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Dr. Bruce
Dr. Bruce, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 17836
Experience:  15 years of experience as a small animal veterinarian
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My cat is 17 years old. I have had her since she was eight

Customer Question

My cat is 17 years old. I have had her since she was eight weeks old. She has been diagnosed with a thyroid condition and needs medication twice a day. Unfortunately, I travel for work often and cannot afford to pay someone to come twice a day to give her the needed medication (when I am out of town they only give it once). Also, when I am not traveling I work at home and due to her medical issues, she is loud and relentless. She has bad teeth, and I give her between 6-9 cans of food per day, and she only licks up the gravy, begging for more within 45 minutes. Oddly enough, I also keep dry food out for her and she does eat this regularly.
The vet I have been going to is very young and seems a bit inexperienced. He often seems to suggest very expensive surgeries and tests that, if I were a millionaire, I would not hesitate to try. However, I am realistic. My cat is old. I love her very much, but to be honest, I am beginning to worry that my own memories of her will be very unpleasant due to the constant irritation and loud meowing. She is clearly unhappy, but I would not classify her as beyond getting better -- I am just not in a financial position to make it happen. Are there any (relatively) inexpensive ways to help her feel better, before making the ultimate decision to put her down? Otherwise, is it unethical to put her down if she is still able to walk, eat, use her litter box, and has her personality?
Submitted: 11 months ago.
Category: Cat Veterinary
Expert:  Dr. Bruce replied 11 months ago.

Hi. Welcome to Just Answer. My name is***** and I've been a veterinarian for 15 years. I'm sorry to hear about this situation with Phoebe. I'm assuming that her condition is hyperthyroidism. Is she on oral methimazole? What dose is she getting? How long has she been hyperthyroid?

Customer: replied 11 months ago.
she is on methimazole but because of my traveling schedule it has been very inconsistent. She is also on a sedative that I give her when she is truly driving me mad, but not regularly. She was first diagnosed with this condition over a year ago, and has lost a lot of weight. Most of her life she was around 11 pounds, but in the past year has been about 6.
Expert:  Dr. Bruce replied 11 months ago.

Thank you for all that good information. Has she ever had her dose amount adjusted? It sounds like your vet discussed possible surgery and / or radio-iodine therapy for the hyperthyroidism. Did they talk about a special diet called y/d by a company called Science Diet?

Customer: replied 11 months ago.
He discussed this iodine-free diet but said it was not a very good option. He also said that there was a medication that could be rubbed into her ears, but that was not a good option either. She has not been re-tested since being on the medication due to the inconsistency of her dosage. However, her behavior has not improved, even with being on the medication (even though inconsistently). Yes, he did talk about the surgery but no one in the city performs it, and it was way too expensive... not to mention that I am not willing to put a cat this old and fragile under anesthesia.
Expert:  Dr. Bruce replied 11 months ago.

I can absolutely understand your concern for not wanting to put her through the surgery as there can be complications with the procedure / anesthesia and there are no guarantees with it resolving her problem. Some can have ectopic thyroid tissue that isn't removed during the surgery and the situation persists. As far as the iodine free diet, some feel it works pretty well. Others may not have as much success with it. It is a diet change when it is used and some cats don't like to have their diet changed. AS far as the topical on the ear, I feel it is a good alternative to the oral medication as it is the exact same medication. There can be absorption issues if not applied properly, but I feel it can be a definite option for those owners that can't orally medicate their cats. As far as your question about making her feel better, probably the best thing there is to try and manage her hyperthyroidism as best as possible. Please don't feel that you are the only owner to have a pet that has a situation that needs daily medications that conflicts with the regular schedule of life. Sometimes some will become loud and restless as they get older as they start to have decreased vision and hearing and this can be displayed like this. Some can have some cognitive issues too where they just don't seem as sharp as they were. I know you asked about it being unethical to put her down in her current situation. Honestly, I would never look down on an owner that made that decision. You are the one that is seeing her at home and being in this condition. You have to have a good quality of life as well as her - it is a two way street. As far as her constant meowing, is she just having that much of a hunger urge as her thyroid situation isn't being controlled as well? Could you keep out more food that she likes to try and satisfy her? That could be something to try.

Customer: replied 11 months ago.
Well, this cat ALWAYS has food. Dry and wet. She does eat her dry food (an entire bowl once a day) but constantly asks for yet another can of wet (that she only licks the gravy off of). She does have bad teeth. Three years ago, she had 5 extracted, and now the vet wants to extract all of them. This is not affordable for me and I also have issues with her losing all of her teeth and going under anesthesia for the procedure. While she may be in pain (and the vet made no bones about making me feel terrible about this), it is not realistic for me to have this done. Also, he wants extensive testing on her kidneys and liver. There aren't any real reasons for this outside of her age (and her urine is not very concentrated he said), but this testing is several more thousand dollars.On another level, I probably would not feel so much at the end of my rope if I worked in an office 40 hours a week and did not have to listen to this all day long when I am trying to get my work done - or alternatively, feeling incredibly guilty when I am out of town for her being alone and undermedicated for a week or two at a time when I should be taking care of her properly. Friends tell me I should not put her down until I wake up and find she cannot walk or eat at all, but to be honest, my own relationship with my cat is in a bad place because of these circumstances. I don't, however, think it's fair to take her away out of "inconvenience." Ugh. Thanks for listening.
Expert:  Dr. Bruce replied 11 months ago.

The bad teeth issue. Obviously your vet is presenting their best recommendation for helping to have her health as best as possible. Honestly, she could do just great with no teeth. I've seen numerous cats over my career that do just fine with no teeth left (they've been lost due to extractions from dental issues). AS far as being going through with it in one her age, that is a tough call. Your vet is making sure you know your options. Could there be complications from the extractions or the anesthesia? There could be and that has to be weighed into the decision process. If you say you don't want to pursue it, then they should respect your decision. As far as doing more testing on her kidneys and liver, I would always ask if something was found, would an owner treat the situation any differently. Your quality of life needs to be good too again. You need to be happy and she needs to be happy. At this point in time, it doesn't sound like she's having discomfort because of all this. I know you said the food is always out, but could she be satisfied if she got more of what she really likes? Believe me, you're not the only owner that has been in this position. You are looking at all your options and trying your best to figure out what is best for everyone involved here. I truly respect that!

Customer: replied 11 months ago.
Thank you for all of your feedback tonight. I really only have one last question. To be honest, I am not willing to spend a lot of money on surgeries and tests, and the results of such tests would not make me change my mind. My cat has had a full life, and I'm hoping she's been pretty satisfied with it. My question is this.. I have told the vet that I would prefer to just give her a lot of sedatives and pain killers (if she's really in pain) just to calm her down (and yes, shut her up) and make both of our lives easier. He did give a sedative but seemed very reluctant and told me not to give it to her often, telling me I don't want her "drugged up" all the time. I have been sparing in giving her this medication, but to be honest, I would not mind giving it to her daily (or even twice a day) as she definitely calms down and makes life better. Should I tell this vet under no uncertain terms that I want to medicate her regularly (I would rather have her calm and my life peaceful than extend a miserable life for both), or is this an ethical issue for vets?Thanks again for all of your feedback, and have a great night.
Expert:  Dr. Bruce replied 11 months ago.

I respect an owner when they are straightforward with their beliefs and financial situation. At my ER, sometimes the most frustrating situations are ones where owners just can't be forward with what they want to do / can afford to do. What medication is it that she's getting?

Customer: replied 11 months ago.
Acepromazine, 10 mg tablet -- 1/4 tablet dosage -- says once every 8 hours, no more than that, but he said not to give that much. I give her no more than once per day, and usually try to skip it if I can tolerate the noise. However, I would probably prefer to give it to her at least once or twice a day.
Expert:  Dr. Bruce replied 11 months ago.

Acepromazine is a pretty commonly used sedative. It is used for numerous things from calming for travel, to trips to the vet to sedating to help keep a pet quiet at home for a period of time for something like an injury to heal post surgery. Could you try it once or twice a day for a few in a row to see how she responds? It would be a trial. Obviously you need to make sure she's still being a cat that is having a decent life at home.

Customer: replied 11 months ago.
Sure, I could try that (and look forward to it). As far as making sure she's "still being a cat that is having a decent life at home," that is hard for me to tell. When she sits in the hallway and bleats for hours at a time without responding to affection, I can't think she's too happy -- if she's a little high and sleepy, I assume she's better, but I just don't know. :-( Thanks again for everything, you have been responsive and helpful.
Expert:  Dr. Bruce replied 11 months ago.

I'm hoping for the best!

Customer: replied 11 months ago.
One last thing. I have never used this site or service before and just noticed that these conversations about people and their pets are published. I really prefer to keep this thread private.
Expert:  Dr. Bruce replied 11 months ago.

I can send this on to the moderators of the site to see what they can do to help do that. I'm not sure what all access is had with it. Does that sound ok?

Customer: replied 11 months ago.
Sure. If there was something in the terms of agreement that included publishing the private information about my relationship with my cat and her health, I sure missed it, and really do not want it published. Thanks.
Expert:  Dr. Bruce replied 11 months ago.

Glad to help. Please don't forget to rate how I was able to help! I'm again hoping for the best for you and her.

Customer: replied 11 months ago.
I just want you to know that I have been informed twice by your customer service representative that I must give a "positive" rating in order for this very personal information to be unpublished. While I was impressed with your professionalism, this site, by forcing "positive" ratings in trade for confidentiality is absolutely shady, unethical, and possibly illegal. I wonder if this comment will be published as well. I am thoroughly disgusted with such business practices and hope that if you were unaware of this, that you will think twice about participating with a company that does this to its patrons.
Expert:  Dr. Bruce replied 11 months ago.

I'm very sorry to hear about this "situation". In a very honest statement, I wasn't aware of this. Thank you for letting me know this and I wish this wasn't the case. Even though I'm a veterinarian, I'm a user of this site too. I'm hoping for the best for you and Phoebe. Thank you for letting me know that I was professional as that makes me feel good. Take care!

Expert:  Dr. Bruce replied 11 months ago.
Hi,
I'm just following up on our conversation about your pet. How is everything going?
Dr. Bruce

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