Think my kitty has reached the end and it is scary

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Ocean Planet

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Hi all,

It's been a tough couple days. I have a 17 year old Bengal, girl. She had a routine appointment 2 weeks ago for updated rabies and check up blood work. She was fine 3 weeks ago. Was lethargic after the appointment, but it was always normal as she gets super stressed out going to the vet. She'd usually perk up after 3 or 4 days but didn't this past week.

Got home from work on Friday and noticed she was breathing a little deeper and not eating much anymore. Kind of panicked and took her to the emergency vet. They said her lungs sound good, but an xray showed fluid building up in her chest . They offered to do a tap to get some fluid to test it, but I know how stressed she gets so I decided to just take those findings to my regular vet and let my cat rest from that visit.

I talked some things over with the regular vet the next day and it pretty much doesn't look great. She is 17 years old. She has had a heart murmer most of her life. She had started medication for hyperthyroidism last year. When she goes to the vet, she gets so stressed out that her heart rate doubles and she gets worked up to where her tongue is hanging out her mouth trying to catch her breath. The vet said she could try to pull some of the fluid with mild sedation, but it could be tricky because she DOES NOT like being held down by strangers. The vet is afraid to try to use anesthesia because she might not be strong enough to survive that given her current conditions. The vet and emergency vet said that even if they do get a sample, the 2 major things would be some kind of lymphoma or heart failure. Both the vet and emergency vet also said blood or pus are least likely to be the culprit given her age and condition.

I've been mentally trying to process things this weekend and spending a lot of time with her. She eats very little and while still follows me around sometimes, she just flops down on the floor and zones out. Her breathing has been heavier ever since I noticed Friday (it hasn't gotten worse, but it will). Yet, there are times she acts normal such as cleaning herself and using her box correctly. She used to be very vocal but hardly says a peep now. I'm guessing she is too weak to. Of course I read things on the internet that I could get the fluid drained, but most people say it comes right back anyway and the main causes could mean further treatments and stress to her. My vet and family members all seem to think I'd prolong the inevitable by trying to start a bunch of testing and treatments, to maybe get another month or couple of months?

I guess I'm posting this as sort of a release for myself. Do my thoughts and judgments make sense to others? I keep thinking, will I have done enough if this is it? Should I have done all of those tests and treatments? But the stress from that could take her too. I guess this is normal for everyone to go through, you always second guess yourself. During these tricky times, I think I've found a practice to come to my home to let her go. That's the only thing that's made me feel better.

Thanks for reading and I hope this all made sense. My mind has been a little out of it this weekend.
 

cat nap

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Hi O Ocean Planet ...you've definitely given this a lot of thought.
The only thing that I would probably try is medication like lasix or some sort of diuretic to try and get the fluid off the chest.
I'm not sure if your Vet would be okay prescribing that without blood work, though..or if you've already discussed it with them.

Perhaps having a Vet that can come home to you and draw the blood, or prescribe the meds would be another option,...but it does sound like you have an excellent relationship with your Vet, and I would first consult with them.

I'm really sorry that you have to make this difficult decision, and wish you Peace, Strength and Love in whatever you decide.

It's like the hardest decision we ever have to make, but so personal that only you can make it.
Feel free to post photos and tell us her name if it makes you feel a little easier.
You sound like the type of cat guardian that if I were a cat...I would want...since you've given so much thought to the quality of life of your cat.
 

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I am so sorry that you are facing this and you are making very logical sense. We try to be logical but these situations also defy logic as half of what we are doing is trying to make the right educated guess, as is the vet in some cases.

You should probably do what your intuition and instinct are directing. Rule out the fact that you are going to make the so called "wrong" decision because after a lifetime of love and care that is not going to happen. You are only able to make the best choice out of choices which are not that great to start with.

cat nap cat nap suggest lasix which is better than something invasive, more than likely, and something to consider. Home vet is another option and you could discuss it with your vet. It does not mean that you would turn her care over to the home vet, but just use them to facilitate the blood draw or other standard procedure to avoid the trip to the vet.

From my own experience, I do worry about extreme stress on already debilitated animals from vet procedures which might be invasive or even cause enough stress to trigger a reaction. That is just my POV and not something that should resonate with you if it does not seem right.
 

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Hi. I agree with cat nap cat nap and fionasmom fionasmom about possibly considering an in-home vet visit to draw blood, maybe with a mild sedation as the vet suggested could be possible in order to aspirate some fluid from her belly? I realize you are the only one who can determine whether or not she has quality of life remaining, but from you describe it does sound like she might.

Also, given her age and circumstances, are there human foods that she loves that you could feed her, just to help with her strength until you make some more decisions about what direction to head?
 

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Hi there
Sorry youre going through this.
My cat had heart failure and genetically has HCM, hes on a daily high dose of diuretic lasix to keep fluid off his lungs.
The vet can also give a lasix injection to work faster and quicker then send you home with the pills to maintain it.
We didnt know what was wrong when we found my cat breathing badly and not eating and the ER told us we could put him down or do an intense round of lasix and home meds.
He has been with us for a whole year after that incident!!!
 

pearl99

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I would ask the vet about lasix for sure.
I don't think you will make a wrong choice. You've loved and cared for her for 17 years and no matter the choice it will be from that love.
I've second guessed myself when making the final choice, I think we do that. But, have come to see in time that I did what was best.
I'm so sorry. I feel the same about considering more tests and procedures, does it prolong death, or truly help?
Please keep in touch. We are all here :alright::hearthrob::redheartpump::hugs:.
 
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Ocean Planet

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Thanks everyone! Appreciate everyone who has chimed in.

I had not heard about this Lasix drug before, but it sounds like it's worth a call to see if I can try that. I hope it's not too late to try as that sounds like a good, non-invasive attempt. Wonder why they didn't suggest it? She's been pretty life-less the past 4 days since I noticed things (labored breathing and always sleeping/staring into space). Sometimes she can't get comfortable sleeping and it's getting difficult to see her like this.

I'll call my vet in the morning about this. She just had bloodwork drawn on the 11th, so they should have recent record of things.

Interesting enough, I never fed my cats people food over their lives, so I couldn't tell you what she really likes. Except for maybe some tuna juice.

Her name is "Girl Cat" by the way. I know.... I'm a pretty creative guy!
 

pearl99

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Thanks everyone! Appreciate everyone who has chimed in.

I had not heard about this Lasix drug before, but it sounds like it's worth a call to see if I can try that. I hope it's not too late to try as that sounds like a good, non-invasive attempt. Wonder why they didn't suggest it?
If fluid is around her lungs (called a pleural effusion) and in her chest (on the outside of the lungs) as opposed to inside the lungs, lasix wouldn't really help I don't think- that may be why they said they could go into her chest to get a fluid sample- since they said they were seeing fluid in her chest- now that I reread your first post. If fluid was inside her actual lungs it would have shown up on the xray of her lungs (I was a nurse and I'm going by human knowledge.)
If this is the case then yes procedures could be a real stress.
Still call and talk things over!
 
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Ocean Planet

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If fluid is around her lungs (called a pleural effusion) and in her chest (on the outside of the lungs) as opposed to inside the lungs, lasix wouldn't really help I don't think- that may be why they said they could go into her chest to get a fluid sample- since they said they were seeing fluid in her chest- now that I reread your first post. If fluid was inside her actual lungs it would have shown up on the xray of her lungs (I was a nurse and I'm going by human knowledge.)
If this is the case then yes procedures could be a real stress.
Still call and talk things over!
Right, it is around her lungs and not in them. Thanks for your thoughts and, like you say, I'll still call and ask about it to see if there is any relief there for her just in case.
 

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Hi Ocean Planet.

Well, I, too, wonder why Lasix wasn't considered, because my understanding is that Lasix is NOT selective about its target - nor, it seems, does this reliable veterinary reference indicate any specific targeting:
Edema
Furosemide (Lasix) can also be used to remove fluid from body cavities or peripheral tissues.....
Lasix is available as an injectable too, and can easily be given via a tiny syringe with a quick jab into the scruff - no fuss, no muss. I used it in this way, at home, with my 'white shadow', Sam.

Given her reaction to travel (the extreme breathing with tongue hanging out), I'd be very weary of taking her in right now. If a Vet were to resist allowing me to administer an injectable in that situation, I'd be searching for a competent feline Vet. (Immediately,though, I'd have a mobile Vet come by.)

Hope that helps you, and I know you'll not delay - because, time is everything here, I think.
.
 

pearl99

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Hi Ocean Planet.

Well, I, too, wonder why Lasix wasn't considered, because my understanding is that Lasix is NOT selective about its target - nor, it seems, does this reliable veterinary reference indicate any specific targeting:
Yeah if she has congestive heart failure, lasix may help- I zoned in on it possibly being lymphoma. Lasix works by targeting the kidneys to pour out more water by peeing then the body reacts by moving fluid from where it's pooled or overloaded to balance things- but it may or may not move fluid out of a pleural effusion (outside of the lungs between actual lung and the lung lining.) Sometimes there the only way is using a needle to withdraw it, depending on the cause. And in the case of cancer (lymphoma) it would build back up again.
Here's hoping it will do some good!
 

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Agreeing with everyone above. Id ask if they can administer it via injection first to get a high dose in.
My cat had to be on IV lasix to get it all out then he takes 2.5 tablets of it a day (18.25 mg) a day.

thats more than my mom takes for her heart failure!
 
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Ocean Planet

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At some small times she seems to be herself when she is fully awake, but her breathing is getting a little quicker I noticed this morning.

My normal vet is not in today so waiting on a call back from another Dr at the same practice. Waiting is bad and I'm at work, so this has become extremely stressful. :( Not sure if try the emergency vet again tonight or what.... It sounds like a bad parent but sometimes you don't know what to do! It's like being in panic mode and trying to weigh the good and bad options of every possible choice. (Sigh)... hope they call soon....
 
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Ocean Planet

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Finally heard back from my current vet, but different Dr.

The reason 3 different doctors did not suggest Lasix is because that is only for when fluid is inside the lungs. She said it is rarely helpful when there is just fluid in the chest cavity. Doesn't work the same. So my choices are two-fold at this point:

1. I let her live out her days at home naturally and call someone in when things go more south than they are.

2. I take a chance to let them drain the fluid to help her breath better. Also, then they could at least test it to see what it is. However, there is no guarantee how long that relief will last. It could build back up in a couple days or a couple weeks. However, based on her stress level, the mild sedation may not be enough and they'd have to use anesthesia . There is a chance that due to her age and heart conditions I could lose her in surgery. But if sucessful, she would feel better for a while and hopefully get her appetite back.

I need to make the final call now. They gave me the price of the procedure and I can afford it, so that is not a barrier for this decision.

My thought process is this, and man I hope this doesn't sound bad. Given this situation there is a good chance I'll lose her in another week or two. Whether I lose her naturally or I lose her in anesthesia, I at least gave her a chance to feel better for a while if I try this? I'm unsure if to take this risk with the procedure :(

She sleeps most of the day but when she is up for a bit, she still looks good. My gut doesn't know which way to go. If she wasn't so stressed I'd have done the procedure by now.

It's not a black and white decision :(
 

pearl99

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It's tough. Have her go through the stress and maybe lose her or let things play out without some immediate relief.
Risk having her go with you not right with her or let things play out with her.
With the needle aspiration the fluid will build back up most likely again it sounds like,and she'd be back where she is now, but it could buy more time.
I think it sounds good to try for some relief, with the risk. The down side losing her with you not there.
Either way she knows how much you love her, how good of a life you've given her. It comes down to how you feel about it. I'm not sure what I would do.
Either way she will have had a great life with you and go happy. I'm so sorry. :redheartpump: :alright:
 
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Ocean Planet

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Exactly. Thanks for your comments. Not only is it hard on the owner, but I'm thinking of my other 2 cats who will notice she is not around. One who has been with her for 14-some years, so I need to keep an eye on him.

All my cats are spoiled to my ability, so yes to great lives for sure!

I'm going to sleep on it. I'm maybe leaning towards trying. When I see her breathing the way she is I want to try. I don't know :(
 

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The reason 3 different doctors did not suggest Lasix is because that is only for when fluid is inside the lungs. She said it is rarely helpful when there is just fluid in the chest cavity. Doesn't work the same.
Whatever the reason, it's clear that they're not aware that Lasix (and other diuretics) are used in the treatment of fluid accumulations in body cavities.

I've given you the one reference already - that's an accepted, credible veterinary site that's intended for the pet owner. The author is this Board-Certified Vet Specialist: Wendy Brooks DVM DABVP.

A fluid accumulation in the chest cavity is known as a pleural effusion. Here is an article written by another Veterinary Specialist on managing pleural effusions in which she speaks to the use of diuretics: dvm360.com - Managing Pleural Effusions. Now, that author has three veterinary specialty degrees (of which two are Respiratory Disease and Emerg & Critical Care), is with Tufts University, Cummings School of Vet Med, and her bio is here: vetprofiles.tufts.edu - Elizabeth A. Rozanski DVM DACVIM DACVECC.

Yes, (some of) the fluid needs to be drained, but the diuretic is part of standard/accepted treatment.

I don't want to make things more difficult for you - just giving you something you could discuss with them.

Now, another type of fluid accumulation can occur in the abdominal cavity and that's called 'ascites'. Part of the treatment for that also includes for a diuretic. Here's a reputable coverage (for pet owners) on that: petplace.com - Ascites in Cats.


There's a non-narcotic drug that's increasingly used these days to relax very anxious cats prior to veterinary appointments. It's called Gabapentin. You might want to ask your Vet if that might be useful for her, if you decide to proceed.

Hope that can help.
.
 
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Ocean Planet

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Thanks! Actually they did give me some Gabapentin for her last appointment and it did make a little difference for her. The doc I work with will be in tomorrow and I'm going to give a call again to go over the possibility of draining this.... at least give it one good chance maybe. Talk about if her bloodwork a couple weeks ago was favorable for anesthesia, if it came to that, etc.
 

amandag1

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Finally heard back from my current vet, but different Dr.

The reason 3 different doctors did not suggest Lasix is because that is only for when fluid is inside the lungs. She said it is rarely helpful when there is just fluid in the chest cavity. Doesn't work the same. So my choices are two-fold at this point:

1. I let her live out her days at home naturally and call someone in when things go more south than they are.

2. I take a chance to let them drain the fluid to help her breath better. Also, then they could at least test it to see what it is. However, there is no guarantee how long that relief will last. It could build back up in a couple days or a couple weeks. However, based on her stress level, the mild sedation may not be enough and they'd have to use anesthesia . There is a chance that due to her age and heart conditions I could lose her in surgery. But if sucessful, she would feel better for a while and hopefully get her appetite back.

I need to make the final call now. They gave me the price of the procedure and I can afford it, so that is not a barrier for this decision.

My thought process is this, and man I hope this doesn't sound bad. Given this situation there is a good chance I'll lose her in another week or two. Whether I lose her naturally or I lose her in anesthesia, I at least gave her a chance to feel better for a while if I try this? I'm unsure if to take this risk with the procedure :(

She sleeps most of the day but when she is up for a bit, she still looks good. My gut doesn't know which way to go. If she wasn't so stressed I'd have done the procedure by now.

It's not a black and white decision :(
Can you ask if its okay to give gabapentin before the procedure?
Its used as a mild sedative for stressful vet visits
My thoughts are if this is due to heart condition, getting the fluid out and then maybe maintaining her with heart meds for a little while
It is so hard :( heart goes out to you
 
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