Older Cat Traumatized from Hospital Visit

[FeebysOwner]

He might just like the extra attention he gets from you on your days not at work, so he is inclined to eat better. Maybe the food is fresher too?

 

[scteel24]

Could be - I open a new can every night now and no longer heat up the older stuff I used to put in a tupper-ware. Is the fact that he's much less vocal concerning? Sorry for all the questions. This is only my second pair of kitties and the first only lived to 9 and 11, sadly, so senior/geriatric issues are new to me.

 

[FeebysOwner]

Being less vocal would really only be a concern if he has always been very vocal all of his life before now. If his vocalization increased with his more recent issues, and now has lessened, then that would be a good thing.

 

[scteel24]

Well he was always super vocal, but stopped when he got ill. He'll meow occasionally and when I mix his food - otherwise, he's pretty quiet.

 

[FeebysOwner]

If I understand correctly, he is vocalizing a bit more now, but not like he was before he got ill? I'd say that sounds like it is on par with the slow recovery he seems to be going through overall.

 

[scteel24]

Yes - he used to meow a lot, all the time. Not much at all when he was sick. Now he only meows once in a while and when I'm getting his food ready. It's much raspier too and softer if that makes sense. Old man voice? Is he just conserving energy? I should stop worrying and take the wins when I get them : )

 

[FeebysOwner]

Right now, you want to monitor the 'big' things, especially his eating. Pay attention to whether or not you think he is feeling any pain - and nausea since you are going to stop the Cerenia. If he needs more of either, don't hesitate to ask the vet. The rest should come in time. He is older, and just like humans, it can take some time to bounce back.

 

[scteel24]

Thank you all so much - not just for the tips, but the support is such a comfort. I'll keep making updates. Here we are watching TV last night. Houdini is on the right and my other boy, Delfino on the left. We're enjoying relax time on our Pedro Pascal blanket
And one of Houdini when I left this morning.

 

[scteel24]

Hello all - update - taking him to the vet tomorrow. He still won't eat much of anything. He looks for food, asks for food, then barely eats. He's wasting away. So sad. He also hasn't pooped in a few days, not that he should have much. Hoping this is not the end, but fear it may be soon....

 

[DeesCats]

I hope the vet can help him tomorrow, keep us updated.

 

[scteel24]

Hi all – back from the vet. Not great news. His creatin is down to 2.2, which is much lower and down to Stage 2. But, as we were suspecting, the kidney disease is not the reason for him not feeling well and not eating much. Then he had pancreatitis, but now that has cleared, yet he was down a full pound in just 3 weeks. There appears to be an underlining cancer, even though no masses were seen on his x-rays. He’s also very anemic, but until this certain blood test comes back from the lab, she can’t treat it until she knows what is causing the anemia. They suggested an ultrasound but I am on the fence. Why spend another $800 and stress him out to confirm cancer when it can’t be treated? It’s not about money – I’ve spent thousands on him already, but I won’t do chemo or surgery on him at 15+ years to get a few more months. That sounds miserable for him. I’m so sad, stressed, and just let down. I was hoping to treat his CKD and get at least another year, but this whole time it’s been something other than the kidney disease. At least I now understand why such a rapid decline over just 2 months. The doctor is upping his prednisone from 0.5 ML to 1.5 ML – a big jump, but that’s all they would do for a lymphoma type cancer. Not sure if I should do this ultrasound or not. Any thoughts would be greatly appreciated.

Thank you all.

 

[FeebysOwner]

How sure is the vet that this blood test they are waiting for will result in identifying the cause of the anemia? I guess I would wait for that and see what comes of it. Anemia can be part of CKD; and whether or not it happens, pretty much varies by cat.

An ultrasound, in and of itself, will rarely actually confirm cancer/lymphoma. There are two steps that can be followed, depending on if any suspicious tissue is found - 1.) fine needle aspiration (FNA) done during an ultrasound if there is tissue to aspirate. Such as an enlarged lymph node. 2.) if the FNA is inconclusive, then a PARR Assay can be done on that same tissue, which is a deeper analysis. That is how Feeby's lymphoma was determined. But, it also all depends on what/where the suspicious tissue is found as to the ability to do the FNA/PARR Assay, and despite what I just said, there are some cancers that can be relatively identifiable based on where they are located. Adding those two tests, if appropriate, would likely double the cost of a standard ultrasound; but, they are not done if there can't be tissue taken.

I am not sure why you say that if it is cancer that it can't be treated. Chemo is often given to cats, even when a cancer is not confirmed, and most do very well on it. Due to Feeby's multiple medical conditions (including CKD), the oncologist did not want her to take Prednisolone, but thought she could handle trying the chemo. I chose not to because she was already 18+ yo by the time the lymphoma was confirmed. I might have done it had she been younger.

There are a lot of things to consider, and asking your vet to walk through all of them with you is something I would encourage you to do. Sorry, I suppose, I am not really being much help.

 

[scteel24]

Hi - thank you - it does help! Just knowing others have been in the same boat. The vet gave me so much info this morning - she did mention doing biopsies and FNA which I declined because he'd have to be under anesthesia. I'll see what the blood tests say and perhaps treating the anemia will help him feel better. It seems like he has a lot going on at once. The cancer might be treatable, but chemo at 15+ she agreed would be a lot with only a small added amount of time. I don't want his last days spent at the vet or at home but hiding under the bed to avoid the vet. I'll keep everyone posted. I was feeling hopeful, but today was a tough blow.

 

[FeebysOwner]

Yes, please keep us posted.

I do want to say that with an FNA/ultrasound, sedation is not necessarily needed. Feeby went through 3 ultrasounds, the 2nd one with an FNA, and the 3rd with FNA/PARR Assay. The only time she needed sedation was for the 1st one, and that was to shave her belly! And, that wasn't even sedation, but rather a fast acting calming agent. She was fine an hour afterward.

 

[scteel24]

Hi all – wanted to share an update. The vet feels Houdini has a type of leukemia or lymphoma in his stomach. She did not recommend putting him through ultrasounds or FNAs as defining the type of cancer would not change her treatment and she does not recommend chemo. She also could not identify exactly why he was anemic and does not recommend a blood transfusion and said the medication she could try takes a long time to have any effects. I got the impression he wouldn’t be around long enough for it to help him. This is so heartbreaking. I am now faced with the difficult task of when to euthanize him. I definitely want to do so at home but would need to schedule it since they sometimes have no openings. So the big question, is what do I do???? He barely eats, but still comes looking. He is still licking the flavor off the BBQ chips. He still lays in his favorite sun spot. He still purrs when I pet him, and he still lies with me on the couch at night. I think the bed is too much effort for him. He wobbles a bit now – he’s so weak and skinny. This feeling is so awful. I feel guilty. I appreciate all the support here. It really helps.

 

[FeebysOwner]

Thanks for giving us an update. I am not sure I understand how your vet can be so conclusive about treatments if they really don't know any more than what you have said. Maybe they are taking some of their cues from you/your reaction to things? How do they know that chemo would only result in a few extra months?

I guess the vet doesn't think doing a blood transfusion is worth it? I know they only work with certain types of anemia-causing conditions, even if leukemia would be the issue. But, without knowing the cause, is there a reason they think it won't work?

Is Houdini still on anti-nausea meds and an appetite stimulant, just to help from that standpoint?

No offense to your vet, but can't they offer a set of palliative care medications for him? These would be things that can help him feel better for the time he has, and some could extend his life a bit without being intrusive.

I did palliative care treatments for Feeby, just so she would not waste away so fast, and have some time that she could enjoy. She and Houdini don't/didn't necessarily share the same conditions, but still there was a plan laid out to help her out. It did extend her life and I thought made things better for her during that time.

Sorry, I can't help but ask.

 

[scteel24]

I appreciate the input. I guess I trust the vet. This is all based on the specific blood work they did. I don't think I'd put him through chemo at his age anyway. The vet visits really stress him out and I don't want his last days to be spent hiding under the bed. She just wants to make him comfortable as do I. She upped his pred to 1.25ML. The appetite stimulant makes him hungrier, but he does not eat any more so it's just more stressful on him - making him want to eat but then he doesn't, or can't. He won't eat any solid food. If there is a miracle cure, I am all for it, but based on his tests and what she said, I don't think there is - the labs were sent to his regular moblie vet. I will ask him for a second opinion. And he was on Cerenia but his appetite was the exact same so we took him off.

 

[FeebysOwner]

I do really understand. It is helpful/comforting to be able to trust one's vet. So, no ongoing anti-nausea meds? Or, pain meds? It is just curious about the BBQ chips and his interest in them.

Even the oncologist I saw for Feeby was willing to try chemo, even when she didn't want to use Pred. Feeby had a lot of other medical conditions, and at her age (18+ yo at that time), I decided not to do it. But, she wasn't anemic and that unto itself can play a big role.

My cat was a crazy fighter for her life, which was not necessarily a good thing. I feel she fought against the odds to stay alive, and so I fought with her. I think some cats are more resolved in knowing their end is near and can be content with that and enjoy the simplest of things. Maybe that is Houdini...

 

[scteel24]

I have pain meds for him, but he doesn’t seem to be uncomfortable. I know cats are great at hiding pain, but his sleeping positions would indicate he’s not in any pain. We tried Cerenia and Famotidine and they made no difference in the amount he ate. The appetite stimulant seems almost cruel as it just makes him want to eat, but he doesn’t actually eat more – it just makes him feel hungry. The BBQ chips are an odd thing, but if they make him happy, then so be it. I’ll check with the vet again on a blood transfusion to see if it will help or explain why it won’t. I’ve been checking home euthanasia companies. Boy, do they capitalize your grief. So expensive. Still the route I’m going, just surprised at the cost. When do you know it’s time to schedule? And what if they are booked. Do I schedule while he’s still feeling ok? This is so awful.

 

[FeebysOwner]

If anti-nausea meds don't seem to make a difference, then the only other thing that I know that might affect his appetite would be pain. I know that anemia may attribute to inappetence, but then one has to decide to try to treat the anemia as well and see if that helps any.

I can't help at all about when to time euthanasia, as I couldn't do that with my cat. There were too many things that told me that I would have been premature. But, Feeby's issues were entirely different.

It is a question that all of us face when our cats are very ill, and I don't think no matter how many people that respond to it that you are going to find the right answer for you. It is one that really cannot be made by anyone else than you. All any of us can do is offer our support in any way we can.