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Time to put to sleep?

Species: Cat
Breed: Siamese mix
Age: 8-11 years
I adopted my cat about 1.5yrs ago. When I adopted her I was told she was 3 yrs old; however, I have had two vets tell me since she is actually around 8yrs or 9-10yrs. She had mites when I adopted her and they were successfully treated. She also had her vaccinations and was Feline leukemia tested (neg.). I had noted after I adopted her that she wasn't chewing her food well so I brought her to my vet and he said her teeth were completely rotten and needed to be extracted (she has only about 8 teeth left). He gave me a quote of about $800; however I was moving provinces before I could get her in for the surgery. Meanwhile, about once a month since I adopted her she would urinate somewhere in the house (bathtub, shoes, bag, etc) but never in the same spot. Then about 6-7mths ago she began vomiting every day and didn't move a lot...during that time she urinated in the bath tub every day. I took her back to the vet for blood work and urinalysis. The blood work showed low grade chronic pancreatitis, which I am treating with 5mg of Pepcid AC daily; however the urinalysis came back clean, so we figured the urinating outside of the litter box was behavioural.

I was given a dental quote by my Vet, in the city in which I reside now, of $1800 with tax. He said it could be as low as $1000 before tax; however it's unlikely. The reason why I am giving such a medical history on her is this: am I unjustified in thinking it may be time to put her down? That is a lot of money for me (I have a ton of student loan debt), and I have already spent a lot on her so far. I understand that in order to have a pet I need to spend money, but I would hate to spend all of that money and then have her pancreatitis led her to diabetes, which I would need to then treat. And I still am putting up with behavioural peeing, which I have tried to stop by making her space calming, using feliway, giving her multiple litter boxes, not changing the litter and cleaning it everyday! Granted the peeing outside of the litter is a lot's only once a month again. I also don't mind a senior cat, but I was expecting a relatively healthy 3yr old, as the vet who did her exam before I adopted her said she was a healthy 3yr old, and now I need to deal with all of these health issues right from the start.

I know you can't tell me what to do, but I don't want to put her down thinking that the pancreatitis will get worse, when it may not. Or that she is going to die in a year because she is older, when she may not. $1800 is a lot of money when I may need to treat another thing within a few months. She seems happy and content now...I just want to make the best choice for everyone! Thanks for your help :)

Online vet, Dr. Marie

Dr. Marie replied:

This is a really tough situation.

The problem with making decisions like this is that it is often difficult to tell exactly how your cat is feeling.

If you ask a veterinary dentist, many will tell you that if a cat has dental pain and you can't afford to have the teeth dealt with then euthanasia should be considered. In all honesty though, if I were recommending this then a very large number of cats in my practice would have to be put down. It is common that a cat has dental issues but the owner cannot afford the full treatment.

Is she in a significant amount of pain? I don't know.

Chronic pancreatitis is something that can be serious but can also be quite manageable. From what you have described, if she is doing well on Pepcid then I would not let the possibility of pancreatitis factor in to your decision making. No one can tell what the future holds, but I think her risk level for a serious pancreas problem is not severe.

Siamese cats can live a long time. So, even if she is 10 years old she could still have another 10 years left in her.

If I were your vet, here are the options I would give you:
-I would offer financing through a company like Care Credit.
-I would suggest perhaps trying to put away $100 per month so that in a year you would be able to afford a complete dentistry.
-Depending on my clinic policy and your credit history I might consider offering you a payment plan.
-If doing the dental work is not an option then I would perhaps try periodic doses of antibiotics which often can help.

From what you have described, I wouldn't immediately jump to the conclusion that it is time to put your cat to sleep. With that being said, if there is medical care that your vet feels is absolutely necessary and you are not able to provide it then this could be an option. Another option could be to try to rehome her. That can be difficult to do though. But, in some areas you can find good Samaritans who will take in cats with health problems.

It's a tough call. Please let me know if you have more questions.

Dr. Marie.

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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

Customer reply:

Thank you so much for getting back to made me feel a lot better! The way the vet makes me feel usually is that she needs dental work done and needs it now! I just would like to know how painful it is to have severe periodontal disease? Vets just keep saying it's painful, but if you could relate it to something I would appreciate it!

As for her pancreatitis, I upped her dose to 5mg as the vet originally put her on 2.5mg but she was still vomiting everyday. I tried gravol but to no avail. Now with 5mg I would say she vomits roughly 2x a that still being controlled, or do you have any other recommendations? I feed her "taste of the wild" canned food (protein 8.5%, fat 5%, fiber 1.5%, moisture 80%, Ash 3.0%, taurine 0.5%, 951Kcal/kg. Grain free, natural ingredients), do you believe this is a good choice or do you recommend another brand for cats with pancreatitis? Also, does chronic pancreatitis usually lead into diabetes? And if so, would this be easily controlled with insulin/diet?

Do you feel that the urinating outside of the litter box could be contributed to her teeth/pancreatitis? I am just worried that dental disease can spread inflammation systemically, which could be contributing to pancreatitis and behavioural urination due to pain/stress. What are your thoughts?

I am sorry to dump this all on you...when I take my cat into the vet they have very little time to explore these issues with me. Thanks again, you've been extremely helpful and I really appreciate it.

Online vet, Dr. Marie

Dr. Marie replied:

The questions that you are asking are ones that no one really knows the answer to. In people, periodontal disease is quite painful and I would guess it is in animals too - but painful enough to euthanize? I would say in most cases, no. But we really don't have a lot of ways to indicate how severe the pain is. Sure, if the animal's appetite is reduced then we know that this is bad, but just because a cat is still eating does this mean they are not in pain? We really don't know.

I would say that if a cat is vomiting 2x per week this is not bad at all. With pancreatitis if there is regularly vomiting AND a significant reduction in appetite then I would et concerned. Regarding foods, you'll need to get recommendations from your vet as I can't really recommend a food without knowing your cat's full history. I'm generally not a fan of grain free foods. You can read some of my thoughts on that in this question.

I would not say that chronic pancreatitis usually leads to diabetes in my experience. Now, because diabetes is related to insulin which is made in the pancreas, there can be some cats that do have both pancreatitis issues and diabetes, but I can't recall ever having a case where a cat with chronic pancreatitis went on to get diabetes. That's not to say it can't happen, but I don't think it is common.

There are many causes for urinating outside of the litter box. Yes, stress can be possible, and yes, it could be because of the dental pain or pancreatic issues but it could be a number of other things too. It's often hard to know.

Hopefully that helps.

Dr. Marie.

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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.