Considering Euthanizing 14 yo Diabetic w/IBD, heart disease and UTI

I’m considering euthanizing my cat, and I struggle because I don’t know if I’d be doing it for her or for me.

I’ve been treating her diabetes for a year and a half. At the end of last year she began vomiting frequently and having diarrhea. We sought treatment, and she’d be better for a few days and then would show signs of being ill again.

Two weeks ago she started losing control of her bladder. We did a urine culture and repeated bloodwork, and opted for an ultrasound. With the diagnosis of IBD, a switch to z/d and meds, the gastro problems have subsided. Her diabetes is unregulated in the past month and a half, with BGL frequently over 400. They increased her insulin dose to 3 units twice daily.

The culture was negative and we treated her for a stress UTI, I’m blanking on the technical name. Since then we’ve made a lot of improvement. At her worst she was peeing droplets 12-17 times per hour. Now some days are like nothing is wrong, other days she’s having accidents all over. The vet started her on antibiotics just in case. Last night she was peeing frequently with a tinge of blood and some sort of mucus. It reminded me of uterine lining.

She’s been living in my bedroom in my small apartment for the past two weeks since I’m able to cover all the surfaces with pee pads. There is a window, but she can’t access it because it is too high for her to jump to in her old age. On her good days I let her out into the livingroom supervised.

I have asthma and for the past week I’ve been unable to stay at home. Last night I did because I was concerned about the blood and her lack of interest in food. She snuggled up happily, peed only twice during the night, and ate her dinner.

I can’t afford to take her to an internist, though my vet is consulting with one. I believe she is receiving excellent care from her vet.

I’m at a loss for what to do. My vet is hopeful about her prognosis, but this is affecting my health, I can’t stay at my home, and she isn’t consistently improving. My quality of living has suffered and I’m sure hers has too. I feel guilty for not being physically able to be with her as much as I’d like when she is unwell. I’m considering euthanasia, but who is it for?

 

Sometimes the decision has to based on both the cat's health/quality of life and that of the caretaker. It is a very personal decision to make. You will make the right decision.

 

What a sad story. I wonder if you've looked into re-homing her before you make a final decision? It sounds as if she does still have some good days and the vet is hopeful that she is not ready to leave just yet - but if your health is suffering you need to consider yourself too. Could you ask around locally if anyone would take her on? Some organisations may have fosterers who might fit the bill in this instance.
I hope you make the right decision for both of you.

 

This is a very personal decision, I think only you can really asses the situation and really how bad is she.

I do know from my experience that a cat can actually live a happy almost normal life (I do have to give meds) with diabetes (it will eventually get regulated it just requires time an a bit of patience), a hart problem and CKD(again with some meds) at least for a reasonable time. The UTI can be controlled even if it is idiopathic-stress induced or unknown cause, and once the crisis is over the cat starts feeling better, I do not have any experience with IBD.

 

I know that rehoming would be devastating for her. I’ve been her person since she was a kitten, and she doesn’t care much for other people.

I’m very sad about it.

 

Hi, I didn’t mean to come off as wanting to put her down because of the diabetes. We’ve been managing it pretty well until recently. Thankfully she’s no longer vommiting daily, and her appetite has mostly returned.

The biggest issue is the UTI. She’s currently on 4 medications and she’s still having problems. It’s been two weeks. I’m not sure how long it typically takes for symptoms to subside. I know that she is likely to do well if I give it time, but as it is now I can’t be in my home. I don’t know how long is practical to continue.

 

Thank you.

 

It sounds to me like your kitty has idiopathic cystitis. Sheba used to get that periodically. Symptoms are dribbling urine, blood in urine, sometimes straining. Reducing stress helps. I used a feliway collar, gave extra fluids and used a tablet that helps the lining of the bladder. I can’t remember the name but I’ll get back about it. Antibiotics don’t usually help. Here is a link about it. Lots online just google FIC
https://icatcare.org/advice/cat-health/feline-idiopathic-cystitis-fic

 

Have you tried medications like Prozac or amitriptyline for the idiopathic cystitis? Sometimes they can make a huge difference by helping to reduce the stress that causes most of the problems.

 

I think this is what they are treating her for. She’s on gabapentin, buprenorphine, and some medication that starts with a P. I can’t remember the name off the top of my head. The antibiotics were added after a week of treatment on the others was ineffective.

 

That sounds like the treatment for FIC. Ask about the Prozac that Chris mentioned. It helps.
I remember when Sheba first got it I was very worried about it but it did settle down. Flared at times but then settled. Look into the feliway products. I think they help.
I’ll try and find the name of the med I gave for the bladder wall. Try giving extra fluids if you can. Maybe make a chicken broth and give that. To make put several chicken drumsticks in water. Nothing else. Gently boil for several hours.. up to 5 or 6 hours. Then strain the liquid and put in frig. When set skim off fat and use. I put the extra broth in ice cube trays in the freezer then when set put in baggies and used as needed. You can feed the chicken meat to kitty as well.

 

I’ve used SSRIs In cats previously. I’ll ask about this at our recheck tomorrow. Thanks

 

The other medication she is on is Prazosine. I will ask about the Prozac.

Where can I find a feliway collar? I don’t see them on amazon or chewy. I have a sentry calming collar on her now. ( I modified it so it’s now a breakaway.) I haven’t purchased the plug ins because there are two air purifiers running in the room she is in. I’m not sure how much help it would be.

She’s on a strictly z/d diet, previously on a limited ingredient diet due to food sensitivities, so unfortunately I can’t give her broth. I’ve been monitoring her water by letting her drink from a liquid measuring cup. She’s been drinking about 300-350ml per 24 hour period and the vet is pleased with that.

Thanks for your suggestions.

 

I’m sorry. Hugs to you. Such a difficult decision.

 

Probably prazosin, a urethral antispasmodic.

 

Have you tried a water fountain to try and get her to drink more and flush her urine so to speak? Or add water to her dry food to help?

 

Is clear you don't want to and that you are trying to help her otherwise you wouln't be asking her for help, but sometimes is hard from the distance to really know how she's doing, specially when there are multiple issues at play and not only diabetes.


For the idiopatic UTI, At one point I gave Babu L-lysine to help with his bladder lining ( it helps a lot of other issues too), giving him D-mannose has also helped but what I think helped the most was trying to eliminate all stress triggers, being alone was one of them so he got a sister to keep him company and giving him lots of extra water, I actually gave him extra water with a syringe at least twice a day when he had the UTI flares to help flush everyting

 

Thank you for the suggestion! The vet thought Prozac would be good for her. We will start as soon as she’s finished with the amoxicillin, and keep her on gabapentin for a couple weeks until the Prozac starts taking effect.

 

I can start her back on the lysine. She had a herpes flare up in December which was the start of her recent issues. She had a recheck today and the vet is pleased with her progress.

She’s had a great 48 hours except for an accident in the carrier but I think we can chalk that up to a stressful car ride.

 

Thank you, Suzi.

 

We are starting her on Prozac. Thanks

 

It is a very small suggestion and perhaps no help. But for covering surfaces in addition to puppy pads there is poochpad.com. These large pads are washable.

 

Hi please don't get rid of her it would be horrifying I think I know you would miss her and that would be good for your mental state. I have degenerative joint disease and a pacemaker and I have congestive heart failure and it's hard for me but my boy Elvis is the love of my life and I wouldn't give him give him up for anything and in my life he comes first he comes before me even so try and deal with this the best you can because I just feel that you can handle it and you can get through this! Like I said I have congestive heart failure and it's hard but the thing is I feel I would be worse off if anything were to happen to my boy Elvis!!!

 

I put my non diabetic cat on .25 xanax because she was having cystitis all the time peeing out bloody mucus and since starting her on them she hasnt had 1 since