Decision making over veterinary bills in treating old cats

For me, it’s a balancing act between assessing how comfortable a cat is and will be, the benefits and risks of surgery or treatment, the quality of the remainder of the cat’s life and lastly the cost of treatment. Decisions, decisions, decisions….

Photo by Christina Rutz
Photo by Christina Rutz

For all cat caretakers, there comes a time when veterinary bills are liable to mount. This is when your cat is old and starts getting ill more frequently.

In the US, it is estimated that just 0.3% to 1% of the cat population is insured against veterinary bills¹. This is a very low figure. It appears that most people don’t want to add to their regular outgoings. They’d rather take a chance and hope that their cat remains healthy. However, at the geriatric stage of a cat’s life the usual feline illnesses such as kidney disease, hyperthyroidism, cancers, heart disease etc. start to click in and so do the decisions about what to do.

Do you spend lots of money on vet treatment or do you decide that it is time to euthanise? Your vet might advise you wisely but, ultimately, the decision is the cat caretaker’s and often it’s not about money. On the contrary, it’s mainly about emotion, love and loss.

The relationship between caretaker and cat has deepened over the past 4 decades. The bond is stronger and letting go is harder. Fifty to one hundred years ago you’d probably find that people were more willing to have their cat PTS when old rather than fork out on expensive treatments. It may have been the norm.

Treatments have improved, there are many more options and greater expectations. Veterinary surgeons can do wonderful things nowadays at a wonderful price. The decisions are more complicated.

Obviously, what a person spends on vet bills depends a lot on how much money the person has but I’d bet that a lot more people with lots of money are more willing to have their cat euthanised than relatively poor people. It is not about money. It is about a person’s connection and relationship with her cat(s).

Some cat caretakers would spend their last dime on medical treatment for their cat. They’d go bust before they stopped trying to prolong the life of their cat.

However, this can be foolhardy and dare I say it, selfish. The decision to treat the illnesses that beset the lives of elderly cats must include a discussion about the quality of life a cat can achieve with treatment. We are into the same sort of discussion we have in the press about euthanasia of people with terminal illnesses.

It is my belief that the vast majority of people believe that sensible and sensitive use of euthanasia is preferable to prolonging life when the quality is extremely poor.

So, putting aside the cost of treatment of an old cat who is seriously ill, the decision comes down to deciding what is best for our cat, which includes deciding if she in pain and what sort of quality of life is left for her. The decision should not be clouded by self-interest and what is best for the cat’s caretaker. In short, the decision should be governed by unconditional love and it should be as objective as possible.

There is no doubt that at this time an excellent veterinarian who has a lot of experience under his belt is invaluable. This is because the balance between quality of life and euthanasia depends on the information provided by your vet. I’d lean on him/her and ask tough questions. It is hard to know if a cat is in pain. A good vet can assess that much better than us. How long will your cat live even if given the best and most expensive treatment? Do you want her to live for 9 more months because (a) you don’t want to lose her or (b) because she will have a decent 9 months of life ahead of her?

29 thoughts on “Decision making over veterinary bills in treating old cats”

  1. The author of the best comment will receive an Amazon gift of their choice at Christmas! Please comment as they can add to the article and pass on your valuable experience.
  2. Thank you Ruth. Comforting to know it is the early stage. I did read about the seizures being the advanced symptoms. I’m not looking forward to that. I’ll treasure every minute with him. There is such a stark contrast between him, Marvin and the to back yard characters. My life is filled with cat joy, with a bit of sorrow thrown in.

  3. It sounds as if Bigfoot is in the early stages of renal failure and hopefully you may have him around for a good while yet. Our Felix lived a long time after he was diagnosed, the vet gave him regular injections of vitamin B12 which helped him. He drank a lot of water and sometimes had projectile vomit as time went on, but he still had good quality of life.
    We had him PTS when he started having fits, only mild at first and they left him incredibly thirsty that’s all, not distressed. But one Sunday he had a really bad one and the vet came out and PTS, we could tell he had had enough.
    Bigfoot still wants your company Dorothy so he’s not feeling very bad or distressed, old cats do sleep a lot so I wouldn’t worry about that. Ask your vet about vitamin B12 and just keep a close eye on him. You WILL know when it’s time to say goodbye! It’s an awful time to live through knowing what is coming, but try to treasure every moment with him, I’m so sad for you.

  4. Sadly for me, this is a timely article. I hope to get feedback from my POC friends. My Bigfoot seems to be in early renal failure. At least, that is what the doctor suspects. His only real symptom is a tremendous increase in water consumption. The doctor compares the need for increased water as in a bucket with hole in it. It is impossible to fill. Another symptom was a light colored, almost gray, poop, if you will pardon the expression. Again, the vet wasn’t impressed. Of course, reading on the internet only causes more worry for me.
    I agree that it is difficult to tell if a cat is in pain. But I still believe I will know better than a vet. He doesn’t seem to be uncomfortable but he does ask for hours of soothing. Usually at 2:am.
    He has had blood tests twice in six months. The first test showed most everything normal except for a “slight” rise in the kidney number. I didn’t say that well, but I think you understand. His more recent test showed that number slightly more elevated. Still, according to the doctor, not alarming. His thyroid is fine.
    I was not sleeping well, listening to him get up very half hour to lap up water for long stretches of time. Finally, I had a long conversation with the vet on the phone. She said it isn’t necessary to keep a vigil. He could go on like this for one or two years. And, that there isn’t really any good treatment for cats kidney problems.
    Ruth AKA wrote in a comment to me some time ago, perhaps years, that the water drinking could be a sign of kidney problems.
    I should also note, Bigfoot will only eat dry food. I’m sure he was raised on the worst kibble, then left on the street to wander into my life. Probably already an old cat. I’ve never been able to get him to eat anything wet. He is so skinny. Only 8 1/2 pounds. That is two pounds lighter than four years ago. The other signs of his age is he doesn’t groom himself anymore. He has fairly long fur, so I keep him brushed and washed with a warm damp cloth. And he sleeps 22 hours a day. His purr is like a rattle. He is still affectionate and seeks out company by calling out from his perch.
    I will miss him very much when he goes, but I don’t need him to stay for me. I cannot bare for him to be in any pain or discomfort. I think that is my job to discern. I see death as a part of the circle of life. But it is up to me to see that the quality of his life, short as it might be, be the best it can be.
    I find it odd that there is little treatment for renal decline. I ask for your input please.

  5. The worst part is the feeling of guilt at being the person with the power to say to end a cat’s life, even though it’s the kindest thing you can do.
    I relive all the times we’ve had to have very old cats PTS over the 40 years we’ve had cats, but it’s something cat loving caretakers just have to do at times.

  6. This is a time when we must put an old, ill cat’s needs first and ask ourselves if she has quality of life or not. If she hasn’t, then hard as it is, we have to make the decision to free her from pain, it’s the kindest thing we can ever do for a suffering animal.
    All the money in the world can’t reverse old age and terminal illness, we have to be very careful a vet isn’t stringing us along with various treatments because many nowadays have to reach targets for their employer, tests and drugs being two where a lot of money is made.
    Yes take advice from a trusted vet but at the end of the day we know our own cats far better than any vet and we know when the time is right to say goodbye to a much loved cat for her sake.
    We have money put aside for our cats needs but if it wasn’t enough then we’d eat bread and jam for every meal rather than they went without what treatment they needed IF it was in their best interests.

  7. This is great – very to the point. I agree – there can be a level of selfishness – but it’s a fine balance and the decisions are plentiful and hard, and the final decision as you say – has to be for the right reasons. I have not been confronted with this.

    I am just a beginner in cat caretaking. I have dealt with ilness and even had a sick cat die on me but never had to make a final decision. It must be very hard. All I care about is that my cat get’s what she wants. If she wants to live I would like to know or be able to tell and I would do anything I could to make it possible. If, as I have seen, after a point she doesn’t want to live and would rather go in a corner and die, then it’s time. Of course there is a huge and murky middle area where you aren’t sure if or what she (or he, my cats are all girls) wants.

    Nonetheless – given the emotion involved it might be hard to know if you are seeing clearly or not to make that decision but I suppose if you are close to your cat you will know.

    I haven’t the experience that many other people here have had with losing cats so I can’t really comment any more. It must be very hard. I will find it very hard when the time comes. With Red I didn’t have that choice.

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