End-of-Life Pet Choices

[zoom-zoom]

Ugh, we don't know what to do. Our sweet almost 19 year old cat, Lola, is becoming increasingly incontinent. We just treated her for a suspected UTI (vet couldn't get a urine sample to verify that there was infection, but she's had off-and-on piddle issues for the past year. Sometimes blood-tinged and likely cystitis. She's been using the dirty laundry or any towel on the bathroom floor for #1 for over a year. We suspect this is mostly due to the trek to the basement being too much for her. For a while we had a litter box upstairs, but the only place we had to put it was off the kitchen--then our 3 lazy boys would use it, too, and track litter EVERYWHERE, including on kitchen counters. We dealt with that for about a month before we were just too grossed-out to keep the box up here. We figured pee in dirty laundry isn't really a big deal, since it's already dirty, anyhow.

Lola managed 9 of the 10 days she was prescribed the antibiotics. It was giving her horrible diarrhea all over the house and she suddenly started refusing her thyroid meds (she's hyper) in her formerly beloved Pill Pockets. She is supposed to have blood work done to check her thyroid levels in the next week, but after not taking her meds for several days I'm guessing the vet's going to want to wait, again. We have been getting her meds into her for the past few days by wrapping the pill in a glob of melted cheese (she really is my cat, heh).

Aside from being arthritic she doesn't seem to be in real pain...but all she does is sleep. And now she has a constant wet bottom from her bladder issues. She's happy and affectionate...but we wonder if we should be extending her life at this point. The vet did comment that there is a drug that can help cats with incontinence issues, but that it may be contraindicated with her thyroid issues, since it can apparently have a stimulant effect (I think this is what she said).

In 3.5 weeks we have an out-of-state friend's wedding to attend. We will be gone for 4 nights. We're afraid to leave Lola alone for so long. We could board her at our vet's, but that would be stressful for her, too.

WWYD? The last cat we decided to put down was 11 and had suffered a seizure just days before we decided to have him euthanized. He actually died at home just hours before his appointment. I've never had to take an elderly cat to be put down...I'm not even really sure when the time is right. It would be easier if she appeared to be in pain. I wonder if we're considering this out of our own convenience.

[jessmarimba]

It's a really tough decision. I had similar issues with my old blind kitty - and same situation. I had an out-of-town wedding and wasn't sure what to do. My sister actually stayed at my house and watched her while I was gone (with full permission to take her in if it came down to it) and they were fine for the weekend.

I was lucky that Pixar pretty much told me when she was done. One morning I woke up and couldn't find her. She hadn't eaten, wouldn't drink anything, and was hiding (something that attention-crazy cat never did. She was known to bite my nose if I was sleeping and she wanted someone to pet her). So I spent a few hours trying to get her interested in food and when she wouldn't even raise her head I ended up taking her in to the vet.

Three and a half weeks can be a long time for something to change in one direction or another. It's hard to wait until the last second if you're trying to plan around a wedding (especially if you have to fly!) Boarding her could be stressful but the vet's is the best place for her to be, and you never know what might happen in the meantime.

[zoom-zoom]

Three and a half weeks can be a long time for something to change in one direction or another. It's hard to wait until the last second if you're trying to plan around a wedding (especially if you have to fly!) Boarding her could be stressful but the vet's is the best place for her to be, and you never know what might happen in the meantime.

That's kind of what I'm thinking. I think I'll probably talk to the vet about the incontinence med, some more. I worry that if we don't get that under control that she'll end up with sores on her rear from it always being wet and urine can be caustic. Poor old girl. It would be so much easier if she were in real pain.

[GLC1968]

I had almost the exact same situation a few years ago with my older dog. She was dying of lymphoma, had already had a few seizures and was clearly not her old self at all. We had her on various steroids and each one seemed to make her feel so much better that I kept feeling like she was improving. Then, as she got used to the meds, she's start to degrade again.

Her last seizure happened when I was there about to leave for work. I freaked out, rushed her to the vet and they told me that it was the beginning of the end but that she was in no pain and was not uncomfortable. They also told me that she was completely unaware of having had a seizure which was good since I totally freaked out on her as it was happening.

I knew we were leaving the following weekend for a 4 day camping trip. I arranged for her to be boarded at the vet, but even then, they aren't with them 24-7. I just couldn't accept the possibility that she could die alone in an unfamiliar cage. We had her put down a couple of days before we were schedules to leave (one day after that last seizure).

To this day, I question my decision. Even as I type this, I can't help but think that I should have cancelled the trip to stay home with her. But at the time, we just knew she was on her way and I kept trying to think of if as letting her go. Had I not been pumping her full of steroids, she probably would already have been gone. Before we started the first round, she could not even stand to go outside - we had to carry her. This was no minor problem and yet, I still question our decision and my motives.

[spokewench]

It is probably what you can deal with now. I had a 20 year old cat and he was urinary incontinent for a long time before he went to the rainbow bridge. He had a wet bottom a lot and I washed him in the bathtub regularly so that he would not get too sore from the urine. I would just was his behind area and his legs where the urine would concentrate. He did not fight it as I think it soothed him.

I washed I don't know how many towels every day as wherever he slept would get wet; I also bought those doggie piddle pads and put those under the towels so that the furniture or wherever he layed did not get ruined. I did give him a cat box in the house on the same floor as he was but I did not have trouble with multiple cats. He still tried to use the catbox until he was ready to go.

He finally got really weak in the last week, lost his hearing, and did not eat much. He finally stopped eating and one morning he did not get up out of his bed in front of the fireplace at all so he finally said that he was ready to go. He was very sweet and did not want to give up - he was a very happy kitty.

When we left to go somewhere, I had a very good friend who loves kitties who would take care of him as if he were her own. So, if you can keep your kitty at home and get someone to come in and stay with him/her while you are gone or at least spend a lot of time with him/her, that would probably be best. The boarding is really hard on them when they are old.

[bmccasland]

When BonnieKat was still around, I'd board her and Herald at the vet - she was hyperthyroid (meds 2x daily) and Herald was insulin dependant diabetic. They both had their favorite vet techs twisted around their little paws. When I lived in Louisiana, the vet had a boarding facility ("spa") so the kitties shared a "condo", were not in a steal cage.

Zoom-zoom, I was where you were, wondering "when is it time." Got to where I fought with Bonnie to eat, force fed her on occasion. She got scary skinny. I talked to her vet, fretted here, but when getting her to eat got to be a real challenge; she'd cry for food, but the bowl was right by her; we decided it was time. I'd watch Bonnie sleep, just to see if she was still breathing, sometimes wishing that she'd just pass away so I wouldn't have to make the decision.

I hate to say it, but you might be there for your beloved Lola. Something to consider, that her vet asked me: Does she have more bad days than good days?

There's no point continuing the battle when the bad days far out number the good days, especially when every day is a struggle, and because of age, you know they aren't going to get better.

I feel for you. Can only offer zen hugs. I know this is a painful decision.

[goldfinch]

Animals are not like us in that they have no concept of the future. They live fully in the present. My inclination is that when an animal is approaching the end we do not need to "time" things just right. They are not thinking about tomorrow and are not trying to squeeze the last bit out of life as we humans often want to do. Cats often are very place bonded. I question whether it makes sense to board the cat down that she so old and has so many issues. I think you can let her go without guilt.

I understand the difficulty, we struggled with this with two of our dogs. Our current dog is 16 and deaf and crabby. Someday I may very well have to make the decision for her too.

[zoom-zoom]

He finally got really weak in the last week, lost his hearing, and did not eat much. He finally stopped eating and one morning he did not get up out of his bed in front of the fireplace at all so he finally said that he was ready to go. He was very sweet and did not want to give up - he was a very happy kitty.

See...that makes me think it's maybe not yet her time to go. She's still eating well and is alert and is still reasonably strong and able to get around (when we had to give her antibiotics last week she would see us put the "kitty burrito" towel on the floor and take off as fast as she could to get away) and onto our bed and up on our computer desks by using our chairs or cat tower to make her way up. Or even onto the kitchen counters if we leave the dishwasher door down. She's certainly still far from physically disabled, at this stage. We're pretty sure she's stone deaf, but she's equivalent to a 90+ year old, so deafness is to be expected.

We have given her a couple of lower-body baths in the past week and she really doesn't struggle. I think she also likes the warm water. Even as a young cat she was fascinated by the shower, so she tolerates it a lot better than most cats, I expect.

Our vet has yet to suggest that it's nearing her time. She had blood work done 4 months ago to check her thyroid and they also checked her kidney levels and those all looked good...no signs of kidney failure, which is the most common reason for cats to succumb to old age.

[zoom-zoom]

I'd watch Bonnie sleep, just to see if she was still breathing, sometimes wishing that she'd just pass away so I wouldn't have to make the decision.

I hate to say it, but you might be there for your beloved Lola. Something to consider, that her vet asked me: Does she have more bad days than good days?

There's no point continuing the battle when the bad days far out number the good days, especially when every day is a struggle, and because of age, you know they aren't going to get better.

We always wish that all our kitties would simply go in their sleep. Heck, I have that wish for myself, personally.

Hmmm...bad days vs. good. In the past week she had more bad days, but that was mostly the side-effects of the antibiotics. Since she stopped those the only "bad" is the incontinence issue, which actually doesn't seem to bother her all that much (and since we have wood floors it's not really a major issue for us, either...we just have to watch for wet spots and wipe them up). She mostly sleeps, but that's the story of all of our cats' lives much beyond age 5. Lazy beasts, they are.

Ugh, being a furbaby mom is hard.

[westtexas]

Zoom, I understand what you are going through - from my own dealings with beloved, elderly pets, to those clients of mine I counsel and help everyday.

Here is what I have my clients do that are starting to think of end of life issues:

Make a list of the 5 things that you think bring your pet comfort or quality of life. It can be as simple as being interested in food or a favorite place to sleep or coming to the door when you get home (a little more tricksy in kitties since they are so secretive about their favorite things sometimes).

Then decide how many things on this Quality of Life list must be gone before you euthanize. And one thing on the list can carry more weight than others. That way, when you get to the point that those 2 or 3 things are off the Top 5 list - the decision is made for you and there isn't any wavering because you have already made this decision at a time when emotion wasn't a factor.

I had my mom do this when our elderly corgi got sick and we knew "that day" would come. She still thanks me for it to this day - she was torn on whether to treat Penny's condition (acute on chronic renal failure) or whether to let her go and she looked at this list and decision was made, because she knew ahead of time that she had already made the rational choice when she could think clearly and was not a blubbering mess talking to me on the phone.

I hope that helps. If you need anything else, let me know.

[zoom-zoom]

That is really brilliant. I was hoping you'd have some words of wisdom. Thank you!

[tzvia]

Oh, Zoom-zoom...

I had to say goodbye to my wonderful 14 year old Lab Kelev just last Thursday. Spinal degeneration; he was becoming a paraplegic right before our eyes. The last few months were brutal; it tore my heart out. At first I could not comprehend for a moment that I would have to make a decision, I wanted him to curl up in his favorite spot on the rug in front of the front door one night and just not wake up. Instead, he could not get up and cried and I spent a terrible last Wednesday night getting up every hour or so to lift him up and clean up the mess. He was shaking and panting and I ended up just being with him and crying myself. By morning, I realized I had to say goodbye. His quality of life was gone.

Your situation seems harder; your kitty does not seem to be upset, scared, in pain, unable to eat. Maybe sick from antibiotics (heck they make me sick too), and I understand the pee issue all too well as my Kelev had started to crap whenever he fell or could not get up. Maybe you could leave an old towel on the floor for her to use near where the laundry is, and put the laundry in a closed container to keep it out of reach. I'm thinking that, as you mentioned, a litter box there would invite the other cats to use and track the litter all over, but a towel would only be inviting to her (I hope). As for being out for the wedding, if you feel it is not her time, boarding would be the best choice and the Vet would be the best place.

At some point the piddle issues may have you revisit the end-of-life choice, and it's a tough decision to make. westtexas is right, the emotions get in the way and it is best to have some yardstick to measure their quality of life. For me, Kelev had to be able to lie down and get up, and walk. He was happy, in no pain, ate like a pig and smiled last Wednesday afternoon. But when he could only cry and lift his chest on wobbly front legs Wednesday night, it was time.

[Possegal]

I did something similar to what westtexas is saying. I had a list of things that made my Chelsea-cat who she was - she purred constantly, she meticulously groomed herself (she was all white and darn it she kept that fur white!), she cuddled with me the entire night in bed. A few other things. When those things started to fade, I knew she was nearing the end of her 6+ yr battle with renal failure. One night when she was laying in bed with me, not purring, and then piddled herself in the bed, I knew it was her time. We spent the next whole day laying around on a blanket in the yard, and then went to the vet. It was terribly hard, and I'm crying as I write this even though it's been 6 yrs, but I know it was her time and as my vet told me, I let her go on her terms.

Hugs - I know what a tough time it is.

[macski]

We faced that awful last trip to the Vet about 2 months ago and to be honest, I think we waited 4 days too long.

Our beautiful blue Burmese girl, Sapphire, was 18 when she was diagnosed with a gastrointestinal lymphoma. She had chemotherapy and went into remission for a few months and then started to go downhill quite rapidly. She lost a lot of weight quite quickly and then she had an episode of bowel leakage with blood in it. She was in hospital for about a week on a drip and recovered from the bowel infection which caused the leakage but would barely eat and started losing weight again. We took her to the Vet and he gave her a steroid injection which he said would either give her a bounce or not and if it didn't we had to face the fact that it was time. This was a Tuesday and he suggested an appointment for the Saturday. We force fed her a bit for the last few days. She wanted to eat but couldn't manage it. She would lap at water but none was getting in. But she still purred and wanted to be hugged at night and managed to make her way to the table when we had dinner as was her habit. I knew that Saturday would be her final trip but in the middle of the night early on the Saturday morning she tried to get up to go to the litter tray but couldn't stand.

For the last few weeks of her life we had towels everywhere she liked to sleep because she was still having a bit of bowel leakage.

Once she couldn't stand at all we knew it was time - in fact I regretted leaving it for the four days because it was very distressing for her and us to see her like that.

Our Vet could not have been better. I held her in my arms and my partner sat beside me and stroked her head. The Vet gave her a mild sedative to relax her and then the 'green dream' injection. He said to us that her last moment would be spent knowing that she was being held and loved. That gave us some comfort.

zoom-zoom, I know only too well what a tough decision it is and only you can know when it is time. In our case I think we put our little cat through more suffering than was necessary because we weren't brave enough to make the decision earlier.

[zoom-zoom]

Aww...I feel so bad for your furbaby mamas who have had pets with cancer or nervous system issues. I will never forget how fast our Gus declined after his stroke. At first we didn't even know he had a stroke. The vet had just started him on a very low dose of anti-anxiety meds, since he was having issues with a couple of strays who liked to wander through our yard (our cats are all indoors and don't deal well with the strays who spray around their home).

At first we thought Gus was having a very strong reaction to the very low-dose valium, so we didn't give him a dose after that first one. He never recovered. Upon examination the vet thought he felt a potential tumor or two in Gus's abdomen. He suspected that Gus may have had a brain tumor, as well (Gus had had a few very odd sort of mini seizures/strokes a few times in his younger years, so we suspect there was something a bit dysfunctional in his brain for a long time). It broke our hearts to see our big, strong boy go from the boss of the house to a shell of himself; mostly unable to walk, no bladder or bowel control and unable to eat.

On his last night before his scheduled euthanization we gave him run of the house. He had this sort of last-ditch burst of energy that night. When I woke in the morning I had this sort of 6th sense that our boy was gone. We found his still warm and soft body just inches from his food dish. Just bringing his body to the vet broke me up so bad. It was 6 years ago, but it still makes me sad when I think about it. In a matter of just 3-4 days he went from the prime of his life to an invalid kitty.

At least for Lola we have seen her lead a very long and happy life. We know she doesn't have long, but we'll talk to our vet to get her opinion on how treatable Lola's bladder leakage is. She's probably not a good candidate for the sort of standard medication, because of her overactive thyroid, but it appears that estrogen can also help female cats with bladder issues, so that might be something we can try.