Time To Euthanize? 16-year-old With Congestive Heart Failure

[kalico]

Hi everyone,

I'm turning to this forum again as I had a lot of wonderful people offer input to my previous thread and I need help again for the same issue. My friends are amazing but don't have pets - they just can't quite understand.

My 16-year-old cat was diagnosed with congestive heart failure in late July. I've been giving her benazapril, diltiazem, and lasix since. Her laboured breathing initially improved but the past few weeks medication has not been helping. The vet said we could try upping her dosage of lasix but could not offer a concrete answer in terms of when or if to euthanize (I understand how hard it is for vets to do so).

The tough part is that she seems okay. She eats and drinks okay, grooms herself every now and then, uses her litter box, jumps on chairs/her tree, and comes to my bed when I call her.

But she just looks exhausted and falls into these deep sleeps. She's thin (6.8 pounds) but as I said, still eats. And her breathing is laboured, which is what worries me. When I watch her sleep there are longer pauses between breathes and I honestly hope she just passes peacefully. But she usually wakes up with a start, does this weird silent sneeze (like her mouth is open briefly and she kind of looks up) then goes back to her usual.

I don't know what to do. My parents seem to think she only has weeks left, and it's better to "end a week early than a minute too late" and wonder what I'm waiting for - for her to get worse? She isn't going to get better but I don't know if she's uncomfortable with her breathing and just wants to sleep forever, or if she's still content. I did the "cat quality of life" tests and she's right in the middle or slightly towards lower quality. I've been spending every minute with her and haven't been sleeping or keeping up with school - I just don't know what to do.

Has anyone been in this situation? What helped you make a decision?

 

[Furballsmom]

When Is It Time? - Making The Difficult Decision

My parents seem to think she only has weeks left, and it's better to "end a week early than a minute too late"

In my opinion your parents are correct. Listen to them and their thoughts. They certainly aren't suggesting doing anything that will cause you hurt, that isn't their intention ever. However, on the other hand they have a little more objective view of your cat.

 

[1 bruce 1]

Hi everyone,

I'm turning to this forum again as I had a lot of wonderful people offer input to my previous thread and I need help again for the same issue. My friends are amazing but don't have pets - they just can't quite understand.

My 16-year-old cat was diagnosed with congestive heart failure in late July. I've been giving her benazapril, diltiazem, and lasix since. Her laboured breathing initially improved but the past few weeks medication has not been helping. The vet said we could try upping her dosage of lasix but could not offer a concrete answer in terms of when or if to euthanize (I understand how hard it is for vets to do so).

The tough part is that she seems okay. She eats and drinks okay, grooms herself every now and then, uses her litter box, jumps on chairs/her tree, and comes to my bed when I call her.

But she just looks exhausted and falls into these deep sleeps. She's thin (6.8 pounds) but as I said, still eats. And her breathing is laboured, which is what worries me. When I watch her sleep there are longer pauses between breathes and I honestly hope she just passes peacefully. But she usually wakes up with a start, does this weird silent sneeze (like her mouth is open briefly and she kind of looks up) then goes back to her usual.

I don't know what to do. My parents seem to think she only has weeks left, and it's better to "end a week early than a minute too late" and wonder what I'm waiting for - for her to get worse? She isn't going to get better but I don't know if she's uncomfortable with her breathing and just wants to sleep forever, or if she's still content. I did the "cat quality of life" tests and she's right in the middle or slightly towards lower quality. I've been spending every minute with her and haven't been sleeping or keeping up with school - I just don't know what to do.

Has anyone been in this situation? What helped you make a decision?

She's a cute little thing.
I don't know her or you or anything like that, but when you asked if she's still content, my feeling is a cat that eats, drinks, self grooms, jumps on her cat tree and comes when you call her is still getting something out of life at this stage.
Most cats (especially at 16) do sleep a lot. Our asthmatic cat sleeps probably 23 hours a day, but he's eating, drinking, purring and seems content with how things are going. I think he just gets winded easily (same with heart disease) and needs more time to recharge his battery.
Ours with heart disease did pass on his own, but the last things we noticed that suggested a fast downward spiral were things like peeing and pooping wherever he was (not really incontinence, but just "I can't walk 6 steps to the box because I'm exhausted, so I'll go here.")
He also began having seizures, which lasted only for a few days before he passed. Vet said it was something going on electrically with his heart/brain or something like that, it wasn't epilepsy.
The most notable thing I remember is his level of exhaustion went from "normal for an old pet with heart problems" to being almost unable or unwilling to move. One day he was standing on all fours, and rather than sitting or lying down, he just kind of stood there as his feet slowly slid out to the sides and he just kind of "sank" into a laying down position, like the act of moving his legs was exhausting enough.
Has your vet done an ultrasound or something similarly non-invasive to get a feel for how her heart looks, any enlargement, etc.? Would you be willing to try the lasix dosage a little higher for a short time? We did up his lasix to three times a day, and when his breathing got better, we gave him a half dose mid-day (along with his other two doses) and eventually stopped giving the mid-day dose. It seemed to help and for many months after we got rid of the three times a day dosage, he was fine.

 

[FeebysOwner]

Hi, and so sorry. She looks like such a sweetie. I am for upping the dosages of the meds to see if that affects her positively. She is doing all the "normal" stuff that cats do at this point, and when they get older they tend to sleep more anyway. I have a neighbor that just went through this with their 16 yo dog. They upped the meds a number of times over the course of 6 months to a year from diagnosis, and she was on Lasix also. She had her good days and bad; but until she passed, there were a whole lot of good days tucked in there.

It's nice to have others' opinions on this, it's just helps you formulate/analyze your own feelings - but the bottom line is that once you have digested it all, you have to follow YOUR heart.

Keep talking to us, if you want.

 

[1 bruce 1]

Hi, and so sorry. She looks like such a sweetie. I am for upping the dosages of the meds to see if that affects her positively. She is doing all the "normal" stuff that cats do at this point, and when they get older they tend to sleep more anyway. I have a neighbor that just went through this with their 16 yo dog. They upped the meds a number of times over the course of 6 months to a year from diagnosis, and she was on Lasix also. She had her good days and bad; but until she passed, there were a whole lot of good days tucked in there.

It's nice to have others' opinions on this, it's just helps you formulate/analyze your own feelings - but the bottom line is that once you have digested it all, you have to follow YOUR heart.

Keep talking to us, if you want.

And learn all you can about heart disease in cats.
When you're told what's wrong with your animal and have no idea what to look for, what to watch for and what treatments are available you feel really lost and kind of helpless. The more you learn, the more you feel empowered, and kind of "prepared" for what the next treatment option might be. It keeps surprises down.
Our guy had a lot of bad days here and there, but many more good than bad.
I am a believer in the "better one week too early than one day too late", but I also am a believer that a week early might be jumping the gun. It depends on the animal, their age, what's wrong, and the owner, and so many variables come into play.

 

[Weasel21]

I’m going through the same right now. I just made the decision to let one of my boys go two nights ago when he went into a respiratory crisis. He had stopped eating and his quality of life had diminished. I wonder if it was too late and he suffered too long, but I also wonder if it was too soon and if I should’ve pushed through another ER stay. Now my second boy might be declining, despite normal behavior and eating, and I’m repeating the internal battle.

What does get to me is that my first boy was terrified at the vet when we put him down. I paid the emergency fee and had him put in oxygen and had xrays taken, because I wanted to be sure the time was right. But ultimately that just put him through more stress which worsened the edema. He was trying to crawl into my jacket and hide as soon as we pulled him from the oxygen and was panicked. Had I pulled the trigger sooner and had the vet do it in a house call, it would’ve been more peaceful. But I also would be questioning myself even more after the fact.

It’s not an easy decision, and to me anyway, it’s a double edged sword. It’s something you have to do deep soul searching for and that you have to forgive yourself for afterwards and be at peace with, because I’m not sure there’s ever a perfect time. Like mentioned above, the only thing you can really do is follow your heart.

 

[1 bruce 1]

I’m going through the same right now. I just made the decision to let one of my boys go two nights ago when he went into a respiratory crisis. He had stopped eating and his quality of life had diminished. I wonder if it was too late and he suffered too long, but I also wonder if it was too soon and if I should’ve pushed through another ER stay. Now my second boy might be declining, despite normal behavior and eating, and I’m repeating the internal battle.

What does get to me is that my first boy was terrified at the vet when we put him down. I paid the emergency fee and had him put in oxygen and had xrays taken, because I wanted to be sure the time was right. But ultimately that just put him through more stress which worsened the edema. He was trying to crawl into my jacket and hide as soon as we pulled him from the oxygen and was panicked. Had I pulled the trigger sooner and had the vet do it in a house call, it would’ve been more peaceful. But I also would be questioning myself even more after the fact.

It’s not an easy decision, and to me anyway, it’s a double edged sword. It’s something you have to do deep soul searching for and that you have to forgive yourself for afterwards and be at peace with, because I’m not sure there’s ever a perfect time. Like mentioned above, the only thing you can really do is follow your heart.

I can relate, as well as my wife. We've had animals (be it dog, cat, horse, pet livestock, or pocket pet) discovered dead, and we think "we should have acted sooner to spare the suffering."
And we've also chosen euthanasia in a hopeless case, but then thought maybe something could have been done, and second guess.
Having a big heart for all living things and all creatures is a good thing, a blessing. We enjoy them so much and have so many smiles and laughs when they do funny or cute things....but when they pass it can be more of a curse because no matter what happened, we question our decisions.
I've seen, heard, and talked to MORE people who have pets euthanized out of convenience, which makes people who actually give a damn when their elderly pet is failing look like shining stars to me.
I'll never forget picking up a few kittens from a TNR program after their neuter and seeing a careless woman, bored and emotionless, handing a leashed dog to the shelter lady, telling them that they were moving, and couldn't take the pets, and their dog didn't like his feet touched. Two little girls stood by her, each crying and holding and kissing two adult owl-eyed cats.
I wish I would have just offered the shelter their standard adoption fee for those cats, plus a tip, told the little girls that I would see to it that their cats got good homes and gave the woman a death stare.
It wasn't the surrender that bothered me, it was the complete lack of humanity. Her kids were crying, the cats were terrified, the dog looked petrified and she was acting like she was buying a bag of candy at the local gas station. This woman wasn't even showing emotion towards her own crying children having to part with their pets. That was the day I was told "you need blood pressure medication"....
So (sorry I kind of went on a rant there), when people come here and have a sick or elderly cat that is sick or not doing right, it makes me happy because you care. I'm not a wizard and can't offer a cure or a fix, but you all have my support until it hurts.

 

[kmoulus]

Your cat is just like mine! Speedy is 17 years old, 6.8 pounds, and she sleeps like a rock. She was diagnosed with CHF quite some time ago and I was terrified, but she has remained stable for a long time (on lasix, plavix, vetmedin, atenolol and baby aspirin). I think she sleeps so hard because she is pretty much deaf and the vet says that's kind of normal.

Personally, I agree that if your cat is eating, drinking, grooming, using the litter and seeking affection, she is probably pretty OK. But you know your cat best and you know if she is acting weird.

Please ask your vet about your cat's respiration and how to monitor it, and when to change the lasix. In our case, deep breathing is not the worst thing and fast, shallow breathing is what I should watch for. Speedy's respiration is a rock sold 22 breaths per minute. If that should tick up a certain amount for a certain length of time, I am to give her an extra dose of lasix to reduce fluid. I've never had to do it, and I don't recommend that you do it without the vet's OK, which it sounds like you have. Also what are you feeding her? My cardiologist has Speedy on a lower sodium diet, it might be something to ask about.

 

[jcat]

We went through the same thing with our last cat, who had HCM. As long as he was having far more good days than bad days, was eating, moving around easily, playing, cuddling, etc., we took it day to day. However, my husband and I were able to change our work schedules so that Jamie wasn't alone for more than an hour a few days a week, if that, and we had vets < 10 minutes away who agreed to be on call 24/7. My greatest fear was that he would suffer, e.g., have a saddle thrombosis, and I wouldn't have waited had we not been able to accommodate his illness like that.

The day we had him put down was the day he "called" me and gave me the "it's time" look, but you can't depend on all pets to actually do that.

 

[dkb817]

The best thing I can do for you is tell you what I went through with my chronically ill kitty in September of this year and how I knew it was time:

Ally was only 10-ish years old (we honestly don't know age as she was a stray we adopted), but for the past several years, we had struggled with severe megacolon issues. She had been steadily declining since April 2018, racking up thousands of dollars in vet bills during a time when we really didn't have that money to spare, but every time I would say "This is it", she'd perk right up somehow (My vet and I actually joked several times that she knew exactly what she was doing). By September 2018, she wasn't eating, wasn't drinking, wasn't really grooming (so her fur got super oily and matted, when normally this was a cat who erred on the side of OVERgrooming), and started going outside of the litterbox, when she did manage to go (and then frequently layed in it because she was just too exhausted to move). Her medications had practically doubled to the point where she was taking in more meds than food, just to get her through the day. Like you, I kept saying that she didn't seem like she was in pain and kept waiting for that "sign" that she was ready to go. I let my life and responsibilities fall to the wayside in an effort to deal with her issues - There was about a week straight where I was lucky to get a combined 7-8 hours of sleep altogether. Honestly (and I'm aware it sounds bad), I was miserable and emotionally exhausted. I got "lucky" in that the night before we decided to euthanize, she hopped up onto the bed with me and gave me this look that said "I'm really tired, I'm ready to go". Right up until the end, she didn't act like she was in pain, and I'm glad I made the call before she got to that point - but there's always that nagging voice of "Could I have done more?" Unfortunately, that's something that I think all pet owners who have to make this decision struggle with.


None of us can tell you when the right time to make that call is. Do I wish the best for your cat? Absolutely.

 

[kalico]

Thanks everyone.

We had actually been upping her dose of lasix for the past week and there isn't much improvement. Her nose is super dry. Her 'resting' breathing is still laboured as in her whole body moves with each breath, but not as bad as when she was first diagnosed and wasn't on lasix at all.

What I worry is that she'll have a blood clot - I've read enough (and my vet has told me enough) that I know how absolutely horrible it is for cats. It's hard to get her to take baby aspirin (I tried crushing it with water and syringing it into her mouth yesterday - she might have got a little in). When I visited my vet on Thursday he had confirmed we've been doing all that we're able, medication-wise.

Food-wise I've given her a bit of kitten milk, which she enjoyed once or twice and now has gone off it, and anything tasty - we're more concerned with getting her to eat versus a low-sodium diet. She does take interest in Feline Cuisine and Ultra Performance.

I'm on reading with this week so I'm able to observe her (if that's possible to do so more than I've been doing for the past months) and try to find an answer.

As always, thank you for all your stories and support <3

 

[kalico]

*on reading week this week.

** her nose is dry but she is drinking a ton - spending most of her time hanging over a water bowl (we have 1000 set up around the house).

 

[kalico]

I did nurse a cat with congestive heart failure through his final months and know all too well the agony of watching an animal fight for breath repeatedly. We kept going because my mother (whose cat he was) wasn't ready to let go. Hand on heart, if I had that time over again I'd have chosen early euthanaisa. For me, I think the fairest thing is to say goodbye before the fight truly begins. I can't say for certain what I'd have done in your position (none of us can till we're faced with it), but I truly hope I'd have the courage to act as you did. You gave her a peaceful end, and that is the last and greatest gift we can give to our animals.

Columbine, was your mother's cat still walking and using his litter box? I'm at a point where I need to make a decision soon about my cat with CHF - she's 16, her breathing is no longer improved with meds. But she still walks around, uses her box - but sleeps near her water bowls and when she does fall asleep, it's a horrible one with deep laboured breathing. She can still be coaxed to eat a bit.

 

[kalico]

Hi everyone,

I am on the edge of making the decision to put her to sleep this week. I've been watching her fall into her deep sleeps, hoping she passes quietly, but her breathing just becomes more and more laboured and it's awful to watch. I haven't been able to get her to eat much today. She just looks uncomfortable and tired. So hard.

 

[FeebysOwner]

I am so sorry. But, I know you'll do what you think is best for her.

 

[SiameseMummy]

You have to do what you think is best for your kitty however hard it is for us to deal with.

I watched my 3 year old cat succumb to CHF and it is so tough to watch the end stages. It can't be reversed and you can't let them suffer.

 

[Jem]

Hi Kalico,
I just found your thread, so I'm posting to keep a watch on it.
And you're very welcome, anytime. (for the other post/thread )

 

[Diana Faye]

I'm so sorry you're going through this. I think in the end, only you know what is best. Animals, and especially cats, don't always let you know when it's their time. They have such strong survival instincts, which I think makes it even harder for us to let them go.
I lost my senior kitty this summer, and have been wracking my brain for anything I could have missed. He was sleeping a bit more, maybe eating a little less but no red flags. He had just been to the vets for a yearly exam, had lost a little weight over the years but nobody thought anything was wrong. Vet gave me some fish oil to supplement his diet, and 2 days later I came home from work and he was gone. I still don't know why, and I didn't ask for a necropsy because it wasn't going to change the fact that he was gone. I know he had a slight heath murmur, and had some respiratory issues from herpes but that was under control. He went on his own terms, and part of me is glad I didn't have to watch him decline, but not knowing if he went peacefully and that he was alone still kills me. I don't know if I'd have had it in me to know when it was time or deal with the guilt of putting him down, but I wish more than anything that I was there for his last moments like he had been there for me for so many years.

 

[Furballsmom]

 

[1 bruce 1]

Hi everyone,

I am on the edge of making the decision to put her to sleep this week. I've been watching her fall into her deep sleeps, hoping she passes quietly, but her breathing just becomes more and more laboured and it's awful to watch. I haven't been able to get her to eat much today. She just looks uncomfortable and tired. So hard.

I understand. If she's not eating, looks miserable and the breathing gets more labored as she sleeps doesn't sound like a promising situation is on the horizon.
Whatever happens, .
I don't mean to get nosy or forward, but are you familiar with how the euthanasia process works, and what to expect (aka, have you been through this before?) If not, your vet will certainly give you all the information you need and what to prepare for, but sometimes talking it out a little with others that have experienced it can help.