how do you know when it's time

[toby]

My cat is approx 19 yrs old at least that's how long she has been with me.
She's never had health problems until about 2 yrs ago & she started sneezing mucous & has sinus inf. We've had her to the vet repeatedly over the last 2 years. She gets better after antibiotics & steroids for about 2 weeks & then the cycle starts all over again. Vets done all test & x-rays & say she is in remarkable shape for her age. She's been mostly on Science diet, home cooked chicken, beef, & whatever else I can get her to eat.

In the past I felt I knew when it was time to say goodbye to them but with this one I can't seem to make that decision. How do you decide when it's time for euthanasia? Thanks for your help.

[Traci]

Toby, this link should help, it's a guideline...When Is It Time?

But, I have to ask. Did your vet rule out the following: Fungal infection, sinus polyps, combination bacterial infection? Has a scope view of the sinus and nasal passages ever been done? Has a culture and sensitivity test ever been done on the secretions? If not, then your vet has not done enough to diagnose properly, and without knowing the specific problem, then treatment is probably not as effective as it could be.

A culture is crucial because it helps identify the specific bacteria or fungal disease in which to choose the appropriate treatment. Some vets totally overlook the possibility of fungal disease, will treat with antibiotics, and the condition comes and goes but never resolves - that is because fungal disease is resistant to antibiotics, it requires anti-fungal medication. Another example is viral disease, they too will not respond to antibiotics.

If a scope view (rhinoscopy) has never been done, then the vet could be missing where infection or inflammation is coming from exactly and the cause.

Oral disease can also cause these problems. Diseased teeth can cause bacteria to migrate anywhere.

I would request of your vet to either refer you to, or request he consult with, a board certified internal medicine vet and rule out the various types of upper respiratory disease, and how to effectively diagnose and treat them - this has gone on way too long and he could be missing something that a specialist would pick up on right away. Please don't delay this, it is worth it to get a specialist's opinion.

Also take into account kitty's environment. There are various things in the home that could be exacerbating the problem, such as dust, dust mites, house mites (even food mites), smoke, perfumes or sprays or aerosols, carpet powders, heavy cleaners, allergies, etc. Remember also that so many things hover over, or are on the floor at kitty's level, and constant exposure can worsen the problem.

I can understand the frustration in treatment that isn't working, but most of the time it is because the incorrect treatment is given, and tests to rule out fungal or other respiratory problems haven't been done in which to choose the appropriate treatment. Your vet should have referred you to a specialist years ago!

Don't give up on your kitty, I think it would be wise to get a specialist's opinion before you make any rash decisions.

[Auntie Debbie]

Another idea would be something along the lines of Herpes. This can lay dormant and flare up from time to time due to stress. Has he been tested for that and is there any stress in his life?
I hope it's something that further diagnostics can pin point and ultimately cure.
Please check back and let us know how he's doing, ok?