Hard decision, pts or wait?

[poorsole]

Dcat is 17 and has osteoarthritis, heart and kidney problems, he's deteriorated a lot in the last few months. He's now terribly constipated, nothing has worked medication-wise and vet has said he's too high risk to anaesthetise/operate.

Options are pts now or wait and pts when he becomes too ill not to if that makes sense. It's complicated by the fact that he has more fight in him than any cat I've ever known and I'm scared if we go too soon he will fight the vet (he hates the vet and she has scars to prove it!) and it will be awful for both him and me, not to mention the vet.

But I don't want him to suffer, he's food obsessed and still asking to be fed but then can't eat more than a couple of mouthfuls and I'm worried his tummy will be sore and I don't want him in pain. His behaviour is much the same as usual (except he's not harassing me for food quite so often), he's still happy to be fussed and just sleeps most of the time.

My gut is saying wait, let him be content at home for as long as possible and pts only if he's distressed or goes further downhill but I'm worried about him being in pain/distress that he's not showing. I don't know what to do, trust my gut feeling (and the fact I've known him 17 years and feel like I know what he would prefer) or pts in case he's in pain I don't know about?

Sorry for the upsetting post but know people will understand here, I just want to do the right thing for him.

He sounds like he is for now in the purrfect place!
Enjoy every moment op..

Hmm, I hate the idea of our beloved pets suffering and generally think it is kinder to pts sooner rather than later. The not eating thing alarms me, especially if he is a good eater usually. Would it help if the vet did a home visit?

Personally, given your description, I'd be thinking very seriously about sooner rather than later. Cats are very good at hiding pain and the constipation may well be very uncomfortable for him, particularly when added to his other ailments.
You have my sympathy.

To be honest I think the time has come. As Grumpyoldpersonwithcats says, cats are expert at hiding pain. It sounds as though he is hungry but unable to eat, which is not a nice situation for him and will become distressing. A home visit from the vet, if possible sounds like the best option.

It's such a hard decision, but I agree that it sounds like it's time. I had my 18yo cat PTS last year, and whilst I was fairly confident his pain meds meant he was pain free, once he started struggling with toileting and virtually stopped eating, it was time. It was devastating, but it was the right decision.

💐💐💐

Thanks for the replies, in typical cat fashion he has rallied and is much better today! He's done two poo's, small ones admittedly (sorry for tmi) but any movement is good He's much brighter in himself too so it's a cautious 'wait and see' for now I think. He's comfy, has everything he needs in easy reach and I'm hardly taking my eyes off him so if anything changes I'll know straight away.

He was my first pet after I got my own place and will be the first I've had to care for through old age so I'm anxious to get it right for him but it feels like he's telling me he's content where he is for now. Video consult with the vet on Friday to see how he's doing so we'll reassess then but for now I'm just pampering him as much as he'll let me and hoping that's right.

Forgot to say he is eating again too, I'm giving small amounts every couple of hours and he's eating most of it each time now.

Is he on lactulose or klean prep to help with the constipation?

Also, ask your vet about gabapentin prior to vet visits - it helps enormously with feline anxiety aggression

I don't mean this coldly, but isn't your gut feeling just your wish to avoid grief?

Still eating isn't enough to say quality of life is still there. If he can only tolerate a few mouthfuls before stopping that indicates a lot of pain. If you think of how much pain you'd have to be in to keep seeking food but be unable to make yourself eat. Being hungry but then being in pain as soon as you try to eat anything is awful.

Being practical, what happens if he rapidly deteriorates overnight or at a weekend? Are you confident if that happened you'd be able to get him to a vet fast enough to prevent him from suffering?

That would be awful for both of you.

My personal view is that "perfect" timing of waiting until the very last moment while things are manageable but before the suffering is so intolerable he can't mask it anymore is never going to happen. Better to go before the balance tips so far his last moments and your final memories are of suffering and distress.

I know it's a tough decision. You're never going to not feel sad about losing him, so please don't delay on the basis of waiting to reach a point where you don't feel sad about it because it won't arrive.

It's a big responsibility but also a privilege to ensure the end of his life is as good as the rest of the life he has spent with you. Sometimes that means saying goodbye a little sooner than you would wish.

I read here about vets coming to one's home for PTS. If you feel that becomes the right decision, might be less stress.

Glad he's had a good rally.

He's not doing the few mouthfuls thing now, he's eating everything I'm putting for him, I'm just doing little and often to ease him back into eating. He's pretty much back to normal behaviour/quality of life wise, he sleeps lots anyway but is alert and interested when he is awake today which he wasn't yesterday. He's been having lactulose yes but he missed 3 doses over yesterday and the day before because he wasn't eating, it has to go in food as he would tear you to shreds if you tried to syringe it in and obviously I've restarted it today now he's eating. The reason pts was even being considered was because he wasn't eating or pooing, he's doing both now so for the moment there's no decision to be made and we'll see what the vet says on Friday.

I was planning on discussing that with the vet on Friday lljkk, I'm hoping it's an option, thanks for the thought.

That’s great news. If he’s eating, pooing and not withdrawing from you then you can relax a bit, I think. Hopefully now he’s getting the lactose he will get everything cleared out.
The question I always ask the vet is “what would you do if this was your cat?” They’ve seen it all and especially how awful it is to wait too long. Fingers crossed that he’ll have a while longer with you. One thing to look out for is him taking himself off for long periods, cats tend to go and hide when things are too much for them.