Hello I am Dr. Joey. Thanks for trusting me to help you and your pet today. I am a licensed veterinarian with over 15 years of experience. I look forward to working with you.
What a tough situation. I am sending you a cyber hug. I have been through this exact scenario many times with an older cat. What I usually recommend is to at least do some blood work testing (if not already done) that includes a CBC, chemistry profile, urinalysis and thyroid check. The big issues we are looking for includes kidney failure, liver disease, hyperthyroidism (overactive thyroid), cancer, and an infection (like urinary tract infection). Some of these issues are entirely treatable such as hyperthyroidism or infection. And we hold out hope that this is what we find. Unfortunately kidney failure is our most common issue to find in an older dehydrated cat. But I think it is well worth it to put her through a blood draw and urine sample acquisition to know. It is relatively atraumatic to get these samples, when done by an experienced professional. If we find that she is in devastating kidney failure (after getting IV fluids) then her prognosis is poor and considering this may be the end may be the right step. However, if she has hyperthyroidism, then treating her with the medication may help resolve her unwillingness to eat (I have had several patients over the years that had the opposite of what we expect with this disease, which is to have increased food intake and weight loss; the cats just stopped eating and were terribly nauseated as the thyroid levels rose quite high).
I always like to give our significantly senior kitties the benefit of the doubt. We must always remember age is not a disease and there is no reason to give up simply because she is older. However, if you elect to do no further testing and you try all that we can (IV fluids, antinausea medication, and appetite stimulants), then there is not much more we can do. Cats can linger without eating much for long periods of time, sometimes weeks as they wither away. And in that situation we do need to make a decision for her. What is the toughest (and I have been through this personally) is to know when is the right time. With my own pets I have to step back and make some objective decisions, which means for me I give my cats 3 to 4 days of entirely not eating/drinking and then I make the decision. If she has a big event (like a seizure or collapse) then this is our sign, and sometimes it will happen.
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