I'll write to the rescue and see if they know more about Pepper. Since they use the wording "can no longer" it sounds like a progressive neurological problem, not simply CH. I'd have to be concerned about vet bills. Other than that, I've learned to diaper a cat, do butt baths, etc. for my Zazesh. It was quite a steep learning curve because his hind end has some parasthesia so he's inclined to bite when I'm caring for him.