When to euthanise? (Kidney disease)

[KDLangg]

My old cat (18) was diagnosed with stage 3 kidney disease a few months ago.

He’s on a renal diet and probiotics but the vet didn’t recommend any medication.

He’s lost lots of weight (used to be 5.5kg now around 3kg).

typical kidney disease symptoms including the weight loss,drinks loads etc.
His behaivoir has definitely changed,won’t sleep in his bed. A loss of some mobility etc.

However,he still sometimes likes a stroke/company and he purrs.

I know I have to make the decision to put him to sleep but I don’t know when the right time is,will it be obvious? Obviously I don’t want him to suffer. He is still happy ish. Don’t want to PTS to soon either.

I lost my boy recently to Kidney disease. In the last few days he really struggled to breathe in hindsight I wish Id have done it a wee bit sooner as the decline happened so fast at the end and it was pretty horrible.

It's a difficult decision and the last act of love we can do is to set them free. Thinking about you and him as you come to the end of your journey together.

@thisiswheretheseagullfliesaway sorry for your loss 😢 and Thankyou for your kind words.

I don’t want to keep him alive for our benefit. I think it will be soonish.

I lost my beloved Boycat to CKD at only 8. I knew the time was right with him when he started wailing in the night & didn't stop when I called his name, and when he gave me a look that said "mummy I don't understand what's wrong?". He had dropped from about 6.5kg down to not much over 3kg in 8 months, his coat suddenly started to look sort of spiky (usually very sleek) and he had a slightly strange smell to him - signs that his internal organs weren't working properly by then.

You just have to remember better a week too soon than a day too late, and if you plan it properly rather than having to dash him in when it gets critical then you can spend the week or two before spoiling him with all his favorite foods etc - face it, not like it would make much difference at that stage (this is what my own vet said). A good and sympathetic vet is a blessing at this time.

Then you can make sure the vet has a decent length appointment booked so you can take it slowly on the day and take your time to say goodbye quietly and peacefully, then take the time to mourn properly.

Plan what you want to do with the remains beforehand, then when they ask you on the day you can tell them if you want them to take paw prints, ashes returned or not and in what type of container, whether you want to have some set in jewellery or a memorial trinket.

@thisiswheretheseagullfliesaway Thankyou for your lovely words of advice.
So sorry for your loss,and at such a tender age too.
my boy has had a lovely life with us (we got him from a shelter when he was about 10 months).

Definitely skinny and yes spiky fur! He is keeping himself clean at the moment. I know it’s not long.

great advice about better a week early than a day late.

I posted here a few weeks ago about my 19 year old cat. Took her to vet and she has stage 3 kidney disease. She's only 2.7kg, vet suggested a renal diet, a urine sample and to get a blood pressure. Neither if which I did. I got the food tho and she's eating a bit. Still just loves her Sheeba. It's not occurred to me to have her PTS and vet never suggested it. She still seems happy enough. I'd certainly not let her suffer (I do know it's hard to know with Cats). I was hoping she'd be with me a bit longer, just ordered her a new scratch post!!!

My old lady is 20 and has had stage 3 kidney disease (diagnosed) from March of this year. What has kept her going is the amazing product Hydracare, which is basically sachets of rather disgusting liver soup, which she absolutely loves. She was 5.2 pounds in March and has not lost any weight since then. She is arthritic but walks around a lot and even found her way outside into the sun in the garden at the weekend. All of which is to say that stage 3 is not an instant death sentence, though it's good to be prepared for the signs.

I'll have a look into this stuff thankyou x

He has a probiotic (proplan) which has dramatically helped with his bowels. A few months ago (before diagnosis) he had chronic diahrrohea with fresh blood many times a day. This has almost cleared that up.

just ordered some phosphorus binder which I wonder is similar to the hydra care? I’ll have a look at that.

Hello! My cat is stage 3 CKD at the age of two so I've become an unwilling expert! We are managing the disease progression (hopefully) with a primarily renal diet - dry renal food with some high quality "normal" wet food as a treat. We use a phosphate binder to offset the nasties in his wet food - it's a powder that you either sprinkle over his food or give him mixed up with a treat. The most important thing is to keep them eating and drinking so plenty of fluids ( we use Smilla Cat Drink to top him up if he's not eaten much wet food) and trial and error to find suitable renal food that your cat likes. We are also trying to get some extra fluids in via subcutaneous injections, but that's a bit hit and miss.
He's generally a very happy and active little cat so I think it's worth trying to keep him that way for a bit longer, with a bit of extra care, although the CKD will sadly progress eventually.
There is an amazing website called www.felinecrf.org which is run by a lady called Tanya which has so much info and support, it's been invaluable.
I would check carefully about the HydraCare as it's not suitable for all cats - the website I mentioned above has more info on it.
Good luck - I know it's hard.

Phosporus binder is a different thing but you've just reminded me that we've just run out of it - thank you!

Thanks for that link @Puppylucky

“ this has almost cleared that up”

So your 18 year old cat has had fresh blood in its poo many times a day for several months and you are still wondering if it is time to pts?

With respect your cat has given you 18 years of unconditional love and affection, and I think it is time to pay that back.

@viques the vet didn’t once suggest PTS when I took him in for his diahrrohea?
It is one of the symptoms of kidney disease and the vet suggested the Proplan probiotic for it.

Are you suggesting i’m unfairly keeping him alive?

As you are asking , then yes I am. Not all vets suggest the pts option, as we found out once. Sometimes you have to ask yourself the hard question about why you are keeping the cat alive by medication that is not going to cure an illness or improve a quality of life by much.

I finally lost my 17yo girl to renal failure when she had a UTI we couldn't cure. Her last week was so dreadfully undignified and sad for us all. She was very underweight, refused all renal food so we gave her anything she would eat - tuna, pate, Whiskas etc on the basis that anything was better than nothing, and at under 3kg she drank more than the 30kg dog some days.

She was also blind because her BP was so high due to the renal issues it blew her retinas - we only realised when she walked off completely the end of the bed one night. That was painless but also a complication for both her and us as we couldn't move furniture an inch as she navigated beautifully blind. She also walked across the dogs' face a few times which was.... risky until the dog realised what was going on and stopped growling at her. She was on BP meds to her last day.

Whilst I regret dragging the last week out, I'm not sure I know how we could have made the decision any sooner.

Sorry for your loss @ButtSurgery That sounds very traumatic for you all.
We are lucky we are able to euthanise unlike with humans (just my opinion)

@viques thanks for your opinion.
Do you think a cat should be put down as soon as they are diagnosed with stage 1 kidney disease even if they have a good quality of life?

A friend's cat with kidney disease is unexpectedly enjoying another summer after almost being put to sleep with it a year ago. Ups and downs to deal with, anti-biotics needed for infections once or twice, sometimes fluid injections and skinny, yes, but also a quality of life that absolutely can't be denied. OP, ask your vet if Semintra would be a useful medication to try with your cat.

It didn’t read to me as though your cat is enjoying a good quality of life at all. But he is your cat, so what you do or don’t do is up to you.

Honestly I think you might be close
But I was a little too early with my boy and I've never regretted it. My boy had nothing really wrong but he kept having urine issues and the last time I took him in for his steroid, the vet said "he's quite frail and this will stop working eventually"

I didn't want it to be a 2am frantic 45 min drive to the out of hours vet with him in pain or worse. After he had the steroid I knew I had a few days so I booked him in that week

He was purring, eating well, no mobility issues but I look back at the pics of him now and I can see it was the right time for him to go peacefully before he experienced pain
The vet never once suggested it but when I took him in she chatted with me and said I was the most sensible caring owner who was putting him first

Sorry this is long!
Basically I thought it was a bit like going in your sleep at 95 as opposed to being 97 and rushing to a&e in agony type thing

"I don’t know when the right time is,will it be obvious?"
Maybe. If you're lucky. Not necessarily. Some times happen slowly, some things happen fast.

"Obviously I don’t want him to suffer."
No guarantees- see above

" Don’t want to PTS to soon either."
There's no such thing, really, from an animal's point of view. They don't feel cheated out of extra time.

I'm not saying you should euth now, necessarily. But I have seen a big growth in recent years in owners saying , "I don't want to euth too soon" when their animal is teetering on the brink. And then being shocked and distraught if the pet does suddenly decompensate or throw a clot or something and collapse in distress.

Sorry, I'm just feeling a bit crap tonight. Yesterday I euthed two cats, one presented as emergency euth, collapsed and moribund having lost exactly half its bodyweight- I can almost always pick up a vein on a 25G needle, couldn't even do that, poor cat was already agonal gasping so I turned him over and gave the pento straight into the heart - which would normally be painful but he was so nearly dead he didn't notice. Just charged those clients the crem not the euth.
Other cat had lost a kilo in a few weeks and had a squamous cell carcinoma consuming nearly half of its tongue.

Also this week- failed to talk an owner into euth of a cat with very chronic, very severe (and painful) bilateral ear disease. Needs TECABO both sides...but one side is too far gone for that, the facial nerve is buried in a huge morass of chronically scarred infected tissue that no antibiotic in the world is going to penetrate and from which that nerve would never emerge safely of an attempt was made to resect all the crap. That one went home after another 40 minute consultation, with various painkillers, to "consider euthanasia", again.

Also this week- failed to convince a farmer to euthanase his cat, to which he was very attached. Cat was very thin, pale gums, huuuuge mesenteric lymph nodes, palpable small intestinal mass, appetite declining then not eaten in couple of days. Wouldn't euth, wanted to try something, I gave it a stiff dose of dex and said if any improvement call in tomorrow to collect pred. Cat presented the next day for euth having declined rapidly overnight.

I know these situations are not your situations. But just...yeah. I'm tired.

"Basically I thought it was a bit like going in your sleep at 95 as opposed to being 97 and rushing to a&e in agony type thing"

You put it better than I did!

Hi OP

I could have written this exact post about two years ago.
It's really hard to describe but we just sort of knew. We always said we wouldn't let him carry on beyond a happy life and one day DH and I were both wfh and just looked at each other and said "it's time isn't it" - he wasn't moving about much, very quiet and just not himself. He was such a naughty character and it was like the spark had left him. It was such a wrench as I got him before my relationship with DH and we had been through such a lot together, but I knew it was time, as hard as it was.

I think you'll just know as strange as that sounds. Sending love, it's a hard thing to do.
And one way to look at it is you may not know if it was too soon but you'd absolutely know if you left it too late and they suffered. I know which of the two I'd want for myself, let alone my pets.

Please let him go. All you are doing is prolonging the inevitable. He is 18 and very poorly. Put him first before yourself. He won't sleep in his bed. He has lost weight. He will be uncomfortable for sure. Do the right thing

@powershowerforanhour thank you for advocating for these animals. You do great work.