When to let go?

March 31, 2009 11:35 PM

When should we consider euthanasia if our cat is not (visibly) in pain?

Our cat, Kitty, is 16 and a half. She lives with my parents and I've been hearing updates for the last few months about how little she has been eating. Occasionally, she will hide under my dad's work desk and only come out a few hours later.

Now, my mom says that Kitty has eaten even less recently, and is 'skin and bones'. However, she says that Kitty has been doing normal things (sleeping, mainly) is acting generally as she would otherwise. Several questions:

1) Even if Kitty isn't showing any signs of disease or ailment, is she still hurting? How can you tell?
2) Please, without being too graphic, how would a decline like this normally end? Would she die in her sleep, peacefully, or would things get much worse?
3) She hates the vet and my mother doesn't want her last moments to be an anxiety and stress-filled car ride. Do you have any recommendations for a veterinarian in the southern Pittsburgh area that will do euthanasia house calls if this should become necessary?

I appreciate any and all comments. I'm going home to see her in a week.

posted by amicamentis to pets & animals (24 comments total)

Symptoms of pain in cats include panting, dilated pupils, hunching or compulsively licking, aggression when touched (this is more likely for an injury/external pain, though) and more purring than usual (sometimes cats purr when they're hurt or afraid, to calm themselves down). Hiding is probably a pretty clear signal too.

You could try giving her extra-tasty food she'll really like- jars of plain meat puree baby food (chicken, beef, lamb) should make her happy and maybe she'll eat more. Other treats that are easy to eat might be yogurt or catmilk, and I'd give her mostly canned wet food at this point as most cats prefer it, and maybe it'll help get more calories into her. Look for canned food with meat as the first 5 ingredients and no rice, corn, or gluten (usually this means the flavour of food will be called "pate", not "sliced", "chunks", or "cuts").

I don't have answers for any of your other questions, but I feel for you. Poor kitty.
posted by pseudostrabismus at 12:13 AM on April 1 [1 favorite has favorites]

Old cats do slim down as they get on in years. But maybe she has tooth troubles and would benefit from a switch to wet food, if she doesn't already get that.
posted by Scram at 12:36 AM on April 1

I can understand your concern to do the best for Kitty to save her any undue distress. However, it isn't really possible to predict what kind of death a cat is going to have. Sometimes an old cat will pass in sleep, sometimes they aren't so lucky.

How about speaking with Kitty's regular vet and arranging an examination and a full blood panel? Regular check ups for senior cats are essential and can give you the power to help her enjoy her life without pain/discomfort. She may have something ailing her which is easily treatable or manageable. Your vet may even agree to do a house call to examine her if taking her to the vet is just too distressing.

I think that establishing exactly what the problem is that is causing her behaviour is the best practical/humane thing to be doing now for her.

Best of luck to Kitty :)
posted by Arqa at 12:50 AM on April 1

I've seen the "hiding" behavior in very sick cats. They hole up
someplace very quiet and private, and act like they're either going
to tough it out or die there.

If you can afford it, take her to a vet and get a blood panel done.
Old cats and hyperthyroidism go together, and it's treatable.

It's shocking, but you can euthanize your cat any time you want to.
I got a cat that was going to be put down because his owners were
moving, and didn't want a sick old cat puking on the carpets. He lasted
another three years, mostly happily.
posted by the Real Dan at 12:52 AM on April 1

Our beloved kitty suffered from chronic renal failure in his later days and we struggled with these questions as well. He grew more thin and listless but still seemed to find pleasure in the same things he ever did -- spending plenty of time in our laps, dozing in the sun and admiring birds from his preferred perch. Our vet was somewhat zen when answering our questions about how we would know when the right time arrived. He insisted we would know when it was time and we did. Our milestone was when the cat no longer seemed interested in seeking interaction with us.

Our vet was willing to travel to us for the euthanasia and I'm quite confident that this was a great decision for us for the exact reason you mention. His last moments were peaceful and stress-free on my lap. It wasn't the easiest thing I've ever done, but I feel good about the way we did it.
posted by Lame_username at 12:58 AM on April 1 [1 favorite has favorites]

I have a sixteen year old cat who has a tumor in her nasal passage. Due to this and some dental problems last year, she's lost half her body weight in the past year. I'm now faced with this same question: when do I let her go?

For my cat, I've decided that, provided she isn't in pain, when she can no longer eat by herself (she gets wet food and can gum it down) or can no longer make it to the litterbox, then I'll let her go.

For now, she isn't in pain and she still plays occasionally (though for *very* short periods). She interacts with the other two cats and she comes to me every day for a grooming session (she's not grooming herself anymore).

Good luck with yours, Amicamentis.
posted by LOLAttorney2009 at 1:23 AM on April 1

I don't envy you one bit, I went through a similar thing 2 years ago with my 17 year old cat, also living with my parents, myself having since moved out. She had actually been growing thin for quite some time, had had an operation on her thyroid gland but it didn't really help much, and we didn't want to put her through that a second time. She was always a tough old cat though, with a pain threshold that bordered on the ludicrous, she pulled all the stitches out herself after she was spayed. This meant we could never be very sure if she was in a little or even a lot of pain, but other than being grumpy in her old age, always seemed happy and able. As to how it finally ended, she went missing one day, and was found a few days later in a little used area of the garden, as if she'd gone off for a nap. It was very peaceful and I have to admit to being grateful I was spared having to make the choice for euthanasia, which always seemed on the horizon.

I would say though, my cat had her thyroid op at 16 and though it didn't help, she tolerated the op just fine. Another cat who is still with us and actually is 17 now, had it age 15 and she's a picture of health now, from being skin and bones. An overactive thyroid is a common problem at this age in most cats and at the least, it can be treated with drugs, and if the drugs work, then surgery is a pretty good fix. You hear a lot of cats living to ages like 20 and more these days, your kitty could have a number of good years ahead of her yet.
posted by Elfasi at 1:31 AM on April 1

If the cat is not eating well and is losing weight then take it to a vet. Really, forget this stuff about the car ride and get it some treatment because it may already be suffering. While it's likely the gradual deterioration associated with old age, it may not be. It may be treatable. Either way the vet will be able to give you accurate information on the cats current condition and answer the question you ask here with authority.
posted by fire&wings at 4:30 AM on April 1

There are many things which could be going on here, not all of which are fatal. Kitty is not so old that you should be giving up on her without at least a good geriatric exam at the vet, including blood work. Not liking being at the vet is not an excuse for not giving adequate care to the cat, and a vet visit with reasonable diagnostics will help you make an informed decision about what to do with Kitty. If you cannot or will not take her to the vet for diagnostics, then you should arrange for a vet to come to your home to examine the cat.
posted by biscotti at 5:08 AM on April 1 [1 favorite has favorites]

I'm sorry to hear about this. Watching a pet grow old and not having enough information to confidently figure out the best choices for it is awful, but you're obviously asking the right questions now.

I had a cat euthanised weeks after being diagnosed with cancer -- she stopped eating and started hiding. I had another cat put to sleep because although she seemed happy, if scrawny, one day she fell down a couple of stairs and was so weak from kidney problems that it took her a long time to stand up again. And I had my last cat put to sleep, after a week of puzzling symptoms and some expensive tests and treatments, including emergency surgery.

I know how tough it is to determine if you're going too early or too late sometimes. I was helped each time I made these decisions by the assessment of a good vet.

In your case, you need an answer to your last question because your cat hates travelling to the vet. Repeated for anyone in your area:

DOES ANYONE READING THIS KNOW OF A VET THAT DOES HOUSE CALLS IN THE SOUTHERN PITTSBURGH AREA?

Your cat may have a big but treatable disease, like hyperthyroidism, or she may already be on on slow decline with something more challenging, like kidney disease, or she may have a terminal cancer, which is awful for her but probably a more clear-cut decision for you. You may or may not get an unambiguous answer about what ails her. It may take more than one vet visit and some lab tests to figure this out. A visiting vet may be expensive, and two trips even more so. I hope you and your parents aren't stretched financially, but if you can afford the bill for a house call or two, you should commit to it. Get an assessment first from a professional, then act.

And if you can't get a house call arranged very soon, you should still take her to a vet nonetheless. She may hate the visit, but she may be in enough pain right now that you would still be doing her a favour.
posted by maudlin at 5:21 AM on April 1

You have my sympathies, losing a beloved pet is so rough. My 18 year old cat showed almost no change for years - we would joke that she was born old, because even as a young cat she was always quiet and slow and kept to herself. Furniture that eats, you might say. She did sleep more and more, and I thought that eventually she would just not wake up. The end, when it came, was very sudden. She had a stroke or something similar during the night and lost the ability to walk, look around, or even sit up. She could still eat and drink and had bowel control, but it was obvious that she was unhappy and afraid. We took her to the vet to end it that day, and though I regret that she was so scared at the end, there's no way I could have predicted a day or week in advance that the end was near. I loved that cat, and I still miss her.
posted by WowLookStars at 5:31 AM on April 1

Like everyone else, I think you should take the cat to the vet. My parents' old old cat got thin and his fur started looking very dull, and they took him to the vet with the intention of getting something to make him comfortable until he died. The vet gave the cat an IV of something, and switched him to a different cat food, and he lived another very healthy and happy year.
posted by mjcon at 6:20 AM on April 1

Go to the Vet. I had the same situation with my 14 year old cat a few months ago, vet pronounced him as having renal difficulties, switched him to wet food more appropriate for the condition -- change was immediate, like a new cat inside of a week. He's put weight back on, returned to his activity level of ten years ago, and now seems likely to live quite a bit longer. Kinda freaky, really.
posted by Pufferish at 7:17 AM on April 1

I have no personal experience, but Google tells me that there are at least two. Barbara L. Smith DVM shows up at [phone] on a number of searches, but does not appear to have a web site (or at least not one that is easy to find). There is also David Ruble, DVM. Some of the vets on this list may be in cities close by, but my Pennsylvania geography is not that good. If the cat has not had a good workup, getting one done is a good idea. They could have minor easily correctable issues and even fatal conditions like CRF can get significant relief that will allow your pet to live a lot longer and happier than you may think.
posted by Lame_username at 7:34 AM on April 1

Be ready for the worst.

I had a similar situation with the cat I grew up with. I had been long-gone from my mom & dad's house, living on my own. The occasional letter told me that the cat ("So-long", a siamese) was "getting old" and that he had thinned down.

When I visited my parents one fine autumn day, I found the reality -- So-long was 22 years old and quite sick. My folks hadn't wanted to be the ones to take him to the vet to put him down, so they put it off until I visited. By that time, he didn't have any strength left to resist going to the vet (he didn't enjoy vet visits, either).

I guess what I'm saying is that he suffered needlessly; my parents understated his health issues because they wanted to avoid being "the ones" to put him down, and So-long paid the price.
posted by dwbrant at 7:46 AM on April 1

This recent episode of Fresh Air with the author of Speaking for Spot may be helpful in your thinking.
posted by jerryg99 at 8:00 AM on April 1 [1 favorite has favorites]

FWIW, my cat is almost the same age and she too slimmed down dramatically in her older years. Right now she has lots of energy, though, and seems to be enjoying life. Just another data point... older cats can slim down without it automatically meaning ill health.
posted by wastelands at 8:24 AM on April 1

You really need to get this cat to a vet. For several reasons. One, despite the traumatic car ride, they can actually help. Meds to help control the symptoms of whatever's going on. Antibiotics if kitty's fighting something bacterial. Appetite enhancers. Pain killers. The list goes on. But most importantly, they deal with this euthanasia dilemma every single day. Ask their advice and they will give it to you. They can tell you what sort of quality of life your kitty is having, or could have. The benefits outweigh the downsides here. And when the time does come, it's a huge relief to know that the vet is supporting your decision.

I'm so sorry you're going through this -- there's no getting around it, it sucks. I was in the exact same position a few years ago. My beloved Stripe was 19 years old, I'd had her since I was 7, and although I moved out several years earlier, and my parents and I wrestled with the decision for weeks. Finally putting her down was one of the hardest things I've done, and I left the vet a complete mess. Heck, i'm starting to tear up again; damn I miss that cat :(
posted by cgg at 8:26 AM on April 1

Yes, vet, ASAP. We had an elderly cat who wasn't eating, and it turned out he just needed some teeth pulled. He lived a few more years after that, though he never regained his prior robustness. He was put to sleep earlier this year b/c he had a tumor, was clearly not enjoying life anymore, and the treatment would have probably killed him.
posted by Mavri at 8:57 AM on April 1

You might want to take a look at this thread -- it's about letting go of a dog, but I think some of it will probably apply to your situation. Very sorry you're going through this.
posted by pised at 10:17 AM on April 1

Thanks to everyone who shared their opinions and experiences in this thread. When I go home next week I will do my best to get Kitty to a veterinarian and see what's going on. Worst-case scenario, we can make her as comfortable as possible until the end. But reading about the other curable diseases that could be causing her to not eat, I am slightly more optimistic and will see how up Kitty is for a vet trip. If not, I will look into house care.
posted by amicamentis at 12:35 PM on April 1

By the way, our 18-years-old-next-week cat Evel has been prescribed a saline drip to help with his kidney function deterioration. We do this at home, it's quite routine (though he howls in indignation), and his general health and energy levels are markedly improved for it. As we get closer to drip day, his fur looks duller and he becomes listless. The change is striking, and I am grateful our vet helped us find a way to help him keep going.
posted by Scram at 2:23 PM on April 1

The treatment Scram describes, called subcutaneous fluid therapy, is indeed a marvelous thing for cats with renal issues. It added years to our cat's life and dramatically and visibly improved his health, energy and apparent happiness. Our cat very quickly adjusted to the treatment and didn't complain about it at all.
posted by Lame_username at 7:38 AM on April 2

Update: Kitty died last night. She couldn't walk right and stayed outside until my parents took her to the vet and had her put down. I wish I would have been able to make it home to see her again but she couldn't make it. It was nice to hear that she didn't freak out at the vet and even let them hold her to put the IV in.

She's buried in the front yard and I'm glad she didn't suffer much. Once again, thanks for your kind answers and all the help.
posted by amicamentis at 12:15 PM on April 2