Cat - bad news at vet

[ladybugsbw]

My sweet cat (former barn cat upgraded to house cat) was showing signs of a urinary problem the past day, so I took her into the vet. I got more bad news that I ever expected and would love advice or opinions.

Backstory:
I got cardi as a barn cat from a students apartment complex. She was semi feral and about 8 months old at the time, but quickly bonded with us as a barn cat. When she was about two, she was attacked by a dog, hurt her hind in, and came inside full time (while getting vet care). She is now 6 and has seemed okay, with some mild stiffness and muscle atrophy in her hind end. I have come to adore this cat, she is my shadow and best buddy in the house.

Now:
Took her to the vet today for suspected urinary issue (figured uti or stone) and found out a lot more.
She has a significant heart murmur and enlarged heart. The X-ray showed a decent sized bladder stone. There is no bacteria in her urine, so no infection yet. The vet can’t tell if the stone is the calcium kind or the kind that can dissolve with diet (my brain can’t remember names now). But thinks surgery would be incredibly risky due to the heart issue and found out her bloodwork shows diabetes (that’s new too).
Not only did we find the stone, heart murmur, and diabetes, she also saw her hip on the X-ray and said it is completely trashed. Vet suspects she is in significant pain based on the image and would suggest an extensive hip surgery to help, but again, surgery is not really an option.

So basically our options are to try a diet for about 10 days and recheck to see if the stone is dissolving. If we do that, we are still left with a painful hip and diabetes. There is a 50/50 shot on the type of stone, so the outlook on it dissolving is meh.
The other option is to let her go now, before things get worse.

I cannot make this the million dollar cat. I adore her and want the best for her, but absolutely do not want her suffering. Would you try the food given the other issues? Is that just selfishly prolonging the inevitable?

Thanks for any advise or opinions… I just want to do right for this sweet girl.

[dressagetraks]

With the hip and back end injury history plus the stone and diabetes and everything else added together, I would give her the most perfect day ever and then let her go. She has had a wonderful life with you. I’m a firm believer in better a day too soon than too late. I’m sorry.

[trubandloki]

Is getting a second opinion on any of this an option?

Before I would jump to euthanasia I would get a second opinion at least on the thought that the messed up hip is causing her extensive pain.

Diabetes in cats is manageable and from what I understand no reason to euthanize now.

I do agree with dressagetraks though, that a day too soon is not a bad thing when it comes to making sure our pets don’t suffer.

[ladybugsbw]

Thanks y’all! That is along the lines of my thoughts too. She is wonderful and I would be willing to manage whatever health issues, but not if it is a source of pain or misery.

[4horses]

If the hip has been messed up for years, yet she still acts normal, then I would hope that it is not terribly painful. Does she play and move around pretty normally? Or does she sleep all the time?

I would look at her urine ph before switching her diet to the prescription urinary stuff. If her urine ph is high, then the diet is likely to help dissolve the bladder stone. If the ph is already low, then I don’t think the diet will work. But sometimes it takes multiple urine samples to truly see what the ph values are.

I had one cat that normally had a ph about 7.5-8. That’s why he had struvite crystals. He had to be on a urinary acidifier for most of his life.

Check for thyroid disease as that can cause heart issues.

Blood sugar is not real reliable in a stressed cat so I’m not certain you actually have diabetes vs a cat that was stressed.

[ladybugsbw]

My vet said all of those things! The ph was low, so it’s a slim chance of it working honestly. Thyroid was pretty normal. And yes, she said diabetes could be a stressed cat thing, but with her weight and drinking habits, and how high it was, she thinks it is an issue.

She isn’t a playful cat, but does climb on the sofa and cat tower. She will not jump baby gates or on counters. Vet thinks the stone could be from the stress of being in pain. She said her hip was absolutely trashed on X-ray. We are going to meet with her and see them this evening.

[StB.YM]

If her pain is manageable and she’s ok with the diabetes shot, I would take a chance with the diet. Was her heart rate and blood pressure elevated? If so, you can ask your vet if metoprolol would be appropriate for managing her heart disease.

[moonlitoaksranch]

We have a cat that has a nerve issue in his lower back (he was squished behind bales of hay at the feed store as a tiny kitten). He shows pain by yowling, biting, and spinning. He will be on gabapentin the rest of his life. It works well to control his pain. He was an orphan kitten that was rescued from behind that those hay bales as a two and half week old kitten. We didn’t know he had a nerve issue until he was older.

If your vet thinks she is hiding pain, maybe you could try her on gabapentin to see if she seems more active and comfortable.

[Simkie]

I’m so sorry you got some tough news about your kitty

Cats are so very stoic. A second opinion, preferably from a referral hospital is an excellent idea, but do sit with this news from the vet and really consider it. Perhaps consider treating her pain aggressively for a short time to see how she changes before saying that she seems to be doing fine with it? “Absolutely trashed” sounds pretty bad, and even the stress of not feeling fully mobile could be impacting her, along with the actual pain.

[ladybugsbw]

I greatly appreciate everyone’s feedback!

My husband and I went and looked at her film and had a long talk with our wonderful vet. There is an orthopedic vet on staff who also came in with us. They both agreed that giving her 10-14 days on the special diet (royal canin urinary so) and some pain management would be fair to give her a shot. The plan is to do that and reassess with more X-rays then. If there is no improvement with the stone, we will let her go then.
If the stone improves, the ortho thought she could do okay with some management of pain for her hip. Is she going to live comfortably forever? No. But can we try and manage it and let her go when she is uncomfortable, yes.

So that is the plan now. She is happy to be home and is currently purring in my lap after her first meal of special food.

I am a firm believer and not letting them suffer long term, so I am comfortable knowing we have a plan in the coming weeks to reassess and decide.

[trubandloki]

This sounds like a wonderful plan! I am so glad you and your vet were able to come up with a plan to move forward.

Jingles for your cat and for you!

[ravenclaw]

The plan sounds really good! I agree that you don’t want her to suffer but it sounds like she has been doing OK with her hip. I hope the stone will get resolved and things will become stable and you’ll have more years together.

[ladybugsbw]

Side note: because I’m always thinking ahead!

Has anyone tried adequan for cats? There are some really good case studies that show some good results online. Obviously I will talk with my vet about it, but curious if anyone has any first hand experience.

[rubygirl1968]

I haven’t but am planning on asking my vet about it for my arthritic old man.

[trubandloki]

@ladybugsbw

Has anyone tried adequan for cats?

I can say that it worked wonderfully for my dog. I have not tried it on a cat.

[stargzng386]

If you can get a handle on the stone add in the platinum performance for cats. I have a kitty with spine arthritis who was having a hard time a few months ago and euthanasia was on the table if we couldn’t get it under control. The vet would only let her be on pain meds for a few days twice because of the side affects. My vet recommended a joing supplement but she refused to eat any of the other cat joint supplements but will eat her dry food with the platinum performance added and shes totally back to normal. We know we have to watch her but she hadn’t climbed to the top of the cat tree in months and is happily purring from there right now.

[CanadianTrotter]

@ladybugsbw

They both agreed that giving her 10-14 days on the special diet (royal canin urinary so)

I swear by this urinary food, I’ve had all 6 of my cats on it for several years now.

[BootsAndCoffee]

Diabetic Cats In Need has a wonderful program for the owners of newly-diagnosed cats. They’ll send you insulin and supplies, along with tons of information on diabetic cat care (it’s much easier than you’d think! My old diabetic boy would chirp and dance when I grabbed his insulin, ‘cause he knew he’d get treats!)

Adequan has worked well in cats, though it’s not widely prescribed everywhere. VCA has a write up on it here.

I really hope things work out for your kitty. She’s lucky to have a person so invested in her well-being.

[ladybugsbw]

So just an update on sweet kitty if anyone was wondering.

We re-xrayed on July 27th and her stone had not changed. But She was acting better, having normal pees (not shaking her booty and spraying except occasionally), and still playing with her brother. Our vet said we could keep feeding the special diet and recheck in a month (unless things went downhill).

Today, she hasn’t been interested in eating much, threw up some bile, and was clearly straining to urinate. She even had some blood spots in her urine (she sprayed the back wall behind the box, which has a puppy pad hanging).

We’re taking her in first thing in the morning. We will X-ray again and do a urine check, but I just don’t think it’s going to go well. Hubby and I have prepared ourselves and have been giving her all the best attention and toys lately!

Keep us in your thoughts! Maybe just maybe the stone has broken up and she is passing it, but I think it just may be her time

[tikihorse]

Jingles for your sweet baby. Hugs for you. I love cats and I know how you’re feeling.