It Is So Difficult To Decide How To Proceed With Our Senior

[21rouge]

We have had our 18 year old orange tabby since she was a 2 month old kitten.

He is and has been an indoor and outdoor cat for much of that time...even now.

He has had kidney disease for a number of years, arthritis the last few and now deaf.

Even with all these serious health issues I can tell you that he eats regularly, drinks and still likes to go outside. He is able to jump on our bed (when I don't pick him up in time to help). As far as I can tell he does not urinate or defecate inappropriately.

This past week we had a mobile vet come to our home for a check up and vaccinations. We really like this service as it minimizes the stress for all 3 of our cats and me .

During the visit, doing a physical exam she discovered a large "mass" in the belly area .

My partner and I have talked long and hard about the options and given his advanced age and other health issues we are strongly leaning towards not moving forward with poking and prodding and tests and surgery. But instead we will monitor him carefully to see the first sign of further deterioration of key bodily functions. I know I am saying the obvious but it is difficult weighing all the options.

 

[aradasky]

This is so hard. I have a 16 year old, long-haired black who was in/out but for years has been an indoor only. She ate too many birds.

Now she has arthritis. I got her some steps for the two beds she climbs the most, but still had little trouble getting where she wants to go.

She eats, drinks, pees, poops and occasionally still plays.

I had made the decision to provide palliative care for her. She will get tons of love, food, beds to sleep in, sun to follow around but will not get pills given to her. She is one who will hide after one or two and it stresses me and her. When it is time, she will tell me. She will be in pain or may stop eating and drinking. I hope she just falls asleep in the sun. But what time she has left will be good times for her, and lots of purrs for me. She is the Queen of the house and the three younger cats.

 

[PushPurrCatPaws]

I love access to mobile vets. It's really an invaluable service for senior cats, and for cats who really are terrified of being at a vet clinic.

I think if I were in your position, I would do the same thing that you and your partner have decided to do: monitor him carefully. You might consider, if you can afford it, having the mobile vet come out in 3-4 weeks again, just to check to see if the belly "mass" has increased in size or changed in any way. If it is cancer, many cancers can grow quickly.

Having had him for 18 years, you probably know him VERY well, so you will be able to notice any odd behaviors that might signify he is in pain.

This TCS article is helpful:
35 Signs That Your Cat May Be In Pain

And I also really like this off-site article on recognizing pain in cats:
How Can I Tell If My Cat Is In Pain?

It's likely that if you want him to be as comfortable as possible, you'll want to talk over pain management options with your vet, if you notice indications that he is not doing as well as usual.

 

[danteshuman]

I would add asking for pain meds ahead of time and if he seems uncomfortable, to try the pain meds and see if he does better. I fall on the side of letting them go before making them suffer. My mom falls on the extend their life as long as possible. A year later after we had to put Sarah down, she admits she should have done it sooner. (She lost a lot of weight, wasn't eating much, and cried loudly when she went #2 because the poor dear was so constipated. She ended up having an impacted colon which could be cleaned out under anesthesia but was likely to happen again due to her partial paralysis. She was 19.)
It is a hard question to answer, especially when you love them so very much.

 

[mewcatmew]

You could ask about a fine needle aspirate, it is very minimally invasive, and the biopsy results will probably give you answers as to what the mass is. It could be something benign or treatable. Just something to consider!

 

[MizLizzie]

I agree with the suggestion to do a fine needle biopsy. Ultrasound is uninvasive other than the belly-shave, not horrifically expensive, and in some areas can be done at home by a mobile tech. If it is cancer, yes, I would keep pain meds on hand, and discuss with your vet beginning prednisolone in chew treats from BCP Pharmacy in Houston. They are highly palatable. It is my understanding that pred will delay development of some cancers, but once begun, makes the cat ineligible for certain types of chemo. Your vet can better explain this, and determine whether your senior is a candidate, but it is often a no-turning-back choice, as I understand it. We used it once, and it bought our senior gal a happy six months, IIRC. I think you are approaching this with the attitude that is best for your cat. At eighteen, she should not have to endure any fear or discomfort. Good luck to you all.

 

[arouetta]

It is a difficult decision, and I think it's even harder to stick with the decision you made when the cat acts fine. I've also got a senior kitty where I've faced that decision and I reaffirm it every day (admittedly except the day I posted a video of her here). I also decided that poking and prodding was not necessary because the answers wouldn't change my decision. So why put her through it? Even a needle biopsy, think about the last ultrasound you had (oww!) and the last time a doctor stuck a needle in you (oww!) and ask how is a senior kitty who can't understand the reason behind it going to feel?

The questions to ask are this -
#1 What is the vet's assessment of the odds? What are all the possible diagnoses and what are the chances of each one happening? Of those that can be treated, what are the odds of an 18 year old deaf cat with kidney problems surviving the treatment with a great quality of life after treatment ends?
#2 What level of discomfort or pain are you willing to put your cat through to rule out/confirm each of the possible diagnoses?
#3 What is the difference in life expectancy and in quality of life between not treating and best possible outcome of treatment? Is the difference so great that it's worth the discomfort/pain of diagnostic tests and what would be experienced during treatment?
#4 (Maybe the most important) Once you have all the information needed to actually have informed consent, what of your options are you best able to live with? Not just now, but during the rest of the cat's life and after the cat is gone.

No matter what decision you make, there will be people who disagree with it. I often on this forum compare the human experience, and it applies here too. Think of someone with a "no lifesaving measures" living will trying to be talked into treatment by a person who believes in "do everything possible and then some" or vice versa. There will be disagreements. Sometimes good, it makes you re-evaluate your answer to #4, sometimes bad because it can cause guilt where none should be.