Can you tell if a cat is in pain.

[richardbajor]

We have a 19 year old cat with hyperactive thyroid and also either IBS or bowel cancer. The vets did an ultrasound which showed thickening of the stomach linings (not sure if right description) but without an intrusive biopsy, which they don't recommend at her age, there is no way of telling which it is.

The hyperactive thyroid seems to be being successfully treated with medication as later blood tests have come back good. However she has had periods of being sick and has bad periods of regular diarrhea which I assume is linked to her stomach. We also cannot get her to take any of the meds for IBS and are onto our 3rd failure and have also tried putting the med in the little cat pill treats without success. We have no chance of forcing this down her (when she goes to the vets they have now given us chill pills to give her beforehand) so are reliant on it being in the food which she turns her nose up at and I am very reluctant (given weight loss) to not give her any other food until she eats the one with the meds in- not least because that means she won't be getting her thyroid meds either.

I'm writing this after 3 particularly bad days in a row of cleaning in and around her litter tray and this morning she hasn't eaten anything and has not released any poo for about 40 hours. Based on past patterns over 3 months it might correct and we get a few days with clean poo but you obviously start worrying after a long run of it.

The behavioural changes I have noticed are that she is much more clingy (although maybe all older cats are?) and a tendency to more often sit on her tummy with legs tucked under her rather than sprawled out. Also not noticed her doing any sprints and quite slow with her walking but can still jump up onto chairs. She has stopped coming upstairs onto our bed last thing at night but cats do often change their patterns. We do still get some purrs when she is being cuddled and some excitement when she gets something from the dinner table.

Obviously we will be back to the vets with these problems (although I would welcome any suggestions) but my main question is that I accept she may not have that long to go (although wouldn't like to guess whether this might run into months/weeks or year or more). But my main question is that maybe cats don't always display symptoms of pain or discomfort readily and I'd like some guidance about when you could see signs that she is unhappy enough to consider having her put down and will you actually see those signs in obvious ways.

I'm happy to keep cleaning out the litter tray and do whatever is needed and we won't rush a decision but am concerned that if there is constant diarrhea (not throughout the day just when she is due her normal poo) that it can't be comfortable for her and that some of the behavioural changes may be signs of being uncomfortable. Will it be very obvious when it is time to make the decision or do we have to make a judgment call, say after 2 weeks of constant diarrhea, that she is not enjoying life?

[Epsom-cat-lady]

Hi Richard, So sorry for your worry’s & stress.
My sweet 19 year old girl has kidney & thyroid problems, I give her her thyroid meds which is a liquid on a Pringle lid with a little bit of Sheba lick stick - she gets a treat & I know she will wolf it all down.
I don’t feed her for about 45 mins so I know it’s been absorbed.

She only goes to a number 2 every other day or so don’t know if that’s the thyroid or normal.
Sorry can’t help with the IBS

[Mollycat]

So sorry for your woes, it's a tough time when the treatments become almost as difficult as the problem.

Your cat takes the thyroid medication fine? Good, but if you need it there is an alternative, it's a special formula ultra low iodine food. My cat is unpillable and we used the food to keep her thyroid under control.

The pills your vet has given for her digestive issues, is that a steroid? Steroids are the medication of choice for lymphoma or Inflammatory Bowel Disease (IBD) and usually started at the maximum dose and gradually cut back until the lowest effective dose is found. It's critical to keep the medication up with steroids, missed doses or stopping suddenly can cause problems. The biopsy under general anaesthesia can identify which it is but I gather isn't certain to, and anaesthesia have risks especially for an older cat.

There is a 6-week lasting injectable steroid, which is given by the vet. The main advantage is no pills and a guaranteed correct dosage. the disadvantages include that once it's in the cat it can't be stopped, and the cat may not need such a high dose, and steroids have side-effects. Also, cats on steroids can't have certain other medication including Metacam. But you might want to ask your vet about your options.

Have you tried things like Pro-Kolin to help tame the Dire Rear symptoms?

You know your cat best, she will let you know when she's had enough. It does help if you have some idea of what is most important for your cat's quality of life so that when she no longer enjoys those things you know in advance the time is coming to say goodbye. Try not to tie yourself up in knots about it though, this is a precious time when your time together is limited. Be sure to make it a good time for her, and for you one day to remember her by.

[richardbajor]

Thanks you for the replies.

For the IBS she is on Metronidozole which I believe is part steroid, part antibiotic. She simply will not take this- they gave her tablets and then liquid and for both she detects instantly and refuses to eat the food. She also has cobalaplex which she does take but I'm not too convinced of its benefits. The tip for a 6 week injection sounds very promising and I will ask the vet tomorrow whether this might be appropriate. Sounds to me like it is better to get this into her and risk the side effects than to do nothing. It's would also be very useful when we go on holiday- although she gets very good attention and virtually someone coming in or staying most of the time it's harder to ensure getting meds and top up food into her when you're not around all day long and unable to monitor what she has or has not taken.

She has finally eaten a bit today after about 24 hours and just been on our laps with a purr but distant all day and wanting to be left alone and no bowel movements yet.

I really appreciate the response- there was some useful advice there on all the questions I asked.

[Mollycat]

To be honest I've been there, hyperthyroid with one cat and the IBD/lymphoma with another.

Cobalaplex is a vitamin B mix with the accent on B12. When matter passes too quickly through the digestive system due to inflammation, some nutrients are not properly absorbed and the cat can become deficient in them quite quickly. Again, to bypass the mouth end, B12 can be given as an injection, but I don't think it's a lasting thing. My lad had B12 injections in the early stages of his problems, then that stopped working for him and we went to steroids, and unfortunately quite quickly that wasn't enough any more.

[richardbajor]

Thanks- sounds like the Cobalaplex is useful then and I guess that is one of the reasons for her blood tests coming back good. Never got around to asking the vet about this one as there were more important things to worry about- assumed it was to help her tummy upsets. No problem getting her to eat this one with her food. It's just the IBS that needs sorting out somehow.

[richardbajor]

Just want to thank Molly for the advice. For all I know the vets would have suggested this anyway but I mentioned this and they gave her a 5 day steroid to test her out and this has worked perfectly- back to her old self, solid poo, appetite back and just generally happy. She now moves onto a 4-6 weeks one.

Obviously I have been warned that there will eventually be complications/side effects and having both conditions doesn't help but for now we have a happy cat and hopefully a fair bit of time left for her now although they did say to my loaded question that it would likely be less than a year.