Caring for a dying cat?

David in Keizer

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I would appreciate any advice on caring for my cat, who is beginning to die.

Sophie, 11 years and 10 months and 100 per cent sweetness and kindness, has high-grade lymphoma and, the veterinary hospital said Friday, 6 to 8 weeks to live. She’s gone from 16.7 lbs to 10 lbs in a year, and has lost 1.4 lbs now in less than a month. She’s very thin and bony. Yesterday she developed a limp, and today it’s worse and she’s having trouble getting around.

The oncologist at the Oregon State University Small Animal Hospital says we could start chemotherapy that might give her 11-12 months at best. We’re talking tomorrow; it would involve weekly trips there, an hour each way. At this point I’m worried, if she and I go ahead with it, about all the stress on her, and if it might not be better to just care for her at home for the time she has remaining. I don't know.

But how would I do that, give her palliative care at home? I don’t know and it scares me. She wants to stay down on the floor, where I have a sheet fluffed up for her that she’s now curled up on. She’s not eating much at all. I had been giving her Mirtazapine as an appetite stimulant 2-3 times a week, which worked and noticeably improved her mood. Should I continue to do that? Daily? How best to help her with the litter box, which is currently two rooms away? What’s the best way I can comfort her going forward? At times she wants to cuddle and at times she wants to be alone.

Any advice appreciated. Thanks.

David
Keizer, Oregon
PS: Picture from 5/18/11
 

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neely

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Welcome to TCS albeit I'm sorry your first post is in regards to Sophie being diagnosed with Lymphoma. I agree with you that weekly trips, an hour each way for chemotherapy, would be stressful for both of you. However, this is a decision only you can make with the help of your vet. Pertaining to your question about using Mirtazapine permanently I would also consult with your vet. With regards to the litter box being two rooms away why not have more than one, i.e. keep the one where she is used to going but have another one or even two close to where she usually sleeps or is most comfortable. You may want to consider a low sided litter box to make it easier for her to step in and out. There are many options available or you can make your own but here is one example:
https://www.amazon.com/dp/B083RKWF87/?tag=thecatsite

What’s the best way I can comfort her going forward? At times she wants to cuddle and at times she wants to be alone.
The best advice I can give you is to keep doing what you're doing, i.e. love her when she wants to cuddle and give her space when she wants to be alone. You know her favorite spots and places so simply be there for her. :catlove: Since you mentioned you're talking to the oncologist tomorrow make a list of all your questions and go from there. If there are other family members talk it over with them too. My sincere and heartfelt sympathies to you. Please feel free to ask any more questions or come here for our support.:grouphug:
 

FeebysOwner

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Hi. So sorry for what Sophie and you are going through. I am unsure as to how to respond about the chemotherapy, but I know that other members have been through very similar things and I hope they will come along soon to offer you some insight and their thoughts.

I thought perhaps this article (see link below) would be helpful - whether you choose chemotherapy or palliative care - it seems to me some of the extra care you can try to give her applies to both scenarios. And, regardless of what you do decide to do, ask both the vet and the oncologist about continuing the appetite stimulant (if it were me I would - as long as the vet told me I wasn't doing any harm).

I echo neely neely 's input, sympathies, and offer of support.

End of Life (Hospice) Care For The Dying Cat | Cat-World (cat-world.com)
 
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David in Keizer

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Thanks very much for the replies, I appreciate them. Right now she might be having problems with both back legs but in any case seems unsure she can get up and seems very confused about it when she tries. So she lays back down and goes back to sleep. If she can't eventually make it to the litter box, I suppose she will go where she's laying... but how long is that a sustainable situation? I'll be talking to the vet and oncologist tomorrow, but meantime.

I was petting her and watching her face this morning when she was having trouble moving and I swear I saw her suddenly realize that she was beginning to die. It broke my heart. Then she starred into space for a few minutes. Maybe I'm anthropomorphizing.
 
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David in Keizer

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Also, both the vet and the hospital do not allow owners into their buildings. If I have to euthanize her, is it possible these days to get a vet to come to my house? I'd prefer to do that in any case instead of the stress of taking her there. I just don't know if vets do that.
 

FeebysOwner

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I have no advice for you, other than maybe you can place her in a litter box that is very close by, see if she uses it and then help her back to her place where she rests.

Ask both the oncologist and your vet about in home euthanasia, they may have some contacts for you. You can also do your own search on the internet to see if you can locate one.
 

Pjg8r

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I don’t know where you live, but lapoflove.com is an at home euthanasia vet practice. They have changed some of their procedures but I just checked and they are still coming to homes. I have used them in the past and found them to be a great option to avoid taking a pet out of the home for end of life care.
 

stephanietx

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We were in a similar situation recently with our 15 year old kitty. For us (me and my husband), it came down to quality of life for our kitty. Would her life be improved while on treatments? How long would it extend her life? What was her life expectancy post treatment? If it wasn't going to give us a couple of years or more, then was it worth it? Would it just be better to love on her as best we could and let her go peacefully without heroic measures? Could we live with that decision? How much strain would it be on us emotionally, mentally, and financially. If she did improve, would her quality of life be restored or would it be a new normal? How would it affect the other kitties who share our home?

Ultimately, we decided to let her go because in her case, treatment wasn't really an option and due to her age wouldn't extend her life more than just several months. We didn't want to see her suffer or be driven to/from appointments and upset the whole house each time we left/returned. It doesn't mean we didn't love our kitty because we did and her presence is missed every day, but we treasure the years we had with her and are thankful that she didn't suffer because we tried to keep her alive for us.
 

fionasmom

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For the time being, you need to make whatever accomodation is needed for her. If she needs a litterbox in her immediate environment, just put one there for the time being. Likewise, do anything else that seems to make her comfortable. If a litterbox becomes out of the question, get some unscented, hypoallergenic or organic baby wipes or a warm washcloth and keep her clean. If you need to put some plastic under her sheet to protect the floor, do that.

I would push the oncologist about what "at best" means. To a doctor who works with statistics of survival, it might mean that most cats in her condition made it for one month but the outside calculation could come to 11 -12 months.

Unless you are told that the mirtazapine should not be continued, I would continue it. Ask them how frequently you should administer it.

My guess is that Oregon State does palliative care for animals. Ask them what it means and how you would do it. For some hospitals, it means actual treatments such a acupuncture, for which you might not want to transport your cat, but it might also mean pain management with medication which you could do.

Write down a lot of questions, including all the ones you have asked here. There are no bad questions. What I did with my dog at VCA in Los Angeles when he was evaluated for more cancer surgery during COVID was to type up a list of questions and send one copy in with him and keep one with me in the car. I had them numbered so I could refer them back to number 7, for example. Writing things down will help your brains from going out the window which is what happens to all of us in these circumstances.

I take exception to preventing owners in during euthanasia as my cat vet does make accomodations which involve a 6 foot long piece of tubing which allows them to stand opposite the client and cat. Under the circumstances, I would look for home euthanasia. It might seem pricey but this is not something that you will have to do, hopefully, often.

I am so sorry that you are facing this. She is a beautiful and obviously well loved girl.
 
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David in Keizer

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Thanks again for everyone's advice and experiences. I talked to Sophie's oncologist at OSU, and I've decided against chemo and for palliative care at home. She's fragile now and already gets stressed when traveling -- the last thing I want is her dying by herself in the traveling crate in the back seat of the noisy car, and the OSU hospital is an hour away. He noticed how stressed she was in the hospital, too. I want her to die here at home with me where it's quiet and she feels comfortable and safe.

Thanks for the lapoflove suggestion -- I have a message in to talk to them. Sophie is doing relatively well today and eating, but it's still shocking to pick her up (like to help her off the bed) and realize how small and light she's become. It occurs to me that with people this end stage is often hidden in hospitals and nursing homes; with pets we see the decline 24x7 and it's difficult to constantly watch and monitor. At least that's the case for me.
 

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David in Keizer

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By the way the oncologist said that extending life through chemotherapy can give 11-12 more months at best, in Sophie's case it's likely to be only a few more months. That's a lot to put her through for that. I guess. It's not my idea of her best last few months of her life.
 

fionasmom

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I think you are making the right decision and I completely get that you do not want her to pass in the car or at OSU in the midst of some unsettling situation. She is happy at home with you and at peace. She knows you are there for her and that is the only place she wants to be.
 
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