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April 09, 2009

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Teri and the cats of Furrydance

I always go back to what I learned at a seminar on grief and pet loss I attended at least 31 years ago (about the time I had to make the decision to euthanize my very first cat, who had intestinal lymphoma).

The speaker said "Keep a journal, and when out of 7 days, there are 4 good days and 3 bad days, that is the time to give your pet the gift of that "gentle sleep". Try not to wait until there are 4 bad days and only 3 good days.

It helped me with my decision to euthanize my first cat, and 2 more cats in the years that followed. And it helps me at the cat hospital where I work too, as I can talk to clients of my experience and give them something that might be able to help them with their decision, too.

Your advice of making a list of things your pet used to do-activities, personality, interacting with other pets and people, and what it does now, also helps put into visual terms that quality of life situation too.

I also think when a client asks if their pet is suffering, they know that it is, because that term just isn't used when you have more good days than bad...

Teri and the cats of Furrydance

At the practice I work at, we often use buprenorphine during that "hospice care" time and as you said, what people notice is that their (cat) is coming out and interacting more, being affectionate and sometimes even eating more.

Penny's mom

We are euthanizing our cat today...it may be that we are doing this too soon. But, our cat has an oral cancer that is growing, and while our cat still wants to eat, she can only manage very small amounts. The cancer keeps her from being able to intake much food. It's location at the base of her tongue also prevents her being able to groom herself. She has an infection in her mouth that we now treat with 3 antibiotics, but the soreness from the infection remains and contributes to her inability to eat. It is clear the antibiotics soon will no longer control the infection. She is active and affectionate; but, she spends all of her time hungry. We prepare all sorts of special foods; but, what appealed to her one day or one morning does not appeal to her again. We are constantly trying ways to prepare food so she will eat. She loses weight on a daily basis and is down to 6 pounds.

We feel it is time. We feel that letting her starve to death when she is unable to eat yet is obviously and constantly ravenously hungry is no quality of life, and is in fact cruel to her. Her mouth infection will soon be out of control and soon the tumor growth will not allow her to swallow any food. At that point, there would be no question as to her need for euthanization. But, we prefer not to let it get to that point. Our vets say our care has kept our cat alive far longer than they thought our cat would live. If she were not so clearly starving all the time and were not continuing to loose weight so rapidly, we would choose to wait longer...

Doc

Hello, Penny's Mom,

I wish you could be spared this. It is a decision that is so difficult. I agree with what you have said.

Best wishes.

Michelle

I am sorry for you Penny's Mom. I am struggling with when to let my cat go also. She has lost a lot of weight. She still likes to eat, but vomits several times a day and cries a few times a day. She is messing outside her litter box in the garage which is a mess. She sleeps a lot in the house other than all that. She still wants to eat and purrs when she is petted. I really don't know when to let go and how much pain she is in. She has probably lost close to half her body weight. The vet says she will continue to lose weight. So when? Eating, purring, but vomiting and crying. No fix. I don't know what to do. I just lost an elderly dog last month. I don't want to put her to sleep because it would be easiest for me to get away from trying to keep up with the messes and trying to feed her food that agrees with her and because I am tired of all of it. She still purrs. And she still loves me and depends on me.
Michelle

Doc

Hello, Michelle,

This doesn't sound like "convenience" euthanasia. I've not doubt that you cat still loves you and loves being with you. On the other hand, it sounds like she cannot keep food down, loses weight and is getting weaker every day.

Are there any "good days" (versus bad days)? It doesn't sound like it.

Purring doesn't always mean contentment. I wish it did.

Francis Bacon said, "A healthy body is a guest-chamber for the soul, and a sick one is a prison." Is your cat living longer, or just dying slowly?

This is a tough decision, but it is one you will soon have to make, from the way you are describing things.

Best wishes.

Penny's mom

Michelle--Please know that I miss so much our wonderful cat. But I believe we did the right thing for her. Peace.

Janie

I just found this topic as I'm battling with the issue of having my 12 year old cat put to sleep and battling with the convenience issue.

She was diognosed with OCD about 10 years ago wich included urinating all over the house, the issue was addressed with medication and worked for a time but then she would revert back, we tried medication many times but in the end I have just cleaned up after her continuously.

About 12 months ago she stopped using the tray completely for urination and number 2s, I tried everything I could to solve the issue but nothing worked and I have just continued cleaning up her mess, thankfully it is in just one area of the house because she has segregated herself from everyone (which is also sad). She has stopped grooming for the most part and when she does groom she throws up fur balls all over the room she stays in including on our bed.

I know I have put up with what many people would not, my husband had enough a long time ago but has only told me recently how he felt because he knows how much I love her, our clothes only have to drop on the floor for a few moments and they are wet along with school bags, towels, etc... She also appears to have trouble walking in her back legs in the last month or so. She has always had a fear of people even though no harm has ever been done and in the last 3 years has chosen to confine herself to the laundry and my bedroon and sleeps all day and night. She seems to be eating fine though but is sick from time to time.

We adopted her as a 7 week old kitten who within a couple of months showed what I can only term as mental issues, she was never a "normal" cat, always scared, always hiding and I have done so much for her in the 12 years.

Yet I am still battling if I'm ready to let go or am I just selfishly trying to make life easier for my family and myself. My Mum who is a big cat lover has been telling me for years it's time to let her go, but the guilt I feel is almost too much even tough I know deep down her quality of life in next to nothing these days.

Making this decision is the worst part of loving a pet.

Doc

Hello, Janie,

I don't envy you your situation or your decision. It sounds like the cat doesn't have much quality of life, but I understand and sympathize with your desire to avoid a "convenience" euthanasia.

These are tough calls, because living with the cat is so difficult for the family. It's hard not to feel a little guilty when you contemplate being freed of that burden.

On the other hand, what would you think if found this cat today, with no knowledge of its life before hand? Would you want to let it go to a peaceful death, or would you want to try working with it?

What if you knew that it wasn't going to get any better than it is right now? Because it probably is not.

It's not a simple decision. Does that cat have good days? How good is "good"? Are this cat's good days as good as a "normal" cat's lousy days?

I wish I could make this easy for you, but it just is not easy.

Best wishes.

Katie

We just had to put our sweet little guy down because he was diagnosed with diabetes and it affected his kidneys. I can't stop feeling guilty and awful that I made a bad decision. I have never had to make the life or death choice and it is playing on my beliefs of being a good human being.

He was 12 years old and lived a very loving, happy life. Over the last 6 months he began using the bathroom all over the house and drinking excessive amounts of water. He moved slower, played less and cried more often. The vet said he wasn't in pain, just wasn't comfortable. Was I wrong to let him go?

Doc

These decisions are never easy. We sometimes ask if there are more bad days than good days. Was he able to do anything that he enjoyed? Was he really living or just "existing"?

Francis Bacon once wrote:"A healthy body is a guest-chamber for the soul, and a sick one is a prison."

It is always hard, but I believe you did the right thing (based on what you have told me).

Best wishes.

Su Jackon Ross

Miles, my 15 year old cat has been living isolated in one room for years. She never was very social and isolated herself when I introduced two terriers into our home. She sleeps all day in her bed where she aso eliminates. She still eats and only likes me. Her eyes seem clear, but she wants nothing to do with anyone or anything. My husband says she has no quality of life. It is impossible to get her off her perch to even bring her to the vets, I've read about buprenorphine, maybe that would help. I don't want her to suffer, but she can not be happy.

Doc

Hello, Su,

This is indeed a tough situation. The sign that is most disturbing is that she is eliminating in her bed. That would suggest that she has totally lost her mojo.

I would be concerned about a painful condition. Buprenorphine is a mild narcotic that works well in cats, and is not difficult to administer. However, your veterinarian could not dispense it for a patient he has not examined (illegal).

Perhaps you could get a big traveling crate that would accommodate her bedding, and just take her in for a check-up, bed and all.

I wish that I had an easy answer for you, but I do not. We certainly see cats her age who still function well, but chronic slow deterioration of the kidneys is common, along with other geriatric diseases.

If you get a professional evaluation of her condition, I believe it will make it easier for you to make a decision about what is best for your cat.

Good luck.

Marie

my cat has developed lymphoma.. the vet gave us steroids to try to help her appetite, which they did, for a while. The past few days though she is hardly taking in any food, although she appears hungry. She cries for food but just won't take it. I spoke with my vet today and she said we may want to start thinking about when it may be "time." I know in my heart that it is, I don't want her to die a slow painful death, but it is still so hard. I feel like because she is still alert and moving around, I shouldn't have her put down. But then again I don't want to wait until she has nothing left in her. I feel she deserves better than that. She's been there for me for over 9 years and I need to be be there for her too.

Doc

This is always a difficult time. I might ask your veterinarian about adding some buprenorphine in for additional pain control.

The time is coming when you will have to face this difficult decision. Sometimes you're not living longer, you're just dying more slowly.

Best wishes.

Pam

I have a cat who is 21 years old. He is very frail and for the past six or eight months has refused to use the litter pan at all. He drinks an excessive amount of water and sleeps all the time. He eats vigorously and purrs when I pet him and is very vocal. He gets lost in the house sometimes and doesn't know where he is I believe. I do not know what to do for him, because he never feels good and walks very stiffly. I look at him and am afraid he is suffering although he is always glad to see me and knows who I am. I am so torn. I love him so dearly.

Doc

Hello, Pam,

I'm not sure that anything can be done about your cat's cognitive dysfunction ("kitty Alzheimer'").

On the other hand, it seems from your description that the major thing that hurts his quality of life is likely to be arthritis pain.

We do not have a lot of options for cats with arthritis. They don't tolerate most of the medicines used in people or dogs.

Metacam has been used, and is approved for cats in Europe. In the U.S., the FDA recently required the maker to put a "black box warning" against using it in cats. If the cat's kidney function were okay, it might be worth a try.

The excessive urinating and water drinking could indicate poor kidney function. So that could rule out the Metacam. You would need a blood test and urine test to check that out.

Using some form of cortisone, like prednisolone, can really help with the arthritis. However, it can have side-effects, so the use of the drug should be monitored carefully by your veterinarian.

Nutraceuticals, like Cosequin for cats can help a lot, and are very safe. They take about a month to really start showing improvement, though.

Acupuncture is really safe and can help a lot, as well.

Having said all that, 21 is a phenomenal age for a cat. You have obviously given him great care or he wouldn't still be around at all.

You just have to ask yourself whether he is having more good days or more bad days, and if there is anything that can be done to improve the bad days. It is possible that there is, but you're not going to make him young again, and that's for sure.

I wish that I had an easy answer for you. You should discuss this with your cat's veterinarian.

Best wishes.

Robin

I have a 13 yr old cat w/ nasal lymphoma - diagnosed about 5 weeks ago (also found in his kidneys) I've decided to go w/ palliative care, just steroids and keep him comfortable until it seems time to put him to sleep. I just can't figure out if now is the time or I should wait... he eats and moves around ok, but has difficulty breathing, nosebleeds, and has lost much of his enthusiasm for playing. He's still affectionate, but somewhat withdrawn and anxious as each dose of steroids wears off.
Any advice?

Doc

Hello, Robin,

Your question is so difficult to answer. My standard answer is that when you have more bad days than good days, it is time to make the decision, as difficult as that is.

You know it is not going to get better, so it's a matter of deciding how bad you let it get. It's tough when you ahve to make the decision.

When he cannot enjoy the things that he liked to do before he got sick, it's time to start getting ready.

Best wishes.

Carole Lewis

My 16 year old cat was diagnosed with a sarcoma 4 months ago. Since that diagnosis, his tumor has grown from a nickle size to almost 4 times that. He was a very large cat...but now skin and bones...but still eating. My Vet wanted him to have a $1,000 surgery, and even said that the cat would probably live another 5 years with the surgery. However,I declined because I do not have the money. I have been searching for answers...and comfort and strength for myself. Thank you for your kind words to everyone. It has been the answer to my prayers.
Carole

Doc

Hello, Carole,

I am sorry to hear about your cat's situation. With a sixteen-years-old cat that is down to skin and bones with a sarcoma, I would be very pessimistic about being able to give significant help. Not many cats live to that age, even without cancer.

That being said, I would say that your veterinarian has seen the cat and I have not, so he/she is in a better position to give an accurate prognosis.

I know that you will miss your friend, but you have given him a long and happy life that he would not have had without you.

Best wishes.

K Hansen

Kashmir, our nearly 14 year old cat, was diagnosed with jaw cancer three weeks ago. Her eating has slowed down and she sleeps on our sofa with a favorite blanket all day and night. The pain medication is really difficult to give her. She purrs but is definitely unhappy. We are wrestling with when is the right time. Today , no food or water seems to appeal to her, she continues to drool and is not caring for her coat as she used to. You can see she has lost weight. Will she let us know when the time is right? The vet told us to keep her comfortable for the next several months but her not eating has us concerned.

Doc

Hello, K Hansen,

You might ask your veterinarian about buprenorphine. This can be dispensed in little syringes ready for use. While given orally, it doesn't have to be swallowed. The dose is really small, like 1/10 of a milliliter, just a drop. It is absorbed across the mucus membranes of cheek and gum.

Another option for pain control would be a fentanyl patch.

Both of these are narcotics and not terribly cheap, but pretty good pain control.

Bone cancer is reported to be very painful. With cancer in the jaw, I can see how Kashmir might soon be unwilling to eat.

Purring does not always indicate pleasure or contentment. Sometimes it is seen with agitation. When I see a cat with ears down and tail lashing, I can't rely on that purring on my exam table as being a good sign.

Things can change rapidly in a case like this. What your veterinarian saw three weeks ago might be a really different picture today. Give them a call.

Best wishes.

Terry

I found this website while searching for advice on determining when is the right time to end my cat's life. It is so difficult to come to a decision, but I am more comfortable after reading your posts. Our cat, Scarlet, is 20 years old. She's been with me since she was 3 and has been with me for many ups and downs in my life. I feel I owe her a peaceful end. She eats, but vomits several times a week. She doesn't always make it into her little box, even though it is easily accessible. I sometimes wonder if she has a bit of kitty alzheimer's when she stares at her water dish motionless for minutes at a time. She doesn't seem to be in much pain, but her back leg is becoming lame, similar to a stroke patient. To top it off, we have an 11 month old puppy who thinks she is a play toy. Up until a few weeks ago, she could hold her own with the pup. But now, she has slowed down a great deal and my biggest fear is that she will get hurt - that would leave me feeling very guilty. I will sleep on this tonight to be sure I am doing the right thing for Scarlet. Thanks for helping me to feel comfortable with choosing to give her peace.

Doc

Hello, Terry,

This is always such a difficult decision. Best wishes as you say farewell to your friend.

Tanya Manning

I have a 12 yr cat who has a tumor on the roof of her mouth. I chose not to do a biopsy b/c surgery was not an option. almost 2 months after her diagnosis she was starting to not eat very well. I could tell she was hungry, but knew it must be painful. I asked the vet if there was any pain management I could do and he prescribed 5 days of Burpenex. This helped, she started to eat again(although not as much as she usually does). Then I asked the vet if there was a more cost effective way for pain management, so he decided to try Meticam + Tramadol. Well, needless to say the Tramadol was fun treat!(not) but ever since I started this 2 1/2 days ago her appetite is ferocious, like it was before she stopped eating. She still sleeps in her favorite sunny window, she comes and sits w/ me on my lap, really pretty normal. However my concern is is it a quality of life if she has to be medicated 3 times a day w/ tramadol(which always causes a foamy reaction for 20 min)? The meticam is a piece of cake. I mean I'm okay giving her treatments(I'm a future vet tech), but I wonder does it take a toll on her if it's only for a few minutes of the day that she is uncomfortable, if everything else seems pretty normal??? I don't want to keep her here for my selfish reasons, I want to make sure she is reasonably comfortable, I just would love a 2nd opinion on whether it is worth the 3 times a day w/ Tramadol? I hope to hear some advice. Thank you, T

Doc

This is a difficult situation. If it's just a question of feeling crummy for 20 minutes three times daily, versus feeling crummy 24 hours a day, that's not too hard.
What makes it more difficult is determining how she is feeling for most of the day. Does she eat well? Does she play? Does she just sit in one spot and want to be left alone?
I don't see anything wrong with using the pain meds three times daily if she feels pretty decent as a result (despite the stress).
The difficult question is whether she is in fact feeling halfway decent.
It sounds to me like she does, so I'd stay with it as long as it's working. We know that someday it won't be enough, and then you will have to make the hard decision.
Best wishes.

Tanya Manning

Thank you so much for your advice. I go back and forth every day on the "right" thing to do. I think in my heart if it were really bad then yes I would put her down. I just don't want the rest of her days to be painful or uncomfortable, and if she is still the same w/ in the next few weeks I will continue w/ the medication. I just wanted to get an objective point of view, so I thank you dearly for your advice. Regards- T

Kris Daugherty

My cat is 14 years old and the sweetest cat you can imagine. Over the past year however, he has periodically peed or pooped in various parts of the house. These episodes are happening more frequently. The vet said health-wise, he is perfectly fine. The litter box is in the same place it's always been and we use the same litter we always have. He is our only pet. My mom feels it's time to let him go because he continues to do this. I feel horrible because he's so healthy and full of life, he just seems to have these mental lapses. I don't want to give up on him. Thank you, ~Kris

Doc

Older cats, like older people can certainly develop cognitive dysfunction, getting "senile" or whatever you want to call it. The body is still okay, but their elevator doesn't go all the way to the top anymore.
I will post your situation with a veterinary behaviorist and see what they suggest.

Doc

In speaking with the behavior specialist, she suggested maybe revisiting some possible physical problems that might be very subtle, and have intermittent signs. Thus, they might not have been real obvious at the time of your cat's last examination.

Sometimes the physical problems (e.g. arthritis, spondylosis) can be subtle and have intermittent signs so they may not show up on a routine exam. Radiographs or even a trial of pain medications may help.

It is important that the litter box is clean (at least daily). It helps to have more than one litterbox sometimes. Sometimes the cat has problems with the old location, maybe because some loud noise occurred while he was there.

Also, older arthritic cats may have trouble climbing stairs to get to the litter box. They can have trouble climbing into a high-sided litter box.

Somtimes a urine specimen looks okay with standard analysis, but a culture will reveal an infection. Before I give up on ruling out medical problems, we usually do a bladder culture.

If we have gone "the extra mile" trying to rule out all possible medical problems, then it may be behavioral.

You can teach old dogs (and cats) new tricks so referral to a behavior specialist could be useful if this is "just" behavioral.

As for cognitive dysfunction, the behaviorist said she would also look to see if there were any other signs. For instance, does he seem disoriented, get lost, can't find his food, etc.

Good luck in getting back to a more enjoyable situation.

Anne

We have made the very sad decision to have our sweet 15 year old female cat put down today. I was very conflicted about the decision until I read some of these helpful posts. I think the key question is "are there more good days than bad?" Unfortunately, in this case the answer is no. She has jaw cancer and has never shown obvious signs of pain but has shown obvious signs of discomfort. She has always been extremely clean and dignified and it is sad to see her unable to groom herself. Worse is that her mouth is twisted and deformed from the cancer and she has great difficulty eating. We will miss her dearly and forever but each day her quality of life is worse. From rereading what I have written, I feel I am trying to justify this decision. All I can hope is to find peace in knowing she was well loved all her life and we did the best we could for her. Not wanting to go to the bitter end we hope to spare her desperate pain and misery and I hope it is not selfishly wanting to spare ourselves more grief too.

Doc

Hello, Anne,

This is a terrible place for cancer. While it is sometimes possible to amputate much of the jaw and follow up with radiation, this is certainly not always successful. It is also pretty tough on even a young, healthy cat.

This is a terrible condition with little chance of doing anything but getting worse.

None of wants to give up a friend, but we also don't want to watch them suffer.

You just have to make the best decision you can.

Best wishes.

Denise

My husband and I are trying to decide what to do about our beloved cat, who is 10 years old.

She has always been on the small size, but was 9 or 10 pounds at her largest. She has recently lost a lot of weight and is down to 6 pounds.

She hasn't zoomed around the house in eons, and isn't interested in playing (string, balls, etc.). She does eat - but seems to be getting less interested in food by the day.

She has an impacted hairball (or some foreign body, but probably a hairball, since she hasn't thrown one up in 6 months now, very unusual), probably in her colon, according to the vet. Vet-prescribed laxatives haven't dislodged it. She often cries when in or leaving her litterbox.

There is obviously (and our vet agrees) something much more serious going on than a hairball as well.

She's become very lethargic, and just sleeps on the floor or sofa most of the day. She doesn't usually go in parts of the house where she doesn't have to (no more exploring the garage or visiting me in my home office). But she still likes having us around, purrs when petted or brushed, and often tries to get our attention & affection. She is so sweet. But she doesn't have that sassy, rambunctious personality she used to.

She will still go walk around the yard and explore. (The yard is actually new to her, as we moved 8 months ago and didn't let her out - always supervised - until a couple months ago.)

Part of me just can't wrap my mind around putting her to sleep when she still has much of her personality left.

But she is so small, and I know she is going to get smaller. You can feel her bones. I know she isn't feeling like herself, and has some level of discomfort or pain. She just seems like she doesn't feel good.

We are having great trouble with deciding if it is time to end her life. She is still herself, just a very thin, muted version of herself.

I don't know about good days and bad days...really she is about the same every day now.

I've heard from more than one person, "She will tell you when it's time." That seems right...but I'm not sure really what that means.

As kids, my husband and I both had cats that got very sick, withdrew from everyone, and hid. (One disappeared for days and was finally located hiding in the back of a closet.)

Our kitty just isn't at that point. So I wonder if it is really time to say goodbye or not. It is so painful trying to figure out what is best to do.


Thanks for your thoughts.
best,
Denise

Doc

Hello, Denise,
This is a tough situation. Even knowing everything about a case, it is difficult to make this decision.
Without knowing any more than you have told me, I'd say that a major diagnostic workup is in order to be sure that this is not something treatable. This may already have been done. Or it may not be financially feasible.

This certainly does not sound good as far as a long-term prognosis is concerned, I must say.

If there is nothing to be done, then it is a matter of weighing the good days versus the bad. What can she still enjoy? What no longer brings her pleasure? What has she quit doing? Is there anything left?

I wish I had an easier alternative for you.
Best wishes.

Anne

Thank you for your comments. We did have her euthanized that day and know that it was the right decision. She passed away very gently and peacefully and that was all we could ask for.

Christi

I am so glad I found this site today. My 19 (maybe more?)-year-old TinTin has taken a huge turn for the worse. He's been eliminating inappropriately for several years now, and it's getting worse. He had been a chunker but lost a considerable amount of weight over a year ago when he was 17+. I thought then it was time to say goodbye and I took him to the vet. She didn't find anything major--no diabetes, leukemia, infection, cancer--we just chalked it up to old age, and I switched him to senior cat food. Now he's only skin and bones. We have a young cat who had been playing with him very aggressively, but even she is noticing that he's taken a downturn and is not bothering him. TinTin only lays next to the water dish, with his tail across it. It seems he can't move his tail, which is alarming. He also has very tottery hind legs and stumbled this morning on his front legs. He had been such a lover, now you can tell he's really having a terrible time of it. He does still eat--pretty much all day--though he doesn't gain any weight. He also drinks a lot.

I have an appointment with the vet tomorrow. In anticipation of it, I did a bit of Google research. TinTin seems to have many of the classic signs of feline diabetes. I see that it's not necessarily a death sentence and can be managed. I have friends who give their aged cats injections and fluids, but I don't know if that's something I could do adequately, being a single, full-time-working mom.

On the one hand, he's nearly 20 (or maybe older--he was a young adult when I got him). On the other, diabetes *can* be managed. Who would prolonging his life serve, though--his or mine?

I have had to euthanize two other beloved pets before their time. No one really knew what my dog Milou, aged 12, had. She had emergency surgery to remove her enlarged spleen and never really regained her strength. One day she went out to the back yard, fell over, and couldn't get back up. Her eyes BEGGED me to let her go. Even then, I hesitated. I thought she'd make it to 14 or 15. Our cat Eek was about 10 when fluid built up in her lungs and she couldn't breathe. We were blindsided and not prepared.

Now that my cat is ANCIENT and in poor health, it's still hard to know if it's his "time."

Doc

Hello, Christi,

This is always a super tough situation. Even if the exact cause is found, it may not be treatable.

Your cat's problems also sound like the cats with thyroid tumors. I'm sure your veterinarian will discuss all the options with you.

Best wishes.

A Miller

I have an 11 year old cat who was diagnosed with a vaccine associated sarcoma on her right rear leg about 10 months ago. We did the surgery to get it removed but it ended up being incomplete since it is basically attached to her back leg. The tumor ended up coming back but we decided it wasn't worth putting her through another surgery and the vet said it would most likely come back stronger after every surgery. We also didn't want to put her through radiation therapy because it was really expensive and the cat won't enjoy it. Another option was amputating her leg but we felt that would lower her quality of life too. Our decision was to just give her the best life possible until it got too bad. At the end of April we got an x-ray to see if the cancer has metastasized at all and it hadn't spread anywhere. Now though she is losing a lot of weight. She's always been small and was 9 pounds at her larget. Now she's around 6 pounds. Her appetite seems to be decreasing more and more every day even though she is now on a steroid that's supposed to help. I also feel like she's sleeping a lot more and she seems to like to isolate herself. She used to sleep next to us or on the bed but now she sleeps in the bathroom. She's becoming a lot more boney than she used to be and the tumor obviously keeps getting bigger. She's started to limp on her back leg too. I don't know how to tell when it's time to put her down. I wouldn't necessarily say she's suffering, but she definitely isn't super content anymore. She's a lot more lethargic and I just want what's best for her. Any advice on what to do would be greatly appreciated.

Doc

Hello, A Miller,

Sorry about the late reply. I was out of the country for two weeks visiting my daughter who is a Peace Corps volunteer in Zambia. We had not seen her for 17 months.

I would recommend talking with your veterinarian about adding more pain medicine, like buprenorphine orally, or a fentanyl patch.

It certainly sounds like your cat is feeling pretty bad. If the pain cannot be controlled, then we really have to start looking at euthanasia.

Best wishes.

Carolyn

My 19yo cat Calvin was diagnosed with Chronic Renal Failure about 6 weeks ago. (He was 4mos old when I adopted him)

He has lost almost all of his body fat and is basically just skin and bones. He has difficulty walking, and regularly eliminates on himself. He can no longer stand upright when defecating.

I've been giving him apo-benazepril daily and two different powdered supplements in his wet food, twice daily. When I asked our vet about how to know when it was his time to go, he suggested that when Calvin stopped eating, then it would be time.
Now, I'm not so sure. He just sleeps and eats and poops all over himself. My 12yo daughter has taken to sleeping on the couch with him most nights and he does love snuggling a bit, still.
I don't know how much longer I should let him continue to get more and more emaciated, just because he still eats. He doesn't seem unhappy (only when we come home to find that he's had loose stool all over himself and is just laying in it) but isn't overly happy either.

How do I decide that it's time to go? It's going to be devastating in our house no matter when it happens, and we know that he's not going to get any better...but if he's not going to just go to sleep and not wake up (vet says unlikely) how long do we let him deteriorate?
Thank you.

Doc

Hello, Carolyn,

I don't know how you could ask me a more difficult question.

Without the emotional factors involved, it would seem like it is time, and PAST time.

But there ARE emotional factors involved. All of you love the cat and don't want to lose him, yet don't want him to suffer, either.

The cat has emotions, too, in my opinion. He likes being with you, too.

I don't know if this is helpful, but my criterion is "more bad days than good days" and "not living longer, but dying more slowly".

I wish I could just "tell you" and make this easier.

Best wishes.

elle

Found your very helpful page whilst agonizing over my beautiful 11 year old cat’s quality of life and wondering if I am being cruel by keeping him with me.

My beautiful Tashi has recently been diagnosed with bone cancer, but to me his x-rays look clear, however he limps constantly and will not put any weight on the affected front leg.

He only began to limp three months ago, but seems to be painfully limping more every day even though his appetite and weight is good and he still loves to spend his days in the garden. He grooms and purrs…I realize that purring is not always a good thing but he also loves to lick me too…as he’s always done, he appears happy but his must be in pain to let it show.

He takes Metacam as his pain med as he cannot take Pred. He is still my lovely boy who apart from his lameness, seems the same as before..he will chase ribbons, but his playing is not as ‘hard’ as it was.

I cannot bear to lose him but equally, I cannot bear to cause him to suffer….am I being selfish by keeping here with me, or should I make that dreadful decision?…I’ve lost so many cats these last four years, I am heartbroken.

Thank you so much for reading this.

Elle

Doc

Hello, Elle,

From your description, it sounds like the pain medicine is helping. If your cat will still play, I would guess that he is more weak than painful.

You might also ask your veterinarian about adding buprenorphine for pain orally, or even a fentanyl patch. Buprenorphine is three times daily by mouth, and the patch is changed every 3 days. Both are mild narcotics.

The day will come when there are more bad days than good days, when the playing stops. For me, that is the "time".

You face a difficult time, but you will do the right thing.

paty

My 12 year old Tommy was just diagnosed with IBD just last month but without an invasive surgery it could very well be cancer.

He's down to 5 lbs 8 oz just this past Tuesday. He lost 7 ounces in the last 3 weeks. He was dehydrated, so he's only fluid therapy every other day, today being the 2nd day.

He was weighed today and lost another 2 ounces. :O( He's very emaciated. It tears my heart out to see him like this.

I hate being the one to play God and say WHEN! I don't want him to waste away and be in even more discomfort and/or pain until I decide. I see his eyes, he has bright eyes still and I see MY Tommy in there some where. As if he's being trapped.

Please, I just need words or encouragement and comfort. I think it's time but I just can't! I can't!

He was a strictly an indoor cat from '03 to just 3 months ago. I fixed my backyard, so no cat can leave the yard to keep them safe. Now that he was able to go outside, he got sick.

It kills me! Am I being selfish? Good days? Bad days? I don't see any good days really. He eats. Sleeps mostly. He was jumping onto the top of the fridge just last week but is too weak to even walk without being wobbly.

I know. I know. I think it's time. Oh God, it hurts so much! A lil' piece of me dies with every pet I have to send home.

Doc

Hello, Paty,

I wish there were something I could say to make this easier for you. You already know what needs to be done.

Samuel Johnson once wrote, "A healthy body is a guest-chamber for the soul, and a sick one is a prison."

When you let him out, he will go someplace else and run and play and be a kitten again.

Best wishes.

Stephanie

My 11 year old Mataeo was diagnosed with diabetes almost 2 years ago and so far we've managed ok (two shots a day). He's lost a lot of weight since the diagnosis but still eats like a horse if given the opportunity, my other cats need to be fed in other rooms because he will muscle them away from their food too.
The problem is coming from his incontinence; Any corner, anything soft like laundry left on the floor, rugs, jackets, everything but the couch (which is essentially his bed). We have litter boxes in every room of the house that he's allowed in but he seems to prefer clothing or bedding. I've change litters and feel like ive done everything possible.

Also It's beginning to seem like the only enjoyment he's been getting out of life is his food and cuddling with me on the couch. He's always been a very loving cat, and will still push anyone or anything over just to be near me. But I've had to start closing my bedroom door because of his urinating on everything and he just sits outside it and cries.
He has also recently become very fearful. He was always a bit of a scaredy cat but now we can't walk by him without him cringing or running away. He doesn't seem to be in any pain but he's defiantly not the sweet and wonderful guy he used to be. There are no good or bad days with him, they're all just the same.

I'm in such a dilemma over this, I don't know how to make him more comfortable or if it's time to let him go. . .

Doc

Hello, Stephanie,

Incontinence means that the cat cannot control the emptying of his bladder. This typically means that he would be dribbling as he walks, or (more likely)leaking while he is asleep.

Urinating all over the house would be more appropriately described as "inappropriate urination behavior".

This can be due to urinary tract infections, which are common in diabetic individuals. This is especially true for patients who are poorly regulated and spilling sugar in their urine.

A urinary tract infection also makes it harder to control blood sugar levels.

If he is still losing weight and is urinating all over the house, I have to wonder whether his blood sugar is really where it needs to be.

Have you talked with your veterinarian about checking his blood sugar situation? Cats that are difficult to draw blood from can have a fructosamine level checked. This gives you an average of how well the sugar has been regulated in the past two weeks.

Also, has a urinalysis and urine culture been done?

I really cannot give you specific advice without seeing your cat.

If you have not recently discussed this with your veterinarian, I urge you to do so. When we do not hear from our clients, we have a tendency to think that things are going okay.

Good luck.

Donna

Wow, I'm glad I found this site. We are having one of our cats euthanized tomorrow. She has a tumor on the bottom of her tongue. When I read the post from Penny's Mom on 2/3/10, I could've written it myself because it's exactly what we are going through. I have been guilt-ridden about "giving up" on her, but I know we've given her 12 years of a very happy and healthy life. At this point she is just eating to survive because it's all she knows to do, but at some point she won't be able to even if she wants to, and that's not fair to her. Anyway, I finally feel like I'm at peace with our decision. Thank you.

Vicky

SO thankful I found this site!! We are scheduled to have exploratory surgery on Friday on our 14 year old boy, Reilly. He has an abdominal mass (probably a diffused lipoma), and has also recently become diabetic. I've read all the posts about cats losing weight, we have the opposite problem. He looks like he swallowed a basketball, and has gained almost a half pound a week now, for over 3 weeks. He still eats well, but spends most of this time sleeping in a closet. He still comes in our bed at night and snuggles and purrs, but he can't groom at all anymore, and has a really hard time maneuvering around with that huge belly. We have 3 other cats, and he is being harassed by them at times. Our vet really can't give us a prognosis of any kind, even after all the ultrasounds and x-rays. They won't know what they are going to find until they get inside. I'm having second thoughts about putting him through this. I think I would rather see him die comfortable, then have him sliced and stapled, and suffering for the rest of his time, just trying to heal. It's SO hard to know what the right thing to do is...you want to hope against hope that the surgery will "fix" him, but at his age, that's not likely. Him suffering is my greatest fear.

Doc

Hello, Donna,

Thanks for reading and writing. I know you have made a difficult decision.

Best wishes.

Doc

Hello, Vicky,

I know that you are very conflicted in this situation. I would say that even a very large mass can sometimes be successfully removed, thus extending the patient's quality of life, as well as the length of life.

If your veterinarian were to find that the mass were inoperable, your friend would already be asleep, and could be euthanized without waking up.

I obviously don't know your pet's medical information. It seems to me that being anesthetized for a surgery that offers a possibility of a good life extension is not something that will increase suffering.

If the situation is terminal, euthanasia could be performed at that time. If it's fixable, it could be fixed.

I'd say it's worth a shot.

Share your concerns with your veterinarian.

Thanks for reading and writing, and best wishes.

Vicky

Thank you SO much for your reply!! I talked with my vet yesterday at length, and that is EXACTLY the agreement we came to. He is going to open up our boy, and if he determines there is nothing he can do to improve the quality of his life, he is going to call, and will euthanize. I feel more peaceful now, it is in the Universe's hands. Thank you for your swift reply -- this is an AWESOME site, and you are a true gift to the veterinary medical community!!

Doc

Thanks for letting me know. I hope they find something fixable.

Good luck.

Vicky

hi there!!

Reilly had his exploratory surgery on Friday, and they were able to remove 1 lb. 10 oz.'s of diffused lipoma!! His kidneys were buried, his pancreas engulfed, bladder flattened, and in his diaphragm alone they removed "3 ice cream scoops of grapes" in adipose tissue!! He has 21 staples!! He came on the next morning, and he is doing REALLY well. There is no indicator of how fast it will come back -- and our vet is pretty sure it will, but for the now, he has a brand new lease on life!!! He is so thin, like a normal cat! He's even grooming himself again!! Thank you for you help and suggestions, you were right on!!

Doc

WOW! Great to hear that things are working out so well so far.

Congratulations to you and your cat and your veterinarian.

Sheila McCormick

I have read through many of these stories & comments. It has proved very helpful. My 11 year old cat Benny has been battling lymphoma (in his pericardial sac) since last December. Now the disease has spread & is finally out running him. These comments have made it easier for me to face what I know I have to do. Thank you all & the best to all the animal lovers who have contributed & shared their grief here.

Doc

Hello, Sheila,

It is obvious that you have given much thought and consideration to this difficult decision.

It's hard to say good-bye to a friend, harder to see them suffer.

Best wishes.

Kris

Hi,
My almost 15yr old cat is urinating inappropriately. This has been going on for a couple of months and is totally unlike her. There hasn't been any changes in my household. She still uses the litter box, but I have the feeling she is not able to make it there in time. She drinks alot of water and the amount of urine in her litter box seems larger than usual. She is also more aggressive at times and doesn't play at all. She throws up sometimes and has lost a couple of pounds. She is still loving though. I'm going to take her to the vet right away to make sure it is not an infection of some kind. What I'm afraid of is that she may be having kidney issues. If she does and this continues is it best to let her go before she starts to really suffer? With my last two cats I think I waited too long and I don't want to do that with her.

Doc

Hello, Kris,

It is certainly possible that there is a treatable medical problem at fault here, possibly a urinary tract infection, possibly even diabetes. These are definitely treatable.

Your veterinarian will want to run a urinalysis and a some blood tests. These will be necessary both to make the diagnosis and to formulate a treatment plan.

The weight loss is a definite concern here.

It is also possible that she is just losing her concentrating ability. In other words, her kidneys can still filter the waste from her blood, but can't save water so well.

Again, she could also be having trouble fully eliminating waste from her blood, and this would certainly make her feel bad. Often these patients can feel much better with a change of diet and some fluid supplementation.

Before you start looking at euthanasia, let you veterinarian find out what the problem actually is. It may not be nearly as bad as you think.

Thanks for reading and writing.

Karen Morris

Hi - I'm Mom to a 13 yr old Tortie who was a feral rescue and she's been with me since she was 2-3 weeks old. Willi was diagnosed with diabetes 3-1/2 years ago and has been insulin dependent ever since. If this was just about the diabetes there would be no issues.... I love this animal and would do anything to help her. She has recently developed a really bad limp so we tried Metacam which didn't really help so I opted for x-rays which showed extremely bad arthritis in the elbow joints and severe disc degeneration. We've tried special food and Cartrophen injections as well as the Metacam after doing blood work and urine samples to test for kidney function.

It comes down to this - she spends her day under the bed and comes out only to eat, drink and use the litter box. She is crying, hissing, biting and obviously in pain that is not being helped by our efforts. I just spent the last hour crying and trying to find some answers online and found this site. I'm torn.... I know it's my decision but with this history, can you offer an opinion about her future?

Thanks for any input..

Doc

Hello, Karen,

It sounds like your feline friend's quality of life is pretty poor.

The only thing I can think of to add in pain management would be fentanyl patches (like Duragesic). These give a constant slow release of narcotic pain reliever. You have to shave a place to apply the patch and they last about 3 days.

As to her future, I am sad to say that it sounds like the situation is doomed to become gradually worse.

You should really discuss this with your veterinarian who knows her case so much better than I ever could.

Best wishes.

Sperb

I have had my cat since she was 7 weeks old; she is now just over 9. When she was a kitten, she had an obvious deformity of her hips which affected her walking but she seemed to grow out of it. She has always been a "ginger" walker and only played gently but chalk full of personality. But in the past two years, she has become markedly worse. Rarely, if ever using the litter box - I think because she can't "position" herself appropriately and now, because she is incontinent. She has also stopped walking in the past 2 weeks. Instead, she drags her back paws on the floor and pulls she body with her front paws. The vet determined that she spine has fused in a crooked manner and has recommended euthenasia. We are willing to deal with her incontinence, She is still eating, purring, and, for the most part, wanting affection. Her continued personality and cognitive functioning make it very difficult to justify saying goodbye. My question is, is it cruel to keep her around if she continues to be unable to walk?

Doc

Hello, Sperb,

If your cat cannot walk or control her bladder, then you will probably have issues with bladder infections and urine scalds on the hair where she lies in it. She also may cause sores on her legs as they are dragged.

Frequent monitoring of her urine specimen by your veterinarian would be recommended. Frequent cleaning and drying of her fur may become necessary.

I have never seen a cat use a cart like the K-9 carts, but she might learn to use one. The carts require supervision, but can offer mobility with supervision.

It will be challenging to maintain a good quality of life for you cat, but you may be able to do so.

Best wishes.

Sperb

Thank you very much for your response. I was having a very hard time dealing with this decision. Since I wrote my question, I have decided that it is time. While she still loves us and wants love, I think the majority of her time which is alone while we are at work is difficult and likely painful for her. She is showing signs of scalding as well despite my efforts to keep her clean. At this point, she is obviously scared and in pain when I clean her. I wanted to let you an the other readers know and express my appreciation for this website and your attention. We will be saying goodbye to our sweet girl on Saturday.

Doc

This is always a difficult decision. I am glad that you have come to terms with it, but I am sorry for your loss.

When I euthanize a pet, I always say, "You've been a good friend, but your body won't support your spirit any longer. Go to sleep, leave this broken body behind, and run and play be a kitten again."

Best wishes.

Ben

I'm going through a similar situation right now with my 10 year old cat. Two days ago I noticed her breathing seemed more labored. The vet took an X-ray and found fluid in her chest cavity, which was compressing her lungs. He said this was likely due to cancer and would continue to get worse. I thought about getting a second opinion, but after googling the problem, it looks like even if it was due to something else, the prognosis wouldn't be any better.

I've decided to keep her comfortable and as happy as possible until it looks like she's suffering. Right now, while her breaths seem to take more effort, she appears completely normal in every other respect. But I'm a little worried about how this is going to play out and if there will be a clear point when I should have her euthanized. I'm imagining that in the next few days her breaths become much more of a struggle or are more weezy or something, but I don't know. This morning she had some diarrhea and did the butt-scooch thing on the carpet, which she's never done before. I suppose if that increases, it would help with my decision.

The vet also gave her some diuretics and antibiotics to possibly help, but if it's just delaying the inevitable, I don't know that I want to stress her out with pills in these last days. I've broken some of the pills up and put it in canned food, but she doesn't always eat it all. Do I need to even bother with these pills? Will they decrease the suffering this last few days?

This is my first time ever having to make this decision, so it's good to see I'm not alone. The fear that I'll be euthanizing her too soon is apparently very common, which gives me confidence that I'll make the right decision as long as I'm making it for the right reasons.

Doc

Hello, Ben,

Most of the reasons for fluid in the chest carry a very bad prognosis. In other words, no matter where you were willing to go and what you were able to spend, they are not fixable.

A ruptured thoracic duct can be treatable if you have a board-certified specialist surgeon, so there is one potentially treatable cause.

Diagnosis might require exploratory surgery. Expect to spend in the two-thousand dollar range if you see a board-certified specialist surgeon.

My experience with pleural effusion cases (fluid filling the chest and compressing the lungs) is limited. Much physical stress can just cause them to quit breathing. They have been known to die from the stress of being handled to take the X-ray.

You just can't "get your breath". If you stay quiet, you may feel okay.

If you see open-mouth breathing, or she cannot sleep, it will be time to look at euthanasia, as she will be in distress.

Best wishes.

Ben

Thank you for the response. In the days since writing, her condition deteriorated a bit further and breathing appeared more difficult. When she stopped eating, I decided it was time to let her go.

My biggest problem were my feelings of guilt especially over whether I was euthanizing her too soon. For anyone struggling with this decision, I found it very helpful to make a list of all the reasons I thought it was the right move. Later when she'd be a little more alert (probably because she was in the car!), I could refer back to the list and remind myself of why this was the right decision. I also expressed this concern to my vet, who talked me through all the options and what that would mean in terms of stress or pain for my cat if I chose to go those routes.

This is definitely one of the most difficult decisions I've ever made. But I feel good that I did my best to make them for completely non-selfish reasons and in my cat's interest.

Thanks again.

Giz

I am very glad that I found this site. My 10 1/2 year old cat has had breathing difficulties for a month. She still eats and plays, although not as energetically as formerly. Today we had X rays taken of her head and they found an immense inoperable tumor that is blocking her nasal passages so that they can't even extrude the mucus 'plugs' formed in the nose. Last year she had a malignant lymphoma in her intestine. This is possibly the same cancer; we won't know til the biopsy comes back tomorrow. The poor cat is good at hiding her pain but not so good when she is asleep. Night time is terrible, with her vocalizing and attempting to breathe; I often hold her head up so that she can breathe better. This is taking a toll on both of us. I would like to remember her as she was, and am worried about the tumor metastasizing into her brain. So I have decided to have her put to sleep when she is still not suffering too much. Thank you for the good/bad day comparison. The days are good but the nights are often very terrible.

Doc

Hello, Giz,
Thanks for sharing your story. This is never easy. The joys of owning a pet are many, but the more you love something, the harder it is to lose it.

Best wishes.

Lee Ann

I really need help...the love of my life...my 11 year old Tigger was diagnosed with squamous cell carcinoma. After not eating well and doing a dental he still would not eat...additional jaw xrays showed deterioration of the lower jaw...only a week after the dental the xrays were so much worse.
I drove over 2 hours to an oncologist who at least was honest and told me there was nothing she could offer,..same as the surgeon i saw that day.
My heart is broken..i have never loved anything ..nor has anything ever loved me that much. Tigger doesn't eat from the mouth ulcers...i assist feed and he hasn't lost an ounce...he sleeps most of the time but he still cuddles with me at night and will still play with is favorite toy once in ahwhile.
I am having such a hard time with this. This wasn't supposed to happen...i have 2 16 yr olds who are crf...heart failure and diabetic...they're doing fine and my Tigger got sick so fast.
I can't think straight nor can i imagine losing him..this is so horrible.

Doc

Hello, Lee Ann,

Medically, I am sure I cannot offer more than the oncologist.

Decision-wise, you know that he must be in some constant discomfort, since his mouth is too painful to eat on his own.

You will just have to look at the good days versus bad days. I would not want to wait until the cancer causes fractures, or infections that affect his whole body.

It is a very difficult decision, and I don't know how to make it easy for you.

Best wishes.

Lee Ann

Hi,
Every day for him is a good day for the most part..he plays..purrs and sleeps so contently...the problem is he wont/can't eat.
I can not take the most important thing in my life and kill it because he's in "discomfort"...if he were laying and in pain it would be different...but this is a cat that still runs to the door to greet me...plays with his toys and my other cats and sleeps curled up next to me.
Maybe i am trying to justify this but this honestly has to be the worst thing that has ever happened to me...i'm 45 yrs old and watched my father die slowly but i still functioned...i hurt but i was able to get through every day....with Tigger i'm finding it impossible to keep moving all day...i'm living like a zombie here.

Doc

Hello, Lee Ann,

I don't think that anyone is suggesting that you euthanize your cat while he is still enjoying life. If you are able to maintain his weight by hand-feeding without causing him undue stress, then I don't see a problem with that.

I recommend that you not get so interiorized into this that you can't think about anything else.

When you start to feel that way, take a walk outside. Put your attention as far out into the environment as you can. Look at things that are far away and pay attention to them. Look at things that are up close. Touch them. Really notice them. Then put your attention far out into the environment again.

This really helps. If you are just stewing about it, you cannot even enjoy the time you have left with your cat. When you start feeling zombified, take a walk, as above.

Lee Ann

Thank you so much for your advice.
I just don't want to lose sight of reality by wanting to not let go.
I am going to take Tigger back to the vet tomorrow to let him assess his weight and hydration..i am hoping the new medication peroxicam he just started will help a bit.
thank you again,,,have a happy new year.
Lee Ann

Sue Winters

Please help. I have a 15/16 year old cat who I rescued at 1yr old and he has worshipped me from day one. Now diagnosed with hyperthyroid, hypertension, IBD, iffy renal but is still alert and bright-eyed. He still walks with me and enjoys the outdoors (his passion) but won't eat much. Ultrasound showed inflamed bowel, pancreas, abnormal kidneys. Tried prednisolone and hypertension meds but the cure for all would be difficult and too many trips to the vets (which he hates). I can't euthanize my best friend who looks at me completely alert and trust me more than anything. Isn't there something I can give him to stimulate his appetite and make him comfortable till he is more "ready" to die? I will never be able to live with myself having the image of him looking at me with trusting wide-open eyes just before euthanasia!

Doc

Hello, Sue,

The best person to advise you is the veterinarian who is seeing your cat.

You might ask him/her about using mirtazapine tablets as an appetite stimulant (it is usually given to cats once every 3 days).

Also, for cats who are hard to medicate, the new Y/D prescription diet has been effective in reducing thyroid hormone levels. This would take time, however. Using methimazole may be needed to start with.

The problem, as you have alluded to, is that the cat has multiple problems.

The lowest combo I can think of from the information you have given me would be the mirtazapine, prednisone and methimazole (for hyperthyroid, maybe switching to Y/D, after cat stabilizes).

With this many problems in a cat of this age, it may not be possible to make him comfortable, even short term.

Share your concerns with your veterinarian.

Best wishes.

Sharon French Barre

Rex is 17 and has renal failure. I've had him for 13 years. He is experiencing extreme weight loss, not eating well, daily vomiting of foam, not really seeming to be aware of his surroundings at timeis due to the toxin build up in his body, does not associate with our cat he's been pals with for the last 13 years, does not get in bed with us for his 15 or 20 minutes of uninterrupted Rex time, does not snuggle on the couch me like he used to. IWe have been holding off on having him put to sleep but I don't think we can any longer. His quality of lies is not going to improve and do we really want him to get to the point where he has no [pleasure out of life before he dies. Even though I don't want to lose him but I think at this point it would be more cruel to let him live his life out in pain and basically starving to death. I spoke with the vet yesterday and he said it's beest to do this before we leave on vacation the first of March in order to give our other kitty time to adjust to Rex being gone before we leave her for a week in the care of a caretaker.

Doc

Hello, Sharon,

It sounds like you have been given sound advice by your veterinarian, and you have given this very careful and serious thought.

You are doing the right thing.

Best wishes.

Cubby

My cat "Kitty" is almost 18 years old and after 7 years of battling "Hyper-Thyroid" (medication twice a day) now she has a massive cancerous tumor the size of a golf ball on her left hip. She was 5 pounds in November and as of 3 weeks ago she was down to 4 pounds. My poor girl seems interested in food when I'm preparing it but doesn't really eat, just kind of licks and then lays down by the bowl. She is peeing and pooping all over the house after being flawless with a litter box her whole life. Jumping on the sofa is now a struggle especially with the increased weight due to the tumor on her backside. Discovering this website and reading the prior posts makes me feel a little better, but I just want to hear some re-assurance that I'm not being a bad parent by putting her to sleep on Monday. My gut tells me it's the best thing even though I'm sick thinking about it. Gosh, I wish our pets could talk. Hopefully you can lead me in the right decision. Thank You.

Doc

Hello, Cubby,

If they could talk, I'm not sure it would be easier. When my mother was dying with ovarian cancer, and in hospice, she asked me more than once to smother her with a pillow. Not easy (I didn't).

From what you tell me, it sounds pretty definite that your kitty's quality of life is pretty lousy, and can only get worse.

You are doing the right thing, as difficult as the decision is. It won't be easy, but the right choice is frequently not the easy one.

Best wishes.

Mary

I have a concern with my 5 year old cat. I'm awaiting blood test results, but my vet fears he has a chronic condition that causes ulcerated gums. It is painful and makes it hard for him to eat. My vet has warned me that this condition is generally hard to treat and nothing really works long term. Extracting all the teeth may provide a solution, but the cost is $2500...and that would be after a long, expensive course of treatment. My cat is still very much alive...but has started eating less due to the ulcers in his mouth. I love him dearly and have only had him about 7 months. He was a rescue cat...so I don't know much about his history. He needed his teeth cleaned as soon as I got him, but less than 7 months later, he has the ulcers again. I would like the opinion of others as to the option of euthanizing a younger cat when his prognosis is not good. I don't have the money to get into an expensive course of treatment. Even if i did, is it ethical to drug a cat for years, only to have to put him to sleep when the drugs cease to work?
I have had many cats and have had to euthanize most of them, at some point. My last kitty was 18 when the time came. It is not an easy decision, but in the past, when it was time, I knew it was the right thing to do for the cat.
This situation is not as clear to me.
I would really like to hear opinions about cost vs quality of life...etc. I love my kitty like crazy, but I don't have the money to keep him well and is it fair to drug him, only to have it all fail one day anyway?

Doc

Hello, Mary,

It sounds like your cat is suffering from chronic stomatitis. This condition is poorly understood, but is believed to be related to the body having a kind of allergic reaction to dental tartar that accumulates under the gum-line.

Some patients respond to treatment with antibiotics. Many patients respond to corticosteroids in the early stages. Unfortunately, these medicines tend to become less and less effective over time. Finally they don't work at all.

The extraction of all of the teeth is a drastic remedy. It solves the problem in about 70% of cats (according to the last dental specialist I spoke with). The cost you were quoted is similar to what the specialist quoted for my patient.

It seems obvious that there ought to be a better way to handle this, but at the present time nobody knows of one.

The longer you wait to extract all the teeth, the less likely it is to be effective.

This is a horrible disease and very frustrating for doctors as well as the cat's owners. We want to do a great job for you and we don't have great alternatives in these cases. They are miserable.

You ask if it is ethical to use medicines for years and then euthanize the cat. If you cannot possibly afford the major oral surgery that is recommended (and many people cannot), then I'd rather add years of decent life than just euthanize the cat right now.

As far as the quality of life you can achieve with medical care (versus the oral surgery), my experience has been that this is highly variable. Some cats go months between flare-ups, some cannot be controlled at all.

If the alternative is immediate euthanasia, then I think that medical treatment is certainly worth trying. It can be pretty rewarding in the short term, though usually not successful in the long term.

It sounds to me like your veterinarian is recommending the right things, but you haven't really fully asked your questions, nor gotten the doctor to fully answer them.

I'm happy to do what I can, but I can't see your cat. You really need to call the doctor back and tell him/her that you have more questions.

Best wishes.

Mary

Doc, Thanks for your response. The blood tests came out great...no underlying problems. My vet has started my cat on antibiotics and prednisolone. The vet hopes this will put him in "remission". I believe my cat is in the early stages of the disease, but I really don't know, as he is a rescue cat and I have no idea what went on earlier. My cat will be rechecked in about 2 weeks to see if the situation has improved. I'm hoping that it will!
At the end of the day, if I can nurse him along for awhile...hopefully for years...I will be happy. I doubt I would ever opt to remove all his teeth because, at that point, I feel it would put him through too much trauma. I will not keep him alive just for myself...but only if he can live a relatively normal life, without pain and trauma. I'm trying to keep it all in perspective. He is the perfect kitty, though and I would be very sad if I have to lose him.
I'm sure I will know more in a couple weeks. My kitty is otherwise very healthy and happy. As long as he can stay this way, he won't be put to sleep.
Thanks again!

Mary

Doc, If I may ask another question...
Is chronic stomatitis EVER cured? I guess the word "chronic" suggests not. But I was wondering if some cats do well for longer than just months, or is that a best case scenario? Does regular teeth cleaning help? My cat just had his teeth cleaned 8 months ago, right after I adopted him. He had some red spots on his gums at that time too.
I just wonder if I should hold out any hope at all that he could do well?
My vet didn't sound too optimistic, even though she was delighted that his blood tests were excellent.
Thanks for helping me understand this whole thing.

Doc

Hello, Mary,

The best chance of cure is the full-mouth tooth extraction. Medicine is unlikely to do more than relieve things temporarily.

Keeping the teeth descaled and polished below the gumline should be helpful. There can be plaque and tartar there even when the crown of the tooth looks great.

I don't know that I can help you understand this, since nobody really does understand the "real why".

As far as being traumatic, yes, having all teeth extracted is a big deal. That's why you want a dental specialist to do it - least trauma, and shortest time under anesthesia.

With local nerve blocks and fentanyl patches and buprenorphine, the post-op pain can be minimal.

It is not uncommon for people with several teeth left to get the remaining teeth pulled in order to get dentures and start eating again.

Cats with no teeth can eat commercial cat food perfectly well. Their teeth are designed to catch prey and shear it into chunks small enough to gulp down. They don't grind their food like horses and cows and people.

I wish you the best with this frustrating disease.

Mary

Doc,
Again, thanks for the info. I will continue the medicine for now...and see how he does. I guess it will be a matter of deciding if I can spend A LOT of money to have his teeth removed. If I thought that would 100% cure him forever...perhaps it would be worth it? But, of course I know it's not always a sure cure.
I will know more after this course of treatment, and how long it provides relief. And, I'll consult with my vet to see what she thinks I should do. Apparently, no one thinks teeth removal is "cruel and unusual", as I had originally thought it was.
Thanks again for the guidance. I'll let you know what happens!

MeowMeow

Reading through many of these posts, I find myself relating to everyone's hard decision that I am now facing. I have to admit that some of the posts made me teary-eyed. I have been researching various things the last few days since finding out my cat has soft tissue sarcoma. I have had her for almost three years now, after finding her on the side of a main road. She had been spayed and was immediately receptive to my approach; obviously someone's pet. No one ever claimed her, so she decided to stay with us. Anyway, the sarcoma is a large mass just under her left front leg, and is pushing it out slightly. I just noticed it last Friday because she is fairly aloof, although loving. She has been hiding a lot the last few weeks due to a new puppy in the house, although she is out a lot more now.

I went to my regular vet and they took an X-Ray along with a few blood tests. They recommended a visit to an oncologist, who then recommended radiation treatment as the best course of action. It would be 19 treatments (five days a week for four weeks).

While I did not raise her from kittenhood and she is not constantly throwing herself on me (my BFF kitty Daisy is laying on my forearms as I type this, as usual)...I still feel incredibly torn about this decision. Putting her through the risk and stress of anesthetic almost everyday for a month, and then not knowing if that will cure her...it breaks my heart. The vet estimated her age to be around 7 or 8 years old, which to me, is pretty young. Their prognosis is that she can live for another 2.5 to 3 years if the radiation and surgery are successful.

I obviously do not want to make the selfish decision to keep her around if she is not experiencing a good quality of life...but I wish I knew whether or not the radiation treatment would be her best option.

Doc

Wow, that is a difficult decision. Those tumors are very aggressive, very likely to recur with surgical removal alone.

Not being an oncologist, I really cannot speak to the effectiveness of radiation treatment.

I suppose I would ask the oncologist what the odds are. Also, whether this is highly effective, or just the best we have.

I don't think that anyone would say you are being selfish, nor that if you chose to euthanize that you would be doing it for convenience.

I would really recommend spending more time asking the oncologist your questions. We often think we have communicated thoroughly, simply because the client doesn't ask any more questions. I am sure the specialist would be glad to speak with you at length.

Best wishes.

MeowMeow

Thank you for the response, Doc. I did get the odds of the 60% effective rate of radiation treatment, but along with the 2.5-3 year life extension for her. I am going to take some time to think of more questions and contact them again.

Rachel Cole

I hate myself because on Tuesday I had to make the awful decision to let our cat Sammy 'Go To Sleep'. I keep thinking I made the wrong decision and it's eating me up inside. Sammy was almost 16 years old and had had a happy and healthy life until about 8 months ago when he started staying out and losing weight. Blood tests were inconclusive and our vets advice was not to worry. Just after Christmas Sammy disappeared. After putting out leaflets we were delighted to find him safe & well. It appeared he had moved into retirement with a lovely old lady in a quiet secluded bungalow (we have 2 young children, another cat & a boisterous young dog). He refused to go inside and refused any fuss from her but the kind lady allowed us to visit him. We have had regular contact since and lots of fuss & cuddles although it broke my heart to think of him alone outside during the cold winter nights (we did provide him with a shelter). Last friday I visited and was horrified to find he looked like he had swallowed a football. He hates the vets and was still happy, eating well and enjoying fuss and the sunshine so we took the decision to monitor him over the next few days. Despite seeing him again Sunday when he appeared to be eating and happy by Monday he had stopped eating although he still enjoyed his cuddles with me. I decided it was time to visit the vets and then everything went downhill. The did bloods and we were able to take him home (to his 2nd home). They showed aneamia but otherwise were inconlusive and the vet insisted he be taken back in the next morning for sedation and xrays. I did spend some very precious time kissing and cuddling him just in case that morning as we had been advised it may be bad news. Unfortunately the vet called and said he had a ruptured tumour which appeared to be on his spleen. They had drained a lot of blood but there was so much blood and fluid still inside they couldnt get a clear view as to whether the tumour had spread and whether any organs were affected. We were given the option to say goodbye or consent to them opening him up and removing the spleen and for further assessment - the problem being that he was seriously ill and may not make it through the operation and if they opened him up and found it was too far advanced to remove they would put him to sleep there and then. Even if surgery had gone ahead it would have been very costly, would have meant Sammy would have to be confined for any chance at recovery (he hates being trapped indoors) in a cage and they could give no indication as to what his quality of life or life expectancy or pain would be? I wanted to bring him home and let nature take its course but we were advised that was not possible as he was very seriously ill and it would have been inhumane. We had 2 choices and 2 choices only - consent to surgery or put him to rest :( We were given an hour to make the decision because he was already heavily sedated ready to be operated on or put to sleep because he was so seriously ill. I was devastated. How could he be so so ill when I had kissed and cuddled him only that same morning and he responsed as he always would. He didn't fight to go in his cat basket though which is very unusual for him. I made the fateful decision and we went to be with him and held him and kissed him and told him I was sorry and that I loved him so so much as his life slowly slipped away. I feel guilty? I couldn't bear the thought of not being able to say goodbye (as with one of our previous cats) and him dying on the operating table having only known fear from being at the vets. I wanted him to see my face and know I was there and loved him and for him to have a quiet, peaceful end. I wish the vet had been able to give a more conclusive or helpful answer. I wish I had never had to make the decision. How do you know or can you know that you made the right decision? I love him so so much and I miss him and I want him back. My heart is broken :(

Doc

Hello, Rachel,

With a tumor in the spleen, it could have ruptured any time and Sammy could have bled out internally while he slept.

We always wish that these things would happen without our having to make the decision, and in a way that we are sure there was no suffering.

So many times it doesn't happen like that. We have to face the fact that we have a responsibility to make a decision that does the best we can with what we have. This is often very difficult to do, and to remember afterwards.

You did the best that you could for Sammy. You shouldn't hate yourself for that.

I am sorry for your loss.

Stephanie

I am having a difficult time deciding when I should let my cat go. Chloe is a 12 year old Siamese with CRF. We got her diagnosis almost 4 weeks ago, although 4 years ago she had a major crash and was diagnoised with CKD. She has been on a K/D diet ever since. Her recent blood work indicated that she was in stage 4 CRF. I immediately began sub-Q fluids, AH powder and Miralax in her food, and Pepcid to make her more comfortable. We did okay with the administration of the sub-Q fluids for 3 weeks, but Chloe never really got comfortable with them. Now she has not let me do them for 3 days. She was so agitated that I couldn't get a good stick. The last time I tried I got the needle in but she struggled and thrashed so violently that the needle came out. Chloe is a cat that has never been desperate for affection or petting. She'll sit close and follow me around, but she will only tolerate being touched for maybe 30 seconds, and here I am trying to hold her down for as long as 5 minutes while I stick her with a needle (which I think hurts her because she flinches every time). She's been that way her whole life and I've had her since she was 10 months old. I feel like Chloe may be telling me that she is ready to be let go by not allowing me to administer the treatment. I also feel like the sub-Qs were not helping her feel any better. I think I may have gotten bad advise about how much to give her. My vet said 100-150 ccs but Chloe is only about 6 pounds right now, down from 8 pounds in less than 6 months. I think I was giving her too much fluid and it was straining her heart. She would be lethargic and her breathing would get really heavy after I finished, so I started giving less.
At this point, I feel like I need to respect her wishes and not give her the fluid treatment anymore. She's been getting way too upset, and so do I, when I even attempt now. I feel like I'm assaulting her by trying to force a treatment on her that she so clearly is not amenable to. I have decided not to continue the process even though I bought a 3 month supply.
Chloe is not herself and I know she won't ever be again. She sleeps more than usual, her appetite is diminished but she does still eat, and she drinks large amounts of water and just pees it all out (in her litter box...so far no accidents). I don't know if she is suffering but I have noticed slight wavering when she walks sometimes, or a slight head jerk here and there...signs that things are deteriorating. I know that she will deteriorate much quicker now that we have stopped the fluids because of the dehydration. I am still doing everything else (the AH powder, Miralax and Pepcid) to hopefully make her more comfortable but she sits in the "meatloaf" position, or sits up quite often, and she is getting increasingly restless.
I'm just so scared to let her go too soon or too late. Should I let her go now before her symptoms get really bad? I don't want to watch her suffer. I would feel SO guilty. But I also don't want to feel like I let her go if she still had even a good week left in her, and I suppose that is more for me than for her because I'm pretty devastated that she is dying.
I would appreciate any advice you can offer. I haven't found my vet to be very helpful in this regard.

Jacqueline

Hi Doc

I have a very similar situation to Stephanie (posted march 18). I have a 13 yo male whom I adopted when he was just 4 moths old. He was returned several times to the RSPCA due to being "too timid" and familys wanting a more interactive family member.
His timidity has never left him but he has formed a loving trusting bond with me and sleeps with me every night. He has just being diagnosed with CRF and lost a third of his body weight over the last six months, from six kilos to four kilos. He has been put on Royal Cain prescription food which he likes, for the last five days. His appetite is fine but his weight loss is continuing rapidly with a further loss of 300gms over those five days. He is a large cat (some Persian in him) and he has become very bony. It's clear he has also lost muscle mass as he seems to struggle sometimes lifting his head and climbing. He is also uncoordinated and falls off things or misjudges when he jumps and misses the mark.
Clearly there are medically a few more things I can try like steroid injections, IV administrations and more drugs, but these all require lots of vet visits and me "doing things to him" that cause a lot of anxiety in him. As I said, he is very timid and will only allow me to touch him. At the vets, he freezes and gets very stressed and stays stressed for a couple of days later.
As to good days versus bad? I wish I could tell the difference. He is still alert and affectionate. He enjoys food and is eliminating ok. On one hand, he seems himself but a little bit miserable. This could be because I have him under "renal watch" ie, observing his eating and eliminating, and watching his overall health, which has him restricted to just one part of the house. On the other hand, is he a little miserable because he just doesn't feel good?
The prognosis isn't good for renal failure. What he has ahead of him just to stay alive is breaking my heart. But to euthanize him now or soon, when he is still relatively happy and healthy, also breaks my heart. I have the means and the will to go down the medical journey with him. I truly just want to do What Is Best For Him. I am having real trouble understanding what the best thing is for him.
I would appreciate your opinion.
Thank you
Jacqueline

Doc

Hello, Stephanie,

I can appreciate that your veterinarian is having a hard time helping you with this decision. It is not something we can really decide FOR you.

It is obvious that you are willing to go the extra mile, but some cats are just not going to cooperate. The stress of the more intensive supportive treatment can sometimes outweigh the benefit of making the effort. It sure sounds like that is the type of situation that you are dealing with.

From what you have said, it is obvious that when you make your decision, nobody could possibly consider it a "convenience euthanasia".

It seems to me that you already feel the end is in sight and your greatest concern is for your cat.

It sounds like we really don't have any days when the cat feels really good. She's just "making it". As this gets worse and her appetite finally disappears, you will be faced with the decision.

I wish I could say "you'll know", but it is a terribly hard decision to make.

When she no longer reaches out to you, it's time to let her go on.

I wish that there were some way to make this easier.

Doc

Hello, Jacqueline,

I think you have said what's important - that he's still relatively healthy and happy. It's not time.

As the situation deteriorates (like Stephanie's situation), the decision gets forced on you.

What you've described to me doesn't sound like you're being selfish.

Best wishes in this difficult time.

Jacqueline

Hi Doc.

Thank you for your response. Sadly, Jackson has taken a turn for the worse. He was started on anabolic steroids and tramal yesterday as he was still losing weight. He has completely stopped eating and interacting with me. He has stumbled a few times today and wants to just go off and hide. He won't even even sniff my hand when I offer it to him. I am not sure if this is because he is getting sicker or just stressed from the treatment.
Any further thoughts?
Thank you
Jacqueline

Mary Wilson

Hi Doc,
I have an update on my cat with chronic stomatitis. (postings on Feb. 8th) We did treat him with antibiotics and steriods and he was rechecked after two weeks and my vet said he did VERY well. She said he would be able to do "more treatments", since he responded so well.
However, less than two weeks after his last dose of steroids, I started noticing the bad breath again and now (about 3 weeks later)I notice that he has started eating less and showing signs of mouth pain again. I'm fairly certain he is suffering again. The problem probably came back even before he was done with the steriods.
I am planning to call my vet tomorrow...but I can't imagine why I would re-treat him, when he probably needs the tooth removal surgery. Right?
Initially, I thought removing his teeth was "cruel and unusual", but I've decided that I cannot put him down and would like to try to "cure" him of this. The expense will be difficult, but what else can I do?
My question is, what if my vet says to treat him with antibiotics and steroids again? Should I opt for the surgery as soon as possible? I think, from everything I've read and from your advice, that the sooner the better is the thinking with this surgery.
My kitty is a big boy. He weighs 17 lbs. right now. I think he's otherwise very healthy. I've only had him about 10 months, so I really don't know his history. He has always been "sleepy"...not much energy or playfulness. I just thought it was his personality...but now I'm wondering if he's just been "sick" most of the time I've had him? He's estimated to be about 4-5 yrs old.
I also know that the surgery needs to be done by a specialist...with radiographs, etc., so I assume she will refer me to someone?
If you have time, I'd love your opinion. Is it a bad sign that his ulcers reoccured so quickly? Does that reduce his chances of a complete "cure"? I'm scared that I will spend all this money and he will not be done with this.
Thanks for your help!
Mary

Doc

Hello, Jacqueline,

If your cat does not respond to the anabolic steroids and pain medicine, then I would have to feel that we are on the downhill slide.

Sorry that I can't make this easier for you.

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