To operate or not? Old cat dilemma.

[Tortoiseonthehalfshell]

I've lived with Elder Statesman since I was a teenager freshly out of home and he was a tiny kitten with bright blue eyes and enormous ears. Sixteen years later, he's survived cancer, snake bite, no end of various fight-related wounds. He is completely blind from cataracts and at least partially deaf. As near as I can tell, he still has a decent, albeit circumscribed, quality of life; he doesn't demonstrate pain on movement (do cats even get arthritis?) or irritability, his teeth are still fine for his age, his weight is stable and his peeing habits have only changed to the extent that his blindness limits his roaming area. He no longer roams, preferring to stay in the house or on the deck where he navigates by memory and feel, and he spends his days sleeping on the couch. He's forbearing with the todder, and he still purrs when I pat him.

However. He has a growth just next to one ear, which is very likely to be cancerous but might be a benign growth. He's had cancer before, as I said, but that was cut out and hasn't recurred for five years, and was in a completely different area of the body. It isn't bulbous, it's largely hidden by fur unless you see it at the right angle, but when you do see it it's exposed and bloody and gross. I originally thought it was an abscess from a badly healed injury, which he's had several times before. But no, we've tried antibiotics, it's definitely a growth.

So it needs an operation. But here's the thing. If it's cancer, I have no intention at all of agreeing to an ongoing course of treatment. He's sixteen years old. He's blind. If it's not cancer, then it will presumably just stay where it is and not do any actual harm. If he survives the operation, which he only probably will, he'll in all likelihood heal slowly and the wound site will be prone to infection. He heals slowly due to his age, and gets infections easily. There are already patches on his skin with no fur. It doesn't bother him at all - he doesn't seem aware that it's there, doesn't scratch at it, it's certainly not painful. So...is there any point in actually operating on him?

I'm trying to find the most neutral course of action. I don't want to make a choice that will artificially extend his life, thus not agreeing to any ongoing course of treatment, because he's ancient and blind and you know, it's probably his time. But I don't want to make a choice that artificially compresses his life either. Leaving this growth where it is might hasten the spread of the cancer, if it's cancer. It might act as a site for infection because it's open to the air. But operating on him might weaken him, and might provide a wound site that attracts infection, too. And might be useless if the cancer has spread.

I'd be being dishonest if I didn't admit that the money involved, the better part of a thousand dollars with pathology included, wasn't a concern. But Elder Statesman is my longtime companion, and if a simple operation will restore him to (elderly doddering blind) health, that's fine by me. Except, except. All of the above.

[Hassled]

If it is cancer and you operate you are probably only going to extend his life by a few years - and I realise how precious those years will be to you, but they will also be a few years of other cat old age ailments. Yes, cats do get arthritis and they get increasingly stiff, and they get senile which means they can stop cleaning themselves and get fairly bewildered by what's going on around them (I saw both with my old boy - he was eventually PTS at 17).

Whatever you decide, you'll probably always be wondering if you did the right thing - it's a miserable choice to have to make. I think if it were my cat I wouldn't operate - I'd make sure what time he has is as comfortable and non-distressing as possible. I'm sorry you're going through this.

[Tortoiseonthehalfshell]

Yes, this is the thing - I don't want to extend his life past what he'll reasonably enjoy. But I also don't want to fail to see to a medical condition which I would absolute have operated upon if he was younger.

My husband says "it's a lot of money just to buy another year" and I don't want to think about it that way, but his other argument, that the cat isn't currently in any discomfort, holds more weight.

Thank you so much for reading such a long OP.

[girlywhirly]

There is also the risk of the general anaesthetic, which is greater in an older cat.

I took that risk with my older cat, because he needed teeth removed that would have given him much worse health problems if left. Admittedly not very costly, but there was always the chance that he would just expire on the table. Fortunately, he was fine.

I think you should have a frank discussion with the vet, and ask for a prognosis if you don't opt for the surgery, and what you could do to treat the sore. I would ask, if in their opinion, the cat was in pain because cats hide chronic pain very well. If you don't have the surgery, it could cost a lot in medication to keep your cat well for the rest of his life, more than the cost of the operation. I think I would personally risk the operation, having made an informed decision, even if I had to pay for it in installments.

I suspect that there will be a noticeable deterioration in your cats condition eventually, whatever you do at which point I think you will be advised to put him to sleep.

I don't know if this will help you, but I hope it does.

[Tortoiseonthehalfshell]

Thank you, girlywhirly, I'm going to see if I can talk to the vet by phone today. And yes, I'm absolutely accepting that this is the beginning of the end no matter what, really. I mean. 16. Blind. Deafish. I wouldn't discount senile, although it's a bit hard to tell what with the blind-and-deaf thing. He's done very well to live this long, considering how hard he's lived.