How Do I Know It’s Time?

[Lotusflwr79]

**Long Post Warning.**
My 16 yr old cat, Lily, has been having constipation issues for 2.5 yrs. She’s been in the hospital, where they gave me no guidance after I brought her home on how to treat her constipation, only a bill for $2k. She was back and forth at the vet for enemas, and since then, we’ve completely taken her off dry food for the past 1.5 yrs, and she’s being fed a liquid diet both morning and night with a tiny pinch of psyllium husk, olive oil, wet food and beef broth. This has worked for the past 1.5 yrs, but more recently she’s been getting constipated more and more. I’ve started to “help” her make a bowel movement bc it was so stressful for her to go back and forth to the vet and I was nervous they would tell me to put her down bc we were getting enemas so often. In the past month or so, my husband and I have noticed a significant weight loss and she’s been constipated 2 times in less than a month for a few days at a time. Vomiting, not eating, isolating herself, crying—it’s awful to see. So we made another vet appt. At her last visit, she was 5.5lbs and the other day, she weighed 4.2lbs—she’d lost about 1/4 of her weight. From her last blood panel, she had elevated kidney levels (not sure of the number) but enough that it bothered the vet. At this point, I feel like my cats quality of life is no longer there, and I’m constantly stressed and worried when I’m not with her. Our vet said she’s still constipated and said it was up to us on how we wanted to proceed. I’m struggling bc I feel like her mind is still there but her tiny organs aren’t working like they used to. She’s uncomfortable when she’s held bc she’s so frail. It’s so awful to watch. We’ve taken her off the psyllium husk and will try miralax to see if there is a change. At this point we feel like we have nothing to lose. She can still jump and is social when she’s not sick, we just never know when she will get sick and it happens almost spontaneously. She has good and bad weeks. My question is do we let her go when she’s not in pain, or do we wait until she gets another bout of constipation and then decide? I don’t want to be selfish. I just want to make the right decision and not let her go too soon.

 

[les26]

I am sorry that you are having to deal with this and of course it is not easy, so so tough to have to play God sometimes. I do know that at the end of his life Sebastian was very constipated, and his kidney levels were also elevated but not so high that any of the vets he saw were alarmed, but the one vet did tell me that the constipation was from something else happening to him, most likely drawing water from the kidneys, and he passed shortly after that and did not want to eat anymore, I can still recall holding him near the end and Deb trying to syringe feed him wet food and he just pushed it away with his paw and buried his little face in my arm

But I am sure that you will be able to tell when it is time for your kitty, and she might even make the decision for you if it is truly time. I don't know what else to say, except follow your heart and feelings and if you trust the vet listen to what they suggest too. I wish you luck and send prayers in this most difficult time.....

 

[Lotusflwr79]

Thank you! We are hoping she does let us know when she is ready.

 

[chrisjoesepp]

First, do you have absolute faith in your vet? They are only human and I know from bitter personal experience, some are better than others. I was also active with a local animal rescue for years and though several vets were willing to take in and check animals we brought in, we clearly saw a difference in the quality of care between vets. If you have any doubts, ask around for a recommendation and seek out a second opinion.
Animals value their lives, and I don't think any of our pets would fault us if we wait too long in the hopes of saving them. Each of us knows when it has become hopeless, or at least have a strong feeling that it is, and know when to say good-bye. Whichever route you go, you have obviously given it your best shot and no one, including your pet, would question your choice, nor doubt your love.

 

[Lotusflwr79]

Thank you. I am giving the miralax a chance and hoping it works. Our vet is very sweet and has 3 cats himself. His concern was a balance of both our qualities of life. A liquid diet and still becoming constipated was another concern of his, along with the rapid weight loss. He definitely wouldn’t tell me what to do the other day, but said it was my choice in the end.

 

[chrisjoesepp]

Thank you. I am giving the miralax a chance and hoping it works. Our vet is very sweet and has 3 cats himself. His concern was a balance of both our qualities of life. A liquid diet and still becoming constipated was another concern of his, along with the rapid weight loss. He definitely wouldn’t tell me what to do the other day, but said it was my choice in the end.

It's good that you trust your vet, but I wonder if something else is going on with your cat. She sounds exactly like my Lilli, but my girl has a digestive tract condition (there is a name for it by I can't remember it) that is controlled with prednisone. Strangely with her, she takes her pred like a doll when she's ill, but once healthy, forget it. Then her condition worsens and we start all over again. As I said earlier, taking the time to make sure it's the right time

 

[chrisjoesepp]

Sorry, one of my cats decided to play with the computer before I could finish. Taking the time to make sure it's the right time is not a bad option, a very good one I've learned over time. I've gone way beyond the time with some of my pets and had both spectacular success and heart breaking failure but I never regret trying, however, I've also had times where there was a slim chance offered to me but I've known in my heart not to pursue it and simply let go. Whatever you decide, have faith that it will be the right choice. Good luck.

 

[di and bob]

You will see it in her eyes, there is a definite change, a sadness that you will detect. Try the miralax for a while, I know it helped my seventeen year old Burt, 1/4 - 1/2 teaspoon mixed in tuna juice or an egg yolk. But he had other issues too, cancer that took him from us.
What ever you decide, it will be out of love. There will come a time when living becomes existing, when no joy is found and no interest in her surroundings. That is the time. My poor boy started sleeping in his litter box and not coming to lay with us in the evenings. His world was reduced to pain and sleep.
Try to have the vet visit your house if at all possible, it reduces the stress and fear. My heart goes out to you, I'll pray for you all, in this time of indecision and anguish. The bond you have formed over the years will always be there, use it to send your comfort and love. wIt hurts so much because e love so much.......May the good Lord bless and take her into His loving arms. May you be comforted in knowing you gave her what she wanted the most in this life, your love.

 

[Mamanyt1953]

As di and bob said, you can see it in their eyes, when the time has come to say goodbye. You and Lily have both Fought the Good Fight. Continue fighting it until Lily says, "It is time. Let me go now with love, and my spirit will abide with you always."

 

[Lotusflwr79]

Thank you, everyone for your kind words. We are definitely taking it day by day. We’ve started her in the miralax, still constipated today but I’m giving her some time to maybe adjust to it and see if she can make a bowel movement on her own. I will update. The constipation issue isn’t cut and dry. I wish there was a handbook for this problem in older cats. Her digestive system is so sensitive. Any little change and she’s constipated again! Uggh.

 

[Purr-fect]

My question is do we let her go when she’s not in pain, or do we wait until she gets another bout of constipation and then decide? I don’t want to be selfish. I just want to make the right decision and not let her go too soon.

You cant kow the exact moment for certain. Many posters in this forum have felt they either waited too long or did not do enough to save their loved pets. They often blame themselves for the outcome. This feeling is normal, but not warranted, as the final outcome could not have been changed.

Its a very difficult decision to make. I found it helps to ask others in your family what they are observing, was today a "good" day? Did your kitty seem to have some happy moments? Did they hide, or cry or lay in their litter box? Are they eating, drinking, pooping, peeing effectively and painlessly?

I once read an article in which a vet said its better to make the decision too soon rather than too late. That may sound callous. My eyes are filling as I write this......but I would rather my boys spent their final days reasonably happy and healthy enjoying the sunshine, their favorite treats and chasing thier toys, than confused, scared and in pain......even though it would mean they would have fewer days and the terrible loss I would feel came to me sooner. To them they would simply go to sleep......they would not know the loss of their time alive...but most importantly they would not suffer.

Each day my wife and I would talk about our little girl's day....would today be the day?.......or was she still enjoying life? We made the decision together and I think we both found some comfort in that.

I suggest you find a vet clinic that is nearby and available 24 hours. That way if Lily takes a turn for the worst in the middle of the night, she doesnt have to suffer for hours before a clinic is open. We did that for our girl and I am glad we did.

 

[Purr-fect]

Of course you first ALSO do research, talk to the vet(s) and consider reasonable treatments, as you are doing.

 

[kittyhonored]

Hi. Actually thee is an e book written about feline constipation. Perhaps you read it? Constipation generally is a WATER issue. Have you asked your vet if it can be a joint/muscle issue? Try arithritis treatments and if it is slowdown inside Cisapride(motility drugs often used). DO NOT kill a cat because of constipation. There are effective treatments seems like your vet isn't that astute on the matter.
Often WE have to know more than our vets do since we have an incentive they don't have.
Seriously, if you eliminate it being a cancer/blockage issue then I elieve you can help your caT BY ADDING MORE FLUID TO FOOD AND USING MIRALAX. Learn to use sub q and even to give a felineenema(like taking temperature).

 

[Candybee]

How is Lily doing now? I am sorry that she is going through this. Don't know if she has seen a specialist but it might be worth the extra money to take her to one.

 

[Mamanyt1953]

Just...thinking of you both today.

 

[Lotusflwr79]

Her diet is 90% moisture and she drinks a TON of water. She has been on a liquid “soup” diet 2 times per day for the past 1.5 years. Moisture and water isn’t the issue. The miralax seems to be helping and she is off the psyllium husk. She still is getting constipated, though. But she’s doing better than a few weeks ago. Again, we are taking it day by day. We have spent thousands already on Lily and unfortunately, we can’t spend thousands more at a specialist. She is 16 and has lived a wonderful life. We are loving her for now and enjoying the rest of our time with her. It could be years more.. I don’t know. Thanks everyone for the kind words!

 

[Timmer]

Glad you are giving us updates. Thinking of you.

 

[Candybee]

Keeping my fingers crossed that the miralax continues to help her.

 

[kittyhonored]

well thats good that on liquid diet but that doesn't change the FACT that constipation is mostly a water issue. Therefore, as mentioned, your cat actually doesn't have constipation. Its a muscle issue/motility that's causing constipation. What is happening, and common in older cats, is the muscles are failing to move the stool though in a timely fashion. The longer the poop stays inside, the harder/dryer it gets. That is why the miralax is helping. Miralax keeps the waste soft. Therefore, even if cat goes a few days without pooping the added effect of getting hard/dry which is painful and hard to pass is being avoided. However, miralax keeps the poop soft by drawing water into the colon. That makes it VERY important that cat still gets alot of fluid so there isn't a deprivation.
Cisapride is a drug that helps with moving it along. But to repeat, you would wanna make sure there isn't some other reason that keeps cat holding his stool. Pain can be one of the reasons and that why arthritis should be eliminated.

p.s My KITTY also ate only can food with extra water added and still had poop issues. Miralax pretty much solved the issue but the amount needed is an art form and might need constant adjustments. Realize also that any meds can also mess up the balance and miralax adjustments need to be made.
Pet enemas can be use to SAVE thousands. Cats hate it but it is a safe lubricant that stimulates the muscles to poop. But if its a motility issue that is causing the poop to stay in deep then meds needed.

 

[Lotusflwr79]

Thank you for your concern. I do know all this as she’s been in the hospital and I’ve been back and forth to vet for enemas. I know what the miralax does and hats why she’s now on it. We’ve been dealing with this issue for a few years now.