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I have two cats, both of whom are pretty old.

Our old girl

The older cat is 17 years old (sometime this month, as she was a ‘barn cat' we don't really know her exact date of birth).  She started off as a cat that my roommate and I out of college thought would be good.  The roommate left after a couple of years, and the cat stayed with me.  She was never sick a day in her life, but a checkup a couple of years ago revealed that her kidneys were starting to fail.  This is pretty common for older cats.

The vet also discovered a slight heart murmer.

The vet advised that I start treating her by injecting fluid under her skin.  This would allow more liquids to flow through her kidneys, more than she could get by drinking water.  The vet advised that each bag, which would last roughly a week, would cost $28.  I found an alternate source that costs $10 per week, and the vet agreed to write a prescription to allow me to purchase the medication.

Within a few months, a checkup revealed that the treatment was doing it's work.  Her kidney function, which had slowly been declining, had now leveled off.  Since then, she's been on a steady regimen.

The sensitive guy

Our other cat will be 13 years old in a couple of months.  I got him as a ‘gift' from an ex-girlfriend.  She's long gone but he remains.  He's always had a bit of an attitude, never taking well to strangers, and is pretty much a one-person cat.

Most cats will eat only the food that they need.  Not so much with this cat.  He became obese, weighing in at over 22 pounds at one point.  He also started developing issues where he got severe constipation.  The vet indicated that he needed to lose weight and would likely need medication to control his ‘movements'.  We did lower his weight (he's around 12-13 pounds now), but he still does require special food and medicine to control his constipation.

The phone call

Every so often, I have to contact the vet.  Since they both require special food, as well as the medicine for the constipated cat and the prescription for the other cat's kidneys, I am in touch with them regularly.  When I recently contacted them to get both taken care of, the tech indicated that the doctor wanted to see both cats to ‘check their levels'.

When I inquired what that meant, she said that:

  • For the older cat, she wanted to make sure that her kidney levels were still level
  • For the constipated cat, she wanted to make sure that the medicine was not causing problems in any of his organs, something that can happen with prolonged use.

I questioned this and asked if this really was necessary.  I had a long discussion with the vet where I outlined the following:

  • The older cat is limited in the amount of fluid that she can take, because at a certain point too much fluid would impact her heart (due to her murmur).  She's already capped out.  On top of that, she's showing signs of old age.  She's 85 in ‘cat years'.  She is going hard of hearing.  She's walking more gingerly.  She doesn't jump as high as she used to.  She sleeps more.
  • The constipated cat has been on this medicine for eight or nine years.  So far, he's shown no ill effects from the medicine, and even if he did, changing over his medicine would be pretty disruptive, and might not even work, in which case the resulting constipation would be very awful for him and for us.

Now, keep in mind that we get both of the cats full exams every year.  They get full bloodwork and other testing, and for both cats, during their last exams (roughly six months ago), they both came out just fine.  So, it's not like I am going years and years between having them checked, and they will get checked during their annual physical.

The question I asked, first myself, then the vet, was that even if the testing showed that the various approaches were becoming less effective and/or leading to other issues, what would be the options available?  And where would they ultimately lead?

In the case of the cat receiving the fluids, the vet admitted that because of her restrictions due to the heart murmur, there would likely be little else they could try should her kidneys start regressing again.

In the case of the other cat, as noted above, it would require a big upheaval in terms of his medicine and potentially his diet.  This is not a cat that responds well to change.  One other thing to keep in mind is that when his problems with constipation started many years back, the vet told me that in most cases with cats with his severity, that a life span of 10 years would be considered ‘very good'.  He's already almost three years past that.

I couldn't really get the vet to commit, because I think it's in their nature to try to treat everything that they can, but I could tell she understood where I was going, which was basically that continuing down their course of action is probably preferrable to any potential alternative options.  Kidneys don't improve, they just stop regressing for a while during their treatments.  You can't recover the lost function.  Add that to the effects of old age that are becoming more and more sympomatic, and, well I see no point in testing for potential problems that have no real fix.

In the case of the constipated cat, it's the same thing.  Any ‘damage' found would not be reversible, and any new medicine would be a major disruption to his life and would introduce a whole host of potential problems.  At his age and given that he's already ‘on borrowed time', I don't think that's an avenue I want to pursue.  Besides, the levels that they measure have not so much as budged in any direction, so there's not even early indication that the medicine is having a reaction to any of his organs.

This leads me to realize just why it is that pet care costs have gone up so much.  Just like with our medicine, the research and opportunities available for pets have increased tremendously, and vets will present these options. And cheap dog insurance isn't the easiest thing to find as you probably know.

As pet owners, though, we each have the responsibility to make decisions on behalf of our pets as they can't make those decisions themselves.  I'm sure there are some pet owners out there who would think nothing of doing every recommended test I outlined, as well as changing treatment if in fact something came up.  Others probably fall on the opposite side of the spectrum, and may never have begun the various treatments in the first place.

I like to think that I fall somewhere in the middle.  I'm willing to provide the necessary care to my pets health as long as it is within bounds that I consider reasonable.  When I look at the options should something have been discovered, I just don't see that there are any options available that I would consider reasonable.

When I explained it to my vet, she understood, and allowed me to sign waivers indicating that I understood the risks involved and would not hold them liable if they ended up getting sick or dying when testing might have revealed problems along the way.

My wife and I have both talked about it and we agree that their treatments will continue as such for as long as they are helpful to them, but that anything beyond is not something we want to pursue.  We will take them in for their annual checkups just as we always have, but new courses of treatments are just not in their future.  And, knowing my cats, I somehow think I'm doing just what they would do if they could put the thought into that decision and express it themselves.

Readers, at what level do you decide that your pets care has reached its plateau?