I think his condition certainly would be helped if he was lighter on his feet. Even two pounds loss over a few months could give him some relief. Regarding confinement, if I put one of mine in a bathroom for surgery recovery or in a separate bedroom because they are acting out with another cat, there is lots of complaining, crying, and paws under the door. How I solved that was to obtain a 48" cage, one that two of me could get inside and sit. I deck it out with a fluffy towel, a hammock that I created with a large towel and PVC pipes, water and food bowls, litter box, and a favorite toy or two. It's so nice that other cats try to get inside of it. I sit this cage out so the cat can watch the goings-on in the house. The cat won't feel segregated. And when the recovery is over, I fold it up and put it in the back of a closet. It has been a lifesaver. Just a suggestion. Hugs to you. I know this isn't easy.I am now considering weight loss. My boy is 16 lbs -- if I could get him down..