Our cat is rejecting his hyperthyroidism medication and wants to be left alone. Is it fair to take him for tests when he might be in his final days or should we have him see a vet?
Original Question: Monty is our 17 1/2 year old neutered male indoor Siamese cat. Many years ago he was diagnosed with hyperthyroidism and put on Tapazole. After almost every blood test the dose was increased. After a routine senior cat blood test in January, Monty refused to take the medication no matter what we tried. The vet was also concerned about his kidney levels and suggested a different medication. He was put on Methimazole liquid 20mg/mL a dose of 0.21ml orally every 12 hours. He has had a few follow up blood tests and was doing well. Eating and drinking well and urinating and defecating normally. 3 days ago he started resisting the medication. Yesterday he absolutely refused it and also vomited a couple of times and has refused all food and water and medication since then. He is not urinating or defecating. He is mostly sleeping but doesn’t appear to be in pain. It seems to me that he is dying and doesn't want to be bothered with any attention. He is very afraid to go to the vet although it is very cooperative when there. They love him but we feel doing a huge battery of tests is more than unkind if he is slowly dying. We want him to be comfortable and go quietly in his own home. We have decided to wait until tomorrow and see what happens but are we doing the wrong thing? So far he shows no signs of discomfort but only wants to be left alone. - Geraldine
I am sorry to hear that you are going through what sounds like a very difficult situation with your beloved cat, Monty. I would definitely be concerned that he has not eaten or been interested in drinking for more than a day, and also that there has been vomiting. These signs may be related to a complication of the thyroid disease (such as kidney disease, which occurs frequently), or could be another, new disease process entirely. Any cat that has these signs and also has an underlying illness needs to be examined and treated by a veterinarian as soon as possible.
I can certainly understand why you want to keep him comfortable at home and avoid over-stressing him. The reality in situations such as yours is that our pets (especially cats) tend to hide just how uncomfortable or painful they are feeling. As veterinarians, we are trained to recognize when animals may be in need of care or pain control and work on their behalf to treat them and make them more comfortable. Your veterinarian can work with you to provide the best solution for your family, but I would encourage you to seek out care sooner rather than later. Whether your decision is to proceed with diagnostic tests, medications, palliative care or even euthanasia, the best thing you can do for your cat is have him assessed and treated. Many veterinarians offer mobile services and can visit you at your home for an exam and consultation. Perhaps this would be an option for you. I hope this is helpful for you and Monty.
Dr. Kim Hester
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