Species: Cat Breed: domestic short hair Age: More than 15 ye
Dear Dr. Marie:
My cat is 25 years old and has been relatively healthy in the 10 years I've had him. On Sunday, he was diagnosed with hyperthyroidism, anemia, and high blood pressure. The test for kidney function were inconclusive and xrays showed a mass which may be a tumor or may be undigested food by his stomach. My vet would like me to start 3 medications, 2 to be taken twice a day.
I am a single woman who lives alone. I work long hours an hour from home and travel frequently. I love my cat but am concerned about the amount of care he may now require as well as the cost, and have no interest in keeping him alive past a time that is pain-free and high quality for him. I have twice now tried to engage my vet in a conversation about euthanasia but she does not seem willing to discuss. She said the medication should be no problem to administer and that he could live to be 30. I'm not sure what to do? I don't want to seem callous but I would like to have a real conversation about my options. Am I jumping the gun? How do I have this conversation with my vet or should I see someone else? Your opinion would be very much appreciated. Thank you!
Dr. Marie replied:
These are very valid concerns! First of all, though, I would like to say congrats on having a cat who is 25. I don't see too many in my practice who make it to this age.
With this being said, if I were your vet I would still be definitely advising you to give the treatment a try.
Hyperthyroidism is a disease that can be controlled relatively easily in cats. Of all of the conditions that cats get, a thyroid problem is one of my favorite diagnoses to have because I see some wonderfully dramatic improvements once we start medication.
The high blood pressure, possible kidney issues and anemia may be directly related to the thyroid problem and there is a good chance that they will resolve once the thyroid problem is better. However, it's hard to comment on the mass. If there is a tumor in the stomach then we are not likely going to be able to do much to help.
Most cats will take thyroid medicine well. What are the other two medicines that he is on? Possibly blood pressure medicines? I usually will not prescribe blood pressure meds right away unless the levels are dangerously high. Rather, I usually try and see how the cat does with thyroid medicine and then see after a few weeks whether blood pressure meds are necessary.
As an aside, I just wrote an article about an exciting new development for cats with hyperthyroidism called y/d. It is a food by Hill's that will apparently make it possible to treat thyroid disease without medicine. You can read about it here: Hill's y/d. This food will be available some time in October.
I would love to see you give the medication a try. But what I would recommend is to set some guidelines. So, I would say, "If this is happening, then it is time to talk about euthanasia." "This" could be that his appetite stops for 48 hours, or that he doesn't come upstairs to your room, etc. etc.
I hope this helps with your decision. Feel free to respond. I am heading offline right now (it's bedtime here) but I'll be back on in the morning to check on you.
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Thanks so much for your response! It is very reassuring to know that these conditions might be something we can correct or even manage through diet. He is currently on Hills k/d and has been since a bout of inflammatory bowel disease about 5 years ago so it should be easy to switch over.
The other meds are for BP and anemia. His BP was 220 over ? even after several hours at the doctor. She said he will be on this for the rest of his life. So I will give the meds a try. Do you think I can expect to see an improvement within 30 days?
I still wonder how to effectively broach this subject with my vet when and if I feel that things have deteriorated to a level that is unacceptable to me? What should I say to her to initiate the conversation?
Thanks for your help!
Dr. Marie replied:
You're very welcome!
I would agree, with a BP of 220 he should be on some blood pressure medicine. With blood pressure of this level he is at risk for serious heart disease or even blindness, so we definitely want to work at getting this down. It's possible that once his thyroid is controlled he may not need it or need less of it.
Most cats with thyroid problems have significant improvement within 2 weeks of starting medicine.
I think you'll find that your vet is actually more receptive than you think. At this point, all of Midnight's "conditions" are potentially quite easily manageable and so I likely would have had the same attitude in strongly suggesting treatment.
Dr. 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.
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