with the vet and my husband trying to figure out what was right for all of us. Eventually, we decided to try a low-key medication-only approach. He lasted just a few days and spent his last 48 hours being cradled and carried in my arms before dying peacefully at home with all of us there. I feel absolutely secure that we made the right choice, but I never got any affirmation from the vet, just lingering guilt. Needless to say, we changed vets after that. I think you have to follow your heart with this one. You know the cat better than anyone, even the vet. If you think it's time, it's probably time. My heart goes out to you. I know how tough this is. Quote Link to comment Share on other sites More sharing options...
Tree House Academy Posted April 10, 2009 Share Posted April 10, 2009 I have had many cats in my life and did rescue for cats and dogs for some time. Hon, it is time to end the suffering. You are not doing anything more than prolonging her life for whatever time you can get. She is not going to "recover" and be her once healthy self ever again. I think you know, in your heart, what the right decision is...but only you can be the one to make it. Hugs and prayers for you during this time. Quote Link to comment Share on other sites More sharing options...
Jean in Newcastle Posted April 10, 2009 Share Posted April 10, 2009 I have had many cats in my life and did rescue for cats and dogs for some time. Hon, it is time to end the suffering. You are not doing anything more than prolonging her life for whatever time you can get. She is not going to "recover" and be her once healthy self ever again. I think you know, in your heart, what the right decision is...but only you can be the one to make it. Hugs and prayers for you during this time. :iagree::grouphug: Quote Link to comment Share on other sites More sharing options...
Soph the vet Posted April 10, 2009 Share Posted April 10, 2009 Hi Lisa, I just saw this, and BTW, I do check the "Ask the Vet" daily unless I am out of town. I am so sorry you are going through this.:grouphug: It is never an easy decision even when your pet is older and in a debilitated condition. I would always give an owner a few option, not just "treat". I would not treat the labwork in your cat's case. I would look at the patient and see how to make her the most comfortable at this point. The calcium of less than 1 does not make any sense to me as that would be incompatible with life. Usually calcium goes up dramatically with chronic kidney disease unless it it a thyroid/parathyroid thing that is making her calcium do weird and wacky things. I think you need to make the decision that is best for her quality of life and your family's quality of life, your pocketbook (unfortunately) based on the overall outlook for your kitty, which is grave. If you decide to put her to sleep do not beat yourself up over it, it can be a very merciful thing to do for a suffering animal. Soph Quote Link to comment Share on other sites More sharing options...
Lisa at Home Posted April 10, 2009 Author Share Posted April 10, 2009 Well, yes, the calcium is related to her having been on thyroid meds, which have obviously been discontinued. The fact that you state that the calcium issue doesn't make sense makes me want to keep her at home and just watch her. The vet did say that the lab was so surprised that they ran it twice to double check. She also said she was surprised that the cat wasn't having seizures. She doesn't seem to be in pain, is eating well today, alert, and licked up some catnip that I sprinkled near her. She isn't having any trouble making it down the basement stairs to the cat box, so this should be some kind of indication to how well she is managing all of this! I am questioning giving the cat all these fluids. She seems a little swollen around the belly, which may be normal for this many fluids or not; I just don't know. Because the vet said that she was going to start throwing up all over, but since she hasn't yet, I have opted to give her a very diluted amount of chamomile tea instead of meds. I feel like that at this point, most pharmaceuticals are too toxic for her wasting kidneys, and since the liver enzymes are elevated, I'd rather not put any stain on them either. Do you have any experience with herbs and animals? Ina human, I would use parsley for kidneys, but it can be overwhelming if too much is taken in a cat. I found this product while looking for a feline kidney blend that contained parsley, which I am very tempted to buy, with what I know about herbs. http://www.petwellbeing.com/cat-kidney-disease-p90.cfm?s_kwcid=ContentNetwork|2559687323&gclid=CLOH2uaP5ZkCFWVM5QodtGBOQw I don't know how you feel about commenting on such things. Thanks! ~Lisa Quote Link to comment Share on other sites More sharing options...
Soph the vet Posted April 11, 2009 Share Posted April 11, 2009 I use nutraceuticals or herbal remedies based on how other clients tell me they like them. The FDA does not regulate them so they may work really well or be horrible but there are no peer-reviewed studies on them as they are not required. So I always go with "first do no harm" meaning try things in small amounts first and see how it goes. I believe there is a lot we can do with natural remedies that we are not doing. In the link you posted the one ingredient that jumped out at me and made me go, hmmm is the "Oregon grape". I know grapes and raisins are toxic for dogs, it harms their kidneys because of the tannins. In cats I just don't know. People do not usually feed their cats grapes so it has never come up for me before. That would be my one caution. The rest of what you are doing sounds fine. Feed her whatever she wants and will keep down. The rounded abdomen may be ascites (fluid) if she is losing protein in her urine excessively, in which case she can look like she has extra fluid but she is still dehydrated because the fluid is not in the cells and vasculature like it should be. Soph Quote Link to comment Share on other sites More sharing options...
talexand Posted April 11, 2009 Share Posted April 11, 2009 Soph, Oregon grapes are actually not grapes. I only know because we have them in our woods in Oregon ,unless there is actually a grape by the same name. They are a berry that looks enough like a grape that they got the name. I don't know if that makes them more or less safe. Lisa, your post hit home because I also have an 18 year old cat with thyroid problems. It showed up in a blood test and the vet wanted to operate. I just don't think operating on an 18 year old cat is a good idea. We opted not to do the medication either and have been letting nature takes its course. I don't know, he's comfortable so far, in fact still doing quite well but I know he will start to fail at some point. But he's 18. He is a very special cat to me. I have to admit I am kind of avoiding the vet because going there just puts us on a roller coaster of actions taken that I don't want to take or guilt about going against her recommendations. Quote Link to comment Share on other sites More sharing options...
Lisa at Home Posted April 11, 2009 Author Share Posted April 11, 2009 1) Kitty is getting diluted chamomile tea in low sodium chicken broth. 2) I added 1/4 teaspoon fish oil. If this does not cause intestinal changes, I may increase this a bit in the next week. I didn't buy pharmaceutical quality, but I may change my mind about that based on some things I've read since yesterday. 3) I added a realtively expensive, but high quality digestive enzyme made for cats and dogs. I have to tell you, the cat is perking up. ?!? None of the things the vet said would happen have. I know it's still kind of early to tell, but this cat is not behaving in the crisis manner that the vet said she would. I will look into the Oregon grape issue futher, Soph. Thank you for commenting on it. ~Lisa Quote Link to comment Share on other sites More sharing options...
Lisa at Home Posted April 11, 2009 Author Share Posted April 11, 2009 Just thought I would post here that the ASPCA says that oregon Grape is non-toxic to cats, dogs, and horses. Quote Link to comment Share on other sites More sharing options...
Guest Alte Veste Academy Posted April 11, 2009 Share Posted April 11, 2009 I have to tell you, the cat is perking up. ?!? None of the things the vet said would happen have. I know it's still kind of early to tell, but this cat is not behaving in the crisis manner that the vet said she would. I'm so glad about this. :001_smile: Quote Link to comment Share on other sites More sharing options...
elise1mds Posted April 11, 2009 Share Posted April 11, 2009 Keep us posted... I've been wondering. Quote Link to comment Share on other sites More sharing options...
Catwoman Posted April 12, 2009 Share Posted April 12, 2009 Thanks for the update -- hope things continue to go in the right direction for Sasha! You're a great Kitty Mom to her! Cat Quote Link to comment Share on other sites More sharing options...
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