How will I know when it's time?

[Lydia Leftcoast]

As many of you know, my cat Kidley was diagnosed with renal failure about two years ago. Since he absolutely refused to eat the special foods the vet suggested, I have just been feeding him the best quality cat foods around with occasional meat snacks. I can't afford expensive treatments or vet visits.

He has been going downhill gradually for a long time, losing energy, drinking a lot of water, having occasional tremors, and so on, but he still enjoyed his food, jumped up onto my chair for scrunches and sideways hugs, and looked positively blissed out when I brushed him.

However, in the past week, he seems to have entered a new stage. He still pesters me for food at his normal times, but he takes only a few bites and walks away. He drinks huge amounts of water. He has trouble jumping onto the bed, so I have brought out a step stool for him. His coat is matted despite frequent brushing, and he doesn't groom himself at all except for licking his paws. The tremors and the vomiting seem not to have changed in intensity or frequency, but he spends most of the day sleeping under coffee table. He just seems kind of weak, and for the past three days, despite it being summer, he has not come in to wake me at first light but has waited till 8:00 or so.

Maybe it's the right time to say goodbye now, but I'm in the midst of two huge jobs with strict deadlines that run till Labor Day.

Kidley is the first cat I've had full responsibility for, so I'm not sure what to do. Any input from experienced cat owners would be welcome.

[shenmue]

1. {{{Lydia and Kidley}}}

[narnian60]

2. This quote from a vet always helps me in this difficult situation.

"Better one day too early than one day too late."

[Mosby]

3. I don't agree with that

I think the pertinent issues are pain and suffering and mobility.

When any one of those things is predominant that's the time.

[Lydia Leftcoast]

4. That's what makes it difficult

He just became very active begging for food, and he eagerly ate about 1/3, but now he's back to sleeping.

[ginnyinWI]

5. We had one with renal failure.

In retrospect, we did let him go on a little too long. Partly so the college age daughter who grew up with him could come home at Thanksgiving time and say her goodbyes.

He had heart trouble along with it (almost 18 when diagnosed), so the vet put him on a daily pill for that--no big problem for me. He kept on eating, although they warned me that sometimes they can get an acid stomach and don't feel like eating much. Kidley might have this--and they can give you an anti-acid for it, which may help.

It is very tough to know "when". Our Tim was eating and peeing in the box okay but started pooping in other spots. The vet explained that they go into a kind of mental haze and don't really know what they are doing. We did take him in several times for IV fluids and to have fluid drained from his abdomen--I think a side effect of the heart failure. We probably spent $700-800 on him in that last period.

In the end he died at home, probably of heart/kidney failure after being rather ill for about six months. If I could do it over again, I'd have had him put down right after Thanksgiving--which would have been two months earlier than he died.

I don't think he was suffering at all. He was just weak, tired and in a mental fog. We took care of him the best we could, even buying him a heated bed. We had a little "kitty-hospice" set up in one corner of the kitchen: heated bed, food and litter box close by. His fur was in bad shape, falling out, and he got pretty thin. He wasn't enjoying hanging around. He would perk up after a visit to the vet, but then would go downhill again. One day he walked over to the patio door and reclined there and looked out--for him that was a lot.

My husband was the foot-dragger; I think I would have taken him in before he died on his own.

I've promised myself to heed the advice of our vet next time. He had been telling me it was time, but my husband wasn't ready to let go and I was caught in the middle. Veterinarians see this all the time and know when it is time much better than we do, who are all wrapped up in emotions.

Good luck--hope some of this helps.

[narnian60]

6. Thank you for sharing your story.

This is a good example of what was meant by the above quote. Animals are so good at masking pain and suffering that that is not always a good measure of when to end their lives. Quality of their life is what should be considered first and foremost. By the time we see them in pain is, in my opinion, sometimes past the time we should have allowed them to live.

[ginnyinWI]

7. well, that said--

When you have a senior-aged animal who is normally sleeping a lot and lower-energy, it's really hard to know. As long as a cat is eating normally, they probably are okay. Eating, sleeping and using the litter box are things I look at.

With Tim, it took our daughter coming home after spring semester to notice the change, because she hadn't seen him for a few months. Otherwise they change so gradually, it's hard to realize. At that point he was still eating, sleeping and using the litter box. Didn't run into difficulty until September, and was gone by January.

[tencats]

8. Have lost thirteen of my home cats since mid 2002

Just now made myself a list of those that were confirmed CRF at their end and its seven cats. All were the oldest 14-22 yrs old. Four lived 8 mo to 3 yrs after being diagnosed, the last three cats went down hard very quickly. Five were put down while I held them at the Veterinary clinic. One cat, the most recently lost, died at home. All of my cats that when are found to be ill have had frequent recheck examinations by my Vet. Blood labs at 2 - 6 mo intervals. Thinking back on it now how I made the decision to have the cat put down its been almost always at the clinic, the cat on the exam table and in discussion with my Vet. Its been about half the time I knew it was the last trip out with the cat to the clinic. The other half of the time I thought the cat was coming home but then something very bad was reveled during the exam. I fear for the worst now when ever the Vet orders up an ultrasound exam, its always been bad results for my cats. When I think I know that the cat is on short time and I have confirmed renal failure or a fast developing cancer, I try to evaluate the cat's quality of life. Most of these cats I have started assisted feeding because they cannot or will not eat their food. The most important behavior I look for and dread to see is when the cat wants to go into hiding. When the cat wants to go deep into a dark corner it is in pain and dying. When a cats daily routine changes its very important to recognize something has changed and its telling that the cat's health is slipping. At the very least I would recommend that you have a basic blood chemistry profile done on your cat. That should not require an appointment since it just requires a simple blood draw usually done by the clinic lab tech. The sample is sent out and results are returned within 24 hrs by fax/e-mail. It would be very helpful to know where your cat is with his blood BUN and Creatinine levels. Cost for this report has been something like $65- $85 recently at the clinic I use. If your Vet hasn't seen your cat in the last 12 mo its likely that they would not do just a blood lab without a current exam but you could inquire as to that. Try syringe feeding your cat soft foods. Assisted feeding has worked well with some but not all my cats that were short on time remaining. Other warning signs are a cat that starts laying next to the water bowl, a cat that stops using the litter box and again the cat that wants to go into hiding. Call the Veterinary clinic you know or is closest and inquire in advance about how they deal with an end of life appointment, what are the hours, cost. My clinic that I use is no wait during the normal clinic open time for a dying cat. Almost every cat that I have signed off on for the lethal injection I have later questioned myself later if it was the right time but having the Vet's advise is most helpful. With the CRF cats in the end I have always done a full load SQ fluids waited just another 24 hrs for the lab report to confirm whats suspected. Not sure about how the cat feels but for me it hurts the most to watch a cat slowly die laying near by me at home.

[shenmue]

9. Mercy

[Curmudgeoness]

10. I can't tell you when it is time

but I can tell you that it is probably time. I lost a cat to renal failure one Christmas morning. She was doing ok, although she did go blind and was so good at still getting around the house that I hardly noticed it at first. But she still seemed to be pain-free, and that was the one thing that I was not going to allow----pain. But she went downhill so fast that I didn't have time from when it was obvious that it was time (the day before, Christmas Eve, when the vet was not open) to when she died. But I didn't have a problem with the way she went either. She died laying beside me in bed and just had a tiny seizure and was gone.

I have talked to the vet and my human doctor, and I am told that renal failure is not at all painful. People feel a sense of euphoria as the toxins build up in the system prior to death, so don't worry if you do wait too long.

[ellenrr]

11. My last cat also died from kidney failure. The vet told me

when I asked if she was suffering - that it was like feeling "hungover".

I wonder how anyone knows how the cat feels...

I think we have to go by quality of life.
For me - my cat went quickly, bec. I was not informed re kidney disease, and I didn't recognize the signs. So when I got the diagnosis, she was already pretty sick, plus she was 19 years old.
So I considered briefly the treatment, which is injecting liquid, and I rejected that.

I kept her warm. When she could barely walk, I made a small litter box and put it near her, she barely ate. It was clearly time.

In your case - the fact that you say your kitty has entered a new stage, seems to me to indicate perhaps the time is now, or near. usually when cats change their habits dramatically, something is going on with their condition.
All these things - lack of grooming, not jumping, not eating - imo are signs.

but whatever you decide, know that you have done the best you could for kitty, and I'm sure kitty had a wonderful life with you. And it is so sad that we outlive our buddies. Many of us have been where you are. I'm wishing you the best. and crying for you and kitty. anyway you look at it, it's so sad.

[hamsterjill]

12. There is no right answer.

I do cat rescue and I face this decision quite frequently. Many of the kitties that we rescue are already in bad shape when we get them, and despite good care, can go down hill quickly. Others live longer lives, but may still succumb eventually to issues that result from the years of neglect before they came to us.

The following information is not a perfect answer, but it has helped me in the past evaluate the quality of life that a pet is enjoying, and it is something that I, personally, refer to when faced with the difficult decision.

http://www.pets.ca/dogs/tips/euthanasia-and-the-hhhhhmm-scale-pet-tip-228/

I am so sorry that you are having to face this and I wish you and Kidley peace and comfort.

[Lydia Leftcoast]

13. Kidley seems to have improved somewhat, although I know that the

improvement is temporary and that he will be making that last trip to the vet sooner rather than later.

At the moment, however, he is well enough to boss me around ("Morning, you lazy human1" "Breakfast!" "Brush me!" "Afternoon treat!" "Brush me again!" "Bedtime!&quot .

[hamsterjill]

14. I am very happy to hear this!

The best of luck to you!

[shenmue]

15. {{{Kidley}}}

Thank you for making this Earth a little more awesome, kitteh.

[tosh]

16. Here is a link...

that I found helpful when my sweet Marley was nearing her end:

http://www.allfelinehospital.com/when-to-say-when.pml

and another that I found when searching for that:

http://www.cathospitalofchicago.com/online-cat-health-library/quality-of-life-considerations




It is so hard. My Spike is getting closer now and I just hate this for you and for me.