hypothyroid and renal failure - help with judging the final steps

[OneMoreForExtra]

I'd really like to hear experience and advice from people who have lost a cat to hyperthyroidism and renal failure. ExtraCat is 20, and has both. I'm trying to judge what the PTS point is.

Not to drip feed, she is thin and hungry, but the vet say she's on the max dose of thyroid meds. She got arthritis and stopped using a litter tray, so has puppy mats on the floor. She does enormous lakes of wee and needs to drink loads so I have a big basin down for her. Lately I've noticed evidence of occasional incontinence in the form of slight widdle stains on my duvet cover. She has muscle spasms in one leg fairly often. She's on anti-inflammatories which will speed up her kidney decline, but help her arthritis day-day. She's jumpy and doesn't settle on my lap anymore, although she comes for a purry head-rub as much as ever. She only really relaxes when she's asleep, but still does the pretzel curl and looks blissed out then.

I know we're in the final stages, but don't have the distance to judge when the good day / bad day balance goes wrong. The hypothyroid keeps her active and hungry so I don't think I'll see the withdrawing clue. I don't want to leave it till she crashes and has to spend her final hour being terrified in the vets. But despite all the above problems she's still bright, friendly and interactive, in a highly strung and scrawny way.

Has anyone who's gone before got any advice?

[OneMoreForExtra]

Hopeful bump. And the title should of course be hyperthyroidism, not hypo, but I'm sure you worked that out!

[isamonster]

I think you need to think about her quality of life. Cats are clean creatures - not using the litter tray and being incontinent tells you a lot. Talk to your vet perhaps? But remember 20 is a grand old age for a cat. You've obviously looked after her well. The end game is hard but it is for you to continue to do your best by her. I appreciate it is tough. This may not be the moment but as you say, sooner is better than leaving it so late she's really suffering.

[GRW]

I can sympathise because I have a 19 year old who also has hyperthroidism and renal failure. She drinks and wees a lot too and has the jumpy look about her that you describe, but she does sleep for most of the time. Her blood tests show her thyroid levels are ok on the medication. She is still eating well and not incontinent, uses a litter tray. My vet started her on a medication called fortekor which reduces the protein in her urine, and she has been much better since then, and her blood test for kidney function improved too. I think if my cat was becoming incontinent I would think seriously about putting her to sleep, as I don't think she would be happy to be like that. It must be a very hard decision and I hope I will know when the time is right for my cat. 20 is an amazing age, she must be very much loved to have lasted so long.

[OneMoreForExtra]

Thanks both of you. It is, as you say Isa, all about her quality of life - but I'm finding that surprisingly hard to judge. She doesn't seem aware of her leakage issues, although she comes and tells me fast and loudly if there's an accident on the floor.

I guess I'm hoping to know whether this just carries on until it's intolerable, or whether there's a change to look out for in hypo/renal cats that takes us from muddling asking with enough good times to too many bad times.

[OneMoreForExtra]

GRW I hope your cat continues to do well on her meds and you have lots more purrs and cuddles amidst the wees and jumpiness.

[Wolfiefan]

My old girl was 19. She was on tramadol for arthritis. Thyroid meds. Wouldn't ever use a litter tray. Shouted out multiple times a night to be let out.
When we saw the vet. (She wasn't herself. Wasn't eating. Suddenly really poorly and losing weight and no clear reason) he mentioned dignity. I always thought of pts as avoiding suffering. He said is wolfiecat enjoying what makes her wolfiecat. The answer was not. So hard but right choice. Miss her still.

[PenguindreamsofDraco]

When I took my 20yo to the vet recently he suggested a diary of good and bad days. You'd have to decide what counts as good or bad for your cat - although by mist cat standards not being able to groom or being incontinent would count as bad I guess. When the bad outnumber the good, the decision is made for you.

[idlevice]

How long have you been in this phase for? & what is the opinion of your vet? I'd have to say it sounds like it would be a reasonable time to consider doing the deed, having it done at home when she is sleeping if that felt acceptable.

Our girl cat was much younger when she had cancer & renal failure, & we really tried to do everything, paying thousands for a veterinary hospital in hindsight kept her going longer than was best. Only now about 5yrs later I can think about her without it being too upsetting (not being upset about the end, just not missing her in an overwhelmingly sad way).

I think if I was in a similar position & I'd known I'd had a good life but it was just going to deteriorate I'd rather go peacefully than risk going further downhill.

[MrsJayy]

Once jaycat started having accidents in the house and stopped eating she was only licking jelly frommeat then it was time to go she was 19. Your cat is distressed atthe messing on the pads she has lost her quality of life lovey

[shggg245]

Was exactly in your position 3 months ago. My 20 year old was just fading same chf and hyperthyroidism, she then went blind overnight due to high blood pressure causing retinal detachment.

I was and still am heartbroken but the time had come, she wasn't going to get better and I didn't want to put her through a few more miserable months. It is OK to say goodbye and let her go with dignity.

[shggg245]

Ckd not chf

[MrsJayy]

It is heartbreaking but i think when you are questioning is it time then it is time

[NotYoda]

Hi

This was an almost identical story to mine. I had our lovely moggie PTS a month ago, at the age of 20. I had some good advice on here. It was so very hard to judge. And also, as you say, because even when we decided, she was still eating

For us there were two main issues:

She'd stopped coming to see us, and moreover when we stroked her, she did not purr. I think this was added to by the fact I was doing subcutaneous drips and she'd started to hate it. Except on the morning of the last day when she sat on my lap for half and hour, and ironically I thought "this is how I want to remember you"

We were going on holiday and the thought of her being in crisis or dying when we were away was terrible.


I still think we could have gone on a bit longer, but several people said "better a month early than a week late" The terrible irony is that if you let it go on too long and then she's definitely in pain, or has a fit or something, you'd feel more guilty. My head tells me that is right, but I was unprepared for how hard it was to take the responsibility.

I have made my peace with it now

Here's a poem my vet sent to me:

If it should be.....

If it should be that I grow weak
And pain should keep me from my sleep;
Then you must do what must be done,
For this last battle can't be won

You will be sad, I understand;
But don't let grief then stay your hand.
For this day more than all the rest,
Your love for me must stand the test.

We've had so many happy years;
What is to come can hold no fears.
You don't want me to suffer so
The time has come, please let me go.

Take me to where my needs they'll tend,
But please stay with me until the end
To hold me close and speak to me
Until my eyes no longer see.

I know in time you will agree,
It was kindness done for me.
Although my tail its last has waved.
From pain and suffering I'm saved.

Please do not grove that it was you
Who had this painful thing to do.
We've been so close, we two, these years;
Don't let your heart hold any tears

[NotYoda]

.. sorry for mammoth post!

[NotYoda]

grieve, not grove!

[GRW]

What a beautiful poem Yoda. It really is the last act of love for a pet to PTS in situations like this.

[OneMoreForExtra]

I'm all choked up, NotYoda .

Thank you all for relaying your experiences. One of the issues, I'm realising from Idle 's comment, is that we had to have OneMoreCat pts 4 months ago at 21. I thought I was prepared as she was old and going downhill, but it absolutely knocked us all flat. Apart from how much we missed her, it seemed somehow ... outrageous, that her little life was in our power to that extent and we could do it and be told it was the right thing (she had cancer).

So now I'm really anxious to get it right for ExtraCat. I've tried the good / bad day diary, but there's so much ambiguity. She hasn't had an extreme trigger like not purring, not eating or going blind ( shggg )

I think in the end, Wolfie has nailed it - I've been looking out for a suffering trigger, but I just don't think she's enjoying what makes her ExtraCat. I'll let that thought sink in for a few days, but it's a much more helpful way to think about this situation.

Thank you all. And I'm sorry you lost your pussycats, although its obvious they were deeply cared for

[OneMoreForExtra]

MrsJayy we have the licking jelly from meat too. I need to start writing these down to read back when I'm doubting myself.

[MrsJayy]

Oh that poem is beautiful onemore I really honestly think it is time for extracat i had a romantic notion that jaycat would just slip away in her sleep but it wasn't to be.

[NotYoda]

Yes, you've articulated it exactly. For all I like to think I'm OK with euthanasia, it really is a terrible responsibility

[OneMoreForExtra]

MrsJayy I've hoped for that with both my girls. The vet said that cats are incredible for not slipping away, no matter how ill they are. They get thinner and thinner until there's a crisis or the owners can't bear it, but slip away they don't. I still want that though! (And although that is mostly for her sake, it would get me out of having to decide!)

[PenguindreamsofDraco]

It is a responsibility but it is also a privilege. How many people say they'd prefer that option? I saw my grandmother slip away with dementia - by the end she had lost everything that made her her; and my goodness if she had had a crystal ball, being the person she was she'd had been off Beachy Head in an instant. It is a precious gift that we can give our beloved pets to let them go whilst they still have enough of what made them them.

This is not about you - it's about a payback, as it were, for the years of joy and love ExtraCat has given you.