End of life, quality of life

Question
QUESTION: Hi, Jessica,

Our 16-year-old cat is dying, and we want to do what's best for her. She has had IBD, hyperthyroidism, and urinary tract issues is down to about 4 pounds. She cannot control her bladder and bowels and, during the last couple of days, has had increasing amounts of blood in her urine and possibly also stool. We have to keep her in a small area with a tile floor. Sometimes I think she is not aware of what is happening around her, but when I came home today she looked right at me and meowed. She has also been eating well.

The vet sent home a sedative injection to give her before bringing her in for euthanasia. She is caked with her own mess and not grooming herself. But the fact that she is still eating makes us think she's not quite ready to let go. Can you lend some perspective to this? Thanks so much.

Katharine

ANSWER: Hi Katharine,

I often use appetite as a gauge of quality of life, too. But I have done this mistakenly, at times. Sometimes, a cat's conditions will leave them so malnourished that they are literally starving to death. And despite their weakness, the troopers eat until just hours before their deaths. It has baffled me when a cancer or kidney patient will beg for breakfast, and then I discover that they have suffered their death just hours later. I know from human patients that these conditions are very uncomfortable. The cats just fight through them as best as they can. In those instances, I always wish I had chosen euthanasia sooner.

I think in your kitty's case, it would be in her best interest to take other normal behaviors into account when making your decision. Her failure to groom and inability to use a litter box are sure signs she's very weak and debilitated. I would suspect her appetite is not as much for enjoyment as it is a desperate attempt to gain some energy. Unfortunately, due to her IBD and high thyroid, this need will never be met. This is a very personal decision, but in my opinion, I really think the time is right for her. One vet said to me, and I agree whole-heartedly after waiting too long on a few occasions, "When you start wondering if it's time, it's time. It's better to let them go a day too soon than a day too late."

I'm so sorry you're facing this awful decision. Sadly, terminally ill cats tend to just get more and more ill. I hope you can find comfort in knowing that you took wonderful care of her for a long and full life.

Best regards,
Jessica


---------- FOLLOW-UP ----------

QUESTION: Jessica,

Thanks so much for your reply. We were really hoping our kitty would pass away on her own and in her own time. I am very connected to this cat and have felt that's what she wanted. But how often does that happen?

We are heading into a holiday weekend and her regular vet is only open until midday Sat. (tomorrow). We do have an emergency animal clinic in town, but if she is sedated, she probably wouldn't know the difference. This particular cat has been an absolute terror at the vet's office for her entire life, and I feel so bad about the last moments of her life being in a place she dreaded so much.

There's no making this easy, but are there ways to make it more graceful and loving?

Again, thanks for your help!

K

ANSWER: I certainly understand your desires for her. I think if you have decided against euthanasia, simply being with her as much as possible is best for her. Many cats desire extra attention in their final days. They become restless and need some reassurance that they can settle down and rest. And as hard as it is, I stay with cats who are actively dying. Some prefer to hide. But most calm down when you hold or stroke them and talk to them as they pass away. Be aware that this can take hours and might even take a day or longer.

I don't know if there are any vets in the area that will do house calls. This might be the perfect solution for you. My vets don't normally do them but will do them if I have a particular request, and some other vets in town are mobile vets.

I think I would ask the vet about an anti-inflammatory/pain reliever for her bladder for the meantime if she isn't on one.

Best of luck,
Jessica

---------- FOLLOW-UP ----------

QUESTION: Jessica,

Thanks again for your valuable input. Our kitty was struggling so much that we decided the most loving thing was to let her go. I spent the morning holding her and talking to her. Then I gave her the sedative, we took her to our regular vet, and she passed into the eternal today. My heart is in a million scattered little pieces, but I have the comfort of knowing she is free and no longer tethered to a body that was failing her.

Take care and thanks again for your perspective.

Katharine

Answer
Katharine,

My thoughts are with you. You did a very brave, compassionate thing, and it shows how much you loved your kitty. The decision is difficult, and not everyone is able to make it. But she was very lucky to have shared her life with someone who was able to make that sacrificial choice in her best interest. I hope you're able to heal more quickly knowing that she didn't suffer needlessly.

Take care,
Jessica