20+ year old cat with health issues- please help!!

octobermine

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Summary:  20+ year old Cat may have dental problems requiring tooth extraction, but second opinion vet says the extraction is a bad idea.  I don't know what to do and need to make a decision by Monday.  Apologies for the lengthy description below but I wanted to get all the potentially pertinent info out there.

Hello all,

I've only just stumbled upon your site this afternoon whilst searching for internet answers- have had a chance to read quite a few threads but as our situation is slightly different I thought I would ask for some help.

My cat is roughly 21 years old (we've had her for 20 and she was an adult when we adopted her) and has been going downhill for the past few months.  She is half siamese, so a small cat to begin with (approximately 2.7 kilos).

She has been on a diet of high quality dry food, wet food and steamed turkey breast and fish.  In august she began refusing the wet and dry cat food.  Her weight began to drop, so we went to the vet for blood work.  Blood work came back clear, she does not have thyroid issues, diabetes or kidney problems.  Her liver levels were slightly elevated but not alarmingly so.

As she continued losing weight, we began feeding her baby food (We live in Switzerland- the human baby food she receives what is basically extremely pureed calf or chicken or cow and rice with a small amount of sunflower oil.  She still eats the steamed turkey as well and also receives kitten milk replacement as a treat.).  She liked this and the vet approved it as acceptable.

One week ago she stopped eating almost entirely (still drinking normally, but only halfheartedly taking a few licks of the baby food).  We went to the vet after two days of this behaviour.  The vet said that she likely had an infection in her teeth and that he would like to put her under and take an x-ray next Tuesday.  He then gave her a shot of antibiotics in the office.  He also gave us antibiotics and pain pills to administer (this was Wednesday).  She proceeded to vomit the antibiotics about ten minutes after every dosage, eventually vomiting blood on Friday.  Our normal vet was not in until Monday so we took her to a different one, who told us that he thought it was pointless to do x-ray of her teeth and that it would just unnecessarily stress her, and that the subsequent likely tooth removal would be horrible for her at this advanced age (her heart and vitals are all normal as are her blood levels though).  He suggested a monthly shot of cortisone and didn't seem to think that controlling or treating the infection in her mouth was particularly necessary- he said her teeth looked like a 20 year old cat's teeth and there was not any cure for old age.

I am a mess now as I do not know what to do-  I just want her to be happy and NOT SUFFERING.  I don't want to put her through anything that will make her feel more pain, and I want to help her, but I don't know what to do- I don't want to prolong her life if it is going to be of poor quality or lived in pain but I don't think she is ready to go yet either- she is still playing and running around the apartment when not napping (granted, sleep is more frequent these days).  Should I risk the sedation and x-ray as the first vet wants or should I go with the second vet and just try the cortisone therapy?

We are American (kitty and I) and we are in a strange country with strange vets so it's all a bit much.  :(

Please help!!!  Any advice greatly appreciated.
 

Willowy

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I would hate to put an elderly cat under anesthetic for any reason; there's a good chance that she won't come out of it. But. . .IF the vet is pretty sure she's otherwise healthy and her teeth are what's making her sick, IF they use inhalant anesthetic (like isoflurane or sevoflurane--ask for specific names of all meds/anesthetics used), and IF you can reconcile to the possibility that she may not wake up, I would at least try. Better than just putting her to sleep without trying anything. If she doesn't have any thyroid or kidney issues she really should have a few more years left in her.

I wouldn't do x-rays under sedation. They won't tell you anything you don't know. Just go directly to the dental.
 
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ilovemia

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My sisters cat passed away 2 months ago at age 19. Whats happening to your cat sounds like what happened to hers. The vet examined her teeth and said they were all infected (the 3 she had). They needed to be pulled and she would be ok. Well, her health deteriorated even quicker after the pulling. Her mouth never healed. She was on antibiotics and pain med sdaily for the next 3 months until my sister unwillingly but knowing it was best, put her to sleep. The whole process was so hard on the poor baby. I really believed going under anestesia was exremely hard on her at her age. Mel said if she had to do it all again she would have had her put to sleep before ever having the teeth extracted.

I know you love her ferousiously as we all here love our kitties but you might want to think about her quality of life and whats best for her. Only you know that though. Sendings peaceful vibes to you and your cat!
 

blueyedgirl5946

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Summary:  20+ year old Cat may have dental problems requiring tooth extraction, but second opinion vet says the extraction is a bad idea.  I don't know what to do and need to make a decision by Monday.  Apologies for the lengthy description below but I wanted to get all the potentially pertinent info out there.

Hello all,

I've only just stumbled upon your site this afternoon whilst searching for internet answers- have had a chance to read quite a few threads but as our situation is slightly different I thought I would ask for some help.

My cat is roughly 21 years old (we've had her for 20 and she was an adult when we adopted her) and has been going downhill for the past few months.  She is half siamese, so a small cat to begin with (approximately 2.7 kilos).

She has been on a diet of high quality dry food, wet food and steamed turkey breast and fish.  In august she began refusing the wet and dry cat food.  Her weight began to drop, so we went to the vet for blood work.  Blood work came back clear, she does not have thyroid issues, diabetes or kidney problems.  Her liver levels were slightly elevated but not alarmingly so.

As she continued losing weight, we began feeding her baby food (We live in Switzerland- the human baby food she receives what is basically extremely pureed calf or chicken or cow and rice with a small amount of sunflower oil.  She still eats the steamed turkey as well and also receives kitten milk replacement as a treat.).  She liked this and the vet approved it as acceptable.

One week ago she stopped eating almost entirely (still drinking normally, but only halfheartedly taking a few licks of the baby food).  We went to the vet after two days of this behaviour.  The vet said that she likely had an infection in her teeth and that he would like to put her under and take an x-ray next Tuesday.  He then gave her a shot of antibiotics in the office.  He also gave us antibiotics and pain pills to administer (this was Wednesday).  She proceeded to vomit the antibiotics about ten minutes after every dosage, eventually vomiting blood on Friday.  Our normal vet was not in until Monday so we took her to a different one, who told us that he thought it was pointless to do x-ray of her teeth and that it would just unnecessarily stress her, and that the subsequent likely tooth removal would be horrible for her at this advanced age (her heart and vitals are all normal as are her blood levels though).  He suggested a monthly shot of cortisone and didn't seem to think that controlling or treating the infection in her mouth was particularly necessary- he said her teeth looked like a 20 year old cat's teeth and there was not any cure for old age.

I am a mess now as I do not know what to do-  I just want her to be happy and NOT SUFFERING.  I don't want to put her through anything that will make her feel more pain, and I want to help her, but I don't know what to do- I don't want to prolong her life if it is going to be of poor quality or lived in pain but I don't think she is ready to go yet either- she is still playing and running around the apartment when not napping (granted, sleep is more frequent these days).  Should I risk the sedation and x-ray as the first vet wants or should I go with the second vet and just try the cortisone therapy?

We are American (kitty and I) and we are in a strange country with strange vets so it's all a bit much.  :(

Please help!!!  Any advice greatly appreciated.
Did your vet say for certain that there was an infection in your cat's mouth
 

just mike

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I would hate to put an elderly cat under anesthetic for any reason; there's a good chance that she won't come out of it. But. . .IF the vet is pretty sure she's otherwise healthy and her teeth are what's making her sick, IF they use inhalant anesthetic (like isoflurane or sevoflurane--ask for specific names of all meds/anesthetics used), and IF you can reconcile to the possibility that she may not wake up, I would at least try. Better than just putting her to sleep without trying anything. If she doesn't have any thyroid or kidney issues she really should have a few more years left in her.
I wouldn't do x-rays under sedation. They won't tell you anything you don't know. Just go directly to the dental.
Absolutely 100% what Willowy just posted.  Sending you the best positive vibes
 
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octobermine

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Thanks, Willowy.  I agree with you completely about the sedation and the risks.  The most frustrating thing about being here is that the veterinary attitudes are so shockingly DIFFERENT to what I'm used to in the US.  This is actually our third vet in Zurich- the first one wanted to put her under to take a blood sample!!

The big issue seems to be the language barrier- despite repeatedly asking both vets in both English and German whether or not she had an infection in her mouth, neither one would give us a straight answer.  They said she had the teeth of a 20 year old cat...I assume this means there are several that may need to come out.  The first vet (one that wants to do the x-rays) seemed to think that the teeth are the problem.  The second vet seemed to think that her body is just getting older, the teeth are just standard old age teeth and said something along the lines of, "Where does it end?  You try to fix the teeth but her liver then acts up, she is methuselah, she has had a good life, let her go naturally. Feed her whatever she will eat.  The cortisone shots seem to pep her up, so give her one of those each month."

I think we are going to try to find a dental specialist to have a third look and see if that is what is really the problem.  She just had a full blood panel done in Berlin at the beginning of August and apparently they were wonderful for a cat of her age, except the slightly elevated liver markers.  I don't know if it would be worth doing another blood panel as it has been so recent and it very much stresses her out.  :(
 
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octobermine

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Did your vet say for certain that there was an infection in your cat's mouth
That is actually part of the issue, the vets BOTH said she has the teeth of a 20 year old cat.  The first vet seemed more certain it was an infection than the second, but wanted to do an x-ray to see if there was an abscess or if there was a tumor or something growing in the jaw (that second one surprised me...).  The second vet (who is much younger, maybe just a few years out of vet school) seemed to think that there was no point in working on her mouth if she was eating after the cortisone shots.  Neither one really confirmed an infection, despite pressing on our part.
 
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octobermine

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My sisters cat passed away 2 months ago at age 19. Whats happening to your cat sounds like what happened to hers. The vet examined her teeth and said they were all infected (the 3 she had). They needed to be pulled and she would be ok. Well, her health deteriorated even quicker after the pulling. Her mouth never healed. She was on antibiotics and pain med sdaily for the next 3 months until my sister unwillingly but knowing it was best, put her to sleep. The whole process was so hard on the poor baby. I really believed going under anestesia was exremely hard on her at her age. Mel said if she had to do it all again she would have had her put to sleep before ever having the teeth extracted.

I know you love her ferousiously as we all here love our kitties but you might want to think about her quality of life and whats best for her. Only you know that though. Sendings peaceful vibes to you and your cat!
Thank you ilovemia.  What your sister experienced is exactly what I am afraid of happening.  :(  I want her to have the best possible quality of life and I don't want to torture her with treatments she may  not be strong enough to recover from at the end of it.  :(  I am sorry for your sister's loss.
 

otto

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I'm so sorry you and your beloved kitty are going through this.

Quality of life being the most important issue here, I would have the dental done. Your cat is not eating, she is suffering now, she has nothing to lose by having the dental. If she doesn't survive the procedure, at least you know you tried. You can't let her go on like this, obviously.

She'll be under anesthesia and she won't know a thing about it. I think seeing the specialist is a good idea, if you can get to them soon. The longer the procedure is put off, the weaker and less able to stand it she will be. Sevoflurane is a very safe fast acting anesthesia. Insist that this be used. She will feel so much better with those rotten teeth out, who knows you may have her for a few more years even. But whether she has months or years left, they should be good, not suffering in mouth pain so bad she can't eat.

Keep us posted, I'll be thinking of your precious girl.

PS because the possibility of not surviving is there, just make sure you tell her all about it before hand. Tell her what will happen and why. Tell her if she can't make it, you understand, you love her and will miss her, but know she will be free of pain and you will be reunited again at the Bridge, though you do hope she will come through it and live a long long time with no mouth pain.
 
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momofmany

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I know of a local rescue group here that handles nothing but senior cats. They have told me that they have had tooth extractions done for cats over 20 years old, and in all honesty, they said it like I should be completely surprised that they attempted to do it. They go to a dental specialist with extensive knowledge of senior cats, and that specialist is very careful about what drugs they use. My opinion is that if you can't find someone that specializes in this, don't do it. If you give a senior cat in ill health anesthesia, it can kill them unless the vet really knows what they are doing. A few years ago, I lost an 18 year old cat to old age. When she got so bad that I brought her to the vet to euthanize, she actually died from the sedative they gave her before they gave her the euthanasia shot. When they are weakened by ill health and old age, it doesn't take much to put them over the edge.

It she vomited the antibiotic, try different antibiotics. Many cats get ill from certain antibiotics and switching them to a different one can easily fix that. Steroids can simply make her feel better. My 17 year old senior is on steroids for oral issues and they do make him feel better. Fortunately I don't have to make a decision about a dental for him, as he lost all his teeth 6 years ago from an auto immune disease. The steroids are to keep his gums from getting inflamed and he's been on them for 6 years.

If her blood work is fine, then it seems to me that she doesn't have an infection. Infections change the white blood counts in their blood, so it sounds like there is something else going on. My old boy has been losing weight drastically in the last few weeks. I had him for a blood panel on Thursday and they couldn't find anything wrong. He's having strokes and simply stated, he's dieing. I'm doing everything I can to keep him comfortable.

My heart is with you.
 
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octobermine

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Momofmany, I am so sorry to hear about your kitty.  I hope you're able to keep him as comfortable as possible over the next few days or weeks. 

Charlie kitty has been eating since visiting the first vet on Wednesday (even asking for dry food!), so we are not sure if she is in pain or not, which makes it all the more difficult.  So far I have not managed to find a veterinarian specializing in dental issues in Zurich though.  We will call the vet first thing in the morning to make inquiries though.  She had an antibiotic shot which should last approximately two weeks (from the second veterinarian).
 
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octobermine

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I'm so sorry you and your beloved kitty are going through this.
Quality of life being the most important issue here, I would have the dental done. Your cat is not eating, she is suffering now, she has nothing to lose by having the dental. If she doesn't survive the procedure, at least you know you tried. You can't let her go on like this, obviously.
She'll be under anesthesia and she won't know a thing about it. I think seeing the specialist is a good idea, if you can get to them soon. The longer the procedure is put off, the weaker and less able to stand it she will be. Sevoflurane is a very safe fast acting anesthesia. Insist that this be used. She will feel so much better with those rotten teeth out, who knows you may have her for a few more years even. But whether she has months or years left, they should be good, not suffering in mouth pain so bad she can't eat.
Keep us posted, I'll be thinking of your precious girl.
PS because the possibility of not surviving is there, just make sure you tell her all about it before hand. Tell her what will happen and why. Tell her if she can't make it, you understand, you love her and will miss her, but know she will be free of pain and you will be reunited again at the Bridge, though you do hope she will come through it and live a long long time with no mouth pain.
Otto, she has been eating again since the vet visit on Wednesday- we went to the second vet on Friday due to the vomiting.  Thus we can't tell if she is suffering or if the cortisone shots will keep her comfortable.  She also had an injection of antibiotic and an under skin infusion which should last for two weeks (done on Friday).  I think our current plan is to try to find a veterinary dental specialist somewhere near Zurich and get her an appointment- so far the internet is yielding nothing.  :(  

Thanks especially for the P.S., I will be sure to do exactly that if we wind up needing extractions.  
 

kare4cats

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Have the vet do a pre-anesthesia blood screening, I always do. It really is the only way to tell what anesthesia is best for the animal. I would never have any of my cats put under without a blood screen first.
 
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octobermine

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UPDATE!

We went to the dental specialist today- he said that her mouth actually looks very good and thinks that the other vet was very off base to suggest an x-ray.  He said her overall health is great for a 20+ cat and that we should do a blood screen if she stops eating again and possibly continue with the cortisone shots if the next screen ok's them.  :)  Happy news all around.  Thanks everyone!!
 
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octobermine

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Hi there,

This is a very old thread- but in response to your reply, I'll give an update!  :)  We have moved to the UK and my kitty is still hanging in there and is happy and (with the exception of cataracts and some managed arthritis) comfortable.  Due to her advanced age, I've decided to keep her going (i.e. no extreme medical measures) as long as she is happy (taking interest in life) and pain free.  After interviewing a number of vets we found one here that we were both happy with and who agrees with the managed care philosophy.  She has been eating regularly since the last update and is well and happy (just very very old!).  

Thanks so much to everyone for their advice and good wishes.
 
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