Quality of Life

I've just read an article that talks about quality of life.  I have been struggling with Dock's for a few weeks now.  It's so hard to know if you are doing it too early, or too late.  The last thing I want to do is have her suffer, or to experience something significant like a major seizure when we are not at home, or lose her balance and fall and hurt herself.  I've talked to friends, co-workers, and most importantly, my husband, about this.  I'm still on the fence, so my vet gave an article with a scale to try and quantify her quality of life.
 
http://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=1523

I went through this list, and I found it was a good beginning, but that it is deeper than this article makes it. I'll post her score for each section in brackets.

Hurt - I know Dock's breathing is a bit labored, she is bloated and I think that has increased her breathing.  But what is a normal respiration rate for cats?   (5)

Hunger - She eats well, and is even looking for extra food.  But that is from the meds.  (7)

Hydration - How do I tell she is dehydrated?  What should she normally drink in a day?  She urinates well, but I know she's always had concentration issues, and she does have early kidney disease.  (7)

Hygiene - She barely self grooms anymore.  Thankfully, she has never really matted, or had issues with poop sticking to her long fur on her bum.  But she looks greasy, and patchy, and not very pretty anymore. (2)

Happiness - She seems depressed and tired.  I see it in her eyes, and she can't stand me coming at her with her meds which breaks my heart.  She does not seem interesting in toys, or in the new cat at home.  She just wants to sit beside us, purr and get pets.  That's her only real happiness (3)

Mobility - She doesn't go up and down the stairs as well.  She drags her back feet (particularly her left).  She never stands anymore, she will only sit.  I have just noticed today, she does not raise her tail anymore. (3)

More good days than bad - This is a really hard thing to gauge.  All her days are the same.  I noticed that she is really only awake for an hour in the morning, if that, and 2-3 in the evening.  During that time, she doesn't do much besides sit and get pets. (3)

According to the scale, Dock is 30, which according to their scale is a poor quality of life.  I'm glad to have seen this article, and will discuss it with the hubby tonight.

Waiting the weekend

So Dock's pred is now decreased to once a day.  The last few days (even when she was on the twice daily pred) she was a bit wobbly.  I watch her so much now, that I'm not sure I'm seeing things right, or if I'm imagining things.  But I do know that when she sits still, she wobbles a bit when she breathes.  She also has a full feeling belly so I wonder if she has some fluid build up in her system, as she is quite boney over the back. She still drags her back left paw, and her one toe sits kind of odd.  All she does is sit and lie down.  She sleeps a lot too, making me wonder how much energy and strength she has.Chatting with the vet the other day, she said something to me that kind of hit home.  She said "Seems like she's just existing"  so I'm watching her quality of life this weekend. I already noticed her stumbling a bit here and there, and she came upstairs this morning which she did before we increased her meds, but didn't when she was on the higher dose.  I'm suspecting that it will be next week that we'll take the final trip.

6 months

So I looked back, and it's been about 6 months since Dock's suspected diagnosis of Meningioma.  At that time, we were given a prognosis of 6-8 months, so it seems we have been doing ok so far.  But more symptoms are starting to arise.  I noticed the other day that she is dragging her hind left paw when she walks.  I can hear her nails scraping the hardwood.  I looked and it appears that she is not retracting her claws on the left side as she does on her right.  I have also noticed odd little twitches here and there.  For no reason, her ear will twitch, or her back, her paw or her tail.  She maybe awake or fast asleep when this happens.  I've seen her dream twitches before, and these are different.  Speaking with her vet, meningiomas can typically affect one side or the other, and if it was muscle wasting or weakness due to the high doses of pred, than it would be affecting both sides equally.  She's suspecting  the twitching is focal seizure activity, and the dragging of her left paw confirms that the meningioma likely is increasing in size again and causing neurological signs.

We were thrilled to bring home our new kitty Norris the other day, and so far he has done well in his new setting, and has even played a bit with Mace.  Dock on the other hand is not so happy with his arrival.  We are not sure if that is why she has decided to travel upstairs more.  She has not come up the stairs in about 4 months, so we were a bit surprised when she woke us up the other day.  She found a nice cushy spot sitting on my chest and stayed there happily for a while before moving onto the hubbies side table.  She ventured up again last night.  I woke in the night to feel her fall over onto me.  She righted herself and a few seconds later, laid down on my chest for 5 minutes before going down stairs.  I am not sure if it was a seizure, she lost consciousness, or stumbled.  She stumbled again this morning when she came to wake us up.  These incidents, coupled with the dragging of her paws has led us to increasing her meds.  Pred and Gabapentin twice daily for the week.  We can't use the pred for more than the week as it is too high a dose.  So after a week on the higher dose, we'll see how she does.  

How will this work?

So new cat coming home today.  Norris is Mace's new play buddy, and with Dock still wandering around, I'm wondering how things will work out in the house.  He had some major surgery on Wednesday, so he's not up to snuff, and still on some good pain meds/narcotics.  Mace will take a bit to get used to him anyway, so it's probably a good thing he's not in too playful a mood.  I think he'll just watch Dock, and she'll watch him.

Dock's appetite is down a bit again.  I started giving her medication after she's eaten, and that helped to boost her appetite for a while.  Not sure if it is the heat or another reason.  I've also noticed she is dragging her hind left toes just a bit.  I hear her nails scrape the hardwood floor when she moves that paw.  Not her right, just the left.  I'm taking this as a poor sign.  Because today is Canada day, the vets are off tomorrow, but I'll ask on Tuesday to see their thoughts on this new symptom.