What factors should I use to decide when its time to euthanize my elderly cat with kidney disease?

Question

I am stuck with a decision of life or euthanasia for my 18 year old cat. Should I leave her be or euthanize her now?

My cat's kidneys are bad, but not shut down yet. My cat still drinks water and eats food. She does not eat as much as she did before. I had my cat at the vet for a 24hr IV. My cat still runs, jumps, purrs, and even rides in my car with me in the morning when I go to get coffee. My cat sits/lies on the passenger seat and if I do not take her, she gets mad (I open the passenger door of my SUV, and she jumps into my car and then onto the seat, with no help from me). The 24hr ER vet and my cat's primary vet wrote her off 3 months ago, saying she will pass before Thanksgiving.

My cat's weight hovers around 5 1/2 - 6lbs, depending on how much she ate. My cat does not hide or hide to sleep. There are places in my house my cat loves to sleep, and my cat still sleeps in those same places. My cat follows me wherever I go.

What has me worried is the amount of food she is eating now, which is less than she used to.

My cat still shows signs of life, by eating on her own, drinking on her own, running, etc.

I do not want her to be in pain. I know and understand it is only a matter of time before the kidney issue takes a serious turn.

I did forget to mention, she only uses the litter box when she needs to go. My cat still comes to me when I am eating and wants some of my food and if I do not give my cat pieces of food, she will meow and pace like crazy.

Answer 1

I've had two cats who ultimately died because of kidney disease. In both cases, the cats let me know and the final drop-off was pretty fast. Definitely consult your vet, but it sounds like your cat's quality of life is still good.

A 6-pound cat will eat less than a 12-pound cat. There are ways to get more calories into your cat even if she doesn't eat much; your vet can advise you on this. Keeping her hydrated is important. If you're dealing with late-stage kidney disease then you're probably already giving her subcutaneous fluids; ask your vet if you should adjust the amount.

I said my cats let me know when it was time. For the first one (age 18.5), he'd been declining but was still enjoying life -- and then one morning he didn't want to get up, and when I picked him and carried him to the food dish he took a couple steps and fell. I spent the next several hours with him in my lap and intermittently talking with my vet. He didn't seem to be in pain, but he wasn't trying any more.

The other one (at least 16; we didn't know exactly), she started sleeping a lot and found some hiding places, and on that last day she walked very slowly and unsteadily (and didn't want to at all). Again it was clear, especially after the experience of the first one.

Make your cat comfortable, let her enjoy her remaining time, make sure she continues to get nutrients and water, and consult your vet.

Answer 2

Please take your cat to the vet and express your concerns. Ask the vet directly how your cat feels on a day-to-day basis.

• Is she in pain?
• Is she uncomfortable?
• Is her mental state affected?
• What should you look for to identify pain and altered mental status?

These answers should help you determine when euthanasia is the right time.

Additionally, there may be things you can do at home to help improve her quality of life while you still have her. Subcutaneous fluids often make a cat with kidney disease more comfortable (a greater volume of fluids can help inefficient kidneys clear toxins better), and acid reducing medications can help bring back appetite. Your vet should be able to help with both of these, and if not, find another vet.

Answer 3

This is a hard problem. I have been there several times.

My advice is to let your cat live for as long as it does have a quality life, and I think it is a good thing to be prepared to take the decision of letting your cat go when the time comes.

But for as long as your cat does eat, drink and function normally, it is best to let her live until she starts to have problems.

In the late stages of kidney failure, toxins build up in your cat's organism. This does affect the brain and she might be confused and have other problems.

When this happens, it is best for her to be put down and it is best for you to let her go.

You do not normally need an appointment at the vet for this. Your vet will understand how hard this might be for you.

Answer 4

The best thing to do is see what her quality of life is, and by the sounds of it, it is still good and happy, as long as she is pain free let her have some more time, this way you can prepare for the end as well as letting her have a nice end.

Answer 5

This could be a little off-topic, but maybe your cat has still some months to live, so please read my story :)

We've been there two years ago. The cat was on renal veterinary food already, but suddenly began to eat less. We did the blood test and as our vet suspected it was due to the rising levels of creatinine which is the symptom of the kidneys' problems. With high levels of creatinine, besides other problems, the cat stops eating.

You can lower the level using the right food, then the pills and finally the most powerful solution is giving the cat saline infusions, so to "wash out" the creatinine from the blood. Direct infusions into the veins works best, but if you are not a vet, at home you can give the cat underskin saline infusions.

Consult your vet about this. We had prolonged the life of our cat for something like 1,5 years - he started eating more, he felt good - but we had to do the infusions every two days.

One day even the infusions stopped working, the cat refused to eat, walk... and we had to put him down. But since your cat still feels quite OK - fight for it :) Good luck!

Answer 6

My cat Susie had thyroid problems, a thyroid tumor, a mammary gland tumor, and Stage 2 kidney disease 2 and 1/2 years ago. I couldn't give her medicine or Sub-Q because she was skittish and I would hurt her trying to give medication. My vet found a compounding pharmacy that could make medicine I could rub in her ears to stimulate her appetite and administer prednisone. She lasted two and a half years with this treatment.

Answer 7

You 'know' if a cat is in pain because it will hide and cry. If you would get fluids from your vet, you could give your cat fluids to ease the strain on the kidneys. Your cat is not eating much because she probably feels nauseated sometimes - this is symptomatic of kidney disease. I have been through this several times with elderly cats, it is a common problem in the aging.

What I did was give my cat/s fluids subcutaneously - you can start with 10ml a couple of times a week, then increase dosage frequency to every other day. Maybe every day, depending on how advanced the kidney disease is. Believe me, it will help your cat a lot.

Oh, and change vets! You need to go to someone who can help you 'manage' your cat's kidney disease, not write it off as if she was a goner.

You can do this, good luck!