How do you know when 'it's time?'

[belong2bella]

My Bella is 18, and she has not been well. She has been putting up a good fight with IBD. Her steroids are not working as she is losing weight. I took her to the doctor last week,and the doctor said as long as she is eating then it is not time. So, her doctor said to increase Bella's medicine. I honestly do not agree with this, because Bella no longer enjoys ANYTHING she has her whole life. She barely wants to be touched, and that is not my Bella. She doesn't play, get in the window, or anything. If she is not sleeping, she is hiding. Experienced opinions, please.

 

[kittyluv387]

Have you tried raw food as a last resort?

 

[belong2bella]

Yes, she will not bother with it. Believe me, I have tried everything possible within reason.

 

[artiemom]

My heart is going out for you.. I do not have any suggestions at all.. My guy is going thru something similar.. almost 13 yrs old, IBD, and losing weight.. but he has constipation and possible megacolon.. 

I have been having the exact same thoughts as you have asked.. I am trying everything I can..

Have you tried an appetite stimulant? I am sure you know about mirtazapine.. there is also cyproheptadine, which does not have such strong side effects as the mirtz...

(((((((Hugs))))))))) to you....

 

[belong2bella]

I am sorry to hear from someone else going through this. She is 18, and was 13 when diagnosis was made. Yes, I have been though every treatment regimen available in felines. Even herbs. This is not an easy decision, but I thought the doctor helps to make the decision? I know her answer is not correct by any medical standard.

 

[louche]

It's a tough decision to make. I had my cat, Sassy, euthanized Monday, and after a brief chat with the vet...because I asked her if I was being premature about it....she said, if I was okay with it, she was okay with it. I had been through a rough time with a dog who had Addison's Disease, and I didn't want it to be like that for Sassy.

Quick rundown on her issues: arthritis, hyperthyroid, liver/kidney disease, unsure about her age as I adopted her from people who found her so she was probably between 13-18 years old, developing cataracts

She was taking buprenex to ease her arthritis pain but I had to increase the dosage recently as well as give it to her twice daily. Her appetite was somewhat under control with 2.75ml twice daily of methimazole. Most days she'd eat normally, others not much or at all. Then blood in her stool on and off. I'm not sure if the dry food I'd give her caused digestive issues, but most days her stool was soft, and explosive. Her main diet was canned Royal Canin. I'd leave an ounce of dry RC overnight for her to nibble.  I eventually put training pads down for her because she didn't want to climb the in the box. Then she decided to poop in the dining room (opposite sides of the house and about the same distance away from litterboxes) and pee on my dog's bed in the living room. She slept a lot, but when she was awake, she was herself.

I told myself once she starts losing control of her bowels is when I would make the appointment. I feel conflicted about the decision....though that is my personality/anxiety/both...but despite feeling I was premature about it, it was probably the best for her, considering all she was going through.

I'm sorry, I wish I could be comforting, or helpful. <3 *hugs*

 

[roxanne76]

I am so sorry your kitty isn't well. My kitty is struggling now, too with a very aggressive cancer, with no treatment options. Sadly, I fear he is in his last days. One year ago, I had to make the difficult decision to put his kitty friend down as he was suffering in the late stages of a different kind of cancer.

I had asked my vet the same question; how to I know when "it's time?" She said to think of my kitty's three favorite things. When he gave one of them up, it would be time. It was a hard decision, but a kind one. This is the hardest part of being a pet parent. My heart goes out to you! You aren't alone. **Hugs**

 

[cat-tech]

BelongtoBella,

Ask your vet about malabsorption - this happens frequently with IBD, so the diet may need to be changed - addition of vitamin B12 injections are sometimes helpful (this helps with better absorption, as well as with appetite).

An increase in prednisone (if that's what you're referring to), is not necessarily a bad thing, as long as it is not too high a dose - it can help reduce inflammation while you and your vet try other measures with her diet and other needs.  She could also have a GI tract infection, which is also common with IBD, so an antibiotic approach might be helpful. 

Bella might also benefit from sub-q fluids on a regular basis.

If she hasn't been checked for hyperthyroidism, do so ASAP, I would also suggest a new blood work profile to determine other organ function, and to assess hydration status, etc.  Sometimes even the mildest of things can be quickly treated and help them feel so much better.

 

[belong2bella]

For the previous posters I am sorry you have gone through this, and your loss.


Everything mentioned has been tried on Bella, nothing has helped, unfortunately.

I am going to go talk with a different veterinarian who has seen my Bella. My Dr says as long as she is eating she is fine, but we know that is not true. I can't continue watching her waste away and not enjoying life anymore. Plus, I can't make the decision by myself. I need someone who can help me that is not going to lead me in the wrong direction. I know she is a very compassionate Dr. It's the best I can do, and it will give me a piece of mind no matter what she says.

 

[roxanne76]

I think the last post was not meant for me. Me kitty is 18, and she doesn't have the symptoms of which you are describing.

For the previous posters I am sorry you have gone through this, and your loss.


Everything mentioned has been tried on Bella, nothing has helped, unfortunately.

I am going to go talk with a different veterinarian who has seen my Bella. My Dr says as long as she is eating she is fine, but we know that is not true. I can't continue watching her waste away and not enjoying life anymore. Plus, I can't make the decision by myself. I need someone who can help me that is not going to lead me in the wrong direction. I know she is a very compassionate Dr. It's the best I can do, and it will give me a piece of mind no matter what she says.

You are correct in getting another professional opinion on the next appropriate step. I have done that several times with my own vet! We are with them all the time and are being pulled in so many directions. While a vet is caring and compassionate, they also aren't as emotionally invested and will give you their sound, medical opinion. It will give you comfort and peace of mind. This is such an important step. You are doing the right thing and you aren't alone. Best of luck to you and feel free to reach out at any time.

 

[cat-tech]

You say you've tried everything. But, have you tried things for longer than just a few days?  One has to give medications time to work.  Why are you adverse to your vet's advise to increase medication dose?  I hope you can understand that it is necessary in some treatments to find an effective dose (just as in humans, you don't stop your medication at a certain dose, you increase it to the effective dose). - As I mentioned above, increasing prednisone if she's on it, can be helpful in reducing inflammation that could be contributing to the weight loss.  The weight loss is most likely due to malabsorption of nutrients, so a vitamin supplement (prescribed by your vet), can be helpful, B12 injections can be helpful (again on the vet's direction), fluid therapy can be helpful to address dehydration, nausea etc., all of which can increase Bella's comfort - I'm making suggestions in the event possibly not everything has been tried, that I want for her utmost comfort just as you do.  Your vet isn't trying to ignore illness, she's basing her comments on experience, examination, overall physical appearance etc and wanting just as much as you to keep her comfortable.

 

[belong2bella]

I do appreciate your input. We have NEVER tried Bella on any one treatment for just a few days. We are talking about years, and everything available to a veterinarian's disposal, advice, and discretion.

She has not been responding to any treatment for the past month. She is fur, and bones.
Their bodies stop responding to medicine for the same reasons as a human being's does. Medicine tolerance.

If there is a single human on the entire planet who wants her here, well, I am the one.

That is exactly why I am taking her back to her veterinarian who has known my family ( including Bella) since the day my brother's cat gave life to her. I am not pulling my Bella from the doctor, I am simply trying to get help with this. They are there for this reason too. It's not being selfish, or tired; it's being realistic. And getting her help. Sometimes it takes fresh eyes, ears, insight etc to know beyond a shadow of a doubt that we all are doing everything possible for the only one who cannot ' verbally speak' .

 

[belong2bella]

Well, sadly she is still losing weight. This time the vet said that she most likely has cancer. Nothing has ever showed up on any test, so I questioned that. The veterinarian said that there are many cancers that will not show up. I was thinking that she was going to continue losing weight at the same amount of time as she has been, but her veterinarian told me that she can begin to decline over days, or weeks. Apparently, the steroids stop working eventually when cancer is the culprit. I am completely shocked! The veterinarian said we have tried everything possible within reason for her. Please, advice?

 

[greypaws]

I am so very sorry you are going thru this and unable to get a definitive answer on diagnosis. I don't know that your vet will actually utter the words 'it's time to give her peace'. So you need to look deep into your own heart and then into your dear Bella's eye and make this decision. What has helped me in years past is the knowledge that our animals were not meant to out live us, their life span, even in the wild is so much shorter. Also, thinking about quality of life, instead of quantity, is this life she has right now, any kind of life? If you were in her paws, would you want to live like this? I volunteer at a nursing home, many times it isn't the terminal diagnosis but the emotional failure to thrive that has a resident fading away. At 18 years of age, Bella has had a wonderful life with you. If there is nothing else medically that the vets can do to fix whatever is wrong and turn the tide of her wasting away, then I think it is the right time to help give her peace. Take your time, think about this, take lot's of pictures of her, they will bring you comfort in the months to come and when you are ready, let her pass peacefully in your arms, without guilt for doing the right thing. Your heart will be broken but if you open yourself to the grieving process, time will be gentle and replace your heartache with sweet memories of 18 years together.

No one wants to make this decision for their beloved pet. I think of it as the last gift of love that I can give my animals. Keeping you and Bella in my prayers.

 

[belong2bella]

Thank you for your kind words. Has anyone here experienced a cancer that does not show up on any test? I do not think my veterinarian is incompetent I am looking for support, and possibly someone who has heard of this. I personally think like us humans there is always a test to provide an absolute answer.

 

[greypaws]

I hope others more knowledgeable will chime in, I'm too new to cats to give you an answer. That said, in 40 yrs of being involved in every aspect of pure bred and rescue dogs, there are times that only an autopsy can give you answers. Is there a medical school anywhere near you that might do a phone/email consult with you providing the results of all the tests you've had done?

 

[AbbysMom]

Thank you for your kind words. Has anyone here experienced a cancer that does not show up on any test? I do not think my veterinarian is incompetent I am looking for support, and possibly someone who has heard of this. I personally think like us humans there is always a test to provide an absolute answer.

Maybe. This was twelve years ago and with different symptoms than your cat, but many tests were done and all came back inconclusive. The vet thought it may be some type of cancer. It was frustrating to not know why my cat was dying. Perhaps you can try another vet for a second opinion?

I'm so sorry you are dealing with this.

Have you looked over the quality of life scale?

http://pawspice.com/clients/17611/documents/FelineQualityofLifeScale.pdf

 

[belong2bella]

Yes I have, the only thing I am unsure of is if she is in any pain. The veterinarian said yesterday there is no longer a point to bring her back to the office. It is more stressful than useful. Ultimately she did say that it is my decision either way I go she does not have any other possible tests to use. The only thing left is invasive,and Bella is not healthy for anything as such. I do agree with this. I am sorry, I believe that I am looking for an answer that no one can possibly give.

 

[js124]

what kind of test? did they do an ultrasound because it would show up as inflammation?

were blood tests ran? could be pancreitis,  liver, hyperthyroidism, tons of things that go along with ibd

 

[belong2bella]

Everything has been checked many times. Everything always normal. She does not have any inflammation in her GI tract. PLI normal, liver, WB, RB, kidney, thyroid, B12, folate, everything is within normal limits. That is why I am wondering if the veterinarian is correct about many cancers that sometimes still will not show, and that is why her meds are not working anymore?