Friday, August 9, 2019

Making end of live decisions when you aren't facing the end of life


seventeen-year-old cat sitting comfortably on a comfy chair

I am the owner of two seventeen-year-old cats. Muffin and Eli are siblings that I adopted back in 2002.  If you have been following this blog with any regularity you will know that Muffin is facing end-of-life issues with her kidney disease. Despite knowing she was in kidney failure I made the decision to have a growth removed from behind her ear and she has been suffering the consequences of being sedated ever since.

She is under the care of a vet and is due to have her blood drawn again to check her kidney values here any time now, but in general, she is doing okay despite several scares. My real dilemma is becoming Eli and he is the reason for this exploration of my feelings on what we are facing.

History:

Eli was a very sick little kitten and trying to get him well I made him very fearful of humans by medicating him and then letting him run away as soon as I was done. I thought "get it over as soon as possible" was the best thing, but it only taught him that we were something to run from and fear. If you have to medicate kittens, hold on to them afterward, soothe and comfort them so they don't only associate you with being held against their will and having something really gross forced down their throat. 

When I made the decision to keep Eli, it was with the knowledge that I would never be able to treat him for anything longer than a couple of days. It would absolutely ruin his quality of life and that is just not something I am willing to put him through.  I made the rational and sound and unemotional decision that if the time came, I would rather release him from his body than make him endure something I *knew* would absolutely ruin his life from a quality standpoint. The few times I had to give him medication made that painfully clear.

While he has mellowed in his old age, being able to pick him up when I want to is still not easy. If I walk over to him with the intention of even patting him he evades me. He will come to me and ask for love and attention, and I am happy to give it to him, but he will not take it under any circumstances. Endure, sure, but he hates it.

What we are facing:

Now that he is 17, I know I am coming closer to whatever it is that is going to make me make that end-of-life decision for him. This week has been a hard one for him, as he has had a couple of instances of stomach emptying vomits (aka five or more in the space of an hour). He is also riddled with many lumps and bumps. Each one I have had checked out are simple lipomas (fat deposits) but they can't be comfortable and who knows what is under some of them.

So, I sit here with a seventeen-year-old cat who could probably benefit from some vet care, but is it in his best interest? Is it in mine? (just so you know, he had bloodwork done a few months ago and he checked out perfectly - he has always had regular exams - I am a firm supporter of regular exams for cats)

I know, this might sounds cruel to some, but I don't believe it is in his best interest. Taking him to the vets is hard on him. Having the vet and the techs examine him and draw blood and samples, it is hard on him. The stress is not good for him and if there is something brewing it can just make it worse.

But now that these moments are happening with a bit more frequency (once a month or so) and I wonder if I am making the right decision. Emotions are starting to get pulled into the decision making process. I am not focusing so much on what is right for him, but what is right for me. I really want to know what is going on. I want to test every lump, I want x-rays, I want answers - possibly answers that aren't to be had - as seventeen-year-old cats are often quite inconclusive..

Options:

I have two options.  Take him to the vet for tests or do nothing. 

*If I do nothing, I know nothing. I can give him fluids and I can give him Pepcid for an old man stomach - which is pretty common. I can give him CBD for any possible anxiety or mild pain he might have from the lumps (that don't really seem to cause him any discomfort from my point of view but since cats are so good at hiding things it would be a "to be safe" kind of decision) and when his quality of life is such that I can't keep him comfortable we can send him off gracefully. (which hopefully is years away)

*If I take him in I have one of two outcomes. I still know nothing except everything still checks out perfectly or we find something. Most of what we can possibly find in an old-man kitty means daily if not twice-a-day care, which I would not put him through. And while I hate to say this, but money is always a factor. Very few people are in the position to say money is not an object to treatment.  If he were three, or even thirteen, there wouldn't be much hesitation, as issues at that age are often easily treatable and take very little time but the chances of that diminish with every year of life. His being seventeen, his quantity of life is a factor. Sure, he *could* live until 30, but the chances of that - even with the absolute best care and the most willing patient - is minimal. 

Decision:

At this point, I am sticking by my original "unemotional" decision made in love 17 years ago to give him the best quality of life I can, even if the quantity is reduced. Back then I was sure he wasn't going to make it to five, let alone ten. I am not saying that emotions won't get the best of me and I'll end up sinking hundreds of dollars for an answer that does not help me.. but if I do that doesn't mean it is the right decision.

Eli is in no danger at this point.. he simply vomits a little more often than he used to and has lumps. This is simply a discussion of end of life issues when you aren't facing end-of-life because they are important. I will probably have a few more over the coming weeks because I believe this is a very important topic and I don't believe there are enough resources out there for pet owners who love their pets beyond reason but yet are not willing (or not able) to "do absolutely everything to force them to live". Choosing to honor the cat and what they are able to do (or what you are able to do for them) is not the wrong decision.

And I still believe that in decisions of "when is it time", that a month "too early" is far far better than a moment too late. I do not want my cats to suffer.. Think of it as forcing someone to leave the party before the house burns down.

19 comments:

  1. It is never easy. But you are so right that they all deserve their best interest to be at the fore. And thinking about it before the house is on fire is much better than decision making in a panic.

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  2. My heart breaks for you, Connie. It's such a tough decision to make but whatever you decide will be done with much thought and love. There were some things I wish I had never done with Romeow but my vet gave me so much hope. I will never put another kitty through the same procedure. It made me cry when I saw how miserable he was and how much he was suffering. Prayers for Muffin and Eli.

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  3. I had a cat that was a tad feral. He hid for 2 weeks out of the crate from Humane Society. It took 2 years, but he would sneak up in my bed and sleep in the corner at night. He let me pet him with my foot. Ten years later, he would let me pet him with my hand if I didn't make eye contact. Getting him to the vet was more than difficult and stressful. I decided he had several years of vaccines and goodt was enough. When he was 16, I knew his time was coming to the end. I knew he could not be medicated. I waited until I knew it was time and took him in. He was in heart failure. The doctor could not believe I wanted to "try" I or thatbdidn't bring him in earlier. She just didn't realize I had been preparing for that moment for several months. It's been many years since and I'm still good with the decisions I made for my big man. I gave him a good, safe and unstressful life.

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  4. Anonymous9:26 PM

    Oh, Connie. I truly understand your dilemma. My absolutely regal loverboy tuxie, Romeo, absolutely hated car rides, carriers, vets.. when he got sick at the age of six, it pained me greatly to put him in a carrier, he yowled, ran rather violently around in circles in the carrier (it was not large, and he was 13 lbs) scratched at the door of the carrier to the point of leaving two of his claws behind... to top it off, he soiled himself and the carrier and looked totally humiliated by the time we got to the vet - just 20 minutes away... The ride home was yowling and pawing and he wouldn't come near me for a day... The diagnosis came back as lymphoma. The vet suggested to bring him in for a feline form of chemo and numerous visits... I couldn't put him through that. He looked so ashamed after the carrier incident, my heart was broken. I knew he didn't want me to see him or anyone to see him like that. I couldn't do it to him - even though it was for him. I lost my baby while he lay in my lap at home just two weeks later... It still hurts and I still miss him, but I am convinced that allowing him his dignity far surpasses everything else. When it's my end, I hope to be afforded the same. Hugs and purrs to you and yours.

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  5. You have to do what is best for Eli. Though would giving him something like gabapentin before a vet visit help him to be less stressed? Zoey does not do well going to the vet but since giving her gabapentin before visits, she handles them much better.

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  6. I understand and agree with you completely. Quality is what every being wants and deserves. <3

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  7. It's not pleasant to think about, but absolutely necessary. It can be so hard to make those decisions in the midst of an emotional moment so having plans ahead of time can make a difference.

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  8. I don't even know how to begin to approach that decision. But I know the kind of person you are - and how much you love cats - and I have complete faith that you'll make the best decision for Eli.

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  9. Sometimes there are no even remotely easy answers, and everyone hates being faced with them. You just do the best you can, and I know you will do the best by Eli. Purrs to you.

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  10. These are the hardest decisions pet parents will face, and my heart goes out to you. I remember so many years ago I spent a few years working for vets, and saw things... and I swore I'd never put my own through too much. And I've kept that promise. I know that what you decide will be the right thing for yours. Hugs to you.

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  11. I had to make such a decision some years back with our ten oldest boy, Percy. He had some major medical issues that caused home to be very uncomfortable with vet visits after spending multiple weeks at the emergency clinic, where among other things, we found out the hard way that he was allergic to most of the commonly used antibiotics.
    At only 14, his kidneys were starting to go, but still had enough function to get by on for another year or so. Then he lost his vision, started bumping into things around the house. Anything and everything that came up close caused a startle reaction, and it was clear he was pretty unhappy about it.
    The final blow came when he had a relatively minor infection that could have been treated - in any other cat. Given the long list of antibiotics he had reacted badly to, it just wasn’t the right thing to do to put him through another rough time finding one that would work without making him sicker and even more miserable. We put him to sleep, while telling him how much we loved him, petting him past the last heartbeat. I’m tearing up again as I type, and this was 4 years ago. Still missing my handsome boy.

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  12. It is wise to make some decisions before the end. I always want to know what is going on with a cat, but usually after spending hundreds of dollars, I still have no answers. Only you know Eli and will make the best choices for him with your heart. XO

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  13. Making the decision ahead of time is a good idea, though even with those thoughts it will never be easy.

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  14. One of my cats - who is only 6 so far - is like that about the vet. He has decided to live indoors only (after living as a kitten in my garage all one summer, which is where he ran when he first arrived in the neighborhood. He frequently comes and cuddles, plays with my other cats, and is generally a lovely, well-adjusted cat. but if he becomes really ill - and of course the fact that he is relatively young makes a difference too. All you can do is trust your heart will guide you. We know Eli will not be allowed to suffer. Purrayers.

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  15. You are the best advocate for your cats; you know them. Trust yourself. We all KNOW you are treating Eli (and all of your cats) with an open heart, and with a thorough knowledge base. A vet visit really isn't always the answer.

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  16. In the end I'm sure you will do what's right for Eli, though I do know how difficult such things can be. Before my old Orbit I had Isaac, who made it to about 16. He was suffering greatly and I couldn't find the strength to let him go when I should've, and I when I di finally make the decision I held onto him just a little longer so my children could come and say their goodbyes. Selfish, I know, but it was just so hard. Hopefully when I see Isaac again he'll forgive me.

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  17. Always a hard decision. I have one like this also, I don't think I could even get one days worth of pills in him.

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  18. decisions such as this one are never easy; the questions are always the same; should I, did I, would I, what if, what about. the only "thing" in your head you need to listen too, is Eli and you yourself, will "know" when the day comes when he wants to venture off into his 10th life.... vet visits or not.

    for what it's worth; my mom's cat boomer was diagnosed with kidney failure in 2015; he never saw a vet again until the day he journeyed off to heaven; two years later ♥♥♥♥♥

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  19. It has to be your own decision as you are there with him and know him best. I have been through this myself before and it is hard.

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