Complete Care for Your Aging Cat

by Amy Shojai

  joints; and cataract surgery that can restore vision to cats. Cutting-

  edge heart treatments such as open-heart surgery are available in

  only a handful of veterinary teaching institutions, such as Colorado

  State and University of Pennsylvania.

  Experimental and cutting-edge treatments can be hard to find and

  are often expensive. If your veterinarian doesn’t offer alternatives, it’s

  up to you to ask. “We should not be afraid to offer the best care,” says

  Jeff Johnson, DVM, a general practitioner with Four Paws Animal

  Hospital in Eagle River, Alaska. “It depends on what the client wants

  to do.” It’s important for the owner to understand the pros and cons,

  and what home care may be required before making these care

  decisions.

  Research into feline longevity and health care is stil very new.

  Studies of age-related disorders in other animals, including humans,

  stand to benefit our cats as wel . In the best of al outcomes, both

  humans and their special cats wil enjoy longer, healthier lives—

  together.

  Golden Moments: Zepp’s Last Chance

  Five years ago, attorney Marc M. Gorelnik, from El Cerrito,

  California, decided he wanted to adopt a cat. While visiting the San

  Francisco SPCA, he fel in love with a 12-year-old longhaired feline.

  “He weighed about 18 pounds, and had very light fur with darker on

  top—a cameo color,” says Marc. “He was real y sweet, crawled up in

  my lap and purred and purred. He was very mel ow and affectionate.”

  The cat’s original name—“Peach Pie”—didn’t seem to fit, so

  Marc settled on Zeppelin or Zepp for short, because of the cat’s size.

  Zepp’s heart was as big as his furry outside, and he constantly wanted

  to be held and petted. “He’d fol ow you from room to room, wanted to

  be in your lap, and was al over you when you were on the phone,”

  says Marc. “He was almost a nuisance at times he was so

  affectionate.”

  The first four years together, Zepp had no health problems. “He

  was a very low-maintenance cat,” says Marc. When the cat’s weight

  crept up to 20 pounds, it was easily managed with a reduced-calorie

  food until he slimmed down to a svelte 16 to 17 pounds.

  When he was 16, though, Marc saw a change. “He’d always had a

  great appetite. I noticed he wasn’t finishing his food, was lying around

  and keeping his distance. He just didn’t seem to feel comfortable.”

  The veterinarian ran blood tests on Zepp, but they were from the low to

  high normal ranges, nothing that convinced the doctor that treatment

  was necessary. She suspected he might be hyperthyroid, and

  recommended periodic rechecks to monitor the situation.

  Meanwhile, Marc decided to get Zepp a pal—a Maine Coon kitten.

  He contacted various breeders in January, interviewed and decided

  on one, and made arrangements to choose a kitten.

  Zepp continued to have good days and bad days, and Marc grew

  more and more concerned. “He’d never had any health issues at al ,

  and he very obviously was not feeling wel .” After further tests in March,

  the veterinarian was persuaded Zepp was hyperthyroid, and Marc

  was referred to a local practice to receive what is known as an I-131

  radioactive iodine procedure.

  “It took a long time to get an appointment, so we put him on

  Tapazole,” says Marc. Tapazole is an oral medication to counter the

  effects of the hyperactive thyroid gland. “The doctor said there might

  also be a kidney issue, but we’l deal with it after taking care of his

  thyroid.”

  When specialists reviewed Zepp’s symptoms and tests prior to

  his I-131 treatment, they told Marc the cat was in advanced chronic

  renal failure. “Then Zepp essential y crashed. I knew immediately this

  poor cat was dying,” says Marc.

  Zepp was hospitalized and given fluid therapy. Marc was dispensed

  a couple different kidney diets, and instructed how to give

  subcutaneous (subQ, or beneath the skin) fluids at home. “But he

  didn’t improve at al . He wasn’t eating, his weight was dropping like a

  stone, down to about 13 pounds,” says Marc. “My family urged me to

  get a second opinion, so I made an appointment at University of

  California-Davis.”

  Zepp weighed only 12 pounds by the time he was seen at

  Davis, and had suffered a lot of muscle wasting. Marc brought copies

  of the previous lab work, and they ran additional tests as wel . Al his

  kidney values had climbed. To counter his weight loss, they placed an

  esophagostomy tube to get some food inside the cat.

  Dr. El en Mcdonald, a resident and internist at the teaching hospital,

  told Marc there wasn’t much they could do. They’d try and stabilize

  Zepp and perhaps improve his quality of life for the time he had left. “I

  was beside myself, and in tears through most of this,” says Marc.

  “They said short of transplant there’s real y nothing can be done.”

  Marc was given instructions how to feed Zepp a slurry of food

  through the tube. “It was real easy to medicate him, but he needed to

  be fed three times a day.” He found a local vet tech wil ing to come

  during the day, and Marc handled the morning and evening food and

  medication.

  Despite intensive care, Zepp continued to decline, to the point he

  was unable to get out of the litter box once he climbed inside. He was

  rushed back to the Davis hospital on a Friday. “I thought it was his last

  trip. I was trying to be realistic about it,” says Marc. “He had lost quality

  of life. This was no way for him to live.”

  At the hospital, Dr. Mcdonald asked if a transplant was a

  consideration. They could run the tests to see if Zepp passed the

  criteria. Marc asked surgical resident Dr. Ian Holsworth to look at

  Zepp and his tests. Only a couple minor tests were lacking to qualify

  him for the procedure. “And they had a slot open,” says Marc, stil very

  emotional remembering the events. If the last tests were okay, Zepp

  had a chance to get a new kidney. Marc knew it was the one, final

  chance to save Zepp’s life.

  He took the sick cat home to wait for the phone cal that would mean

  life or death—and Zepp got his miracle. Three donor cats were good

  matches. Zepp was admitted on Saturday morning, and surgery was

  performed by Dr. Holsworth and Dr. Clare Gregory the fol owing

  Wednesday. “They cal ed to tel me everything was fine, and the donor

  cat was also doing fine,” says Marc.

  Part of the arrangement of the transplant procedure is that the

  owner of the recipient cat also adopts the donor cat. Newton, a 17-

  month-old gray tabby, was Zepp’s savior. “Newton is a fabulous cat,”

  agrees Marc. “He is aggressively affectionate, and loves to be rubbed

  on the bel y, but he is brutal y strong. My brother says Newton is hard

  like a tabletop with fur. He’s been neutered but stil has the tomcat

  physique.”

  Newton is the best thing that’s ever happened to Roger, the brown

  mackerel tabby Maine Coon kitten that arrived. They are constant

  pla
y-buddies, chasing each other and wrestling.

  It took about a month for Zepp’s new kidney to become ful y

  functional. He came home with the feeding tube stil in place. “He was

  not good when he came home,” says Marc, but once the feeding tube

  was removed he became a different cat altogether.

  Today, his kidney is fine. His extravagant displays of affection have

  not returned, and he’s stil relatively quiet compared to before his

  il ness. Today, his kidney is fine. “But his quality of life is back,” says

  Marc.

  Since the transplant Zepp has faced other chal enges. Most

  transplant cats get both prednisolone and cyclosporine daily for the

  rest of their lives to prevent organ rejection. But he developed

  diabetes, and it is a balancing act to regulate him because the

  antirejection drugs also affected insulin/glucose levels. “I don’t mind

  giving him insulin shots. It’s easier than dealing with giving him a pil ,”

  says Marc.

  His experience has taught him that veterinarians are very busy,

  and unable to offer the detailed attention an owner could give your pet.

  “Trust your instincts,” he says, and educate yourself to what’s involved

  in the health needs of your cat. “If you have an older cat these things

  are going to happen,” he says. “Try to know your limits and try to know

  your cat’s limits in terms of what they can take.”

  He would do everything again in a heartbeat. “Fortunately, I can

  afford it, so I did it. And I’m glad,” he says. “Zepp has brought me such

  joy. Looking at Zepp right now, lying on the couch a couple of feet from

  me, grooming himself—it’s worth it when you see that. When you see

  him doing normal cat things and enjoying it, it’s worth it.”

  CHAPTER 6--MAKING CHOICES

  Today we are privileged to enjoy sharing the company of our cats for

  longer than ever before. Of course, even two decades of time together

  isn’t enough. Most cats wil not outlive their owners, however. That is a

  sad fact we must accept when we welcome a pet into our heart.

  As they age, we know our cats may develop a health problem or

  disability. We understand that someday we will lose them to death. If

  anything, that makes the short time we share with them even more

  precious. But as our strong connection with special cats grows

  stronger year after year, making choices about her life and death

  becomes ever more difficult. Is it selfish to want to prolong her life?

  When is the right time to say goodbye? Cost of care, concerns over

  her comfort, and guilt about making these choices can make your last

  weeks or months together even more difficult.

  There is no wrong answer. Take a moment to look at your cat,

  stroke her soft fur, and smile through any sadness because you know

  she trusts you to make these decisions for her. She’s not worried. She

  won’t “blame” you, no matter what choice you make on her behalf. And

  what’s more, it doesn’t matter what other folks think, or what they’d do

  —every situation is different, and what applies to others may have no

  bearing on your situation. Give yourself permission to say yes, this is

  hard. It hurts. In a strange way, it’s supposed to be hard. It wouldn’t be

  so difficult if you didn’t care so much.

  A hard decision is often the right decision when it comes out of love

  for your cat. Take comfort because the best any of us can hope to do

  is to make informed choices with the best information available at that

  time. Any choice you make that’s based on love and concern for her

  welfare cannot be wrong.

  The Final Gift

  Cats are born, live for a time, and then they die. Accidents may tear

  them away from us while they’re young. Some drift off in the gentle

  sleep of old age and never awake. Others linger, in questioning pain,

  begging for relief with silent eyes. These last need our help, a gift that

  comes with equal measures of love and pain—that is, giving them a

  calm, dignified and gentle death through euthanasia.

  When do you know the time has come? When you begin asking

  yourself that question, it’s time to consider the possibility the end is

  drawing near.

  Does she stil like her life? Does she enjoy being with you? How

  many more days wil she have that are as good or better than today?

  “I think that’s one of the most meaningful measures,” says Susan G.

  Wynn, DVM, a certified veterinary acupuncturist practicing in Marietta,

  Georgia. “If today is real y bad, and almost every day fol owing this is

  going to be as bad, it helps for you to make that cal .”

  When pain or il ness consumes her with little hope of recovery; when

  your cat knows her fight is done; when prolonging her life offers no

  hope for enjoying that life; these are determinations only you, as your

  cat’s best friend, can make. People who are closely bonded to their

  special cats just know when the time is right. Listen to your heart, and

  your cat wil tel you when she’s ready to say goodbye.

  Preparing for the End

  Veterinary oncologists routinely deal with owners struggling

  with life and death decisions and ultimately grief. “For me, grief

  counseling is part of the therapeutic process,” says Dr. Kitchel . “We

  know what the outcome is going to be. It’s just a questions of how long

  it takes to get there.”

  “The best situations are when a client is emotional y and mental y

  prepared, and they’ve had time to think about their options,” says Dr.

  Garrett. “If you see it coming, you can plan things.” For the most part,

  geriatric cats with chronic diseases such as cancer or kidney failure

  wil not overcome their il ness. Treatment actual y gives back time the

  cat wouldn’t otherwise enjoy. Treatment offers the owner time to come

  to grips with the reality of eventual loss. “Prolongation of life isn’t real y

  my primary goal,” says Dr. Marks, “but if that quality of life leads to

  quantity of life, then that’s tremendous.”

  Dr. Garrett says the best time to talk about pet loss is before you

  lose your cat. “The diagnosis of a terminal disease is often the time

  that the grieving process starts,” says Dr. Garrett. An important part of

  the veterinarian’s job is to talk to clients about their thoughts and

  feelings, and help them through the process to make the right choices

  for themselves and their animals.

  It’s common for owners at some point during a chronic

  treatment to ask about what to expect as the end draws near. That’s

  beneficial because it helps eliminate surprises, and helps you

  prepare. Typical y, veterinarians wil explain treatments and the

  average prognosis at the time of your cat’s diagnosis. There’s no way

  to predict survival with any accuracy, but the doctor can offer an

  average life expectancy based on the condition and the chosen

  treatment. “If it’s a cancer, I’l explain that we can prolong the life very

  comfortably but not cure them, and in the end, you wil lose her to this

  disease,” says Dr. Garrett.

  There may be instances in w
hich owners prefer to euthanize

  the cat while she’s stil feeling good. For example, a brain tumor could

  prompt a seizure or hemorrhage that causes a traumatic, scary or

  painful death that they don’t want to risk their children witnessing.

  “That’s a horrible memory, with no beauty to it at al . They’d rather talk

  it over with the family, and plan a euthanasia, have the family there,

  have her favorite toys there,” says Dr. Garrett. “When she’s fighting a

  terminal il ness, any time is the right time to decide to put her to

  sleep.”

  But remember, this is your choice to make, and many people can’t

  make this decision as long as the cat looks and feels good. “I respect

  that, too,” says Dr. Garrett.

  Talking to Children

  Being there for the euthanasia can be a gift to both the adults and

  children in the cat’s life when the passage into death is painless, calm,

  and loving. The loss of a beloved cat typical y is the first experience

  children have with death and losing someone they love. Dr. Kitchel

  believes it’s very important that children are involved and a part of the

  process. “It hurts to see this,” she says, “but it would hurt anyway to

  lose somebody if you love them.” The bond is often deeply shared by

  children in the cat’s family as wel as adults, and this needs to be

  recognized.

  Children learn valuable lessons from the death of a pet. Parents

  shouldn’t fear including them, says Dr. Kitchel . “This is not just about

  the biology. The relationship has to be honored and has to be

  respected. This is about the spiritual side of that bond between a

  person and an animal.”

  Your children are most affected by the way parents, as role models,

  react. “When they see the parent afraid of death, they’re going to be

  frightened, too,” says Wal ace Sife, PhD, a psychologist and president

  of the Association for Pet Loss and Bereavement. Instead he advises

  parents to explain that al things must die, that even though cats live

  shorter lives, we become better people because of the wonderful love

  that we’ve shared. The younger your child is, the easier it wil be for

  him to accept that death is a normal process, and that your cat wil go

  to kitty heaven.

  Dr. Sife warns that trying to help cushion the pain with euphemisms

  may backfire and terrify the child. “Parents wil say, God wanted him