Senior cat, how to decide when to let them go?

[tassie]

Hello

I have a 16 year old, who last week showed symptoms of flu. I started treatment quick as another cat had it the previous week and many in the area had it.

After 2 days of sneezing she stopped eating and drinking, which isn't that unusual for her when she is off colour.

After 3 days we went to the vet. 24 hours on a drip, Blood work including thyroid and kidneys 100% normal. Nothing on x-ray to indicate tumours. No improvement, more a decline. The vet doesn't think the cause is the flu, more that was the tipping point but can't find anything wrong.

She is actively refusing to eat and drink. I have tried everything she loves. She is home for the weekend, breathing hard through her mouth. Had a cortisone injection 4 hrs ago which I expected but to wake her up a bit but she is still sleeping.

Do we push force feeding her? Do we let it run its course? Do we make the call that this is just old age ( she hasn't had an easy life before us). Any advice appreciated.

 

[FeebysOwner]

Hi. Sorry to hear about your plight. You won't get an unbiased opinion from me. I am not ready to let go of Feeby, who is 15+yo, so in the same circumstances I would certainly consider tube feeding as well as a second opinion from another vet practice. Tube feeding, according to many on this site who have done it, is not that difficult and can buy time in search of an answer. The costs for a second vet can be reduced by getting copies of all her records to share - that also reduces the number of redundant tests that would be performed. There has to be some other testing that can be done, as long as you are financially able to handle that. If a second vet is stumped, perhaps asking one or both of them to consult with a nearby vet university.

When they did x-rays, was one of them of her head/nasal cavities (polyps, tumors,etc.) since you said she is breathing through her mouth. Sorry, just had to ask.

 

[Mamanyt1953]

This is so hard...the decision of how much is enough is the toughest we have to make. If she were my cat, I would talk very honestly with my vet, and ask how long tube-feeding should be continued...do we give her a week to respond? Ten days? At what point are we simply prolonging the inevitable and making her miserable in the meantime. I would certainly want to try tube feeding, but not beyond a reasonable time, which your vet should be able to tell you. The question, "What would you do if she was your cat?" can be invaluable.

 

[daftcat75]

Hello

I have a 16 year old, who last week showed symptoms of flu. I started treatment quick as another cat had it the previous week and many in the area had it.

After 2 days of sneezing she stopped eating and drinking, which isn't that unusual for her when she is off colour.

After 3 days we went to the vet. 24 hours on a drip, Blood work including thyroid and kidneys 100% normal. Nothing on x-ray to indicate tumours. No improvement, more a decline. The vet doesn't think the cause is the flu, more that was the tipping point but can't find anything wrong.

She is actively refusing to eat and drink. I have tried everything she loves. She is home for the weekend, breathing hard through her mouth. Had a cortisone injection 4 hrs ago which I expected but to wake her up a bit but she is still sleeping.

Do we push force feeding her? Do we let it run its course? Do we make the call that this is just old age ( she hasn't had an easy life before us). Any advice appreciated.

Aside from not eating, how is she? Sometimes not eating leads to more not eating and some kind of intervention is required. You can try an appetite stimulant to start with. Entyce works pretty quickly but it only lasts a meal's worth in my experience. Mirtazapine works much better but can make cats a little crazy (more vocal and more attention-seeking.) But you also can't let her hold out for too long because the conversion of body fat to energy is hard on the liver. It produces by-products that can make her feel nauseated and not so much like eating. That's what I mean by not eating leading to more not eating.

A feeding tube is not as extreme as it sounds. Most cats don't mind it much or at all. My Krista really only had an issue with it if I fed too cold or too fast. I got instant feedback on both and learned pretty quickly. The feeding tube saved her life. When it was removed, the site healed up in a few days. It took much longer for her hair to grow back. That was over a year ago. So yes, I recommend a feeding tube to buy you the time to figure out what may really be going on. Or you could try an appetite stimulant first.

 

[jefferd18]

I disagree with your vet, it could very well be the flu that has thrown her off. If a cat can't smell it's food (common with flus and colds), it will not eat. Not eating begets more not eating and then you have a real problem on your hands. Did your vet give you fluids to inject under her skin?

 

[CatGuyAZ]

My philosophy has always been to let them go when all reasonable hope for the cat living a good, comfortable life in the future is gone. It's frightening when your cat won't eat, but since there is no known underlying diagnosis (yet?), I would keep investigating to find out why it is happening. That's just me, though!

I had my Onyx (now gone, sadly) on Mirataz (mirtazapine), which is an ointment that gets rubbed into the cat's outer ear (pinna) once a day. It did boost his appetite, and the thing someone said above about it possibly making them more vocal was definitely true! He would yowl loudly after each meal, which he had never done before. It didn't bother me, though... it was just kind of amusing.

When Onyx was refusing to eat after his condition got worse, I got some RC recovery food (liquid) from the vet and fed him with a syringe. I would squirt some in his cheek and he'd swallow... but if you do, be careful not to give too much or shoot it in the throat where they can possibly inhale it. You can't reasonably feed enough this way to sustain a cat long-term, but it can bridge the gap until more is known about the condition causing all this. RC recovery food is easy to digest and did not make my cat throw up, even though he was probably nauseous. Over the longer run, the vet said Onyx would need a feeding tube to get enough calories, fluids, and protein in. Syringe feeding is just a stopgap that can help for a short time.

 

[Jemima Lucca]

Just let the flu run it’s course. If it doesn’t change then maybe she’s trying to tell you something. Is she normal in everything she does? Litter box, play, routine? Is she interacting with you? Or is she disinterested? I’m a caregiver in a memory care unit. When residents are ready to “move on” they stop eating and eventually drinking. They withdraw from everything and everybody. Hospice says forcing them to eat is actually painful for them. So look at everything and see what she’s telling you...

 

[cataholic07]

My first cat got really sick, and the vet just thought it was pancreatitis, but an ultrasound and biopsy said she had gi lymphoma that could go either way. we elected to put a feeding tube in, and she stayed at the vet for 5 days. Within 4 days she was eating on her own. We started chemo and we had 7 more months with her, until her cancer returned and was in her lungs. Essentially almost both her lungs were just cancer. It came suddenly, she got rechecks monthly and never lost weight until the last month. We let her go when she struggled to breathe, you couldn't pick her up without her wheezing and even surgery wouldnt have saved her. You could just see that she was suffering, so we knew it was the kindest thing to do. This pic was one of the last pics we took of her, you can just see it in her eyes. I would suggest a specialist and an ultrasound as well. Hope your baby gets better.

 

[tassie]

Thank you for so many thoughtful responses. It was a long night.

She is enjoying being held but can't breathe well now. She is adamant not to eat or drink, she won't accept even water in a syringe, spits it out or comes out her nose.

She came to us at ten years old with the hope she could live out her last few months in peace, that was 6 years ago.

Jemima - both my husband and I feel like she is telling us it's her time. The vet said had muscle mass is not existant which isn't a surprise as she stopped going out a year ago and sleeps all day. She is an 85 year old grandma ready to say goodbye but it's so hard to say it back to her

 

[MissClouseau]

The vet doesn't think the cause is the flu, more that was the tipping point but can't find anything wrong.

Then there is no diagnosis. The treatment they try might be the wrong one, as this vet doesn't have a diagnosis.

I'm not there seeing the situation of course but based on your description, I would take the cat to a different clinic, one that has more equipment if possible like giving oxygene. And get a second opinion. This is generally my advice every time there is a decision like this, to get a second opinion from a different vet first.

 

[tassie]

update: So we took her back this morning after no success with food or water - we felt we were just going to be in the same place with a hydration issue plus day 6 of no food. By the way tube feeding wasn't an option whilst the nose is so blocked but the drugs aren't clearing it.

On Thursday when she was under anaesthetic, the vet found an unusual wound on the roof of her mouth, like two pin pricks. He took photos to look into it further but didn't want to do a biopsy due to the pain it would cause her. Nothing unusual showed on the head scan. Today under anaesthetic the 2 pin pricks were 7mm across holes into her nasal cavity and a large part of her palette was gone. In 36 hrs severe and rapid necrosis had happened

We made the decision to say goodbye to her, too much suffering to attempt anything and she was so weak. I am very grateful for the thoughts on here it helped to form a decision.

 

[CatGuyAZ]

We made the decision to say goodbye to her, too much suffering to attempt anything and she was so weak. I am very grateful for the thoughts on here it helped to form a decision.

I am sorry for your loss. I would have done the same thing, knowing what you now do. It's a very hard decision to make; I had to make it just about 3 weeks ago myself with the cat I mentioned above, Onyx. Miss him like crazy, but I know I did the best for him, and so did you with your sweet girl. Letting them go when the hope for the future is gone is the final act of love that we give them, to let them go with dignity rather than to suffer to delay our pain. You let go at just the right moment, in my opinion.

Best wishes in your time of grief. You're not alone!

 

[Mamanyt1953]

I am so, so sorry. Too often, the right decision is the hardest one, and we break our own hearts to help our little ones. We are with you.

 

[betsygee]

So very sorry to read this news. We'll lock the thread now out of respect for your loss, and we invite you to post a tribute to your sweet girl in our Crossing the Bridge forum. RIP, little one.