This is the end...and then it's not...and then it is... and then?
April 8, 2014 12:52 PM   Subscribe

Our beloved 18 year old kitty Skye was diagnosed with CRF 3&1/2 years ago. We were told at the time it was pretty bad and that he could have months or years left. We opted not to go with the sub q because he is so skittish already, I wasn't about to make his final time with us miserable. We changed his diet and it helped tremendously. He has his downs where we think it is the end, and then her perks up in a week and is back to normal. This last down was the worst and the shortest.

I was literally one nap time away from scheduling an appointment to say goodbye, but my kid refused a nap and Skye got a reprise and was back to relative normal the next day. But, not really. Since then he has been wandering around meowling like he is lost (he would occasionally do this but now it's a regular occurrence), randomly peeing on the carpet or any grocery bags left on the floor. His urine output seems higher than usual when it's in the box, randomly licks things, and he has become quite social (needy). We think he may be going deaf or blind or both, because he just doesn't seem to get out of the way anymore when the dog runs past him, or the kid gets too close and tries to grab his tail.

This is going to sound harsh, but I don't want to take him to the vet (we moved and don't have the new vet yet) for them to run a bunch of tests and panels on him only to say yeah, he's bad, you might want to think about saying goodbye or on the other hand, here are 8 million things we can try to see if they help, but we don't know. Not going to happen.

I read that with CRF, when they start 'rebounding' faster, it is actually near the end. Is this true? I don't want to put him down too soon if this is just normal old senile cat stuff, but I also don't want him to be suffering and I miss it because I keep looking at the basics and think he's ok. He's eating (not as much as he used to), gets around, drinks, not much playing- but he was never a big play cat other than chasing his own tail.
posted by MayNicholas to Pets & Animals (13 answers total)
My understanding is that cats tend to "appear normal" and hide their pain when something's wrong (so as not to clue in a predator to the fact that they are weak/ill). So if your cat is urinating on the floor, acting more needy than normal, is sluggish, etc., he is probably feeling pretty awful.

You should be able to have your former vet fax or email your cat's records including the CRF diagnosis, and that combined with his age would probably lead a new vet to agree to euthanize him without a battery of tests. Depending on where you are, there are also vet services that come to you to perform "at-home euthanasias."

So sorry you're going through this.
posted by mingodingo at 1:05 PM on April 8, 2014 [2 favorites]

Have you checked to see if he has a urinary tract infection ? My experience is that sub q is not that bad -- it can become a routine. My cat purrs during it.

But when she gets a urinary tract infection, it seems like she is on death's door.* She won't eat, or lie down, she just sits with her front legs straight, facing a corner, looking into space, and totally miserable.

And then, after a couple of dropper-fuls of clindamycin, she comes back. I always have some on hand to start her on when she gets bad.

*and here's the deal: Cats on sub-q are prone to UTI's. Concentrated urine is more anti-microbial than diluted urine -- who knew ? Not I...

So, whether you opt for sub-q or not, it could be a UTI infection that's causing the random peeing. That's a sign in my cat that something is wrong. Of course, it means a trip to the vet for him. But it is something that can be treated. And it is worth checking out,inmy opinion.
posted by y2karl at 1:09 PM on April 8, 2014 [1 favorite]

My cat had this. We did the sub q fluids for years and it really helped with his quality of life. When the end came it was very clear. We didn't have any rebound, he just got weaker and weaker.

We had a home vet come to put him to sleep (it's only way I would ever euthanize an animal)

When he stopped eating from his bowl, got listless, stayed in one place, we knew it was time to call the vet to come to our house.
posted by bottlebrushtree at 1:31 PM on April 8, 2014 [3 favorites]

At age 18, I'd put a lot of weight on the "is he eating/drinking" side of the scale. When that goes, you know it's time. And yeah, it's totally fine, and even morally okay, for you not to take the cat to the vet for tests. The cat doesn't need the last days/weeks of his life to be full of tests, needle pricks and stressful situations. What will you/he be getting out of it? Another six months?

In terms of the blind/deaf issues and dealing with the dog and child -- is there a happy place you can tuck Skye away? I mean, don't shove him off in a room all by himself. But would he be very happy with, say, being in your bedroom all day? With food, litter, water, etc, but minus the dog? If that's a place Skye likes to be, with smells he associates with happy times, then that might be an idea.
posted by BlahLaLa at 1:32 PM on April 8, 2014 [5 favorites]

Your vet is always going to suggest diagnostics and further treatment because they are professionally obligated to -- it's good practice to give clients every possible option so that they can make informed choices about future treatment. If you make an appointment at your old vet for euthanasia and tell them that you are not interested in diagnostics or treatment, they will respect and honor that decision.

If you have your records sent to a new vet, they will likely feel obligated to at least perform a physical exam before euthanasia -- it's the minimum standard for establishing the valid doctor-patient relationship required before they can perform any treatments, including euthanasia, but they can do it in the back, and if he is as bad off as he sounds, they will also respect your decision. (It's not clear from your question, but if it's been 3 years since your old vet has seen him, they will probably want to at least to a physical as well.)

I'm sorry you all are going through this as well.
posted by Rock Steady at 1:43 PM on April 8, 2014 [1 favorite]

Just a suggestion: Have you or your vet ever actually tried giving Skye sub-q fluids? The reason I ask is that I had a cat who needed them for a while and I expected the process to be a nightmare based on the way that cat normally acted. As it turned out, he was very calm about the whole thing and I was able to give him the fluids without any assistance or injury (except the time I poked myself with the needle, but that was hardly the cat's fault).
posted by Juffo-Wup at 1:57 PM on April 8, 2014 [2 favorites]

My cat (female, 18,5 yrs, no CRF) did this about a week or so before she died. Meowing, random peeing around the house, neediness. A few days later she was colder to the touch and more cranky/angry (she was a bit of a drama queen her whole life). She ate until the very last day, was even more hungry than usually.
posted by travelwithcats at 1:59 PM on April 8, 2014 [1 favorite]

I don't know anything about CRF, but I highly doubt that your new vet is going to suggest a zillion tests. When my dog got to the very end, the changes were abrupt so we did run some tests but it was clear pretty quickly that it was time. I'd say that the incontinence is the key that things are bad. My dog had kidney failure and she was just peeing constantly because her kidneys weren't doing their job. The one thing that we did that was prudent was doing a bacterial culture to see if it was a UTI. When it came back negative we knew.

I had never had to make the decision before and I had never been there to put a pet down before. I was really freaked out but I talked to my cousin who has had a lot of dogs and she walked me through it. It was really helpful for me to know what to expect. If you need some guidance on this, please MeMail me and I'm happy to share my experience.
posted by radioamy at 2:05 PM on April 8, 2014

I have to agree with radioamy, I doubt that they are going to want to run a bunch of tests, and with CRF, there aren't a lot of treatment options, especially late stage. But in my experience (I am a vet student) people often wait until the cat is in horrible shape before deciding to euthanize, either because it's hard to let go or they don't see it or whatever. If the cat is eating and drinking well, I would worry about a UTI. If kitty is barely picking at food or drinking tons and tons and tons of water, it may be time to say goodbye. I have been through this myself a number of times, and it is very difficult, but usually the cat gives a clear sign that it's time. If you aren't sure, you can make an appointment for 'possible euthanasia' and have the vet do a quick PE. Feeling the kidneys and looking at the cat's overall appearance can give a good idea of whether it's time or not. Sorry that you are going through this, and good luck.
posted by bolognius maximus at 2:13 PM on April 8, 2014 [2 favorites]

FWIW, we went through this, were told this kind of behavior was common in cats with CRF and sounds like what happened very near the end of our cat's life. Have your new vet talk to or get records from the old vet to avoid a bunch of unnecessary testing, stress and expense. Sorry this is happening, and best wishes.
posted by cnc at 4:28 PM on April 8, 2014

skye is a handsome, dignified old kitty with his orange and white coat and piercing green eyes. 18 is old for a cat, and skye is probably in the top tier of pampered, well-loved kitties. i'm sure whatever you do will be the right thing for him.
posted by bruce at 5:12 PM on April 8, 2014 [2 favorites]

I'd take him in to the vet and explain what's been going on, that you don't want to do a lot of tests but want another opinion and to rule out anything obvious. If the vet is any good at all, they'll respect that.

My kitty had liver cancer rather than CRF so for me, coming home to find she'd urinated on some washing left on the floor and later on the bathroom floor was a big sign. She was also doing that meowing as though she were lost and confused and couldn't figure out what to do to make it better. I interpreted that as her asking me to make it better, and took her to the emergency vet in the morning. They'd never seen her before and didn't ask for paperwork from her normal vet's, but agreed that while it was possible to run lots of tests and put her on drips and things like that, it was only going to postpone the inevitable rather than make a significant difference, and I couldn't face making her that miserable. I was prepared for that verdict and went ahead and had her put to sleep. I still think it was the best thing to have done for her, even though writing this has made me so sad I'm fighting tears. It's only been a bit over a month.

From your description, it sounds to me like Skye's asking you to make it better. If the vet can rule out obvious fixable things like a UTI, it sounds like it's time. But you know him better than anyone, so it's your call.

I'm so sorry you're going through this. It's so hard. Skye is a beautiful kitty who sounds like he has had a very good and long life.
posted by Athanassiel at 8:59 PM on April 8, 2014 [1 favorite]

I haven't dealt with CRF in my own cats (yet), but a few weeks ago I accompanied my friend to the vet when her cat was going through it. He was ~15. I think he'd been doing poorly about a month prior, bounced back for a bit once she'd started giving him fluids under the skin, and then went downhill again. In this case, it was beyond dispute that the animal was... tired. Not eating, moving slowly, drinking water and peeing, and loose stools. Made absolutely no protest about being in my car or going to the vet. He'd lost a lot of weight. He was also twitching intermittently, which the vet said was caused by the CRF.

Like you and other commenters have alluded to, the vet (an emergency vet on a Sunday, not his regular doc) still soaked my friend for some tests/panels because of course you want to feel like you did everything you could, even if the situation is obvious. We did end up putting him down that afternoon.

Anyway, it doesn't sound quite as clear in your case because Skye is still eating. I agree with other commenters that if he stops eating and moving, that's a pretty uncontroversial sign.

that being said, the definition of 'suffering' is so elusive... hence threads like this one. in my friend's case, her cat's quality of life had obviously been compromised but it was still a crushing decision. But it's never going to be an easy decision to give up on a companion, and you have to think of yourself, too. you really shouldn't feel guilty for making the decision 'too soon' in this kind of situation.

This recent episode with my friend was the first time either of us had witnessed the actual euthanasia. Not sure if you've seen it before or are worried about that but like radioamy said, it is helpful to know what to expect. fwiw, it wasn't as bad as I expected. of course it is still very bad and we were both crying (my friend and I grew up together so I knew & loved the beast), but I guess that is what you're in for when you're a catfool.

It sounds like you have been doing all the right things and taking excellent care of Skye. I'm so sorry you're dealing with this.
posted by perryfugue at 9:13 PM on April 8, 2014

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