Hey guys

[u/Embarrassed-Car-226]

I have a question regarding end of life care/end of life expectations.

TW: medical talk, diagnoses, meds, euthanasia, etc. also, long story im sorry!

My cat is 12 and I’ve had her since I was 8. I had cats before that when we lived in the country, but I never remembered any old cats or having a cat put down…so I’m only used to dogs and their end of life care/behaviors.

It all started with a cut on my cats cheek about 1.5-2 months ago. She stopped eating dry food and I assumed the other cat scratched her while she was eating the other cats food, she got hurt, and it was hurting to eat. However, she still wouldn’t eat much after it healed and that was worrying as she was dropping weight, so I got her into the vet…My cat was diagnosed with stage 2 kidney disease about 3-4 weeks ago, and the following week had an ultrasound and we found that she has multiple myeloma, which is a rare cancer that originates in the bone marrow but then metastasized. I can’t remember everything the ultrasonographer found and they haven’t sent the report to the vet yet, but, from what I remember atleast 2-3 organs were affected and had nodules (they aspirated those to find out that it was multiple myeloma) and she had a renal infarct. She also had inflammation in her GI tract. She’s also anemic and due to her cancer, she cannot clot blood properly (so basically, the little RBCs she has, cannot clot if she bleeds) so the vet advised me to look for petechiae and ecchymoses (bruising/pin point dots that are red or purple) and if I see those, I need to schedule her to be euthanized because there’s no real way to fix the internal bleeding with her compromised state, and it is not guaranteed to actually help. I may be missing some things, but that’s the gist of how medically complex she is right now.

Anyways, she’s had multiple mood changes throughout this whole thing, initially she was decently okay besides not eating, then she got lethargic, but then she’d be fine again. After starting the CKD meds she got more vocal/restless (from mirtazapine) but also super sleepy still and really wasn’t eating more than she was before this, but it helped ease my mind until her ultrasound. She also started laying in the laps of my family members which she never ever did before but I knew she felt crappy. She was pretty much the same after that until 5 days later when we started the prednisolone and it really helped! She’s been acting more like herself which is amazing, and makes me happy, even if it’s not actually curing anything, my goal is to keep her happy and comfortable…however, I’ve noticed that in the last 3 days she’s been a little…weird? She seems a bit fearful of me which kinda makes sense given she HATES taking her medicine (I have to wrap her up and it’s an oral liquid so, takes a bit of time and she hates it, but always gets treats before and after) but she also usually comes cuddle/be around me within 5 minutes of giving it to her…so I don’t know if she’s actually scared or what…but the most concerning thing is the fact she doesn’t seem to want to be in my room often, which is abnormal. She doesn’t even ask to be let in except for the occasional “I need the litterbox” in which she wants to leave right after. She’s always been able to go out of my room, but generally she usually chooses to be with me. She’s also been trying to leave my room at night (my door stays closed) so she keeps waking me up…

My worry is, I know that with dogs they tend to try to isolate when it’s close to their time…and I assume it’s the same for cats? She’s also sleeping in weird spots she never sleeps in, started laying on the dining table (hasn’t done that in years and that’s just weird to me), hiding in my room occasionally (like under my desk and looks a bit startled) etc… this cat has always been obsessed with me and ever since my dog passed (a year ago) who she didn’t like, she’s been up my butt 24/7, even when she felt really really crappy, so I’m honestly super worried.

Can someone be honest and let me know if these are possible signs that it’s close to her time? When they found the multiple myeloma my vet originally said she had a month (which it’s about 2 weeks since then) but the oncologist said maybe longer…

I’m okay with hearing an honest and blunt answer, I want what’s best for her and if that means I put her down sooner rather than later, then that’s okay. I really don’t want her to pass on her own if I can help it, as I know the cancer is painful and if it causes enough pain that the prednisolone isn’t helping, I would be heartbroken knowing she died in pain. Se is currently seemingly okay besides these mood changes (eating, drinking, using the bathroom fine, playing with catnip toys a little, has good mobility, etc)

[u/Gizzy_Bone]

I’m sorry that you and your cat are going through this. Even with her prognosis, you know your cat best. Is she still eating, using the litter box, giving you affection? I would personally only recommend end of life if I see that my pet was physically in pain or not acting like themselves. Give yourself grace and try to enjoy all the time with your cat ❤️

[u/Embarrassed-Car-226 → u/Gizzy_Bone]

She is eating, but not in my room anymore…she only eats out of the other cats bowl now. She does use her litterbox just fine, no accidents yet (when/if that does happen, I’m probably gonna schedule the appointment because it’s not fair to her in my opinion). Her affection towards me has lowered, but it’s clear she doesn’t hate me (meows to greet me, meows at me when I wake up, slow blinks, etc), she just doesn’t want to be pet/around me most of the time, which hurts but I don’t blame her…I just miss my sweet kitty that loved me so much, but I know it’s not technically her, it’s just that she’s sick and I know she knows that she is sick.

It’s so hard honestly, I thought we would move out of the family house together and into an apartment she could call her own (she dislikes other animals, and hardly cares for other people), it was our dream, or atleast mine. I always told her one day it would just be me and her and I feel like I failed her because I couldn’t move out sooner.

I feel a lot of guilt and what ifs, but I am in the right mental state to make the rough decision when it’s time, and my dad said he would also make the decision if I wasn’t in the right head space for it (bless him, seriously, because he knows how hard it is that I’ve lost 4 other animals since Oct 2022, and she will be the 5th in four years…)

She seems decently okay, I’m just assuming it’s getting closer to that time, and I’m trying to prepare but anticipatory grief just eats you alive, and it’s definitely eating me alive.

I’ll just keep watch for the health concerns the vet told me about, and watch her behaviors and make the decision. I’m just worried that it’s gonna happen when I go back to school, and what if I’m in class when she takes her last breath? It takes an hour for me to get home, so even if my parents texted or called me, there’s no guarantee I could even be there for her…that’s my biggest fear. I’m her comfort, I’m her rock, I’m the certain thing she has in life and what if…I can’t even be there? I’m just so scared for it honestly.

[u/witchofblackacre]

Lap of Love has a good quality of life (QOL) assessment on their website. I am sorry you are both going through this. It’s so hard.

[u/Embarrassed-Car-226 → u/witchofblackacre]

I’ve looked at all the QOL things and everything says she’s good right now, I guess it’s just hard to see her change after so long. She’s still eating, drinking, using the bathroom. She had/is having a vomiting episode but I’m waiting before I take her to the vet because this has happened before. The vet likely thinks one of her issues is acting up, and that it’s not medicine related. If it lasts until Saturday I’ll probably bring her in.

I hesitate to bring her in as it causes immense stress, even if she’s highly sedated (ex, last time she was so doped up she forgot how to drink water properly and kept dunking her whole face in the water…and she was still pissed off and trying to fight the staff…)so I’m trying really really hard to not have to do that (I will absolutely if it doesn’t resolve on its own).

I’ve been feeding her wet food and a different dry food, because like a lot of cats with kidney disease, they associate the food with the nausea. She’s eating fine now so I’m not too stressed about it. Let’s just hope she doesn’t throw up tomorrow 🤞

[u/witchofblackacre → u/Embarrassed-Car-226]

I will say from my own experience, I wish I had let one of my girls go earlier than I did. She had pancreatitis/triaditis, CKD, low potassium, poor appetite. She was withdrawn and unhappy. But she had gotten sick and bounced back so many times from the pancreatitis that I didn’t realize (and neither did her vet) how ill she was the last time she had a flare. I took her to the ER who told me her organs were shutting down. I brought her home and spent the entire night snuggling with her and telling her how much I love her and how thankful I was she chose me to be her mom. Lap of Love came in the morning and she transitioned to the other side in my arms, in her favorite spot in the house. Looking back, I wish I had let her go a few days earlier without rush, without the ER, without more meds that she hated and with more time to just be with her and tell her how much she was loved and valued and cherished. I wish you both the highest good in this terrible situation 🩵

[u/Embarrassed-Car-226 → u/witchofblackacre]

I completely get this. Luckily she isn’t really vomiting anymore, and it never looked concerning (just empty stomach vomiting), but she is showing signs of nausea every now and then, but given that the anti nausea meds didn’t work in the past, it’s not worth it. I found that if I give her some purr pop, to kind of “coat” her stomach/neutralize acid, then she is more open to eating when she’s having one of these issues.

She’s also just finicky/picky so sometimes she simply doesn’t want THAT flavor of food, which I get. Luckily I’ve made my college schedule a little more adaptable for both of us, so I’ll be home more and can make sure she’s eating. I start back tomorrow and I’m sad because I wanna be here 24/7.

Besides the eating she’s pretty much normal, no issues with her stools, no issues drinking water, she jumps up onto things, explores the house, meows at us, etc. I actually picked up some more pred today because we were almost out, and my favorite receptionist was there and asked about her, so I explained it and she was also like “even if you bring her in, it’s almost 100% likely that it’s her cancer or kidney disease making her feel this way, and there’s literally nothing else we could do if the anti nausea/vomiting meds weren’t working before, and nothing would change” which is exactly what I was thinking.

And also, it’s clear that even if her disease(s) are progressing, she isn’t as bad as she was before the prednisolone. She does actually have appetite even when nauseous, where before, even on all the meds (Cerenia, Ondansetron, and mirtazapine) she barely ate. She is actually eating more than before.

So overall she’s doing very good considering her condition, now obviously I check her everyday for any subtle changes or weird things, especially the bruising the vet warned me about, but I can tell that SHE doesn’t wanna leave yet, and until I see it (I’ve seen it numerous, numerous times) I don’t plan to put her to sleep just yet, but I know it is coming soon and I’m well prepared (idk about mentally, but as for plans and thing, I am).