Dear Sinéad, Siouxsie and Thomas:
I was searching the Internet for some help regarding my 17-year-old calico cat. I have taken her to the veterinarian but the vet and myself are completely lost to what my cat may have.

About 4 months ago, my cat had two large abscesses on either side of her jaw at two separate times. We had complete bloodwork done, in which everything came back normal. She appeared to be healthy for another couple of months. Then, almost suddenly she began to limp. I checked out her paw and her toes were swollen. One digit was completely gone, exposing the bone. There was a lot of necrotic tissue around her existing nails as well. I have been soaking her foot in Epsom salts and administering antibiotic. There was no improvement and now three out of four paws are swollen. On each of her paws, only one small pad is swollen; it is hard to the touch and painful to her. When I took her to the vet we did a FeLV/FIV test and it came back negative. Her heart rate was around 200 resting at home.

What do you think this could possibly be linked to? My vet and I think this might be due to cardiomyopathy, which could have been due to hyperthyroidism (she has an increased appetite). A biopsy is not possible because of her age. Is there anything that I can do to help her be more comfortable?

Thank you for your help, I really appreciate it.
~Jessica

Sinéad: Jessica, this is a hard time for both you and your cat. When a cat reaches the age of 17 or so and starts manifesting signs of serious illness, you have some difficult choices to make.

Siouxsie: From your report that your kitty's resting pulse was over 200, that definitely sounds like she has some type of heart disease and may be in the early stages of congestive heart failure.

Thomas: We've found an article on hypertrophic cardiomyopathy (HCM) at the about.com cats forum, which gives you a lot of good information about the disease. We also found an off-site link to a page where a cat owner discussed the warning signs of congestive heart failure, as she observed them in her own cat.

Sinéad: This heart condition could also be causing the necrotic disease in your cat's paws. You see, when a cat's heart isn't working properly, she can develop blood clots, which can then break apart and travel through the body until they lodge in smaller blood vessels and cut off circulation. Symptoms of blood clots blocking blood vessels include pain, and possibly paralysis or swelling of the affected limb.

Siouxsie: On the other hand, diseases like diabetes also affect the circulation and can cause necrosis in tissues far away from the heart. We assume your vet has tested your kitty for diabetes as well as the other conditions you mentioned. Diabetes can cause heart and kidney problems as well, so if your cat has diabetes, managing that might make the rest of your kitty's illnesses more treatable.

Thomas: If your vet wants to run a diagnostic test for heart disease, this is usually done by taking an X-ray or an echocardiogram (ultrasound). Of course, both of these procedures can be stressful for a cat, and sometimes cats need to be sedated for ultrasound exams. Sedation is very risky for cats with heart disease, so your vet may choose not to do this test if he or she believes the risk to your cat is too high.

Sinéad: Diagnostic testing for diabetes is much the same as it is for humans. Your vet can test your kitty's blood glucose levels to see if there's anything out of the ordinary. A full test would probably involve fasting the cat overnight, measuring her blood sugar levels, then feeding the cat something with a lot of sugar and monitoring the cat's blood sugar levels at periodic intervals to see how her body is handling (or not handling) the sugar in the food.

Siouxsie: If your cat does have heart disease, your vet might want to consider placing her on blood thinners. This is what human doctors do when humans develop blood clots.

Thomas: We should state for the record that we're not veterinarians. We're cats with a caring human who has lots of experience as a lay person in caring for cats at all stages of life. Our mama has even nursed a cat with congestive heart failure through the last hours of her life.

Sinéad: That's right. Our great grammie Shaughnessy developed congestive heart failure at the end of her life, too. She was having trouble breathing -- she was panting, and whenever she moved, to go to the litterbox or to eat, she would have to sit down for a long time afterward and just breathe. Mama and her human mama knew that the end was near, so they made Shaughnessy as comfortable as possible and sang her across the Bridge.

Siouxsie: You need to understand that CHF is very painful and scary. If you have asthma or you've ever been in a situation where you couldn't breathe, you know how anxiety-provoking this is. The most important thing you can do for your kitty is to help ease her anxiety. There's a great product called Bach Rescue Remedy, a liquid flower essence preserved in alcohol. It's designed to ease emotional and physical trauma, and it works like a charm. Mama's used it on us, and her friends have used it on their cats, and it's almost universally reported that it helps to relax a traumatized cat (or person).

Thomas: To dose a cat with Rescue Remedy, simply put two drops on your finger and rub it gently into the skin of her ear flap. The medicine will be absorbed through her skin and should take effect pretty quickly.

Sinéad: If your cat does have cardiomyopathy, your vet can treat her with drugs that will help her heart work better and eliminate excess fluid buildup. Keep in mind, though, that these drugs treat the symptoms but cannot cure the disease. Managing the symptoms would probably make your cat more comfortable. But if you know your cat would be traumatized by having to take several pills a day, this may not be the best solution for you.

Siouxsie: Basically, Jessica, you're at a point where you need to make a decision. If you really, honestly think your cat will benefit from a lot of medical treatment, and that she will enjoy a good quality of life for a couple more years as a result, then feel free to embark on as much veterinary care as you can afford.

Thomas: We think you would benefit from reading Complete care for Your Aging Cat by Amy Shojai. It's a wonderful and comprehensive book about issues ranging from health concerns to emotional situations, and Mama says she's benefited a lot from reading this book. We actually think anyone who lives with a senior cat should have this book in their library.

Sinéad: If you know in the deepest part of your heart, even if your head doesn't want to acknowledge it, that your cat won't be able to enjoy her life any more, no matter what you do, you may choose to make her as comfortable as possible and ease her transition into the next world. Maybe your vet can give you some medicine to manage her pain -- again, since we're not vets, we don't know if there are actually any pain medications that are safe for cats with heart disease -- and if you dose her with the Rescue Remedy, her anxiety will decrease.

Siouxsie: We're advocates of allowing cats to live their natural lifespan. If we reach a point where we have no quality of life, most of us would rather leave our bodies than continue to struggle to breathe or suffer in excruciating pain. You could conceivably take heroic measures to save your cat's life, but maybe you'd rather spend your final days together with your cat, saying goodbye and sharing your love.

Thomas: There are other natural remedies that you can use to help your cat be comfortable in her final days. Mama recommends the remedy Transition from Green Hope Farms. It's part of their Animal Care Collection, and it's designed "for the dying process, both to give physical stamina during the work of dying and also to help with the spiritual work done during the last stages of life," according to the website. You might also consider taking the remedy Grief and Loss ("for when a caretaker, friend or animal companion dies; loss of home or sense of purpose; breakup of family; for despair, depression, brokenness and grief") for yourself. All the remedies in the Animal Care Collection can be used on humans, too.

Sinéad: We commend you for wanting to make your kitty more comfortable, and we hope we've been able to give you some recommendations that will help you to do so. Please let us know how everything works out for you and your beloved cat.

Got a question? Need some advice? E-mail us at advice@paws-and-effect.com. None of the material in this column is meant to be a substitute for regular veterinary care.