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June 14, 2014 1:06 PM   Subscribe

My little lady is 16 this month. She's been my best pal since I was 21. But we're hitting a rough patch, and I'm not sure what my course of action should be.

Ever since I had her fixed (at 6 months), my beastie has had weight management issues. She's averaged between 11 and 15 pounds her entire adult life. Except during her kittenhood, she's never been particularly playful; doesn't care for toys, just likes to nap and snuggle with her human. As a result, it's been a lifelong battle to get her weight down, with unspectacular results.

Now she's 16 and (predictably) suffering from arthritis in her hips and rear legs. She's been taking Cosequin mixed into her wet prescription food (Hill's j/d for mobility) for the last year or so. Her vet and I have agreed not to go the route of corticosteroids because of the attendant kidney problems.

She's at the age where I take her to the vet whenever the slightest thing seems off, so she's had about four inspections over the past year, including X-rays, blood tests, urine tests, and all the usual senior wellness panels. She's had a rickety gait for the last few years, but only in the last few months has she really hit the wall. Instead of sleeping with me - which she's done obsessively since kittenhood - she'd been hiding in the closet or in a remote part of the condo. Occasionally she'd let out a pitiful noise until I came to find her.

Once things got to this point, I took her in again about three weeks ago. Doc said she was in excellent health - no heart, kidney, teeth, or liver problems - but she'd lost about a pound over the past six months, probably because she wasn't coming downstairs to eat as often. We discussed acupuncture, but it is tremendously expensive, so instead he prescribed her 0.3mg of buprenorphine, administered orally twice daily, for the arthritic pain. She's not eating as much as she used to, although she still drinks water and seems to be passing her food regularly. But she really just seems to be lying there in one corner of my room.

Needless to say, I'm beside myself with anxiety. I've become accustomed to a the progression of aging over the years, but this latest development is hitting me pretty hard. It's hard to externally assign values of "happy" vs. "unhappy", but I do have quality of life to consider in the abstract.

So, given there are no discernible health issues aside from the arthritis, what now? Am I looking at an endgame here, or is this likely just the buprenorphine? And are there any other options I should be raising with her vet? I know she's not going to spring back to life at 16, but I find this all terribly depressing.
posted by mykescipark to Pets & Animals (23 answers total) 2 users marked this as a favorite
Jumps could just be painful. Kitty or dog stairs for your bed might help. Your cat is old. Like 90 human years old. She is going to be tired and not do much. Spend time snuggling by sitting on the floor or getting on of those soft pet beds. Maybe find a special treat to perk her interest.
posted by AlexiaSky at 1:14 PM on June 14, 2014 [1 favorite]

What about Adequan? It's not a corticosteroid, and it worked wonders for one of my parents' severely arthritic cats, as well as for my late male cat. If you have no problem with needles, you can learn to do the injections yourself.

Getting the cat to high(er) ground: try arranging strategic ramps, boxes, or steps to the bed.
posted by thomas j wise at 1:21 PM on June 14, 2014 [3 favorites]

My experience with older kitties is they sleep lots more then when they are younger, they steadily lose weight over a period of time no matter what you try and feed them, and they sleep in the most comfortable to them spots. Also it is impossible to get cats to diet - they just will not comply.

I made it about what worked best for my cat till it was time. I took her food to her new food fav spot, gave her the freshest water whenever she wanted and made sure her new sleep spots were as comfy as possible.

It is very hard to do this. I currently live with an 18 year old dog who spends most of the day staring at a fence.

You are a great pet owner for taking such good care of her.
posted by cairnoflore at 1:26 PM on June 14, 2014 [5 favorites]

The best advice I got about "when is it time to put my animal to sleep" was the "Three A's" theory: Activity, Appetite, and Affection.

If your pet has all three of those "a"s still where they were throughout her life, then she's doing okay. If she majorly or completely loses one of those "a"s (like, she's not eating AT ALL but is still affectionate and active), then...okay, yeah, call the vet, but hang in there. If she loses 2 "a"s, then start really keeping an eye on her; it's when she's lost all 3 "a"s that it's time.

It sounds like she's not as active, but that may be due to the arthritis pain more than anything else. And you're treating that, so that's good (that's the other best advice I got from my aunt about pet care "if it's treatable, then...treat it"). You also say she's eating less, but it sound more like "she's eating lighter" as opposed to "she's not eating at all" so....it was wise to take her to the vet, but you're still not quite at Death's Door just yet.

It sounds like you feed her downstairs, but she sleeps upstairs; I wonder if maybe moving everything to one single floor may help so she doesn't have to climb stairs any more. That will help with the arthritis pain, I think.

And in terms of your final question (which I sense is, basically, "How much longer are we talking here") - unfortunately, hon, no one knows but The God Of Cats. You're doing all the right things, though - you and your vet are teaming up to keep an eye on her, you're giving her a lot of attention, you're treating her pain - and your cat knows that and is grateful. Also, your cat isn't anxious about any of this - animals are like total Zen masters, where all that they know is the present moment and that's all that matters. So your cat isn't worrying about Impending Death or anything; all it knows is that you're still there to snuggle her, and feed her, and if her joints suddenly get achy you give her attention and you also have some magic stuff which makes them not hurt, and so she thinks you're awesome. And for her, that's all that matters. We humans are the ones that have this end of things the worst; but that's a blessing, I think, that so far as your cat knows, you're just getting way attentive all of a sudden which is awesome.

Good luck.
posted by EmpressCallipygos at 1:28 PM on June 14, 2014 [31 favorites]

Try adjusting your space so that she can live a stair-free life (feed her upstairs), and have ramps for the places you know she likes to go. You can get cardboard scratchers to use as ramps, or wood with carpet scraps glued to them. Make sure that her litterbox is really easy to get in and out of (you might find a huge high-sided plastic tub with a door cut into the side would work) so it's not painful for her to lift her legs up high. You can find heated cat beds, too, which go a long way for joint pain.

To make her days more interesting, consider bringing in interesting things for her to smell when you come home. She also might enjoy things like leaving the radio or tv on at a low volume, or making it extremely easy for her to get up to a window to look out of it.

This all sounds normal for her age. You're a good cat parent.
posted by Mizu at 1:30 PM on June 14, 2014 [2 favorites]

Oh, she also might like having her food elevated a little - bending down to eat can strain her joints, too. A few books as lifts should do the trick.
posted by Mizu at 1:35 PM on June 14, 2014 [1 favorite]

If little lady doesn't want to come downstairs to dinner, then dinner can be brought upstairs to little lady. Also her cat pan. Also steps built to go anywhere she might want to climb such as onto the couch or the bed.

Consider putting her food into dishes that are raised off the floor a few inches, such as by putting them on top of a cereal box which is lying on its side on the floor. We had a cat who got an arthritic neck and putting her food up so she didn't have to bend her neck made a huge difference.

All that said... Hiding is a bad sign and indicates that she is fragile enough that she can't deal with stuff. It's the instinct that clicks in when an animal knows it can't run, argue or bluff. I'm going to suggest that when she hides you go find her and keep her company in the bottom of the cupboard or behind the stove or wherever she goes, or bring her out for some quality time on your lap or beside you on the bed before gently putting her back where you found her.

Lethargy is not so bad as hiding. When she is out in the open not moving I wouldn't be as worried as when she is hiding behind things. The real bad sign is when she messes wherever she is hiding. You might want to be prepared for that by putting a washable throw down in her hiding places. It will keep her more cozy and make it easier to clean up if the messes occur. If the messes don't occur she and you are still somewhat ahead of the game still.

Also be aware that she could be losing her perceptions. She may be going blind, deaf and losing her sense of smell. That can also account for what appears to be lethargic behaviour. If she can't see where she is going she may restrict herself to only a couple of locations.

Also, beware of her going somewhere you can't get her. If there is any risk of her going in behind some furniture or a wall or fixture you can't move to get in at her you might want to block access off so that she can't do that.

Cats do often recover. You have to wait through the uncertainty. She's not in pain, she still eats and drinks and eliminates, just not the same quantity of food as before, right? In humans arthritis will flare up and ebb down again. She may be having a flare up that will abate on its own or respond to the medicine. If she were mine I would be preparing for the worst but still a long way from giving up on her.

If you can stand it, see if she likes baking herself in front of a heater. This also can give her relief from the arthritis, not only from the heat but because having a heater on could make the room dry and low humidity conditions help with the arthritis too.

This is a very hard time. I have one who entered our home as a second birthday gift for my now nineteen-year-old. He will be entering this phase soon and has begun it with senility causing him to forget where he pees. I'm glad I don't have carpets.

Your little lady is beautiful.
posted by Jane the Brown at 1:43 PM on June 14, 2014 [1 favorite]

You might try another pain reliever, even perhaps a steroid shot every now and then instead. The current one you are using may be causing his lethargy.

At his age, I think the main thing is to make him as comfortable as you can, and you are doing this. (I also like putting all his stuff on one floor.)

And don't be too hard on yourself. You are a loving, concerned cat daddy, so just continue to do the best you can with the help of your trusted vet.

And brush your pal, or whatever he likes best, as often as you can. He is happy that his best buddy is with him.
posted by PJSibling at 1:43 PM on June 14, 2014

Also, if she were overweight to begin with the weight she just lost may not be a bad thing at all. In her pictures she is not a bag o' bones cat, she appears to be quite a healthy weight still.
posted by Jane the Brown at 1:47 PM on June 14, 2014

Is there a reason you're not using NSAIDs? Metacam works really well for feline arthritis and potential side effects can be well managed with 3-6 monthly blood tests. Much better than corticosteroids, which are actually kind of shit and have other side effects (muscle loss for example). Going straight to a morphine analogue seems pretty extreme, particularly as it only stops the pain rather than treats or slows the disease process like an anti-inflammatory. In NZ and Australia Metacam is gold standard of care and both mine and my sisters cats took it for years with good effect.

You should also look into cartrophen (also known as pentosan). We found it made a noticeable difference to my cat's very severe arthritis, particularly when she had to stop the Metacam and switch to steroids due to an unrelated liver disease. You start with very regular injections then taper quickly to once per month. I used to do it myself at home because subQ injections in a cat are super easy.

Also just keeping her warm helped, summer was always better for that reason.

16 is getting up there and is how long Mardy, my arthritic cat, lived. But we were able to make her comfortable with even the eventually very bad arthritis and that's not what got her in the end. It sounds like you still have treatment options to explore and that fixing your cats pain could help a lot with what's going on with her now.
posted by shelleycat at 1:49 PM on June 14, 2014 [4 favorites]

Buprenorphine can definately be sedating. As others have suggested maybe talk to the vet about reducing her dose or trying something different. Perhaps after she's been on it longer her activity will pick up. The vet can probably tell you about that possibility too.
posted by sevenless at 1:55 PM on June 14, 2014


Okay, have you considered cat acupuncture to ease her pain?

Animal acupuncture practitioners are doctors of veterinary medicine in addition to trained, licensed acupuncturists.

See the below list for some resources, and I hope that you and your beloved cat friend find some relief as she gracefully ages, as it is difficult to watch those we love suffer:
  • "Acupuncture for Cats," by PetMD (their tagline is "Vet Authored. Vet Approved." So ... )

  • "Cat Acupuncture Treatment," by VetInfo

  • "The Science Behind Acupuncture for Your Cat," authored by Narda G. Robinson, DO, DVM, on CatChannel website

  • "Acupuncture for Cats," this time from ConsciousCat.net

  • "What You Can Expect from Veterinary Acupuncture," on TheHolisticVet website

  • kindness.
    posted by simulacra at 1:59 PM on June 14, 2014

    Do ask about a different pain reliever. Cats can take tramadol (my dog takes it for arthritis, works great for her!), so ask about that and the medications others mentioned. It will depend on other concerns or her medical history which is best. If the one she is taking does not seem to be working, then that is a good reason to try another one.

    I would strongly encourage you to put all kitty necessities on the floor the kitty already spends her time. Food, litter box, water all without stairs might make a world of difference.

    Be sure, also, that the vet checks her blood pressure. Sometimes older cats get high blood pressure and it can make them do weird things.
    posted by AllieTessKipp at 2:07 PM on June 14, 2014

    In addition to the above: your kitty might really love a heated cat bed. My ancient, arthritic former kitty loved her heated bed, and it seemed to make a difference in her quality of life.

    I also got her kitty stairs and ramps so she could climb up onto her favorite places (my bed, primarily) without exertion.

    With this kitty (who lived to be 18!), I knew it was time to have her put to sleep when she no longer wanted to purr, eat, or do anything but lie in one place all day. When I had to lift her in and out of the cat box, it was time. She made it very obvious that she was suffering.
    posted by Rosie M. Banks at 2:56 PM on June 14, 2014 [5 favorites]

    Does she have one of those semi-enclosed pet beds? It sounds like she'd really appreciate the combination of softness and safe feeling. I'd recommend a _big_ one, so she can stretch out. Maybe get one for the bedroom and one for the living room, so she can feel safe while hanging out near you.

    Definitely ramps so she doesn't have to jump. The combination of overweight and age must make her joints painful on impact.
    posted by amtho at 2:58 PM on June 14, 2014

    You've been a wonderful owner, just keep accommodating your lovely companion.
    You might also consider preparing for when The Moment comes, and talk to your vet now about a house call, instead of taking her in (depending on how she is with trips to the vet).
    We've done this for our last couple of kitties, and it's so much easier, and, I think, kinder.
    The kitty is in a familiar place (your arms, on a comfy bed/chair), and there's no barking, meowing, or weird smells. There's also no trauma of the cat carrier, and no car trip.
    Our vet doesn't do house calls, but there is a local mobile vet who specializes in this. He's very compassionate, and kind.
    posted by dbmcd at 5:02 PM on June 14, 2014 [1 favorite]

    She's a beauty! I too would recommend a heated pad. It was great for our old achy cats. Here's one from Foster & Smith, but any pet store should carry them.
    posted by annsunny at 5:55 PM on June 14, 2014

    Try the Pet Naturals of Vermont Hip and Joint Treats - they may help a bit.

    Once when my cat was feeling poorly, I ended up setting up a few cardboard boxes on their side with towels in them. This way she'd have a sheltered lair where she'd feel safe and warm, but where I could see her and fuss at her periodically.
    posted by sebastienbailard at 7:39 PM on June 14, 2014

    Response by poster: Thanks everyone for your excellent thoughts and advice!

    I should have mentioned that I've already converted her to a single-level domicile, with food and litter easily accessible sans elevation.

    She has never been fond of anything cat-specific (toys or bedding), but I have long considered a heated cat pad, albeit with the expected outcome that she would ignore it as usual. I guess it's time to try.

    I will also look into altenatives for her current medication. Thanks for the recommendations there.
    posted by mykescipark at 8:11 PM on June 14, 2014

    A heated cat pad made my elderkitty seriously happy, although she's turned her nose up at it now we've got warmer weather. We also put steps and boxes next to her favorite pieces of furniture so she can easily hop up to the couch or chair.

    She gets fed and watered on the coffee table next to the couch -- it's messy and a bit smelly, but she can't walk around too much and has slowed down a lot, so I consider it a service to my dear old friend.

    For future reference, you might want to check out the Feline Quality of Life Scale and use it to measure your cat's general health from week to week.
    posted by vickyverky at 10:21 PM on June 14, 2014 [1 favorite]

    Have you looked into glucosamine or fatty acid/fish oil supplements to improve joint function? I'm hearing a lot of pain-management in your description, but not so much about the nutritional aspect.
    A cat chiropractor may be able to help her body feel more comfortable as well... If she's been curled up and compensating for her pain through adjusted movement, she may be all stiffened up all the more in some areas.
    I think more proactive medication and nutrition measures may help, rather than focusing on pain management in isolation.
    My best to you both!
    posted by NorthernAutumn at 10:53 PM on June 14, 2014

    The Pet Naturals treats were how my wife and I started dosing our cat with glucosamine (after meals, as per label). I consider them to be reliable, and believe some other brands have poor quality in terms of dosage of active ingredient.
    posted by sebastienbailard at 12:23 AM on June 15, 2014

    Response by poster: Have you looked into glucosamine or fatty acid/fish oil supplements to improve joint function? I'm hearing a lot of pain-management in your description, but not so much about the nutritional aspect.

    Ducking in once more just to note that I mentioned she gets both Cosequin (glucosamine) and her prescription food (with omega-3s and carnitine) daily in the original question. Thanks!
    posted by mykescipark at 9:43 AM on June 15, 2014

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