Maynard and Sister - Old Age - Cat Forum : Cat Discussion Forums
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post #1 of 12 (permalink) Old 09-03-2018, 01:31 PM Thread Starter
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Maynard and Sister - Old Age

We have two 15 year old litter mates, Maynard and Sister, that seem to be going down hill suddenly and I am wondering what your experiences are with all their issues. Two years ago Maynard was diagnosed with asthma. We quickly got it under control with prednisolone (2.5 mg every other day). A few months later Sister was diagnosed with hyperthyroidism and after about six months of working on it we got it to level out with 2.5 mg of methimazole a day. She stays just a wee bit hypothyroid because 5 mg a day is too much and apparently 2.5 is a bit too little. She has done very, very well. He did well for a quite a while but his asthma would flare with the seasons. Until this spring we could keep it controlled by upping his meds for a bit and then going back.

Suddenly this summer he has gotten in bad shape. We noted his breathing had gotten more congested, (we upped his prednisolone to 2.5 a day and he still wheezes) and he was lethargic, seemed to have lost more weight and was eating less. (He has been slowly losing weight for a couple years - he used to stay at around 15 pounds and is now 12.) He started throwing up foam and partially digested food. We took him to the vet and blood tests showed hyperthyroid (of all things - he was not typical at all) plus one elevated liver enzyme. He was put on 5 mg of methimazole a day. Sis, as the summer progressed, seems to have slowed down as well. In the spring she was running around the house playing with toys and attacking walls. But now she's moving a lot slower and eating a lot less. She has not lost significant weight though. She had stayed at 9 1/2 pounds consistently for the past 2 years.

We took Maynard back for his 30 day check on his thyroid and Sis for her semi-annual blood check. Her thyroid was as it has been but she showed elevated kidney numbers. In Maynard at this visit, the vet heard a heart murmur, the same liver enzyme was up 2 more points and another liver enzyme was at 3 times normal (ALP I believe she said). We have him scheduled with a cardiologist and internal medicine vet and Sis is to have a urinalysis at our regular vet. The vet did say that her issue could simply be a bit of dehydration the day we were there since she doesn't currently show signs of kidney issues.

It just all seems so sudden. Within 30 days things have increasingly gone down hill for Maynard. In hindsight maybe we should have run thyroid before this but other than losing weight, he had no symptoms. She was ravenous and a wild woman, as is usual with hyperthyroidism, but he was not eating and just lying around. He appeared not to feel good but his breathing was so labored at times, it was no wonder. Vomiting is another sign of hyperthyroid but these two have vomited since they were kittens. Daily one of them puked right after eating! Both were healthy and active so we attributed it to their gobbling dry food and then drinking water.

A very long story and probably I've confused it a bit. If he had one of these things, I probably wouldn't be as concerned but with asthma, hyperthyroid, heart murmur and liver issues, it seems an awful lot for him to survive. As well, I am concerned I will prolong his life beyond what I should for fear I am not prolonging it enough. Since it is said that cats hide their sicknesses, how do you know when to let them go?

And for Sis, she's never been without him. Even as kittens they were the two in the litter that always stuck together so I wonder how she will do if we lose him. He's a typical big brother - bosses her around and what she has he wants - but then they both cuddle up on my lap together. He's taught her how to open doors, use the cat door, and beg for treats. I don't know if cats miss companions or not. These are my first!
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post #2 of 12 (permalink) Old 09-03-2018, 08:55 PM
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Hi Love2Cats,

Just a few quick things on the health issues right now as I have to tend to my bolognese sauce:

Has Maynard ever had an ultrasound and/or x-rays?

Vomiting foam is a sign of stomach acid; I'd ask the vet if you can give Pepcid.

Vomiting after eating, if the food is undigested, is technically regurgitation. It usually happens in the morning, when kitties' tummies are empty and stomach acid builds overnight. As you said, they then eat too quickly and it all comes right back up. I'd try Pepcid before bedtime.

What kind of food are they getting?

As for slowing down, at 15, I imagine both have some arthritis. You could give Cosequin (or Dasuquin) daily and see if they seem more sprightly.
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post #3 of 12 (permalink) Old 09-04-2018, 06:18 PM Thread Starter
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Thanks for your input. We are waiting the vet's call tomorrow about the urinalysis on Sister. And Maynard goes to his specialists on Thursday so we will know more. Our vet suggested they'd probably do an echocardiogram and ultrasound on him.

Our vet did suggest Pepcid for the foam vomiting and we will if he starts it again. Sometimes that's connected with his coughing spells from asthma as well but right now he's in a good place with that.

The vomiting is not a concern - for them it is normal. Usually one or the other did it right at our dinner time every night. We changed foods a lot over the years until we found foods that were for sensitive stomachs and we now use foods for seniors. That reduced it a lot but never completely eliminated it. Until lately they've been very healthy so it hasn't seemed to hurt them. Maynard never could tolerate wet cat food. He would immediately throw up even the smallest amount. The advent of the purer foods have certainly helped in that so we were able to find one he can tolerate for his meds.

The vet visits will certainly shed more light on what we are facing. I'll let you know when we get results.
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post #4 of 12 (permalink) Old 09-05-2018, 11:13 AM
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One of my cats has a sensitive tummy to certain canned foods, but Fancy Feast he tolerates and most of the time Weruva. Also, he tolerates well the freeze-dried raw foods, such as "Primal Freeze-Dried Nuggets--Duck Formula" that is reconstituted with warm water.

As far as when one cat dies and leaves it buddy, yes they do grieve, some more so than others, really depends on their bond. I had one female who once nursed a kitten from another litter (two queens decided to share a box with all their kittens together). When the younger one at 15 yrs. died suddenly, the older queen was 18 yrs. and her health was slowly ebbing at the time. She went through the whole house yowling for her buddy, stood in front of ever closed door and insisted I open it so she could see if her buddy was there. At that time they were both indoor/outdoor cats, and she would sit in the exact same spot in the vegetable garden where her buddy sat. She went off her food, and slept the days away, lost interest in everything. Her health declined quickly within 2 weeks, and one night she died while I was asleep.

So when is the time to let an old cat go to the "Rainbow Bridge"? Only you can determine when that time is......if the cat is not eating, appears to be in pain and is suffering, has no enjoyment of life any more, when any medical intervention is going to be more stressful and painful to the cat and will not extent its life much longer, then you should consider it. It's always one of the most difficult, heart-wrenching decisions in life to make, as we love our cats so much and don't want to let go. It's my belief that we will see our beloved pets again in the spiritual world, and that's the consolation for me.

"There are no ordinary cats.";"Time spent with a cat is never wasted."~ Colette
"A loving cat can mend a wounded heart." ~ Unknown Author
Alkitotle aka "Alkee", "Lambie" (July 2/04 - Oct. 2/15) -- white Devon Rex
in avatar. "Always in my heart."
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post #5 of 12 (permalink) Old 09-07-2018, 06:55 PM
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Hi Love2cats,

I hope both Sister's and Maynard's vet visits went well. HyperT masks kidney disease, so a diagnosis of chronic kidney disease wouldn't be surprising for Sister, but the urinalysis will confirm (or not). What's great is that she isn't showing any symptoms.

It's not uncommon that senior kitties have multiple conditions - I guess just like us. My Celia had chronic constipation issues, arthritis, high blood pressure, CKD, then anemia and metabolic acidosis due to the CKD, and then towards the end suspected megacolon. Other than megacolon, all of these conditions are all manageable.

I haven't had any kitties with asthma or heart issues, so I'm not sure how those will affect Maynard's prognosis.

catloverami has given some great insights about how kitties handle grief how you know it's time. Celia lived with another kitty for 13 years. They were never buddies, but when that kitty passed away, she showed many of the same behaviors as catloverami's kitty. She spent weeks anxiously staring out the window, and it was months before she finally accepted that Margaux was not coming back. In the meantime, she became very vocal and needed a lot of comforting and reassurance.

I let Ceia go in April, even though I know we could have had more time if I'd continued to treat aggressively. I asked her whether she was ready when the vet first recommended euthanasia, and her response was to perk up. So I decided that the two ways I would know she was ready were when she refused her favorite treat and when treatment became too stressful, which she let me know by one day refusing to get into her carrier to go to the vet.

The only thing I'd add to the signs that catlover indicated is to watch whether they're sleeping that deep kitty sleep, curled up, sometimes with furry neck exposed, and paw over eye. Celia wasn't, and I knew that meant she was uncomfortable, though she was on buprenorphine, so I don't think she was in pain. But I have now heard from many other people who have noticed this with their kitties too towards the end.

That said, I hope having to make that decision is still a long way off for you.
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post #6 of 12 (permalink) Old 09-24-2018, 09:50 AM Thread Starter
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Ok, it let me in! Update: Sister has early kidney failure and is on a prescription kidney diet. Makes for fun medicine time because Maynard is NOT happy she gets something he doesn't but we've figured it out. Hope we don't have need for a cat sitter soon because I it would take a novel to explain the system!

Maynard - ultrasound showed gallbladder sludge & enlarged bile ducts. He seems to have perked up some since they gave him an antibiotic shot and they put him on a gallbladder medicine. They did not do as we asked and schedule the echocardiogram at the same time. The internal medicine vet rated the murmur a 2 (on a scale of 1-6). They did x-ray his lungs and their is evidence of asthma/COPD damage. We have a broncho-dilator which we not giving him right now because his wheezing is currently better and we are having issues in getting him to take his other meds. We don't need to have him reluctant to come to us thinking we'll be scruffing him and forcing nasty stuff in his mouth! He'd doing better in the past week eating his food with medicine in it and so I may start the liquid med now. The food issue started with wanting Sister's new food and continued when we tried to add the liquid med to his food. Took us a couple weeks to get him to trust that his food wasn't going to have that stuff in it.

Oh, about sleeping position. Sis always sleeps curled up in a tight circle sometimes with her head twisted up. Maynard has always slept stretched out. If he's trying to fit into a small space, one paw is out straight, even if it's straight up in the air. When he'd sleep on the closet shelf, he always be in a comma shape but with a paw out. Never in a tight ball. She gets on your lap and curls up, he gets on your lap and you have a rear paw in your face and his head on your knees or cat from arm of the chair to the other arm. Once in a while, if it is very, very cold, he'll get in circle but never in the summer. We've talked about it many times over the years.

We have a return visit with Maynard in a couple weeks. Hopefully his blood work will show improvement in the liver function. If not, we'll just have to take it from there.

Last edited by Love2Cats; 09-24-2018 at 09:52 AM. Reason: Need to add
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post #7 of 12 (permalink) Old 09-24-2018, 07:34 PM
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Hi Love2Cats,

Thanks for the update!

I am sorry about Sister's CKD diagnosis but glad it's early stage, and even more glad that she's eating the renal food! Celia ate one type for 2 days and then wouldn't touch it anymore; the other ones she barely deigned to even look at.

It must be a relief to have a definitive diagnosis and a clear treatment plan for Maynard. Medicating...I so sympathize! If you start to run into real difficulties, you could ask your vet about getting them compounded into forms and flavors that kitties may take willingly, or at least more willingly.

They seem to be sleeping very well and comfortably. I've never had a kitty who slept with a paw in the air, so whenever I hear about or see this, it amazes me that cats can defy gravity like that!

The best news is that it sounds like you're still quite a long ways off from needing to worry about knowing when it's time!

Hoping for another positive update when Maynard goes in for his recheck!
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post #8 of 12 (permalink) Old 09-27-2018, 05:43 PM Thread Starter
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Thanks, Sprite, for your continued support!

The report is good! His liver enzymes are normal or close to. His ALT was normal and been 441 U/l (ref 27-15 and his ALP was a bit high still. It had been 70 U/l (ref 12-59) and is now 69. At his first blood test in July when he was diagnosed with the thyroid issues, it was 68. We are continuing him on the gallbladder meds. He has gained 1/2 a pound in 3 weeks as well. Two months of thyroid meds have contributed to that I am sure. He's back up to 12 pounds (this boy was 15 lb. most of his adult life and he wasn't fat).

His heart murmur was a lot less - in fact she could barely hear it and his breathing good. She's having the compounding pharmacy send us tablets (like we asked for the first time ) for the breathing medication.

The only new issue is blood sugar that was as a bit elevated. He had just stuffed himself before we left so that could have been the reason on that. Previous testing was done fasting.

We were warned against letting him eat her kidney food because of his gallbladder issues. Now that his appetite has grown, we will get more wet food into him and that will help a lot but we have no way to control the dry food. We have decided that we will have to let her eat some high protien. We will mix the two so that protein is reduced but for her but not so much it hurts hi. It's hard when you have got two cats used to free feeding with opposite issues!

He has finally given up his hunger strike because Sis gets different food and is now eating very, very well.

Just keep your fingers crossed about the blood sugar!
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post #9 of 12 (permalink) Old 09-27-2018, 09:27 PM
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Hi Love2Cats,

Holy cow, what a great and *huge* improvement in the ALT! Out of curiosity, because I've never known a kitty to be treated for just the gall bladder, what is the med?

Unless the blood sugar is super high, it isn't usually a concern. Since Maynard's wasn't, and since it wasn't a fasting result, then I agree that it doesn't mean anything.

I wouldn't worry as much about a higher protein content for Sister, especially with early stage renal disease, as I would about phosphorus content. Controlling phosphorus is far more important, so hopefully, the dry isn't too high.

All fingers crossed for more good results on Maynard's follow-up!
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post #10 of 12 (permalink) Old 10-04-2018, 09:00 AM Thread Starter
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Gallbladder medication

We are giving him Ursodiol which is a human gallbladder medication. He gets 1/4 pill daily. (and at the price that is good news!! The pills are a little over $2.00 each with a discount coupon we found on-line!)

We're hoping when we go back he can go off it. He has so many medications, and his appetite comes and goes so removing one might help the taste of the food. He's strange for a thyroid cat - he is not and never has been ravenous. Sissy would eat twice what he does and she's a lot smaller! I guess that's why we were all so shocked by the test results.

We've got the brochiodialator started and now we'll see if his breathing improves. He has been sounding very wheezy and congested. I hope it help because I sure it will make him feel better to be able to breath easier.

I'll keep you updated on. Thanks again for your continued concern and helpful words!

Last edited by Love2Cats; 10-04-2018 at 09:03 AM. Reason: typo
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