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The litter tray

When to say no to futher tests?

28 replies

negrilbaby · 21/10/2014 14:45

My elderly cat (18 years) has been very under the weather for the last few days. She has hyperthyroidism and has been taking fairly strong medication for the last few years. The last time her medication was increased the vet warned that it could potentially be damaging to her kidneys - but the meds made such an improvement to her quality of life so we went ahead.
Her kidneys now seem to be failing. She is drinking and peeing loads, has lost her appetite and is very lethargic.
I took her to the vet this morning and he started talking about blood tests and further investigations. She is not good with blood tests and needs sedation before they can be taken (even by the most senior vet at the practise). To me it seems obvious that her kidneys are failing.
He gave her 4 different injections this morning - anti-biotics, a steroid, vit-B and something to support her kidney function. He wants to see her back in 2 weeks (as long as she makes an improvement by the weekend).
I'm not sure it's fair to put an elderly cat through this. Is it time to say goodbye. At present she has no quality of life - she is miserable.
Any advice?

OP posts:

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chockbic · 21/10/2014 14:49

I would be guided by the vet over the next couple of weeks and see how she goes.

Feel for you, it is a horrible time.

Bambinho · 21/10/2014 14:55

In my experience I have found vets are reluctant to say they can do no more. My old cat was on his last legs with kidney disease and the vet gave him steroid and vitamin injections the very last time I took him there, he died the next day at home and it was awful.

I had been on tenterhooks for weeks expecting him to to slip away as he looked so weak and slept so much. I kept clinging on to the occasional time he would get up for something to eat and a come over for a cuddle. I wish the vets had been a bit more straightforward with me and had the guts to advise putting him to sleep earlier.

Honsandrevels · 21/10/2014 15:08

Very similar experience to Banbinho re vets. I had two elderly cats with mammary tumours (sisters) and I refused the suggested blood tests as they weren't going to survive any treatment. They were pts following strokes within months of each other in the end but with hindsight maybe should have taken them earlier. They were both happy though and I treasure the last few months I had with them.

catsrus · 21/10/2014 15:16

IMO it's our responsibility to make that decision - and make it sooner rather than later. I once, 20 yrs ago, let an animal be treated for days at the vets - he died anyway but without anyone there with him. I vowed then never to let that happen again. For me it's better a bit too soon than the animal suffers - your cat is old, you know her, you know she is not going to get better, she may have a temporary improvement but nothing is going to fix her. It's different with a young animal where they might find the right combination of meds to give them a good quality of life - I think at this age you are looking to give her a good quality of death.

Sorry if this is blunt, but like Bambhino I do wish vets were more honest sometimes. You have loved her for 18 yrs and you only want the best for her, at this point that might be to let her go gently. I had to have my 18 yr old pts this year so I do know what a hole they leave, but I also know that I knew when the light went out in her eyes in the way no vet could - I could see she was ready to go BECAUSE I knew and loved her. good luck, it's the really hard part of having them.

negrilbaby · 21/10/2014 19:14

Thanks for the replies.
I agree with the consensus but it is just so hard in the vet because I feel like I'm saying 'just give up on her'.
I think I will refuse the blood test. I can't see that it will tell us anything we don't already know. I will discuss the medication she was given today - she does seem a little brighter, so I'll play it by ear and discuss further with the vet in my next visit.
I will ask for a different vet (some of the others seem to be more realistic about sensible/ethical treatment for elderly animals.
Will spend the next week making her feel special and preparing the kids!

OP posts:

Lonecatwithkitten · 21/10/2014 19:36

If you were my client I would be telling you that you are the phase where there is no wrong decision, only the decision that is right for you, your cat and your family.
Everyone is different and there is nothing wrong with saying no more tests thank you.
You know your cat best, but I do suggest when owners are uncertain that they keep a diary of good and bad days to give them a clearer picture of their pet's quality of life.
It is an old saying, but really so true. In making the final decision it is better a day too early than a day to late.
I do often see in my more junior staff the feeling that by suggesting making the final goodbye that they have failed and I remind them that our first duty is to up hold our patients welfare at all times.

Lonecatwithkitten · 21/10/2014 19:36

If you were my client I would be telling you that you are the phase where there is no wrong decision, only the decision that is right for you, your cat and your family.
Everyone is different and there is nothing wrong with saying no more tests thank you.
You know your cat best, but I do suggest when owners are uncertain that they keep a diary of good and bad days to give them a clearer picture of their pet's quality of life.
It is an old saying, but really so true. In making the final decision it is better a day too early than a day to late.
I do often see in my more junior staff the feeling that by suggesting making the final goodbye that they have failed and I remind them that our first duty is to up hold our patients welfare at all times.

negrilbaby · 21/10/2014 20:11

Thanks for that Lonecat

OP posts:

timtam23 · 21/10/2014 22:29

Sorry to hear about your cat

having gone through similar fairly recently with my two 18 year old cats I was so grateful that the vets were all very realistic about how far to go with treating/investigating a very elderly infirm animal (one very senior vet & 2 more junior)
We did go for symptomatic treatment/keep them comfortable but as far as further tests were concerned, if it wasn't going to change the outcome there seemed little point in putting the cats through the trauma of a vet trip/sedation/blood tests etc

with the first cat (who had arthritis and probably kidney failure too) I left it just a bit too late before having her put to sleep - only by 24-48 hours or so but the last night with her was awful as she stopped eating/drinking and completely withdrew from us, I still feel upset about it even now. With the 2nd cat (overactive thyroid, high blood pressure, then developed toungue cancer) we gave him a really good last weekend & made the decision at an earlier stage before he had gone into the final decline and it was a much less upsetting situation for us although obviously still very sad.

SuperFlyHigh · 22/10/2014 17:14

If its kidney disease (which both my cats had) they can survive for a bit on medication/with tablets. However if other things go wrong then it's not fair to keep going ime.

I think you know. My girl cat collapsed earlier this year, horrid locum vet tried all sorts on her, tried to keep her alive (at great expense) but she really wasn't happy. then my own vet did more tests and kept her in overnight but really it wasn't for the best and then they suggested PTS. I think you know though. She was so unhappy I could tell.

negrilbaby · 22/10/2014 22:47

She is a little brighter today - actually went outside for a bit - and has started meowing again. Yesterday she would just open her mouth but no sound came out.
I've bought her some cat milk as a treat since she seems so off her food.
She appears to be having difficulty eating and won't even attempt the food unless it is mashed up fully. I will be heading back to the vet at the weekend.

OP posts:

cozietoesie · 22/10/2014 23:02

Steroids - at any rate the first time - can make a huge (albeit temporary) difference to them. It almost seems miraculous.

SuperFlyHigh · 23/10/2014 09:54

OP - don't discount teeth as well. My girl cat at about 15 or so suddenly stopped eating, I panicked and took her to vet turned out most of her teeth had to be removed (bad owner!) and she was getting blood poisoning after an infection. when the teeth were removed she was fine for another 2 years and I fed her Sheba pate.

glad your cat is a bit brighter today.

Wolfiefan · 23/10/2014 09:59

Similar situation here. Our toothless rescue cat is 18 and in thyroid meds. We nearly lost her in the summer when she just stopped eating, really wasn't herself and lost lots of weight.
The vets put her in a drip and we did the vitamin injections (and something else that I can't remember!) She rallied. I think she may have picked up a bug in kennels whilst we were away.
Your situation sounds a bit different though as it sounds like your cat is on more thyroid meds than mine. At this age I'm afraid it is only a matter of time.
We have decided not to do anything invasive or that would cause her suffering. It's just not fair. Sucks though.

cozietoesie · 23/10/2014 10:31

I lost Darling Twoago to kidney failure when he was only 13 - and with hindsight, I wish that I had taken a decision earlier. (It was taken out of my hands eventually.)

Gradual declines don't strike so sharply as a sudden change in appearance or behaviour. Even with Seniorboy, I notice his muscle loss more clearly when I have other family members round and I see him afresh through their eyes. He's still a happy lad right now but at his age, I'm not going to do anything heroic if he fails badly. (The vet is completely in agreement - we're going for palliative care only.)

All the best at the weekend.

SuperFlyHigh · 23/10/2014 11:11

cozie poor you that was the same time we lost Snowy (13).

girliefriend · 23/10/2014 12:20

I think at 18yo I wouldn't be putting them through tests, kidney failure isn't a nice way to go so would go on my instinct based on quality of life.

However I dread the day I have to make this decision for my cats

negrilbaby · 25/10/2014 11:34

Last visit to the vet this morning. The vet agreed that it was time

OP posts:

Fluffycloudland77 · 25/10/2014 11:46

I am sorry.

Lonecatwithkitten · 25/10/2014 11:53

You have made the right decision for you, this is always the best one.

cozietoesie · 25/10/2014 12:00

I'm so sorry. Light him a candle to see his way and get yourself a good bottle of whisky to salute him with tonight.

cozietoesie · 25/10/2014 12:05

Goodness - she's a girl isn't she? I've only had boys (apart from once or twice) so I just think in terms of 'He'.

I go out to the back garden with a bottle of good whisky and salute them on the start of their long journey.

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girliefriend · 25/10/2014 12:12

negrilbaby · 25/10/2014 18:15

Many thanks for the kind thoughts.
We were all with her when the vet gave her the injection.
She has been buried in the garden along with notes/drawings written to her by DCs.
She will be missed.

OP posts:

cozietoesie · 25/10/2014 18:39

It's very hard isn't it? I think I cried for a month when Twoago died.

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