Advice needed for poorly cat.

[Nedjem]

Warning: Long OP!

My cat, TC, is about 19/20 yrs old (he’s a rescue so unsure of exact age). He has something going on with his mouth. I noticed he was eating less, drooling and constantly opening and stretching his mouth. He was also looking thinner.

I took him to the vets 3 weeks ago and the vet tried to examine him but TC was fighting too much for the vet to get a proper look. He’s a good natured cat but gets very aggressive when he’s scared.

Vet said most likely, given his age, it was gingivitis or possibly a tumour under the tongue which is not uncommon in older cats. The only way to be sure would be to examine him under anaesthetic which she is reluctant to do due to his age. She prescribed antibiotics and a painkiller which did help at first.

A few days after the medication finished the symptoms came back but this time much worse. TC was hardly eating anything and started clawing at his mouth. He ended up cutting the side of his mouth and tongue.
I took him back to the vet and she tried to examine him again but apart from being able to get a brief glimpse of the wounds to his tongue and side of his mouth, still couldn’t see inside properly. He has lost 0.3kg in the past few weeks.

The vet remains reluctant to give TC a general anaesthetic and I agree with this. She has prescribed more antibiotics and painkillers which I give with a syringe. The painkillers are to continue indefinitely.

The painkillers have stopped TC from clawing at his mouth but he’s still not completely comfortable and struggling to eat and drink. I’ve given water with a syringe but TC struggles a lot and finds it painful/distressing. We have tried all types of soft cat foods but he refuses everything. He ate a small amount of Turkey and also cream yesterday so I’ll be getting plenty of supplies in.

Without a proper diagnosis I, and the vet, don’t know if this is a temporary problem that will improve or if he will continue to decline.

I’m so worried about his lack of fluid intake. I can keep giving him water with a syringe but this is very distressing for him.

Has anyone had experience of a similar situation with an elderly cat and got any advice on what else I can do to help TC?

Yes I had the same with me elderly cat. She was the same and vets couldn't get a proper look so she was given antibiotics and pain relief. I was back and forwards for months and she got thinner and thinner.
It's horrible to see.
I really think though when they're so stressed going to the vets at that age, being examined, not eating or drinking and having to be forced liquids it's no longer in their interests.
I switched foods, spent a fortune on different kinds of foods but had to admit defeat eventually, even though I never got a diagnosis I think her teeth had something to do with it but maybe she was slowly shutting down.
I'm sorry you're going through this, unless your vet can sedate your cat I feel you should let him lead you now at this age as sometimes there are things going on that we don't see.

Your poor old cat may very well have a bad tooth. He is definitely in pain and is distressed. Find a more capable vet, or at least insist that this vet gives the cat a sedative so that he can be examined and treated.

I had exactly the same with my old boy (he had been feral, and was approximately 19), and my vet did blood tests to see if he was fit enough to have a general anesthetic, then she extracted one tooth and cleaned the others. He came through it all perfectly alright and was eating again within a few hours.

Sounds like teeth doesn't it. I saw different vets with mine and none of them would even sedate.
One of my other cats had a few teeth removed at 19, the vets had no bother though looking in her mouth.
Op ask your vet if they'll try sedation, its awful seeing them suffer I know.

Thank you for your response Unforgettablefire. I’m so sorry you’ve experienced something similar with your cat.

I completely agree that it wouldn’t be in TC’s interests to prolong things if this isn’t a temporary problem. I’m hoping the latest antibiotics will help which would suggest gum problems rather than tumour. I’ll keep a close eye on him and phone the vet if things don’t improve.

Im so sorry to hear this Nedjem, I think all you can do is watch and wait and see how he goes over the next few days… you know him better than the vets.

My lovely 20 year old rescue was pts 2 weeks ago for a tumour in his mouth and with very similar symptoms. He had been off colour for a while but nothing you could put your finger on, was still eating and very cuddly, although he was occasionally pawing at his mouth but this wasn’t all the time and I put it down to old age.

However, he took a very sudden downward turn one morning, I fed him and he started to drool, clawing constantly at his mouth and I actually thought his jaw had dislocated. I rushed him to the vets where they diagnosed the cancer and said that the tumour had displaced his teeth. He’d clearly had it for a quite a while and was also told that it was very common in old cats.

I made the decision to pts there and then having discussed all options with the vet. He was so clearly distressed and in pain and hated the vets that I felt I couldn’t put him through more visits, medication just for a few extra months. So heartbreaking but I know it was the right thing for him and I was with him at the end.

Our vets advice, with a similar dilemma (anaesthesia risky due to age) was that if our cat continued to lose significant amounts of weight and eating didn’t pick up, then it was time to consider PTS. It’s so hard, but in the end you need to be pragmatic and do the right thing for them overall.

I’m pretty impressed by the stories of PPs of cats coming through dentals unscathed at advanced ages because our experience (of a previous old boy) was unfortunately that he had to be put down on the table as he didn’t recover. So I’m very reluctant now to put any aging cat through the stress of an operation that won’t prolong their good life for years. 19-20 is a great life span.

Sending you and hope that the antibiotics do the trick.

I agree with this.
Your vet sounds hopeless, and as though she has given up on your cat due to his age. He shouldn’t be left with a painful mouth when it could be something easy to treat. My elderly cat also came through a GA with ease.
Take him to another vet and get him sedated and properly examined. I am shocked that your vet has let this drag on for so long.

Sorry about your cat when was it? When mine had her teeth done they took bloods and maybe did other tests I can't remember but I know they did something to make sure the anaesthetic would be safe, and they used a certain one that was safer as she even had cardiomyopathy.
I was absolutely terrified.

Mine had an abscess under a tooth (we think).... this flared up two or three times in the last 9 months of his long life and due to a heart murmur and high blood pressure, they wouldn't consider anaesthetising and removing the tooth. Painkillers and long courses of antibiotics kept it away bay.
We just had to watch him really carefully and take him to the vet at the first sign of any discomfort or swelling.... in the end that wasn't what finished him off, but had it happened again, I might have admitted defeat and known it would have been the kind thing to put him to sleep.

Maybe I'm being naive here, but rather than going to euthanasia, would it make sense to anethetise/sedate so that the vet
can take a good look and come up with a plan, in the knowledge that kitty might not make it through.

Say goodbyes before (cat won't know) and if it is treatable and can survive the anasthetic then that's a wonderful outcome, but if not, the cat will pass when under anyway and won't suffer.

I think if you feel his quality of life is poor and the current treatment isn’t truly working then it may be time to think about being PTS. Alternatively can he be put under on a light sedative just enough so she can get a look? I have heard of this being done to rescue dogs who need to have a matted coat clipped.

If you are at the PTS stage then I would consider getting your vet to anaesthetise him so she can have a good look. There are three possible outcomes

1. He dies under the anaesthetic
2. She discovers something that can be treated/sorted.
3. She discovers something which cannot be sorted and is terminal, and he can be PTS at that time.

If he dies under anaesthetic, he is no worse off as you would have PTS sooner than later.

This makes perfect sense, especially in an old cat who would only suffer anyway. This kind of thing is what causes decline in an elderly animal so isn't it a matter of either look to treat or lose the cat anyway?

This is what we did and sadly it was outcome 3 but I couldn't have let her suffer.

Thank you for all your responses.

I have full confidence in the vet’s decision to not anaesthetise TC.

He can be a lovely boy but when angry or stressed becomes very aggressive and is freakishly strong! It’s thought he was a stray for a number of years and the rescue were having trouble finding a home for him because of his biting. We adopted him a few years ago.
It would be a struggle to take bloods from him or anaesthetise him and the vet thinks the stress would possibly finish him off.

I wondered if anyone had any ideas for food that might tempt him. He’s had a bit of turkey and cream again today. Not interested in tuna fish.

Oh, this was Old Boy and it was 7 years ago - he had all the tests beforehand but just one of those things. We were so upset, we hadn’t expected it and he was always so robust. Looking back, I’d still make the decision to give him the dental but I’d be more emotionally prepared, I suppose.

Then just recently Old Girl has been PTS - she was losing weight, probable stomach cancer (and also dodgy teeth) and the choices were op under GA to investigate and treat, with the proviso that if what they discovered was incurable/too widespread she’d be let go on the table, or steroids for appetite and hopefully to shrink the tumour, plus painkillers and watch and wait. We chose the latter. I couldn’t put her or us through the operation; it wouldn’t have been right for her. She was so lovely but sometimes they’re just at the end of their lives and you know it. She didn’t tolerate the steroids and so… 😥

Try warming food a little so it smells more appetising. Gormet cat foods do little tins of pate type cat food I used to give my cat when we were waiting to get her tooth sorted during the pandemic. I added a touch of extra water because otherwise it can be sticky and that seemed to aggravate discomfort. You can also get cat soups which might be attractive to him.

Sorry, I realise that sounds contradictory - that I’d choose the dental again for Boy but didn’t put Girl through the op. It’s just that they’re such individuals, aren’t they - I think both choices were right for both cats, in the end.

We had best success for Old Girl with those mousse-type very fancy pots like this And lots and lots of Lick-e-lix (although I did tell her it wasn’t ‘proper’ food!)

Yes to likelix! And you can mix this into food as well. And mine liked those tender heart things with the runny sauce in the middle. It's normally a case of trying all different ones, even dreamies because although they're treats it's best they have something rather than nothing. Even with bad teeth they still seem to love those things!

I've had cats with kidney disease too that had terrible appetites. I'd buy one of everything off the shelves just to try and get something into them. Also boiled fish, prawns or anything else stinky.

What's his breath like op?

His breath is ok. Normal cat breath smell.

I really appreciate everyone’s responses. Feeling quite teary here as I fear this is probably not going to get better.

He’s curled up by the fire at the moment and looks very settled. The painkiller seems to be doing its job.

The final decision on whether he’s PTS remains with the rescue so the vet would need to liaise with them before doing anything.

Off for a walk now and will see what tempting food I can find. Adult DS is going to stay with TC and keep an eye on him.

Have you tried little cubes of strong cheese like cheddar ? It can tempt some poorly cats.

It really shouldn't be a struggle to give him an anaesthetic.
A simple sedative injection would suffice to look in his mouth enough to diagnose the issue . If even that is hard, there are drugs they can give you to put in his food at home to take the edge off before he goes in.
Part of being a vet is knowing how to deal with cranky old cats ! Working out the best approach for them.
Yes it's a risk but at this point you don't have much to lose and everything to gain.
Your vets initial response was very sensible as with an older cat the simplest approach is the best but if that hasn't worked and he is struggling and losing weight then they need to make a plan with you to see what the issue is.

Our cat has a tumor in his skull (bone cancer). It took a long time to get a diagnosis but is is younger so was able to be sedated for an MRI. The vet thinks the tumour is pressing on one side of his mouth and causing pain when eating. We didn't think he'd still be with us but improved very quickly with Metacam every day.

We had the same problem with food. I second the lix-e-lix type treats (Sheba make them too... salmon is the favourite here). We also have a very runny pate food from the vet: Royal Canin Recovery. Once we realise he liked it, we order it in bulk from Zooplus. It smells very strong and sometimes he would eat that when he wouldn't eat anything else. For a while we gave it to him in a syringe. It's important to keep food intake up in cats as well as liquid. Happily he went back to eating his usual Felix in jelly for several months, though he seems to be declining again now.

I wish you the very best.

We had teeth problems and tube fed at14.
First thing my boy eat was liky lix
ok now but realise not as old as your boy . Good luck