He seems perfectly happy to me, if a little cantankerous...
October 12, 2011 1:53 PM   Subscribe

Am I doing right by my aging kitty?

My cat, Julien, is working his way through his 18th year. He's been entirely an indoor kitty except for one summer with my mom, and he seems happy -- he eats, he drinks, he does his business, he keeps me company while I work, he sleeps on Mr. Narrative's head. He's my buddy, and I love him.

However, he has obvious signs of declining health. He's become so thin that friends of mine comment on it when they visit. He drinks much more water than he used to, and pees accordingly. He vomits a mixture of water, bile and fur nearly every morning, as opposed to once or twice a week.

The household has been talking it over, and we've tentatively decided not to take him in to the vet.

The last time we took him it went extremely badly, and he sat in a corner of the apartment yowling miserably and shaking for a day or two afterward -- we're actually worried that the shock of traveling by car to the vet's office and being poked at in a building full of strange animals might kill him. On top of that, personal and anecdotal experience suggests that even if there were some medical way to extend his life, the expense and stress of it would be prohibitive, particularly for such an old and crotchety cat.

Basically, we aren't going to take him to kitty dialysis, and we can't afford to give him daily insulin shots or other expensive medications, and we're not really sure that would be in his best interest anyway.

I suppose I want to be told that I'm not crazy? But if I'm looking at this the wrong way, or if any of you have personal experience to contradict my own outlook, I'd appreciate the second opinion. I've never had a cat this old be part of my daily life, and I want what's left of his to be as pleasant and low-stress as possible.
posted by Narrative Priorities to Pets & Animals (37 answers total) 5 users marked this as a favorite
Could you afford a home visit from the vet? He may had kidney problems that some medicine and fluid treatments (both fairly inexpensive) might help.

Also when the time comes and if you have to have your kitty put to sleep, you can have the vet come to you instead of having to go to the vet to have it it done.
posted by bottlebrushtree at 1:59 PM on October 12, 2011

I was raised on a farm. Do not keep an animal alive for your own sake.
posted by goalyeehah at 2:02 PM on October 12, 2011 [10 favorites]

We just lost our 17 year old kitty this summer, and he had visible symptoms too, so I know what you're going through here. He doesn't mind the vet, though, so we went and got the information we needed to make his last days as comfortable as possible. Absolutely see if the vet can make a home visit - and if not, find one that will. You're better off knowing, because he's obviously not well.

If you know what's in front of you you'll be much better equipped to deal with whatever has to happen next. It's not easy, I know, but at this point you really need to be focused on what to do for the animal, not for you. He's obviously not well, and you need to be able to see that as clearly as possible, as hard as it will be for you.

Please feel free to memail me if you want more details or info on what we did with our kitty.
posted by pdb at 2:06 PM on October 12, 2011

I have some guilt about the length of time my last cat was kept alive. He acted happy, but he was unaware of alternate possibilities to going on living the way he was feeling. I am in no way qualified to make a veterinary decision, but it sounds like it's getting unpleasant. A difficult favor to do for one you love.

We had someone come to the house, see if that's available in your area. Whenever you decide the time is right, you shouldn't have to settle for a visit to the vet being your cat's last experience.
posted by TheRedArmy at 2:07 PM on October 12, 2011 [1 favorite]

If you can find a vet that would do a home visit, that sounds like that would be the least stressful thing for Julien.

If you have a vet close to you, ask if they can do this, because he's old, or because he's very sensitive to the vet. It could be something simple, but it's worth knowing what you are dealing with. The vet might also be able to give him some medicine or fluid that will make him more comfortable.

I lost my kitty this year. I knew she was getting sick, and the vet simply confirmed that suspicion. (She had cancer.) I elected not to do anything because of the type of cancer, but it helped me to know how to provide palliative care for her as her illness progressed. The vet was great about removing fluid from her tummy, and giving her medicine to encourage her to eat. These things helped her be comfortable until she was ready to truly go.

Best of luck to you and Julien.
posted by carmenghia at 2:08 PM on October 12, 2011 [1 favorite]

On top of that, personal and anecdotal experience suggests that even if there were some medical way to extend his life, the expense and stress of it would be prohibitive, particularly for such an old and crotchety cat.

Um, having had and known a few old cats, this is no way always true. One example, my parents cat starting having pretty bad old age symptoms, turned out a single, cheap pill each day to even out her thyroid and she perked right up. Lived another four years. And while the best medication may be expensive and difficult (I've been there too), a good vet will also give cheaper options to help improve quality of life if that's not possible. My old cat had a very cheap and side-effect free painkiller dripped onto her food each day for the last year of her life, and it made a huge difference to her life. Even just changing to a different food might help stop the vomiting you're experiencing.

Right now you just don't know any of this, and leaving your cat to get sick without even trying really *isn't* doing right by him. Your cat needs a full blood panel and proper vet checkup. You need to work out how best to make that happen (a home visit might be a good option, sedatives is also something to look into). In New Zealand your cat becoming thin as you describe means you're actually legally obligated to get vet attention and you can be prosecuted if you don't, that's how serious and important this is. Sort it out.
posted by shelleycat at 2:09 PM on October 12, 2011 [14 favorites]

You're just prolonging the poor critters suffering. Take it to the vet, have it put down. Did the same with my cat a couple years ago.
posted by ducktape at 2:09 PM on October 12, 2011

You are allowed to let things happen naturally. If he isn't in any obvious distress/discomfort (at which point you would probably have to consider putting him to sleep), you do not have to put him through traumatic medical procedures that would stress him out during the end of his life. That said, you might want to have the vet come to your house as others have said just to give you a state of affairs.

Just remember--you do not have to do everything you possibly can to keep a very senior cat alive just because there are possible things to do.
posted by Kimberly at 2:11 PM on October 12, 2011 [4 favorites]

Can you get a vet to do a home visit or even a phone consultation? If nothing else the vet could tell you if he's in pain and maybe offer some medicine that might not cure him but make him more comfortable and a lot of that isn't that expensive either. If there is nothing they can do and he appears starts to appear to be in pain, remembering cat's hide pain very well, a lot of vet's will make a home visit to put an animal to sleep when the time comes so as to stress the animal less.
posted by wwax at 2:12 PM on October 12, 2011

I disagree with taking the cat to the vet. My childhood cat was sick and clearly dying, and we finally decided to take her to the vet to be put down, and I wish we'd let her die at her own pace (or gotten the vet out there somehow to do it at home). The fear and misery of that last trip, with all of us upset and her sick and cold and out of her comfort zone, the metal table, the shaving of her skin for the injection - other than Big Interpersonal Failures, it's the thing I feel worst about in my life.

Find a vet who makes house calls if you can, and get palliative care.
posted by Frowner at 2:14 PM on October 12, 2011

Response by poster: Don't want to thread-sit, but just to clarify a couple of things early on:

- Julien really, really doesn't seem to be suffering. He's active, excited about food and people and cat treats, plays a little with the other cat, just a little slower than he once was. My understanding is that animals should be put down when they stop showing an interest in food, or when they're obviously in pain, and Julien is neither.

- I'll look in to home visits. We can't afford it right now, but hopefully next month we'll be a little less squeezed. I'll find out how much it would cost, and try to budget for it.
posted by Narrative Priorities at 2:15 PM on October 12, 2011

He's become so thin that friends of mine comment on it when they visit. He drinks much more water than he used to, and pees accordingly. He vomits a mixture of water, bile and fur nearly every morning, as opposed to once or twice a week.

About six months ago, my parents' 14 year-old cat started having those exact symptoms. We attributed it to his age for a long while. On top of those symptoms, he had zero energy, his coat got mangy, and he was always begging for food. When we brought him to the vet, his weight had dropped from 12 pounds to 8. The vet suspected an overactive thyroid and after some simple bloodwork, his suspicions proved correct. With his daily meds, Puddy is back his crotchety old self.
posted by futureisunwritten at 2:16 PM on October 12, 2011

I agree that your cat probably isn't actively suffering and I think all those talking about euthanasia are being a bit premature. But he is anorexic, drinking and urinating excessively, and vomiting daily. Those are not normal symptoms of old age, and are not acceptable in a cat of any age. This is a sick cat that needs medical attention, the sooner the better. The chances of his problems being treated cheaply, easily and non-invasively go down the longer it goes on (as his health is only going to decline while you wait).
posted by shelleycat at 2:21 PM on October 12, 2011 [1 favorite]

From how you're describing his behavior, I see no reason to take him to the vet or have him put down immediately. My mother's cat is about the same age as Julien and has been hobbling around like a little old man for years. We tease her about his appearance - he's thin and funny-looking and too arthritic to clean himself (either that or he just doesn't care) so my mom gives him baths, but other than that he really does seem to be living a normal, unpainful cat lifestyle. I say as long as Julien is doing the same, he's probably just elderly as opposed to acutely ill.
posted by something something at 2:23 PM on October 12, 2011 [1 favorite]

Our former roommate's cat had similar symptoms - more puking, more water drinking and peeing, getting skinny, and slowing down, and it turned out to be an overactive thyroid (cheap blood test to confirm). The vet put her on meds (cheap) and she is now a little chubbier, much less pukey, less thirsty, and more playful. I vote for a vet who does home visits, some bloodwork, and keeping an eye on him for listlessness or change in appetite.
posted by bedhead at 2:26 PM on October 12, 2011

He sounds the the spitting (and puking) image of my 19 YO who passed earlier this year. I really think she got an extra year (and seriously reduced puking) by me switching her to EVO grainless wet food. I would usually mix in a little warm water and stir. She put on a pound or 2 (which was substantial as she was tiny) and seemed genuinely more "interested" in the world around her after the switch. She really liked the duck flavor.

I also had decided that she wasn't going to the vet again after a really bad experience similar to what you describe. She went downhill fast but her only real symptom was slowing down and seeming confused.

She was certainly one of the best friends I could ever have hoped to have and it's getting dusty in my office so I'm going to stop there.

Good luck with Julien and I really think you are doing the right thing by avoiding the vet's office. I hadn't considered doing an in-home visit but that sounds much better if you decide that it's time for him.
posted by screamingnotlaughing at 2:34 PM on October 12, 2011 [1 favorite]

This could be kidney disease and could just require a change to prescription food. Please look into getting a vet to make a house call.
posted by WorkingMyWayHome at 2:34 PM on October 12, 2011

While my cat isn't as old as yours (she's only 15-16), she was recently diagnosed with CRF. She had stopped eating, became rail thin, drank water like no tomorrow and was in the litterbox all day.

She is now on kitty anti-depressants which stimulates her appetite and Sub-Q fluids 3x a week (which helps to flush out all the toxins and whatnot). Since she's been on this regimen, her kidney function levels have dramatically improved and thus (hopefully) extending her life that much longer.

So I'm here to nth recommend the vet visit (whether it's one that makes housecalls or not).

Anyhoo, just my two cents that it could be a easy, cheap med situation that could help keep him healthy and your buddy for as long as possible.
posted by Zoyashka at 2:36 PM on October 12, 2011

However, he has obvious signs of declining health. He's become so thin that friends of mine comment on it when they visit. He drinks much more water than he used to, and pees accordingly.

These symptoms sound like hyperthyroidism, kidney disease, or both. Both are extremely common in older cats. Hyperthyroidism is easily treatable with medication. Kidney disease is incurable, but there are some fairly noninvasive things--switching his food to k/d, for example--that you can do to slow the progression of the disease, if it turns out that's what he has.

I just lost my oldest cat, who was 17. She had both kidney disease and hyperthyroid for several years, and the vet had recommended we not treat the hyperthyroid because it was protecting her kidneys somewhat. I don't think there's anything wrong with opting for palliative care for an elderly cat with kidney disease (that's pretty much what I did), but if you're lucky enough that the issue is just thyroid, it's an easy fix. I don't think you need to consider euthanasia--the cat seems to have a pretty good quality of life. He sounds a lot like my old girl, who was pretty good until all of a sudden she wasn't. You'll know.
posted by Violet Hour at 2:37 PM on October 12, 2011 [1 favorite]

Agreeing with everyone else on having a vet come and, at the very least, do some bloodwork. There are a few common things that sound like what you're describing and a pretty huge range between them as far as intensiveness/effectiveness of treatment. Cancer? Maybe not so much worth treating. But thyroid issues? It's a cheap little pill. Don't want to struggle with pills? It comes in a gel you can just wipe on his ear! So really, it's worth knowing what the problem actually is so that you can make a good and informed decision going forward instead of just guessing that nothing can be done. And even for some of the most serious problems can be treated conservatively. Chronic renal failure, for example, can be helped by dietary adjustments that put less strain on the kidneys. So even if you don't want to do fluids long term, a switch in diet may help extend the good time you have together at very little stress or expense to you.
posted by troublewithwolves at 2:37 PM on October 12, 2011 [1 favorite]

Like many other people have said, this sounds a lot like thyroid issues to me. We have a cat that lives next door who developed thyroid problems and had similar symptoms; he was 19 at the time. He's 22 now, and while he's very skinny and walks very slowly, he can still scale a fence in no time, and a couple of months ago he beat the crap out of a large dog that had gotten loose.
posted by infinitywaltz at 3:06 PM on October 12, 2011 [1 favorite]

The weight loss, drinking, peeing, and vomiting sounds like kidney disease/renal failure. We had to have our beloved Imogene put to sleep in January because of kidney failure. The latter stages of it are incredibly painful and sad for both cat and owner. By the time we realized how sick Imogene was, she went downhill incredibly quickly and it was very traumatic. Please, please don't let your friend suffer when a trip to the vet and either treatment or a humane, loving death are possible.
posted by mostlymartha at 3:15 PM on October 12, 2011

Nthing hyperthyroidism and kidney disease as very strong possibilities. You need to get a vet's take on this to figure out what options this guy has at this point. When my 16-year-old male cat was diagnosed with end state renal disease a year after he was diagnosed with hyperthyroidism, with several other complications that made it extremely hard to treat the kidney disease, my goal was simply to keep him comfortable and happy. A special kidney diet and subcutaneous fluids (much easier to administer than you might think, and virtually painless) kept him alive and feeling good for a couple more months. In the end, however, it was his liver that failed. Every cat is different, and with a little intervention yours could thrive quite a bit longer than mine; as it was, the extra weeks that working with the vet gave us were very precious.
posted by tully_monster at 3:16 PM on October 12, 2011

I am a former owner/parent? of a dozen or more cats... can't really count them now.

Some died naturally, most were put down. A few lived to 20. Most of the ones that didn't lived into their late teens.

To say I have experience with the end stages is understatement.

I will tell you this: One day soon, you'll have a bad day. Even if it's a year, two, three out there, it's a' coming.

Honestly, it's not good either way. The outs are 1) kitty dies in his sleep 2) kitty is gently put down when prospects look dim 3) you have a crisis and cat dies in agony, afraid and distressed

Of these, the last one hurts more than I want to talk about. It just happened for me. Counting on the first risks the last alternative, so realistically, if you want to assume more of the pain FOR your good friend, kitty, the second is the best.

It's a question of when. I have some thoughts on the matter, but your circumstances are unique to you, so I won't burden you unless you want them.

I'm not one to rush things either, and the hardest thing is intuiting when it's time. No good rule of thumb except to ask if kitty is uncomfortable, and if it's unlikely the trajectory can be changed. Keeping them alive for you can be torture for them. I think you'll probably know.

I finally figured out that any joy you get out of your cat along the way is a sort of karmic pain debt, and you have to pay it all back with interest at once the day they die. From now on, I only enjoy other people's cats... my old man heart won't last through another loss. How is it that they get right in there and become part of our souls? Magic, it is.

1000 hugs to you.
posted by FauxScot at 4:39 PM on October 12, 2011 [3 favorites]

Nthing that it sounds like hyperthyroid, which is common in older cats, and fairly easily and inexpensively treatable. Doing nothing doesn't strike me as particularly kind (though it's not actively cruel or anything). I think at least an at-home vet visit is in order. And then go from there.
posted by FlyByDay at 5:17 PM on October 12, 2011

Take it from an old---and I mean old---friend of mine: You're not old till something breaks, mentally or physically. Julien seems to think he's ok. See if there's anything you can do from a diet point of view, otherwise let him get on with his life.
posted by alonsoquijano at 5:31 PM on October 12, 2011

Over the weekend, I lost a 15 year old cat who was diabetic for a couple years. His kidneys were failing, but he had two strokes about a month apart. He bounced back rather well from the first one, but the second one was just too much for him. :(

I had a cat who was going into kidney failure and had gallstones at the age of 17. The Vet said, "Keep her happy." We did, and she lasted until 21.

Best wishes to you and Julien.
posted by luckynerd at 5:38 PM on October 12, 2011

No guarantee that the home vet won't be traumatic. I had a terrible experience with a home vet, who ended up terrifying my cat even more to get some blood work done. He wouldn't have known deft handling if it hit him over the head - or make that coddle him for an eggs benny.
posted by waterandrock at 5:52 PM on October 12, 2011

Agreeing with everyone else on having a vet come and, at the very least, do some bloodwork.

Amen. I had a cat with hyperthyroidism and have one presently who is in the early stages of renal failure. I wa advised to put her on a renal diet canned cat food and her kidney function has stabilized. She tends to throw up much in the way yours does but I have always associated it with feeding time, in that I reacted to it when she first started doing it and tend to think it is, in part, a learned behavior. I find that keeping her supplied with a little bit of food all the time has stopped the hurling.

Cats and dogs are not furniture to be thrown out when they start to show some wear. You sign on for their whole life time and you do what you possibly can to make it as pleasant and lengthy a life as can be. My rule is that if they want to eat, enjoy your attention, can still purr on the dime's drop, it's your responsiblity to keep them alive.

I don't think giving her fluids, if it is kidney failure, should be out of the question. I plan on doing it with mine. I have had friends who did it for their cats for years and it was no problem for them to do it and their cats put up with it. I don't think it is her time yet, and, in any case, if you take her to the vet and find out what's going on, you will know for sure.
posted by y2karl at 6:25 PM on October 12, 2011

Cats brains don't work the way ours do. They don't know that they're X years old. All they know is that, today, they are feeling well or ill. They don't have regret for what might have been if they'd hung on one more week, or look forward to what will happen next week. They certainly don't understand why the vet tortures them. You, as the human with perspective, have to make that tradeoff. How many good days will you get for him?

It's not a question of "furniture to be thrown out," which is completely inappropriate here, but rather the experience of the individual cat in question.
posted by wnissen at 6:29 PM on October 12, 2011 [1 favorite]

I wish I hadn't said that, myself--I regretted it seconds after posting it. No judgment was intended and, NP, you have my apologies.

I can understand your fears of taking him to the vet. The cat I have now had ataxia come on, all of a sudden. I took her into the vet and she had a seizure when the vet tried to do the blood draw. He cam back in the room and practically threw her into my arms. I got nothing out of the visit.

Yet she was walking on her hocks and practically dragging herself across the room. So, I took her back and got another vet, for whom I put her on the ground and let him see how she was walking. I left that time with what it took to get her back to not quite her old self but able to walk, however floppy she may do at times.

If you can get a vet to come out, well and good. But, if not, think about shopping around for vets, call up a few, explain your fears, his history and see if they can make accommodations so he can be brought in. That way you can find out what you can or can not do, and, in that, perhaps, you may get some peace of mind.
posted by y2karl at 7:09 PM on October 12, 2011

All of this, but remember that the vet will work with you on the cost of care. Almost any vet will come to you, but ask around and find out which one has the best cat-side manner. With an aging cat you are establishing a relationship with the vet that will see him though to the last days.

Hope Julian has a longer and happy cat life.
posted by halfbuckaroo at 6:43 AM on October 13, 2011

This is kind of a late response, but my parents have a 20 year old cat that started to have serious issues with vomiting around age 18. Like every day. They started to give him a quarter of generic brand Pepcid every day and it mostly cured his vomiting, something that had been gradually getting worse over the years. Now he only pukes if he eats something he shouldn't. It should be mentioned that their vet never even suggested it or hinted at a solution.
posted by Bachsir at 7:59 PM on October 13, 2011

I wanted to mention that my vet is great about having fairly in-depth phone conversations and q&a's to help me decide whether to bring my cat in, bring her in YET, etc.
posted by Occula at 11:14 AM on October 14, 2011

Response by poster: Have called our vet, and unfortunately they don't do house calls. If anyone has a recommendation for a Brooklyn vet who will, I'd appreciate it!
posted by Narrative Priorities at 2:45 PM on October 14, 2011

NP, see if googling "mobile pet clinic" in your area yields any results; most large cities have them. It looks like there are several hits; this one was a promising one that came up for your area.

I know it maybe a little expensive, but IME the mobile clinics will also run sliding scales for lower income patients.
posted by lonefrontranger at 9:27 AM on October 18, 2011

Response by poster: In case anyone's curious, a quick followup:

My dad being in town with a car for a few days provided the chance to take Julien to the vet in as comfortable a manner as possible. We gave him a billion treats, went in the middle of a weekday so it wouldn't be crowded, and spent as little time in the waiting room as possible. The vet and her assistants were very nice and gave him the whole geriatric workup. As it turns out, what's wrong with him is that he's super-old.

In all, it cost us a couple hundred dollars, but you all were right that the money was worth knowing we'd done what we could.
posted by Narrative Priorities at 10:03 AM on December 13, 2011 [2 favorites]

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