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I'm posting some thoughts here....I haven't fully thought on what to do, and have to talk to the vet in detail first, but I just feel the need to put this down somewhere.
One of my cats is a 17-years, 4 months old female. I'd noticed recently she'd dropped weight and was doing some vomiting, so I took her to the vet. We went over what was going on with her--she eats well, drinks well, uses the litter box no problem, it was just despite the eating and drinking, she was dropping weight, and the vomiting was a concern. Blood and urine samples were taken, and the vet went over some theories.
He called and left a message for me confirming that she has hyperthyroidism, and he mentioned that she also had kidney disease. He advised that the hyperthyroidism often masked the kidney disease. He said to give him a call back so we could discuss options--he had gone over a few, such as a radioactive iodine therapy or surgery, both of which he advised he wouldn't strongly recommend due to her age and the expense. He also mentioned medication or special diet for getting her hyperthyroidism under control, but advised that it could show the kidney disease to be much worse than what it current appears to be.
I called and left him a message and am waiting for him to call back. And I am looking at all the options in regards to food/medication.
And I find myself wondering if deep down, I should consider letting her go. It wouldn't be the first time I've had to do this--I always tend to have a lot of critters--but it's never easy to do so, and I've had her since she was 12 weeks old, so.....really hard to think about her not being around any more. Especially given that she doesn't really behave like she has a problem--she's slowed down, due to old age, but she'll still do things like go back on her hind legs and 'box' at people to get them to pet her, or fuss at me if I sneeze too loudly (she's never liked that, even as a kitten.)
I should probably wait to talk to the vet more in detail before making any final decisions, but I think deep down, the minute I took her to the vet to be checked out, I was bracing myself for the possibility that it's her time. Which always brings up the age-old guilt question of, "Will I be trying too hard, or not trying hard enough?" in regards of what to do.
I think I just needed to get this out more than anything. Thanks for listening.
I had a male cat about the same age as yours who was hyperthyroid. For a while he was on methimazole (which BTW, I am on also due to hyperthyroid). He then had surgery. That is a really tricky surgery if I remember correctly. I know our vet stopped doing it and they only do RAI now in place of that. I also had read back then that it can mask kidney disease like you were told. A lot of older cats get kidney disease. I had other cat die from that but lived quite a while with it. My thoughts are take this one step at a time. First find out if it is indeed she is indeed hyperthyroid and treat that. Maybe you will only have to give her a pill and she will do fine. Try not to stress. Hyperthyroid anyways is just an overactive thyroid gland, and considering I have one, I know you can live with it. My personal opinion is that is not a reason for you to have to worry yet about putting her to sleep. Whatever you decide to do though is up to you and I wish you and your cat all the best.
I would like to say that I know your pain albeit in a younger female cat, then, in '12. She did, then, have I-131 radioactive treatment & a world of difference til now. Yes, kidney is a worry always, as the 2 fastest ways a cat passes are kidneys & cancer. So, if it were me, I'd op (if she is medically stable) for the just over $1,000 w/ the I-131.
But.. a big but.. if vet feels her quality, w/ failing kidneys, are too far gone then I'd have to consider putting her to sleep. I know how hard that is, so would do all I can to treat her w/ I-131 unless it leaves her in kidney pain so bad it hampers her remaining quality of life.
I'm sorry you are faced with this. A lot, for me, would depend on what the individual cat can tolerate. Some cats can't stand a lot of vet trips and messing about, other cats take those things in stride.
Quality of life is what matters most. You can put her on the methimazole, to help get her thyroid numbers down. This will help her feel better (and reduce the likelihood of stroke), but she will need frequent blood work at first to determine the most effective dose for her, which means frequent trips to the vet.
This medicine comes in pill, liquid or transdermal form (rubbed into the ear flap).
It is true that hyperthyroid can often mask kidney disease, and you may find her CKD more advanced than first thought.
To help her feel well for as long as possible with regard to her kidneys: Feed a wet diet only, to keep her well hydrated and her kidneys flushed. Subcutaneous (sub-q) fluids can be done at home to help support the kidneys as well, if it's something the cat will not be too stressed over.
Again, it all comes down to what she will tolerate. If you think you don't want to put her through a lot of stuff, it comes down to simply managing her days and paying close attention to her quality of life, and when she's had enough (she'll let you know), or when the bad times outnumber the good, let her go.
Just one thing: I really do urge you to NOT feed that Hills y/d product that claims to "manage thyroid health". The products are made with very poor quality ingredients and the kibble doesn't have any meat in it at all. The diet "works" by restricting iodine, an essential mineral. If you do decide to attempt this diet, as a sort of last resort, please, please feed only the wet, which at least has some meat in it, and the essential moisture she needs for her kidneys, though it's still terribly high in carbs at 31% DMB..
I would also recommend talking to her about all this. Let her know what's going on and what you are feeling. Remind her now and then to let you know when she's had enough, make that promise to her, that you won't let her suffer. x
My Girl is 19 and hyperthyroid and taking Methimazole. Her kidneys are okay but she has high blood pressure and is taking Amlodipine. Luckily, she takes the pills in a Pill Pocket that makes life easy for me and her.
If at all possible, you may want to consider having her blood pressure taken. Kidney disease and high blood pressure oftentimes go hand-in-hand. I found this out the hard way unfortunately.
Quality of life is very important and it sounds like she is not uncomfortable or unhappy.
My Girl is 19 and hyperthyroid and taking Methimazole. Her kidneys are okay but she has high blood pressure and is taking Amlodipine. Luckily, she takes the pills in a Pill Pocket that makes life easy for me and her.
If at all possible, you may want to consider having her blood pressure taken. Kidney disease and high blood pressure oftentimes go hand-in-hand. I found this out the hard way unfortunately.
Quality of life is very important and it sounds like she is not uncomfortable or unhappy.
I agree about the BP.
My experience: My tiny little 17 year old girl had CKD, hyperthyroid and high blood pressure. She also had megacolon, severe arthritis and was a cancer survivor. She tolerated the frequent vet trips and blood draws with no trouble, and had no problem getting sub q fluids at home. I gave her fluids 3 times a week, increased to 4 times a week in her last 6 months.
She took a number of meds for other things, but her little body couldn't tolerate the methimazole in any form, so her hyperthyroid went untreated.
The amlodipine (for BP) made her faint, even at the tiniest dose, so she couldn't take that either. The result of course was stroke. She had three, the first, she recovered almost fully from, left with a little deafness in one ear that seemed to go away after a few week.
2 months after the first stroke she had a dental which she got through with flying colors (two extractions) and no increase in her CKD.
The 2nd stroke, 5 months later, was a little more severe, but she rallied, she had a slight paralysis making her walk in a bit of a U shape, but she was still happy and not ready to leave us yet. Her third and last, on May 5, 2009 was severe enough that she asked to be set free and I agreed with her.
However I also want to mention the vet trips. Like I said, she tolerated vet trips well. Never a fuss, of any kind.
One day, in early January 2009, when I put her in her carrier for her 3 month check up, she cried. Just one cry, but she'd never done it before and I knew what she was saying. So I promised her no more vet trips, and when we saw the vet that day I told the vet no more. She has told me, she's had enough.
So she never went back to the vet, until her last trip on the day of the 3rd stroke.
Her main suffering was her arthritis, of course these days there is so much more you can do for that.
You've gotten some excellent advice here and I agree with all of it. We have a 19 year old with the same things. It would be worth trying the medication to get her hyperthyroidism under control and taking it from there. Our Benny has been on medication for about 3 years and is doing decently, given his age and the health issues.
Thank you, everybody. I was honestly close to making the call to have her put down, but talking with the vet cleared up a few things (not his fault--I think I heard 'kidney disease' and panicked). I've got the pills for her, and the food--she likes dry, so I'm mixing the two for now, upon their suggestion, and crushed half a pill in there. She's munching away happily right now as we speak. She goes back in a month to see how she's responding, and I'm hopeful it'll be good.
Thank you, everybody. I was honestly close to making the call to have her put down, but talking with the vet cleared up a few things (not his fault--I think I heard 'kidney disease' and panicked). I've got the pills for her, and the food--she likes dry, so I'm mixing the two for now, upon their suggestion, and crushed half a pill in there. She's munching away happily right now as we speak. She goes back in a month to see how she's responding, and I'm hopeful it'll be good.
I'm glad you are feeling better about it all!
Please talk to your vet about crushing a pill and adding it to kibble, I really do not think this is a good idea.. It's very important that she get the entire dose, all at once.
Also I do urge you to keep her on a wet diet. Her kidneys need the moisture, desperately. Kibble is the worst thing you can feed a cat at risk of kidney issues. The cat really needs a high moisture diet. Also with the wet, you could possibly use your add the pill to food method, just putting the pill in a very tiny amount of food at first, to ensure she gets it all, then feeding her the rest.
Please talk to your vet about crushing a pill and adding it to kibble, I really do not think this is a good idea.. It's very important that she get the entire dose, all at once.
Also I do urge you to keep her on a wet diet. Her kidneys need the moisture, desperately. Kibble is the worst thing you can feed a cat at risk of kidney issues. The cat really needs a high moisture diet. Also with the wet, you could possibly use your add the pill to food method, just putting the pill in a very tiny amount of food at first, to ensure she gets it all, then feeding her the rest.
I definitely agree about the dry food and kidney disease.
Try the Pill Pockets - if it works, it will make her and your life so much more manageable.
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