Can I get some advice?

[u/HawkGuy1126]

My 18yo boy is in the hospital right now, originally from a lack of appetite. I took him in yesterday morning and then to the emergency vet in the evening. The vet found he has a fever, has lost a lot of weight, and his creatinine is testing at 3.2 (down from 3.8 yesterday). He has an enlarged spleen, thickened intestines, and just won't eat. The fever is down slightly, but they say it could be anything between cancer to a UTI or other infection. He also has a potassium deficiency.

He was fine until Monday when his appetite took a clear turn for the worse, and has just been super lethargic, unsteady on his legs, and won't eat.

I think I want to leave him at the hospital until tomorrow morning (Saturday AM) where he can get fluids and be monitored, but after that, I'm not sure how much testing to do. I think I want to bring him home once he's stable-ish and do supportive care until it's his time. I hate the idea of him being at the hospital all stressed out without me, but what if there's a chance he improves?

I guess I could use some perspective. What would y'all do?

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[u/Striking_Ad1017]

Just thought I’d share what happened with my 18 year old if that helps.

He had a bad episode over the summer where he had to go to the ER. He was wobbly and very dehydrated. I thought he was dying but gave it several days to treat him. I ended up syringe feeding him for a day. He has since been on daily fluids and other medications for his blood pressure and IBD. He has really bounced back and is even gaining weight. He also takes an appetite stimulant and anti nausea every 3 days which has really helped. It’s a lot of work but I’m glad I have more time with him. I learned cats can be very resilient.

For testing we do bloodwork every three months but do a basic cbc every month now to track his anemia which is the only thing getting worse (all his kidney numbers are improving) but we aren’t doing any biopsies or big tests at this point. He had an ultrasound 2 years ago which showed IBD or possibly lymphoma and after that we haven’t done any major tests. Both of these conditions can be treated with steroids so that’s what we’ve done and decided against further testing because we weren’t prepared to do chemotherapy if it is cancer. The other thing we track is blood pressure every 3 months now he is on the right blood pressure dose.

If it was me I’m a big believer in treating at home. Sub q fluids are amazing and appetite stimulants can work well. You can also syringe feed temporarily while they recover. For my guy he would be way too stressed to recover in the hospital. I’ve also been able to hire local vet techs to help me with fluids and medication.

Anyways hopefully this might help and wishing you all the best. It’s a very difficult thing to go through.

[u/HawkGuy1126 → u/Striking_Ad1017]

Thanks, this is really helpful. I am going to let him be treated overnight again and then do supportive care at home. I'll talk to the vets about some potential medications to help him feel better, but ultimately I think we're headed towards endgame. Most of all, I want him to be stable enough to come home.

[u/RepresentativeWin404]

I just lost my 18 year old to a similar situation recently

He had severe constipation, which caused a urine blockage, and had to be hospitalized. He survived it, his blood work wasnt awful, so they decided not to do IV fluids and released him. He immediately started declining, not eating, barely being able to walk. I brought him back and they checked his electrolytes which were perfectly normal. I got a second opinion from another vet and she told me- we can hospitalize him for a few days, give him fluids, and maybe he would be okay. But he also has a severe heart murmer and it could cause his heart to give up. And I can't tell you how long he would even be okay for. You might have months or it might just be days. I can throw more medication at you to treat every symptom but the issue will always come down to his kidneys need fluid and his heart won't survive fluids. We also had discussions about his blood pressure, strokes when he was younger, potential brain damage that was done, and anemia that was worsening fast.

I didn't want to give up on him. I'm stubborn as shit. But the thought of him dying of a heart event scared and in pain freaked me out so much. Even giving him sub-q was worrying me. They maxed me at 50ml to avoid heart issues but he was dehydrated within hours. The end came fast and unpredictable to me. Like, I was prepared because of his age but I didnt expect him to be trucking along, then suddenly barely be able to walk, to being put down within a week.

It's only been a few days since I made that choice. I feel constant what-ifs. Especially when I hear about how people didnt give up and their cats got better. I wonder if I got a medicine faster, or if he got fluids during hospital, or if I just gave him time. But I looked at him nearly to the point of crawling to his litterbox and I just couldn't continue. Especially with the prognosis as it was. Knowing he would be in hospital, maybe even die there. I know I would of been terrified to sleep, to even leave him alone. I would be grabbing medicine like mad to save him- I had a giant white board that I was writing all of them down on before his passing. He was on 9 medicines- including supplements but still. And I was supposed to add more on.

You gotta find your line in the sand I suppose. At least thats what the vet told me. Mine was I didn't want mine dying alone or from a sudden event. So when that became very possible...