Pepper: Chronic Renal Failure

My dearest beloved 8-year old cat was recently diagnosed with chronic renal failure. And he is dying. He is severely dehydrated and only weighs 5lbs. We have to help him clean his dry coat because he is too weak to do it himself. He is also incontinent and Mom has been very patient with him and I am so, so thankful for that (he lives with my Mom here in Indy). We brought him back to the vet last Saturday as soon as I arrived in town (literally an hour from the time when we arrived) and the veterinarian gave me four options:

(1) Do nothing, in which he will die in a few days---we may witness it, we may not. But in between, he will be very ill, will most likely have a seizure and be in pain before he goes into coma and die. Not even an option.

(2) Give him IV fluids since he is so severely dehydrated. Start a new strict diet, which can only be purchased at the vet office and continue IV subcutaneous fluid injections at home. He has a 50/50 chance of responding to this treatment. And if he does, we can choose continue to do this.

(3) Hospitalize him for 3 days where he will receive continuous IV fluids and receive medication to stimulate his appetite. Best option for him but again, it is not a cure. There is no cure. This just gives him the best chance to live "longer." And it is also very expensive. It will costs us $400 and even though Hubby is more than willing to let me spend the money, I'm not so sure. Eventually, we will be back to where we started.

(4) Say goodbye and put him to sleep...

I chose option #2. But the thing is, I left the vet office starting to mentally prepare myself that I will be putting my first own pet this Friday. I chose the immediate IV fluid option because I wanted him to be in a somewhat decent state while we spend his last few days and the holiday with us. But Pepper is a fighter and he started responding to the treatment. His appetite has greatly increased. He is able to jump on the counters again. And he is beginning to look "normal." I was instructed to give him 100ml lactated ringer subcutaneously when he stops eating. I still have yet to do that. He asks for food and actually eats an entire can a day. So now I don't know what to do.

Our friend Hannah brought a very good point and I have been thinking about it ever since: I need to make my decision by outweighing the quality of life versus quantity of days. Is Pepper happy? Does he want to keep living like this or does he just want to go? I am so heartbroken and my eyes hurt from constant crying. Ultimately, there is no cure for chronic renal failure. My cat Pepper will die.

If I decide to put him down on Friday, the rest of the family can be there too to say their goodbyes and to give me support. I will also be able to bury him right away in my Mom's front yard by the garden, where he loves to spend his days just watching the birds.

If I decide to let him continue to live like this, I will be taking him home to Georgia. My Mom does not want to see him during his end of life and I completely understand. I truly believe Pepper can benefit from the current treatment methods and may live a few more months. But he is still incontinent, which means he has to stay in a cage whenever we are not with him. That could mean 10-12+ hours on days that I work. He has been staying in the cage on his on will but as a rescue animal from the humane society, I just don't like that idea. Pepper was born in the human society and I hate for him to spend his last few days/weeks/months back in a cage. And because he was born in the human society, I truly believe this is the reason why Pepper loves the outdoors. Even though he has stopped going outside, I'm sure once he is well enough, he will want to again. But I cannot let him go out in an unfamiliar place and possibly let what happened to our late cat Jack happen to him, too (thus the reason he stayed with my Mom). The expense is something I also need to consider (special diet, IV bags, tubings, needles, etc). As much as I don't want it to be, this is a pretty huge factor. Right now, the 1 liter IV bags costs $20, more for the tubings and needles. And his special diet food is $2/can, which he about consumes one can a day.

I have been going back and fort with my decision and I am just so exhausted. I really, really do not know what to do. Please pray for strength and compassion. And that whatever my decision is, it will be not based on selfishness and my happiness but for what is best for my cat Pepper.

P.S. I love that photo of me and Pepper. I am so thankful my husband took a second to snap that photo of us as we were napping.