When Is It "time?"

[Heebeeweebee]

Hi everyone - this is my first time posting, so any kindness is appreciated.

I'm struggling with my elderly cat, Charlie. He has a plurality of health issues that cause him to have good days/weeks and bad days/weeks. He had another "episode" on saturday night that caused me to bring him to the emergency vet, and I thought that he would need to be put to sleep that night. I decided to wait a few days so I could see if he got any better, and he did....again. But the experience is making me doubt my judgement. How do you determine when "it's time"? I don't want to cause him suffering, but he also (most of the time) is still purring and wants to be near me. He still looks out the window, bathes himself, and uses the litter box (for the most part).

Some background:
I rescued Charlie 2 years ago, with no medical history and unknown age. He is part Siamese. I found out recently (I discovered he had a microchip that had been previously registered in Jan. '04), that he is at LEAST 14-15 years old. He has never been healthy since I have known him.

Charlie has IBD that is difficult to control. Constant bouts of puddle poop have resulted in him receiving a prescription diet, a very high dose of steroids (yes, I understand that can cause its own issues), a daily B12 vitamin, a probiotic, and most recently an antibiotic. He takes between 6-8 pills daily now.

A few months ago he had a stroke, but for the most part recovered. However he continues to lose feeling in his back legs (no, not diabetic). I have to lift and lower him from places or he falls (can't get him to use pet stairs). He wobbles around while he walks and falls down sometimes.

Sometimes he gets very sick. I can't get him to drink or eat and he wants to hide. He drags his feet behind him. It's very stressful because I worry he won't get better unless i get fluids in him - I do try to squirt water in him mouth.

He struggles to keep on weight, even though he eats a lot. He throws up every (yes every) time he eats, but he "cleans up," so he still gets the food in him by the end of it.

My regular vet believes that he either has a neurological condition, or has developed cancer that continues to progress, on top of the IBD. The emergency vet believes that these episodes of being very sick are because he is having additional strokes (this pattern does make sense to me). I feel horrible, because I don't want to proceed with the $1200 tests to confirm strokes, and then whatever additional medication that he would need. I love him so incredibly much, but he is also very old and still very sick in other ways.

The emergency vet also heard a heart murmur (so he could now have heart disease), and he was also anemic. His walking is significantly worse still since his "episode" a few days ago, but he is back to eating and drinking.

Any advice would be appreciated. Or anyone who went through something similar and understands.

 

[AbbysMom]

First off, I'm so sorry you are going through this.

It sounds like you have been going though a lot with your guy. I'm going to link to a "quality of life" chart for you to look through. In no means is it cut and dry, but it will help you evaluate how he really is doing overall and give you a few things to think about.

https://static1.squarespace.com/sta...ec2a2/1351627676228/Quality_of_Life+chart.pdf

 

[duckpond]

I just wanted to say i am so sorry that Charlie and you are going through this. So very difficult.
Sending you guys thoughts and prayers.

 

[Heebeeweebee]

First off, I'm so sorry you are going through this.

It sounds like you have been going though a lot with your guy. I'm going to link to a "quality of life" chart for you to look through. In no means is it cut and dry, but it will help you evaluate how he really is doing overall and give you a few things to think about.

https://static1.squarespace.com/sta...ec2a2/1351627676228/Quality_of_Life+chart.pdf

Thank you so much for providing this chart! It has some good things to think about (more good days than bad days, happy and responsive even if mobility is an issue). This will be very nice to have to make objective decisions.

 

[Tobermory]

Hi, Heebeeweebee . What you’re going through is so incredibly hard because there’s almost never “just the right time.” Years ago a friend called me in tears because her kitty, Ruffles, had just died. Ruffles was fine when my friend left for a 30-minute walk and when she got home, Ruffles was curled up peacefully...gone. I was sad for my friend, but also glad that Ruffles slipped away so gently. We all wish that for our friends.

More often, though, we have to struggle the way you are. Here’s a site I found helpful when my little old man, Max, was in his last few months. The site is no longer updated but even if your kitty doesn’t have kidney disease, the site is very thorough about what to look for and how you might go about making the decisions that need to be made.

Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Saying Goodbye
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - The Final Hours

I lost Max last summer at age 20. He was diabetic, badly underweight and had kidney issues. But the week he died, he was still purring, still lying next to me with his paw on my leg, still eating some food. The day I had to take him in, he ate his regular breakfast and went to curl up in “his” chair. But by mid morning, I could see something was wrong. He had assumed a “meatloaf” position and had the long stare. He got up and went to his water bowl (with me following) but just stood over it not drinking. Then he went to his litter box and tried to climb in. He started to pee before I could lift him in. Then back to his water bowl but didn’t or couldn’t drink. By then, I had stationed The Spouse as guardian and was on the phone to the vet. We took him in that afternoon.

Should I have taken him sooner before he reached the point he did? Maybe. I don’t know. He had had some bad days the week before. The first cat I ever had purred when I took her on her last ever trip to the vet. It just about did me in. But she had lung cancer and had spent the day before in misery.

All you can do is watch your Charlie. You know him best. His body language, his responsiveness, his ability to manage daily functions. You being with him will make all the difference for him.

 

[Margret]

This is such a hard decision to make, and only you can make it. I'll tell you up-front, no matter when you make it you'll end up second-guessing yourself; we always do. "Did I wait too long? What if I had decided to try ___? Did I miss something I should have caught?" The problem is, there are very seldom good answers to any of those questions, because this is a decision that isn't black or white; it's all shades of gray.

Two of my favorite authors, Sharon Lee and Steve Miller, had this to say in their novel I Dare:

"We do the best that we are able, my child. We make the best decision we may, dependent upon our experience and our training. It is what we owe to kin and to those who reside under our care. If it were true, I would tell you that necessity makes us wise. What I will tell you is that we all do our best; that we all make errors; and that those who love us will forgive us."

When my Sweet Thing (my heart kitty) was dying of chronic kidney failure I made the mistake of expecting the vet to tell me when it was time, and he didn't, so I waited much too long. I found out later that vets almost always operate under the assumption that pet owners want to do everything possible for their pets, so they just don't say things like "It's only going to get worse from here; you should be considering euthanasia." The thing that seems to work is to say to your vet (I'm assuming that you trust that vet), "If this were your cat, would you be putting him to sleep now?" And if the answer is "Not yet," you say "Will you please tell me when that time comes?"

Regarding the treatment Charlie is getting, has the vet talked to you about subcutaneous fluids? This is virtually painless for the cat, is something that you can learn to do at home, and might be a way to get some fluid into Charlie. You may want to ask your vet about it.



Margret

 

[Etarre]

I'm so sorry that you and Charlie are going through this. He's lucky to have had you in his life to take care of him in his old age. I know how hard it is to have to make this type of decision, having asked all of these questions last year when my beloved kitty was dealing with a seemingly endless parade of health problems. Everyone kept telling us "you'll know when it's time" which we did not find to be the case at all!

In the end, Gwen had a series of small strokes and died at home. But in retrospect, I think we waited too long, and could have saved her a painful and scary night if we had been more realistic about the situation. We were desperate to think that she would improve, and took her better days as signs of an upswing that, in hindsight, was really not a realistic hope. We also thought that the fact that she was constantly seeking affection and cuddles and continued to purr while sitting with us at night was a good sign, but I've since read that cats can be clingy in this way when they're in pain, and purr to soothe themselves, not always out of happiness, which I didn't know at the time.

I wanted to share because we felt at sea the whole time, and well intentioned advice about how we'd know how to make the right decision wound up just being confusing and guilt-producing. Also, we had heard lots of people say they wished they had waited longer in the same situation, but few say that they should've acted sooner, and I think it's important to put it out there that both types of regrets happen.

Good luck to you and Charlie.

 

[Timmer]

I'm so sorry about Charlie and what you are going through. I lost my Timmer over two months ago to IBD. He couldn't poop at all anymore and the prednisone and chemotherapy was not working at all. He never responded to treatment. The deciding factor for me was obvious. You eat like a horse but you can't poop...something's gotta give. I even had him sedated and the stool manually worked out of him twice. I didn't want to put him through that anymore. He seemed fine otherwise which was a shame in and of itself. He was a great cat.

Like Margret said, there's never a good time and you will always second guess your decision. They always tell you to look at the quality of life...that's what my vet always tells me. I've had cats that I kept going too long and regretted it. Timmer was special and I felt I let him go too soon, even though the regular vet assured me no, it was time. I think the GI specialist felt I should have kept going but I couldn't.

Your cat has multiple issues, it sounds like. I can't decide for you. I mean just because they still purr and hang out with you doesn't necessarily mean life is good. They do that for positive stuff us, I believe. Timmer did, but then I would also see him close his eyes and breathe heavily and I knew he was in tremendous pain and it was pain I couldn't do anything about. Maybe think about really trying to look objectively at your cat.
I think you will know in your head when the time is right. Your heart will never feel the time is right.
Dear, I wish you the best. It is such a hard thing to decide. It really really is.

 

[FakeGourmet]

Sometimes he gets very sick. I can't get him to drink or eat and he wants to hide. He drags his feet behind him. It's very stressful because I worry he won't get better unless i get fluids in him - I do try to squirt water in him mouth.

That alone would be an indicator that his time is up. More treatment is more for your benefit than his, IMHO. Believe me, you will beat yourself up more for waiting too long than making the decision now. I know that I went too long on my almost 19 year old cat and I still regret it many years later (2001). I've had family members with these same diseases actually TELL me how badly they feel, and your pet can't do that.

 

[Timmer]

I agree with FakeGourmet, actually. When they won't eat or drink on their own. I mean sometimes a little coaxing with a syringe is fine but if I had to syringe feed my cat all the time, I would say it's time.
And having a terminally ill animal is very hard on the pet's mom and dad. You have to care for them, see them go downhill. Very very stressful. I'm so sorry.

 

[Heebeeweebee]

I agree with FakeGourmet, actually. When they won't eat or drink on their own. I mean sometimes a little coaxing with a syringe is fine but if I had to syringe feed my cat all the time, I would say it's time.
And having a terminally ill animal is very hard on the pet's mom and dad. You have to care for them, see them go downhill. Very very stressful. I'm so sorry.

I agree - since cats rarely show pain unless it's severe, I think not eating and drinking can be a sign that they are feeling awful. It's a tough call with Charlie, he normally eats and drinks well, but then he has periods where he is just very sick. I just picked up fluids from the vet that I can give him at home, "in case of emergency." Fluids always seem to perk him back up (makes sense). Honestly, having access to at-home treatment is probably more just putting my mind at ease!

 

[Heebeeweebee]

We were desperate to think that she would improve, and took her better days as signs of an upswing that, in hindsight, was really not a realistic hope. We also thought that the fact that she was constantly seeking affection and cuddles and continued to purr while sitting with us at night was a good sign, but I've since read that cats can be clingy in this way when they're in pain, and purr to soothe themselves, not always out of happiness, which I didn't know at the time.

Thank you for sharing this - my biggest concern is that I'll bring him into the vet thinking that "it's time," and he will be sitting there purring, and I'll be wracked with guilt or feel judged by the vet. I swear this cat can purr through anything. The first time he ever got REALLY sick, he still tried to cuddle in the vet's arms!

 

[Heebeeweebee]

Regarding the treatment Charlie is getting, has the vet talked to you about subcutaneous fluids? This is virtually painless for the cat, is something that you can learn to do at home, and might be a way to get some fluid into Charlie. You may want to ask your vet about it.

Margret

THANK YOU for suggesting this! I didn't even consider that - I now have the stuff to do it at home, "in case of emergency."

 

[kittens mom]

Reading this my thoughts were to stop testing and enjoy as much quality time with him as you can. Giving fluids at homeis an excellent option. If you are still questioning it's probably not time for either of you to say goodbye. I have never not known. You will know. He will leave the world loved.

 

[Margret]

THANK YOU for suggesting this! I didn't even consider that - I now have the stuff to do it at home, "in case of emergency."

You're quite welcome.

Unless you've encountered it before, this is an incredibly non-intuitive possibility; I can't see any way you could have come up with it on your own. It's a bit disappointing that your vet didn't mention it to you without prompting, however. He may be unaccustomed to cat parents who are willing to learn how to stick a needle between their pets' shoulder blades. (It just sounds so horrible when you think of it that way, doesn't it? And yet it isn't horrible at all, any more than an I.V. is for a dehydrated human.)

Margret

 

[Timmer]

My question is how will you know or determine it is an emergency? How will you know how much fluids to give? Did the vet go over that with you?
I had a kidney cat I gave fluids to. It is easy and she was an easy cat to give them to. My suggestion is put a bath towel in the dryer and get it good and hot, then put the towel on the counter and put the kitty on top. Once you get the needle in, then just sort of loosely wrap Charlie in the warm towel. That will be comforting. A lot of times the fluid is cold even though room temp. and the cat will shiver hard after a bit. Don't be afraid when this happens. The hot towel will help comfort that cat.

 

[Heebeeweebee]

My question is how will you know or determine it is an emergency? How will you know how much fluids to give? Did the vet go over that with you?
I had a kidney cat I gave fluids to. It is easy and she was an easy cat to give them to. My suggestion is put a bath towel in the dryer and get it good and hot, then put the towel on the counter and put the kitty on top. Once you get the needle in, then just sort of loosely wrap Charlie in the warm towel. That will be comforting. A lot of times the fluid is cold even though room temp. and the cat will shiver hard after a bit. Don't be afraid when this happens. The hot towel will help comfort that cat.

Maybe I shouldn't have used the term "emergency" - I plan to give Charlie fluids if I come home from work and see that he didn't drink all day and isn't quite "right"...I don't want to rush him to an emergency vet, when they would just give him fluids the same way I can. Then if needed I can get him to the regular vet in the morning.

The vet wrote out instructions on frequency and amount, and went over how to do it....I imagine Charlie wouldn't be too fussy about it, he doesn't bat an eye for shots. The warm blanket is a good idea! And thanks for the heads up about shivering - that would have worried me.

 

[kittens mom]

Maybe I shouldn't have used the term "emergency" - I plan to give Charlie fluids if I come home from work and see that he didn't drink all day and isn't quite "right"...I don't want to rush him to an emergency vet, when they would just give him fluids the same way I can. Then if needed I can get him to the regular vet in the morning.

The vet wrote out instructions on frequency and amount, and went over how to do it....I imagine Charlie wouldn't be too fussy about it, he doesn't bat an eye for shots. The warm blanket is a good idea! And thanks for the heads up about shivering - that would have worried me.

@donutte is a most excellent cat mom, cat sitter extraordinaire who offers special services for special needs cats I'm sure she could give you some pointers if you ever needed. She rocks.

 

[Tobermory]

When I had to give Max fluids, I always took the chill off the bag by putting it on a heating pad set on low for a bit and then gently shaking the bag to mix the warmer with the cooler fluid. He didn’t seem to mind the needle stick but wasn’t thrilled when the fluids started to run in. Also, he didn’t like sitting still that long even though I was using an 18-gauge needle. We finally ended up putting him in a plastic bin with a warm towel. The Spouse would talk to Max while slowly running Max’s brush down his jaw (Max’s jaw, not The Spouse’s ) while I did the needle work and monitored the fluid flow. We did this on the kitchen counter and hung the bag from a hook on the cabinet door.

 

[Heebeeweebee]

Well Charlie didn't drink today and is back to puddle poops that he cries after. I might have to try the fluid bag for the first time