When is it “time” to euthanize?

Here’s today’s tough question [edited]:

I have a cat, Zoe, who is 15. She is diabetic.   Even when her diabetes is stabilized, she’s so skinny! She has gone from a big 12 pound Maine Coon to a weeny 5 pound Maine Coon. She looks and feel bony. We know she has some arthritis (she gets chondroitin); the vet thinks she may have a tumor of some sort, possibly even/as well as a brain tumor. She definitely has dental problems.

Zoe’s quality of life seems to me to be poor – she will accept petting but is not the affectionate lapcat she used to be; she has always lived in a multicat household but now HATES the other cats; and she’s occasionally incontinent. Mealtimes get her excited but that’s it; the rest of the time she spends asleep.

How do we know when it’s time? We keep taking her back to the vet every 3 months for an assessment to see if she’s in much pain and they
never seem to think she is. I don’t want to euthanize her just because she is no longer a charming little kitten or because she has health problems – she has definitely earned her retirement, but I also don’t want her to suffer through a terrible existence because we haven’t got the guts to make a decision.

My Answer:

Well… no pressure, huh?

The decision to provide euthanasia is often a difficult one.  In fact, it is almost always a difficult decision, even when the situation is pretty
clear-cut (as in the dog caught in a combine harvester header who had all four of his legs cut off: the owner wanted me to “fix him”. Holy cow!)

Quality of life” and “quality of life issues” are the buzz-words.  They are more than just buzz-words, though.  If one is sure that a patient is in constant pain which is NOT going to get better, then the decision is pretty clear.  But what about the patient who just never feels good? 

You don’t really see obvious signs of pain (screaming, moaning, writhing, restlessness, etc.), but you never see what you consider the normal activities.  No playing, no exploring, no interaction with other pets or people.  She still eats and is interested in food, but just sleeps the rest of the time.

With this pet, we know she won’t have any energy — she’s wasting away, burning up her body fat and muscle tissue just to stay alive.  This means that she isn’t getting much good out of her food.  Just breathing is taking all she’s got.

Is she in pain?  This is a very hard question to answer, particularly with cats, as they are very stoic and famous for concealing signs of illness.  Even when you know your pet better than anyone else, this can be a hard call.  One of the few ways that I know to assess this is to give a trial therapy of pain medication, such as buprenorphine, and see if there is improvement.

Another criterion that I use is to think to myself, “If this were me, would I be in pain?”  This is less useful here, as I’ve never been 100 years
old and wasting away (at least not this lifetime).  My great-aunt Clara lived to be 101.  She retained her mental faculties to the end.    You could tell pretty quickly how interesting your conversation was.  If you were boring her, she’d just go to sleep.  If not, the conversation would be lively for as long as you could stay with it.

Aunt Clara was rather feeble physically in the last ten years.  She didn’t feel bad, but she had trouble getting up and walking, even around the house.  She slept a lot.  When asked how it felt to be 100, she would reply, “I’m just surprised every day when I wake up.”

Contrast this with an experience I had with a relative dying with cancer in a hospice environment.  She begged me to smother her with a pillow.

Which brings me back to my opening statement: No pressure, huh?

Whenever a client uses the “S” word (“Do you think he’s suffering?”), I know it’s over.  In 31 years, nobody has ever used this word unless they were looking for the way out.

In your case, you are concerned about whether you are condemning the cat to slow death.  Ironically, you are afraid someone might think you were considering a “convenience euthanasia”.  Since most cats don’t live to be 15 in the first place, and many owners will not go to the trouble to treat diabetics (and it IS some trouble, I know), you could hardly be thought to have cut any corners in the cat’s care.

Here’s what the numbers say:
Your cat has lived to an above average lifespan of 15 years.
Your cat has lost sixty percent of its body weight.
Your cat never plays, explores, or interacts with others.
Your cat never “feels good”.

Your question: is the cat in pain?   Answer: I don’t know.
Your question: is it “time”?            Answer: Only you can decide.

I wish I could make it easy for you, but it never is.

Best wishes,
Everett Mobley, D.V.M.

801 thoughts on “When is it “time” to euthanize?

  1. Teri and the cats of Furrydance says:

    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…

    • JT says:

      I can’t even consider being productive the rest of today.
      I have my first car, my first love that I never thought would happen. I’ve made a mistake, I didn’t know this ending of love could be so possible. You are all so brave. Love takes a strong heart.
      Blessings to you all.

      • Sandy says:

        I’m taking my mom and her cat tomorrow am to the vets to have her euthanized. I am so upset. Nakieta stopped grooming herself a few months ago and my mom had the vet give her a lion cut as the mats were very bad. We wondered why is this happening? Last week we learned that she has squamous cell oral cancer. There is a large mass. As of yesterday she barely can eat. She can’t drink. She’s lost so much weight. We are very sad to do this but all the light is gone from her eyes. We don’t want her to suffer. My mom is 85. This is devastating to her. It’s her companion. Thank you for posting these comments. It’s never an easy decision.

        • Doc says:

          Hello, Sandy,
          That type of oral tumor is horrible, as we really don’t have good treatments. I wish you the best in this difficult time.

        • Marfuerite says:

          Je suis de tout cœur avec vous, et je vous embrasse et je demande à DIEU de vous consoler car vous serez de nouveau ensemble dans le paradis .
          Je suis avec mon chat Toutou en phase terminale il a 11 ans et je sais que ses jours sont comptés.????????????????????????

        • Leanne says:

          Help Leanne,. My 17yr old Siamese has started to pee all over my apt, especially my bed right in front of me right when I get up or a nap! Vet says she’s OK- no UTI. Pottybox spotless. What do I do?

        • Alice says:

          My cat has mouth cancar. She has been doing well. Today we were resting. No provocation. She arose and came at me with teeth and nails. I’m cutup pretty good. Why?

          • Doc says:

            Hello, Alice,
            Your cat may be painful. It is also possible that the cancer is spreading to other body parts, though oral tumors tend to be more locally invasive, and less likely to spread.

    • Cindy Badder says:

      Thank you for the input on your page on sending my 21 Year old cat to Heaven. I knew it was time but hubby didn’t want to let go. I went by myself. I’m in Ky and have a good vet but your page brought me the greatest comfort. I have 9 other rescues but a hole in my heart.

        • Lynne Campo says:

          My 12 year old Manx has gone from 10.4 pounds in November 2020 to 5.5 pounds in September 2021. He is on an onsior pill daily for severe arthritis pain as well as dasiquin. He drinks pro plan fluid replacement daily as he dehydrates despite drinking large amounts. We feed him wet food mixed with water every 2 hours to keep him hydrated. The vet believes he has cancer and an enlarged heart. Also he has the paw pad disease pomodermatitis and is paws are peeling and very painful to walk on. However he is still affectionate. We are evacuees from Hurricane Ida which has made it extremely hard on him living in a hotel room. I’m wondering if I should put him to sleep or will he do better once things settle down. He was incontinent on the evacuation but not now in the hotel room. He suffers from chronic diarrhea (this isn’t new) very foul smelling and has to been washed daily

          • IrisB says:

            Pray for the right choice. I am trying to decide whether to put my cat down, and that’s what I’m doing. It sounds like he’s in a lot of pain and suffering. Only you can decide this, though. One questions I’m asking myself is, “Would I want to live like this?”

          • Doc says:

            Hello, Lynne,
            I had some bugs in my comments, so just now seeing this. That plasma cell pododermatitis can be difficult to treat, even in a cat that has no other problems. It sounds to me like you have been doing everything possible to maintain some quality of life for this guy, but it also sounds like it is a losing battle. It doesn’t sound like he has much quality of life.
            I’m sorry to be so late in replying.

          • Linda says:

            I went thru this with my 20 year old cat. I didn’t want h to go. I tried everything. When the poo is just running out, it’s time. I even tried diapers. I call ed the local vet who comes to your house. It isn’t cheap, but well worth it. My kitty got to pass where he was the most comphy, on my bed. I know how hard this is. I have a 17 year old, the 20 year olds son, who has be be put down tomorrow or the next day. I’m praying for you. My heart goes out to you. Send your baby off with love at home.

        • Jeri Thompson says:

          Thank you for your straight forward advice, more helpful than “it’s up to you.” My 14 year old had kidney cancer and she fought so hard against any meds, liquid or pills (and I have essential tremor). So she got no meds, more trauma for us both. She became all skin and bone and slept most of the time. She had more bad days than good although she was still trying to get out to explore occasionally. I asked my vet if it was too soon. He said “well she’s not going to get better.” That helped a bit and I still wonder, was it the right time? Your words helped the most, thank you.

          • Doc says:

            Hello, Jeri,
            These decisions are never easy, and even more difficult when the pet resists your efforts to help them. When you feel like you are making the dog more miserable trying to give medicine to make them less miserable, you just feel like you’re in a no-win situation. It’s so hard to give them up, but sometimes we are just watching them die slowly, and that’s not easy, either. Thanks for sharing your story.

      • Nuala C Galbari says:

        Cindy,
        I don’t know if you will still check this page. I wanted to say how sorry I am that you lost your cat last year. I just lost my beloved Siamese, aged 14, to Liver Failure with FIV. It’s a long story, but the last few days were exhausting and so traumatic. My husband is a physician and said it was best to let him just go to sleep; he understands the condition. Last week, I had considered euthanasia — we knew he was dying, but he still tried to hard,
        was wobbly on his legs, had lost most of his muscle and weight, but was still interested
        in food and being close to us, although the food was not metabolizing. He also turned
        a brownish color on his seal point areas and paws, and on his face, which I understand
        was Cushings, brought on by the steroids he was taking. He looked terrible, but he was
        still plugging on, so we did not take him in.

        The day before yesterday, he had dinner around 6 PM, stretched out his front paws, purred loudly (his hearing was not so good) and then curled up in his basket. We watched a film,
        but I kept an eye on him, and another cat was lying near him, purring, and keeping him company. He was warm and looked content, and I went up to bed around midnight.
        My husband checked him at 2 AM and later told me that he was breathing in rather a shallow manner, but seemed calm; he was still purring. Sometime between 2 AM and 5 AM, when we did not check him, he slipped away. He was gone when I came down at 8 AM,
        and I dissolved into tears, of course. We miss him terribly; we buried him in the garden, yesterday morning, with his stuffed frog toy that he loved.

        It’s never easy, and any veterinarian will tell you so. Like you, we have other rescues, but each animal is so unique and special, it does leave a hole in your heart. Every loss is difficult.

        By now, you have probably realized you did the right thing. I also think our choice to keep him here, was the right one. I had other cats who passed last year; ages, 19, 20 and 21 — amazingly. But two went into respiratory distress fairly rapidly, so we had to take them
        in and they both had to be euthanized. We all thought it might be Covid-related, which is
        possible, however the cats both had FIV, so sudden illness was not unlikely.

        Blessings to you. To all of us who rescue cats, many of whom have FIV or other health issues, this is our cross to bear. We know loss. But the love and companionship we receive from these animals surely blots out all else. We have our memories and they stay in our hearts permanently.

        Tomorrow, I will plant some pansies (hardy flowers) by Henry’s grave. He was the bravest of cats and he kept rocking on to the very end. We should all be so blessed.

        Nuala Galbari

        • Linda says:

          Hello,
          I have a rescue cat that was in very bad shape when I pulled him from the colony in 2008. He had FIV and a severe infection which caused him to have all his teeth removed except 2. Throughout the years he has had many vet visits to fifth infections but he went from 7 pounds to 18 pounds. He is a large frame boy, very handsome, and he looks like a panther. Anyway, this past Sunday, I noticed his side’s were expanding so my husband took him to the vet and we received bad news that he has fluid leaking into his stomach. That was on Monday. The Vet recommended to have him put to sleep within 48 hours. I could not. He is jumping, eating, playing with his siblings and acting mostly normal. I know I will have to put him down. Is it selfish of me to keep him alive through the weekend and plan for his eternal sleep on Monday? I am heartbroken. I have other rescues and they all look up to him.

          • Doc says:

            Hello, Linda,
            I would not be in a hurry to euthanize if he acts okay. If he is having a relapse of FIV with the fluid accumulation, then the prognosis is not good. But if he feels okay, I’d let him enjoy life as long as he can. The other cats have already been exposed by this time, so I don’t think it increases their risk.

          • debbie says:

            Youwillknowwhenyourlovedoneisready,ihadtodothisformysister,theycallithospice..pretty..muchsameaseuthinasia,andthenextyearmymorher….3..years..later..mybeloved..18..yr..old..cat.who.was.my.life.it.hurts.me. buSt.he. couldn’teator..walk..why,would
            !l.not.do.the.same.for.him

    • Heidi M Palombi says:

      We had our 15-year-old cat euthanized today. It was very sad. The vet said she had chronic kidney failure. She also noticed a stone on her kidney too large to pass. She went from 10 lbs to 5 lbs in the past year. During the past week, she stopped eating. When the vet saw her she suggested hospitalizing her for 3 days and giving her fluids and antibiotics. The cost of that was so outrageous I had to decline. I took my kitty home and was going to have her euthanized at home. A friend told me about doing subcutaneous fluids at home. She said it really went well with her kitty of 16 years who had stopped eating and had kidney disease. I called the vet and brought my cat in thinking the vet was going to give my cat her first dose of fluids and antibiotics and then send me home with a supply to give her at home. But when she saw the cat she said that in the past 24 hours she had gotten so much worse, (her heart and breathing rate had gone down low normal and her temperature was below normal. I remember the day we had her at home between the two appointments. She kept looking at me in the eyes. She wouldn’t take her eyes off of me. She responded well to petting and massage, she purred. She never lost the light in her eyes, even as she lay on the hospital table in the fluffy bed we had brought for her to go to sleep in. She looked in my eyes as if she were human. Her eyes were blue and they glistened. My 12 yr daughter and I sat with her for an hour and 1/2. Then we let the doc came in to give her the sedative and all. She went really fast. Less than a minute. I know this sounds weird but a few seconds after she passed I looked up and saw a cone of blue and green light ascending to the ceiling and going through the ceiling. It was very comforting. I am a musician and trained in energy work and healing touch, I can see auras sometimes. It was just to comforting to see that cone of light. Surely it was her spirit. I even sparkled, just the way her sweet eyes always sparkled .
      I appreciate all of the posts about pets coming back to say hello. I have seen the small dogs I used to have run by my feet. I am careful not to trip over them. I thought I was seeing things, but all the similar posts are comforting to read. Now I know I’m not seeing things, and it’s really them.

      • Nuala C Galbari says:

        Heidi
        Thank you for sharing your moving story about your cat. My Siamese passed away yesterday morning after a brief illness (well, about one month, but he was only really weak the last couple of days).

        I had not been sleeping well, due to the worry and stress, (I have six other cats, three birds, and two horses), but this cat was the most beloved of my cats, and had been with me for
        14 years.

        He passed away sometime between our last check (around 2 AM) and 7 AM, when I arose.
        At about 6 AM, I awakened, and felt a ‘pink calm’ rolling over me like a cloud. I felt suddenly well-rested, calm and fresh — not the way I had felt for the past week. It was around the time he passed and I think Henry (the cat) was telling me he was no longer in pain.

        Animals communicate with us spiritually. And speaking of music, as you are a musician, this cat loved to play piano to communicate his desires with us. He would play when he was hungry, but also when he wanted to go out. It was very amusing but also constructive; he had learned to communicate through music — a very special cat.

        He is at peace now, as your cat is. There is that awful emptiness that follows loss.
        I keep looking at the chair in which he used to take his naps or sleep at night, and
        the Persian Rug where he loved to lie. We buried him in a sunny spot in the garden, a place he used to go to lie on the leaves, in spring and summer. It is situated beside a Sweet Bush, a fragrant, lovely bush with pink flowers. I think he would have wanted to be there.

        Blessings to you, your cat has risen now, as Henry has. Saint Francis will care for them, until we meet them again. And we will.

        With love,
        Nuala Galbari

    • Veronica J Rorrer-Miller says:

      My 14-yr old Siamese, whom I raised from a kitten, crossed the Rainbow Bridge yesterday evening. A couple of weeks ago, I took him & our other 11-yr old cat (whom I adopted 5 yoa), for both to have their claws clipped. The other cat was to be examined due to a drastic weight loss (he was diagnosed w/hyperthyroidism). The Vet wouldn’t do anything other than the pedicure on our Siamese, since this wasn’t a “scheduled wellness exam”. I had to wait 5 more days for my Siamese to be examined. He had a “mild” URI, lethargy, weak meow, heart murmur, anorexia w/drastic weight loss, decreased water intake, he was still peeing & had constipation, then bowel movements that were nonexistent. They drew blood; did xrays which were “unremarkable” other than some stool in his colon (no obstruction was noted); they sent him home with an oral antibiotic & a laxative for fur-balls. It was impossible to give him oral meds with me trying to adminster the doses directly into his mouth. He would growl, jerk, & hiss, & I was afraid of being bitten; I tried offering him water/juice drained off of canned tuna, wet food, & a few of his favorite treats. He would nibble & drink a little initially, but stopped showing interest in that, & it would just sit & dry out. They said there wasn’t anything significant noted in his blood work, other than a slight elevation in a pancreatic enzyme and CPK. They gave him injections of an antibiotic, antiemetic, appetite stimulant, & SQ fluids, & sent him home w/a liquid appetite stimulant. He gagged when I tried giving him the first dose, which I felt guilty trying to force it in him. He wasn’t having anything to do w/food with meds mixed in, either. He continued to not eat. When he licked my fingers, they were dry. I offered him water by dipping my fingers in water & letting him lick them. His scruff tented & he had completely stopped grooming. The weekend was unbearable, dreading him passing at home. I’ve held a cat in the throes of death & it wasn’t peaceful or pain-free. I didn’t want to go through that trauma again. I checked on him frequently. Mercifully, he made it through the weekend. I knew he wouldn’t recover, even with more intensive treatment. I started calling the vet after lunch & couldn’t get through; I was on the verge of a panic attack. I finally reached someone & the procedure was scheduled. I went through a cat euthanasia 8 years ago & my heart was breaking all over again. My baby was so weak, but they handled him roughly to give the massive dose of sedative. I held him as he slipped from consciousness, & his breathing became slower & more shallow. They left for 10 min, then came back & gave the lethal anesthetic. Within seconds, he quietly slipped away. Now, I vascillate between second-guessing myself & knowing, in my heart of hearts, it was his time. I ache knowing he’s gone, but I have another cat needing my total devotion & TLC. That will act as a balm to my raw emotions of grief.

        • Tori Raine Jandreau says:

          My siamese, 16 year old cat wiyh fiv was diagnosed woth oral squamous carcinoma bavk in june. Yhe oast couple days hes been sble to drink milk and broth, but not eating. Hes still so happy and wants to explore outside and play. I have an appointment for tomorrow for euthanasia, am i doing the right thing?

          • Doc says:

            Hello, Tori,
            I am sorry that I did not see this sooner. Oral squamous cell carcinoma is a very aggressive tumor. When he becomes unable to eat, the inability to drink may not be far behind. It’s not so much a question of “if” but of “when”. I am sorry that I was unable to reply sooner.

    • Lyndsey D says:

      I know this is an old post, but I can’t help but wish you were my vet. Why all of a sudden do I feel shamed and/or guilted by the vets(2, due to a move to another town) I have taken my very sick 10 year old cat to when I express it is time?
      The records are there, the history is long, yet the ‘new’ vet wants to keep trying to acutely treat my cat in the clinic and $800-$1000 later each 2 day stay she sends him home on no meds.
      His condition…..either inflammatory bowel disease or lymphoma of the intestines.
      She always wants to do an ultrasound and X-ray and I cannot help but feel she is just running a bill up on me, despite me telling her each time cost is an issue for me, especially when she starts talking about exploratory surgery. She won’t even quote me a price when I ask, she gets defensive and says that’s the only way and he’s doing great here on I.V. Nausea meds and fluids. (He only ever stays one night with her).
      Then I go pick him up and get him home and he is so sick 12hrs later that I cannot handle it. (The vomiting has been going on for 7 months now, the vomiting up his food for 1 month, and this past week uncontrollable loose stools where he can’t make it to his litter box.
      The vet is fixated on getting a diagnosis of inflammatory bowel disease or lymphoma, despite me telling her over and over that he is just existing and severely sick at home, at this point.
      He eats, immediately expels his food, then hides and wants zero interaction. (He used to be so loving).
      This has been hard to watch and deal with. Cleaning up after this sick animal for months is literally taking ALL of my spare time away from work, leaving me to neglect all other household responsibilities and any personal life I might have. And somehow when I bring this up to the vet, they act like I am wanting an unnecessary/convenient euthanasia for him. What about my mental health? She will not even keep him long enough to deal with him getting sick at the clinic and then sends him home with zero medication. What is the purpose of that, other than lining her pocketbook? I wanted to like her as a vet, but I’ve lost trust in her and question her motives.
      I also feel if I go to a 3rd vet clinic I will have to start completely over with testing. This cat is miserable and so am I. It shouldn’t have come to this. Why do some newer vets have the school of thought that I should keep him alive at all costs. Exploratory surgery, chemotherapy, steroids, etc….for what? To prolong the inevitable?? This cat is really suffering.
      To complicate matters, I brought him home again on Friday, by 3am Saturday he was sick again and escaped through the dog door, he has never been an indoor/outdoor cat, just indoor because his normal personality was too scared to stay outside longer than 5 minutes at a time before he was meowing at the door, even if I was out there with him.

      I am now angry and upset with this particular vet that my pet is now potentially, outside hiding before he dies, when he just left the vet 2 days ago. It makes me sad that he felt outside was better than dying inside when she should have euthanized him already.
      What can I possibly say to her to get her to do the humane thing, if my cat comes back home? I can’t stand that he’s out there potentially suffering now.

      • Doc says:

        Hello, Lyndsey,

        I can only speak generally, as I don’t know your cat or its history. IBD and intestinal lymphoma can look the same, not only in external clinical signs (weight loss, vomiting, diarrhea), but on ultrasound, as well. You can see that the intestinal wall is thickened, but that doesn’t tell you why. The only way to know that for sure would be to do a full-thickness biopsy of the intestinal wall, which does require an exploratory surgery.

        IBD when left untreated can progress to intestinal lymphoma. In cases where we suspect these diseases (either from clinical signs and history, or ultrasound appearance), I talk with clients about our options. Often, we opt to “treat the treatable”. IBD often responds well to prednisolone, which is inexpensive. Sometimes it requires more potent immunosuppressive drugs. Intestinal lymphoma will often respond temporarily to prednisolone, but chances of a cure or prolonged remission would require chemotherapy drugs.

        If further diagnostics and treatments are not doable for my client, then I try to give them enough information that they can feel that they are making a decision, rather than just being buffeted by circumstances.

        I am sorry that you are having such difficulty.

    • Jennifer Moore says:

      It was difficult making that decision with my Mikey, even though he was 18 years old. I had him since the day he was born, he became my best friend when my son was born still.
      We had been through everything together and he was everything to me.
      I was literally sick on the way to the vet that evening but I knew it was time. I remember looking at him and he looked totally defeated.
      His death was and still is very difficult for me. It’s been 2 years and I’m not ok yet.
      But it isn’t his death that gets to me the most, it was watching him die over those last few months.
      He was such a proud cat, he was the king of the household, watching him whither away was almost more than I could take.
      Im glad he is resting now and not in pain, someday when I rest my pain will be gone too but not until then.

  2. Penny's mom says:

    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…

  3. Doc says:

    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.

    • Tippers Mom says:

      I hope someone sees this (as I haven’t seen any comments from 2022 :/). I have a 17+yo indoor girl who got diagnosed with kidney disease about a little over a month ago. I’m not sure what stage she’s at, in assuming mid-late due to the rush for sub-q fluids to be administered. When she originally went to the vet, since I noticed pupil differences and weight loss, they took blood & urine tests due to the suspected KD with her age. She was administered fluids (every other day 100-150ml till the bag emptied), and UTI meds (crystals in her urine), and KD food to try and prolong her kidneys. After a few mental breakdowns while administering fluids at home we eventually got into a routine that worked for us and finished off the bag. The UTI meds had no getting used to since she absolutely despises force feeding anything (esp. bubblegum flavor meds??) And she hated the KD food and refused to eat more than 2 bites. Eventually we realized she was thinning out even more, which was scary since the vet had told us she was already semi underweight. So, we tired all the foods, mixing her favorite food with it, everything you can imagine to get her to eat the damn food. She refused. After a few phone calls with the vet we all decided that her eating was better than not so we returned her to her gravy wet food that she devourers and she was enjoying it (we have to puree her gravy food because she WILL just lick the gravy off and leave the protein). After that everything returned to normal for about a week or so, more poops showed up in the litter box, fluids going in good, and finished her 10 days of UTI meds ..thank God.. but then I came home from work and saw 2 spots of puke, her straining to go pee, and she left a small poop on the floor. Mind you she’s a very polite cat and she always makes it to the litter box, if it’s blocked she will make it known and wait it out, so I knew something was wrong since she was straining enough to push a poop out in the open on the floor. There was also small stains on the bedsheet that had a pink color to them from where I’m guessing she was laying down and still straining. There was probably 2 minutes in between each time she would leave the litter box, try to get comfy on the bed, and jump back down to try to potty again. At that point I was on the phone with her vet and asking if this was something concerning enough to bring her in, which she said yes and got me a same day appointment. At said apt, urine test was done, an ultrasound of her bladder, and she got her temp checked. Nothing wrong with her bladder but she came back with another uti & prescribed the same meds as last time but for a month span (not sure if it’s the same one from before, or if she’s becoming prone due to her disease). So today, abt 3 days since her appointment, I came home after 6 hours and there was 2 pukes on the floor which were chunky dry food pukes (which happens occasionally and is usually followed by a fur ball mixed in) and there was 2 stains on the bedsheet, both pinkish in color and had no chunks. It looked like water with a small amount of blood, but she also has dry food available if she gets hungry before she gets her wet food and it is orange/red in color so I’m not sure if it was remainder of that mixed with water ( it had absolutely no smell?) She also pooped on the floor again, this time it was a complete poop and not a nugget. It was also mushy in texture but I usually only see her dry poops in the litter box so I’m not sure if it’s normal for her. The normal vet wasn’t open so I called their sister emergency hospital (vet told me from last visit to call/come in if she puked again) well they’re $160 just to get in the door and also will want blood and urine samples. I just dropped $180 on meds and over $100 on her visit and still have over $500 to pay with my payment plan and I’m 19yo making about minimum wage @≈$14, I can’t afford another round of the same thing she just had done but double the cost due to emergency fees. She was distant when we got home, almost embarrassed about making a mess (like I said she’s a polite cat :/) and she just sat by her water fountain. She wouldn’t come when called and refused to get on the bed for about 30 minutes. She has about 100/150ml left of sub-q that I gave her Incase she was becoming more dehydrated and trying to tell me by sitting patiently by her water. I’m going to try to wait it out till Monday and talk with her vet when they open but I’m worried that she’s declining and I won’t notice since I’m used to her being a homebody cat who likes to sleep and not be bothered much. She seemed just fine yesterday and was her version of “playful” (she doesn’t like toys, treats, or chasing anything unless it’s light reflecting from your phone) which includes play fighting for a short time. But after giving her fluids she was trying to hide under the bed, she did come out when called but I know cats like to hide and die. Which is terrifying. At this moment she’s sleeping on her spot on the bed which is right under my arm as I’m typing this. I’m just worried she’s too good at hiding her illness from me untill it shows physically ie. Weight loss, puking, trouble going to the bathroom, ect. I wouldn’t be able to tell if she’s in pain unless she broke something if that gives you any idea. She’s my baby and has been since I was 2, she’s my best friend and I want to know when it’s time for her to go. I don’t want to rob her life from her if she still has time, but I don’t know if I can differentiate good time and bad time with me being used to her getting sick. I don’t want her to be uncomfortable but I can’t spend a mortgage every month trying to keep her comfortable, I can’t do it but I will if it will help her. All in all, I guess I’m looking for a second opinion on how she might be feeling since I’m bias. I love her to and through death, I just don’t want that to be now.

      • Doc says:

        Hello, Tipper’s Mom,

        I agree that feeding her something she likes is better than having her refuse something that’s “good for her”. You might look at balanceit.com. They have recipes for animals with different diseases. You select the species, medical problem and the basic foods that the pet likes. They then formulate a diet using those foods. There is no charge for this service. They make their money selling you supplements that complete the balancing of the diet. They may have to contact your veterinarian for approval of the formulation.

        When you get to end-stage kidney disease, the kidneys have trouble filtering the waste from the blood, and they have trouble concentrating the filtrate they produce. So, you lose too much water, and you don’t get enough waste filtered out. The more fluid that is passing through the kidneys, the more waste they will remove, even though they have lost their efficiency. Giving subcutaneous fluids helps keep things flushed out. Cats are not big water drinkers when they feel good, and drink even less when feeling bad. When the waste levels are building up in the blood, you feel nauseated. You can also have stomach ulcers.

        It isn’t likely that a female cat would develop a urinary blockage unless there were a bladder tumor. Anything that would be big enough to do that would usually be visible on the ultrasound, unless it were affecting the urethra inside the pelvis. Blood in the urine and straining are very typical of urinary bladder infections, so giving antibiotics certainly can be helpful.

        Anti-nausea meds, regular fluid administration, and antibiotics as needed, nutritional support, all can help prolong the duration of the cat’s life, and hopefully improve the quality of life. They cannot prevent the progress of the kidney’s deterioration. We just try to make the remaining days, weeks or months as comfortable as possible.

  4. Michelle says:

    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

  5. Doc says:

    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.

    • Candi says:

      My baby (cat) is almost 4yrs. I raised him from a week old. There was 3 little ones. He started vomiting and losing weight. He had been too the vet as soon as he started vomiting more them 2 times a day. They said try different food maybe a air purifier. I tried everything thing. They did xrays, blood work, they said everything looked fine. That was in July, in August 2 months later I took him back cause he started losing weight from 16lbs. To 10 lbs. They did more xrays, blood work and ultrasound. They sent me too a specialist. Then more blood work, ultrasound, then a biopsy. I waited for the results about 2 weeks. Thats when they told me it was lymphoma. Its now January and hes still eating a little, I give him anything he wants. He has me hold him up at the bathroom sink and he drinks. He comes up on me and looks at me about an inch or so from my face. I’m not sure if he’s trying to tell me its ok I’m still here or what, cause he sees me upset. I love him so much, I know I need to do whats best for him. He vomits, he doesn’t clean him self, he tries to get outside and he’s never been an outside cat ever.

      • Doc says:

        Hello, Candi,

        I am sorry to hear about your cat’s situation. We know this is a terminal illness, and the best we can do is try to keep the patient comfortable. You might ask your veterinarian about anti-nausea medication or pain medication. It’s hard to watch a friend deteriorate and know that the end is coming. I wish I could tell you how to know when it’s time to let him go.

      • Elizabeth J Ford says:

        God bless you. I’ve had my baby for almost 10yrs. He’s had chronic diarrhea for 7 months. He can’t eat the food he use to & he use to love to eat. He also has feline herpes & I can tell his little eyes hurt. He’s the love of my life. I can tell he feels bad. He doesn’t sleep with me all the time anymore. Idk where he sleeps. He’s breaking my heart. I could bawl my eyes out. My fiance committed suicide on Christmas last year. All of this has taken such a toll on me. I don’t want to keep him here if he’s miserable because I can’t stand the thought of putting him to sleep. I’d rather put myself to sleep. He’s not the same little happy cat anymore. Somebody please help me & tell me what to do.

        • Doc says:

          Hello, Elizabeth,

          This is always hard. You don’t want to give them up, or let them go too soon, but you don’t want them to suffer needlessly. You really have to look at how many good days versus bad days that they are having. If there are no good days, it may be time to let him go.

        • George says:

          I’m so sorry Elizabeth, I have to put my wonderful cat Little B to sleep and it’s killing me, I love this little animal ????, but her quality of life isn’t there anymore, she’s 19 and I will miss her terribly, I wish you all the best in this tough time

        • Ken Ferguson says:

          Hi Elizabath, I just read your post on KVC, it really touched my heart. I hope you are doing well and you have been able to work things through with your Cat. I too am presently going through the same thing with my 20 year old cat, Buddy. I feel much like you, I would rather it be me that was dying than my best friend. I have realized that my desire for Buddy to live longer could be just making her die slower. I am just watching my best friend deteriate slowly. At times she does not even appear sick, but she is. I want to do what’s right for Buddy and not for me. I hope your well, thanks for sharing and listening. Text me if you want at 5873229921
          Ken

    • Miley’s mama says:

      Hello! My almost 4yo cat has fibrosarcoma from a vaccination in her leg. The bump was removed in August 2020 But shortly came back and bigger than ever. She now has multiple bumps covering her entire leg and back area and I recently noticed near these bumps some lesions. She acts pretty normal and when I can tell she’s in pain I give her the meds prescribed but now with the lesions surfacing, I’m worried and wondering is this the right time for her? The bumps have completely covered her side leg and back and as very large. She otherwise acts fine, playful sometimes, eating normally, and cuddling. I’ve noticed the past month she’s been more affectionate actually. I’m just worried with these skin lesions now appearing if she’s not leading on to how much pain she’s actually in. I broke down today debating whether this is the right time to put her down, it’s a lot harder when she’s wanting affection and acting pretty normal. I do know these bumps and lesions will only continue to expand.

      • Doc says:

        Hello, Miley’s Mama,

        WOW! Such a young cat. These tumors are not as commonly seen as they were 10 years ago, but they are still around and they are still bad. Current thinking is that they can occur with any injection, not just vaccines.

        They are very bad about recurring in the same location, and they may spread (as it sounds like they have). The reason we changed our injection site from the back of the neck (which used to be customary) to the hind legs was to give the option of amputating the limb to stop the spread of the tumor.

        I don’t think these lesions are painful until they either get so big that they are in the way, or if they invade surrounding tissue.

        If your cat acts normal, I certainly wouldn’t be thinking euthanasia at this time.

        I had a patient that we de-bulked the tumor 3 times before it became inoperable. She got an extra year.

        • Sarah says:

          My 10 year old cat also has a vaccine associated fibrosarcoma. As with Miley’s Mama, we had Cissy’s lump removed in September 2020. The tumor came back and there are now two lumps. We had them drained 2 weeks ago. Our vet said the lumps are connected and that there is a hard mass underneath. The lumps started filling up with fluid the next day but they don’t seem to interfere with her mobility or cause her pain. But now they are leaking blood. It’s possible it started leaking small amounts that we did not notice earlier, but 2 days ago when there was blood all over the floor we took her to the vet right away. He expressed the remaining fluid and gave Cissy a cone for 2 weeks to allow the lesions on the lumps to heal. We know the lumps will continue to grow, that they may become infected, especially if they are drained frequently, that they may continue to leak blood, and that the lumps may eventually cause pressure on the nerves. But Cissy seems like herself in every other way. The vet said it is coming down to a quality of life issue for her. Would you de-bulk the lumps every 2 weeks if they continue to fill up quickly and continue to leak blood? We still have time left with Cissy but when will we know it’s time for euthanasia? I don’t know if pain/hiding is something we will see with this condition. Cissy seems fine from the lumps up and still enjoys being petted and behaves like her normal self except for her obsessively licking the lumps. She can reach part of the lower one even with the cone.

          • Doc says:

            Hello, Sarah,
            I really can’t give you very good advice without having seen your cat. I would follow your veterinarian’s advice.

          • Anita says:

            My 13-year old cat has the same condition. She scratched and licked the lumps obsessively and they are now a horrible collection of large (2-inch) scabby lessions which burst and smell putrid despite daily cleaning with iodine. Something that has helped and may help others is that when she first started scratching a cone was useless as she scratched with her back leg breaking the skin. I used the vet’s cone as a template and made a stiffened fabric cape which was attached to her collar in the opposite direction to the cone and so when she scratched the lumps she was scratching the fabric cape. When the lumps spread I made a slightly longer version. We are now in the horrible situation of knowing that we can’t carry on for much longer as the lesions are spreading and are foul smelling which is upsetting her. What a horrible coindition this illness is.

          • Doc says:

            Hello, Anita,
            Thank you for sharing your story. I wish that I had some way to make things easier. Best wishes.

    • Barbara says:

      I am not sure what to do ,I love my baby with all of my heart found her when she was a couple days old she didn’t know how
      To eat was flea infested starting taken her every year to the vets for her check up only this year was a lot different after the exam the doctor say everything was good but then about a week after her visit she started coughing so I took her back and then I was told that she needed 3 teeth pulled I said OK do it because I also notice that she was Pawling at her face and thought it was her teeth well did I get a big surprise was told she has mouth cancer . Not sure she is suffering because she still is eating and playing some i I also noticed her eyes look different like they are glass and just noticed that yesterday is it possible that my cat will get over this

      • Doc says:

        Hello, Barbara,
        I wish that I could offer you some encouragement, but cancers in the mouth are extremely difficult to deal with. Lower jaws can be amputated if the tumor isn’t too far back. When it’s in the upper jaw or facial area, we rarely have success, even with an oncologist, board-certified surgeon, radiation therapy and the whole nine yards. Facial/mouth cancers are bad news.

        You will probably need pain meds pretty soon, and there are very few that cats can tolerate. Opioids are good, especially buprenorphine, but it is expensive. Cats can’t tolerate Tylenol or most NSAIDs (like ibuprofen).

        You should consult your veterinarian about pain management options.

  6. Janie says:

    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.

  7. Doc says:

    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.

    • Janet says:

      I have a 12 yr old kitty with mega colon. Medically managed with lactalose, cisapride, miralax, best food I can find, 10 visits since November, traumatic enemas that never helped much last 4 years. She has a little neuro tic, never been too playful since a baby. Considering total cholecystectomy but my gut is torn. All bloodwork showed well except an enlarged heart which cardiologist said no need for meds yet, heart and lungs clear few days ago. I just learned that the cisspride can cause heart probs, 5 vets and no one ever mentioned that. Last vet can do the surgery but has never gone one before. Board certified wants 6/7000. This one 3000. I’m afraid it won’t be done right and she is suffering and feeling like euthanasia is the more compassionate choice. I’m still back and forth with it though. She can’t be in this state more than a few more days. It is killing me and my heart is breaking into a million pieces ????

      • Doc says:

        Hello, Janet,

        As far as I can determine, the adverse heart effects of cisapride were noted in people, not animals. It is certainly possible that cats could have problems, but it isn’t listed as an adverse effect in the literature for cats.

        Megacolon is an awfully difficult problem. In looking at cases on Veterinary Information Network I find that some cats can still require medication and enemas, and some even require additional surgery down the line. There just aren’t any quick fixes.

      • AK says:

        Janet — I’m going through the same thing with my cat right now. He is 14 and has struggled with constipation his whole life, and after 6 years of progressive illness + ~8 hospitalizations involving traumatic enemas and a few deobstipation procedures, it has developed into megacolon. Each episode is becoming more severe for him, with less time in between, and longer recovery. I don’t want him to go through this again (most recent episode was in July) so (I think) I’ve decided to euthanize him in the next month or so, so that he hopefully doesn’t have to experience another painful and traumatizing flareup or go through an expensive surgery with difficult recovery. It’s been an absolutely agonizing decision to come to, and I don’t think I’ll ever feel 100% sure about it, but I do believe for him it’s the more compassionate choice today. It’s such an awful illness to manage + choice to make in the end, as they can have good quality of life between episodes. I hope the outcome of all this is ok for you, whether you decided to go with surgery or euthanasia — but I can really relate to your experience and seeing your post helped me see that (unfortunately) I’m not alone in struggling with this particular problem. Best of luck and sending lots of empathy in your direction.

  8. Katie says:

    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?

  9. Doc says:

    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.

    • Jen says:

      Thank you so much for this thread. We are making the very difficult decision to let go of our 15 year old boy Frank. He was the first cat my husband and I had together. He has been diagnosed with diabetes and is resistant to treatment and diet. He is wasting away, drinking a lot, eating little, and always in the cat box. His back legs are weak and he has been urinating in himself. He has stopped grooming completely. He still looks at us with love, but he just doesn’t seem to have good life anymore.

      I appreciate everyone else’s stories here so much. It helps us. We don’t want him to get to a point he has a seizure or starves to death slowly.

      Thanks for sharing everyone.
      J

  10. Su Jackon Ross says:

    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.

  11. Doc says:

    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.

  12. Marie says:

    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.

  13. Doc says:

    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.

  14. Pam says:

    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.

  15. Doc says:

    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.

  16. Robin says:

    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?

  17. Doc says:

    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.

  18. Carole Lewis says:

    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

  19. Doc says:

    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.

  20. K Hansen says:

    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.

  21. Doc says:

    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.

  22. Terry says:

    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.

  23. Tanya Manning says:

    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

  24. Doc says:

    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.

  25. Tanya Manning says:

    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

  26. Kris Daugherty says:

    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

    • Tami (cat rescuer) says:

      Please don’t put your cat down because he doesn’t use the litter box .. you cannot euthanize a healthy cat. Give him up to a rescue or someone else who will put their time in him. How could anyone do this to a poor cat because they pee on the floor?!?!

      • Doc says:

        Hello, Tami,
        I know that cats are often relinquished due to elimination problems, but we don’t euthanize on that basis.

  27. Doc says:

    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.

  28. Doc says:

    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.

  29. Anne says:

    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.

  30. Doc says:

    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.

  31. Denise says:

    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

  32. Doc says:

    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.

    • Sharryn Peterson says:

      I don’t know what to do.
      I have a 10 1/2 year old cat (guessing as I don’t know how old she was when I got her). I got her when I was 8 so she’s been with me for more than half my life. She’s always had problems going to the bathroom, and has always had a little blood in her urine.
      About 2 months ago she got Really sick. She was vomiting white foam, peeing more blood than urine, had diarrhea, wouldn’t really eat or drink and wouldn’t really get up and if she did, she seemed to be in pain. I was going to make a vet appointment on day 4 while I was at work but got a text (along with photos and videos) from my roommates that she was eating, drinking and moving around. We were all excited. That sickness hasn’t returned.

      Recently she has lost a ton of weight, is eating a lot but not gaining any of it back, scratching at her ears, not playing anymore and doesn’t want anyone to really touch her except me. I finally took her to the vet and she was diagnosed with ear mites, hyperthyroidism, and a small UTI.
      I have drops for the ear mites and it’s helping but I honestly can’t afford the medications for the hyperthyroidism or UTI. I have no income right now.
      I feel like she’s suffering in silence. She is not showing pain but isn’t like her old self.
      She doesn’t play anymore, she hates the other animals in the house now, she loves food but sometimes doesn’t want it even after begging for it, she is having more accidents outside the litter box and she seems overall unhappy.

      I don’t know what to do. I don’t have the money to help her but I don’t want it to seem that I’m putting her down out of convenance.

      • Doc says:

        Hello, Sharryn, I am sorry to be so late in replying, but our website was re-vamped and the blog comments went into limbo. This is such a difficult situation. Hyperthyroid cats require lifelong treatment, and it sounds like she is having other problems (some possibly secondary to the thyroid, some maybe unrelated). If there is no way to get her the intensive care that she needs, then letting her deteriorate and feeling worse and worse would certainly not be what you want. In that situation, euthanasia is an act of mercy, not convenience. You have to make the best decision that you can.

  33. Anne says:

    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.

  34. Christi says:

    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.”

  35. Doc says:

    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.

  36. A Miller says:

    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.

  37. Doc says:

    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.

  38. Carolyn says:

    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.

  39. Doc says:

    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.

  40. elle says:

    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

  41. Doc says:

    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.

  42. paty says:

    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.

  43. Doc says:

    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.

  44. Stephanie says:

    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. . .

    • amy says:

      I know this post is from 2011, but in case people read through the comments like I am in 2021 I wanted to suggest something.

      We had a similar issue of our cat peeing on soft things (clothing, bags, furniture) and I added a new litterbox using a cloth baby diaper. I kept her other box the same with same litter, and just added this as another option. She started exclusively using the diaper box. I would keep a bucket with bleach on the deck and when it was used, I’d drop diaper in to soak before washing in machine. For the poops I just picked up w/toilet paper and flushed in our toilet.

      Something changed that made her prefer cloth, so I just went with it. I’ve told this to 3 other friends who have had similar problems and it has worked for them.

  45. Doc says:

    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.

  46. Donna says:

    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.

  47. Vicky says:

    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.

  48. Doc says:

    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.

  49. Vicky says:

    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!!

  50. Vicky says:

    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!!

  51. Sheila McCormick says:

    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.

  52. Doc says:

    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.

  53. Kris says:

    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.

  54. Doc says:

    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.

  55. Karen Morris says:

    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..

  56. Doc says:

    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.

  57. Sperb says:

    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?

  58. Doc says:

    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.

  59. Sperb says:

    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.

  60. Doc says:

    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.

  61. Ben says:

    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.

  62. Doc says:

    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.

  63. Ben says:

    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.

  64. Giz says:

    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.

  65. Doc says:

    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.

  66. Lee Ann says:

    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.

  67. Doc says:

    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.

  68. Lee Ann says:

    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.

  69. Doc says:

    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.

  70. Lee Ann says:

    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

  71. Sue Winters says:

    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!

  72. Doc says:

    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.

  73. Sharon French Barre says:

    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.

  74. Doc says:

    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.

  75. Cubby says:

    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.

  76. Doc says:

    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.

  77. Mary says:

    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?

  78. Doc says:

    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.

  79. Mary says:

    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!

  80. Mary says:

    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.

  81. Doc says:

    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.

  82. Mary says:

    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!

    • Joan D MacNeil says:

      My 6 month old kitten was diagnosed with this too. I couldn’t believe he should have all his teeth extracted at that age. I went to another veterinary dentist about every 6 months and each time he extracted 5 or 6 decayed teeth. I finally realized I should just finish his extractions since he was almost there anyway and was told that these infected teeth were very painful. He was left with his 4 canine (fangs). My regular vet was right. The teeth extractions were what he needed. He lived to be 18 years old with no problems eating and no mouth problems.

      • Doc says:

        We don’t understand the mechanism behind resorptive lesions in dog and cat teeth (cats being much more commonly affected). I wish we had something better to offer than full mouth extractions, but at this point we don’t.

  83. MeowMeow says:

    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.

  84. Doc says:

    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.

  85. MeowMeow says:

    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.

  86. Rachel Cole says:

    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 🙁

  87. Doc says:

    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.

  88. Stephanie says:

    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.

  89. Jacqueline says:

    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

  90. Doc says:

    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.

  91. Doc says:

    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.

  92. Jacqueline says:

    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

  93. Mary Wilson says:

    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

  94. Doc says:

    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.

  95. Doc says:

    Hello, Mary,

    I am certainly not a dental specialist, and I can’t really prescribe your cat’s treatment without seeing it.

    The dental specialists tell me that the earlier one extracts the teeth, the better the chance for a good result. I have been told that 70 to 80% of cats with full mouth extractions have good results.

    The general track record is that repeated treatments with steroids and delaying the extractions make the long-term outcome less effective.

    The big thing about having a dental specialist do the full mouth tooth extraction is that they will be faster (less time under anesthesia), do the job with less trauma to the mouth, and be certain that all root fragments have been removed.

    A general practitioner could do this, but it would probably take two or three times as long under anesthesia. I would hate to attempt it myself.

    When your cat recovers from the oral surgery, he really won’t have a problem eating.

    I know this is a tough call. Good luck.

  96. Stephanie says:

    Thank you, Doc. I took Chloe to the vet last night and he wouldn’t even check her blood because she appeared so weak. She had eaten next to nothing over the previous 2 days and her drinking has slowed considerably. My vet said I should think about letting her go. He gave her some subQ fluids to help her be more comfortable. She slept all night, from the time we got home until this morning. This morning she became very sick and threw up several times. I have scheduled an in-home service for tomorrow afternoon so that she may pass in peace at home and with me.
    I’m so worried that she will be scared when the time comes. I don’t want her to be scared. Are cats scared of dying?

  97. Doc says:

    You ask me a hard question. It reminds me of when my mother lay dying of cancer. She said, “I’m not afraid of dying. I just don’t want to be in pain.”

    I suspect that cats feel the same way.

  98. LC says:

    Two days ago I had to say goodbye to my 15 year old domestic short-haired, Lizzard (she was originally “Elizabeth” but when we moved to Florida she developed a penchant for hunting and presenting me with small lizards that snuck in, so the name change suited her). She began to lose weight a couple of months ago and after the blood tests came back it looked like either IBD or intestinal lymphoma. She was on steroids/antibxs for three weeks but she just kept getting tinier: 4.75 pounds as of Tuesday. I was willing to try endoscopy/chemo but this just took her so fast. My biggest sense of guilt was that I didn’t bring her in sooner, but since she had always been a chunky cat, I attributed the weight loss to old age and the healthy benefits of chasing and keeping in line our Corigs. She was a wonderful, smart cool cat who kept me sane through some really tough times. On Tuesday the vet was wonderful, patient, and truthful. Fluid had filled her lungs and she was essentially drowning. Diuretics didn’t help. What was so hard was that she was still my girl: eating, purring, even rubbing up against my husband’s leg (although stumbling) while we waited to see if the diuretics would take effect. I did know it was time, and had known it was coming on some level, but it was the hardest thing to experience, especially for the first time. I held her and it was very fast, seemingly peaceful and painless. I’ve never posted anythig online before, but it has been tremendously helpful to read others’ experience. Bottom line, if you are reading or posting to this site, you love your friend very much and are struggling with wanting what is right for him/her. From what I’ve read, no one should doubt themselves; release the guilt, be glad you were there (and I do recommend you be there if you can bear it), and take comfort in the fact that you provided a good life for your friend. I know mine forgave me much: a litter box not cleaned often enough, leaving her on vacation, the endless “battle of the medication.” But she loved me unconditionally and I am so happy I gave her extra attention in these past weeks. I will miss sleeping on the couch (husband slightly allergic) if for no other reason than to wake up with her purring on my hip. She was also the only one who would watch Battlestar Gallactica and Walking Dead with me! Good bye, my friend.

  99. Mike says:

    I just wanted to say thanks for having this blog available as a resource for the many people (obviously) who are struggling with this difficult decision. I adopted my cat Jack as a stray in Jan. 2000, and the vet at that time estimated his age at 3 years, which would make him 15 years old today. He is a beautiful animal, strong and sleek, very handsome, outgoing, and playful. Everyone who meets him likes him. Over the past six months he has become progressively sicker, losing weight, trouble using the litter box, trouble using his back legs, etc. Reading all these previous posts has been really helpful, as I recognize so many of Jack’s symptoms described. But most of all, the idea of “more good days or bad” as a way to decide when. I love Jack and he sleeps next to me every night, but he’s so thin and frail that I’m afraid now I might literally crush him if I roll over too far. I wish I could help him. I do heat food for him about ten times every day, as he seems better able to manage a soft warm paste, but even this way he can hardly eat half a small can every day. I am pretty sure that I will take him to the vet’s in the next day or two. Many of the comments here (especially Doc’s) have been extraordinarily helpful. Thanks again.

  100. Doc says:

    Hello, Mike,

    This is always a difficult time. There is no such thing as an easy decision in these matters. We just have to do the best we can.

    Best wishes.

  101. Kellie says:

    My husband and I just adopted two kittens (sisters). We love them and adore them, but were concerned for one who became very suddenly withdrawn and frail. The vet did a lot of bloodwork and determined she has fatal FIP. She is only ten months old. We are devastated and tortured-we know that soon she will lose her appetite completely and we will have to put her to sleep but we can’t seem to bring ourselves to make the decision. We keep hoping for a miracle. We told ourselves as long as she was eating we would nurse her at home, but she is clearly miserable. She hides all day, I think she is losing her sight and her eyes are cloudy, she winces when we hold her because her fever makes her feel bad…but she’s just a kitten. I feel like we’re killing her by putting her to sleep. I know we don’t have much time, but it’s so hard trying to feel 100% confident we’re doing the right thing putting her to sleep.

  102. Doc says:

    Hello, Kellie,

    What a heart-breaking situation.

    I would not wish this on anyone.

    Soon it will become a question not of living longer, but of dying more slowly. Then you will make the right decision, as hard as it will be.

    Best wishes.

  103. Roxanne says:

    I am extremely thankful for this website. My 12 1/2 year old cat Riggs has been diagnosed with Oral Cancer. We noticed that she was licking her lips a lot, and her breath became quite awful. We took her to the vet, who originally treated with antibiotics for an abscessed tooth. Once the treatment was done we noticed that her upper jaw still remained swollen and her eye was weepy. The next vet visit they discovered a large tumor that had ulcerated. We have treated with more antibiotics, and she seemed to be happy. However, less than 6 days after the last course of treatment the infection is back, and seems to be worse. She is still eating and drinking and is not hiding yet. We have noticed that she seems to be less excited than normal. We have scheduled her in to be “put to sleep” on Friday morning. It has been the hardest decision I have had to make, but after reading the comments above I feel more sure about it. I don’t think she is suffering yet, but I don’t want her to get to that point. She was diagnosed on March 29, and we can already see that it has progressed. I emphathize and thank everyone for their previous posts, as it has helped me come to terms with my decision.

    Thank You
    Roxanne

  104. Doc says:

    Hello, Roxanne,

    These are such tough times. We hate to give them up, but hate more to see them suffer. It would be nice if we didn’t have the responsibility to make the decision, but we do have it.

    It is obvious that you have given much careful thought to this.

    You are doing the right thing.

    Best wishes.

  105. LB says:

    I have a sweet 3 yr old male cat with vestibular disease. It is permanent and though he is relatively healthy, life for the rest of the household is miserable.
    He obsessively licks and chews himself, he sprays all over (yes fixed), eats a LOT, but doesn’t gain weight. He has a clean bill of health. He attacks the other two cats, again sprays all over, often gets caught in a ‘loop’ of walking in circles and so on. He has been like this for a solid year, I recently had to move back with mom b/c she had a stroke and he just ads to the stress of it all. Every single day I want to have him euthanized,not because I hate him, but because it is so frustrating and time consuming to manage him. I love the little dude, but I’m losing it and trying handle everything else. I need advice.

  106. Doc says:

    Hello, LB,

    This is a long way from what I would consider “convenience euthanasia”.

    The cat obviously cannot survive without lots of care, and it doesn’t sound like he is going to get any better.

    It would certainly be a hard sell to advertise him for a new home – lots of deal-breakers for most folks.

    Sometimes people will surprise you, though. Our local animal control officer has a Facebook page with about 3,000 friends and she finds homes for some animals that I didn’t consider very adoptable.

    I’m not sure where you’d get the word out to find someone who wants to be a full-time nurse for this cat.

    To me, it sounds like the cat’s quality of life is not all that great, and your quality of life isn’t either.

    I do not think that there are many veterinarians who would criticize you on the day that you just can’t deal with it anymore. If they do, then they must have a home for the cat.

    Sometimes you just have to do what you have to do.

    Best wishes.

  107. Barbara Jenkins says:

    I have been reading the posts and feel a little more comforted about our decision to have our 16 year old cat Freddy put to sleep tomorrow. He has had diabetes and has been in renal failure for several months. We give him sub q fluids daily and have many varieties of uneaten, opened cans of food in the fridge. He is not taking food now- not even cheese and tuna,and he’s not drinking either. I hoped he would pass peacefully – naturally at home, but unless that happens tonight, our wonderful vet is going to come to our house tomorrow. We are going to take off from work and bury our sweet boy in the yard next to his brother and sister whom we lost 1 year and a half ago. He’s been such an awesome cat and my heart is broken. Peace to all of you who are going through this also. I still feel guilty anyway, like there’s some food or medicine out there I haven’t tried.

  108. Doc says:

    Hello, Barbara,

    I know how difficult it is to make this decision. It’s hard not to feel guilty, even when you know both intellectually and in your heart that you have done everything possible.

    His spirit will leave the worn-out body behind and start the adventure again somewhere else.

    Best wishes.

  109. rita says:

    My micro had a urethrostomy to remove a stone blocking his urethra. On fray he also.had two stones and bad kidney blood work; creatnine over ten, bun I think at 130, and dilute urine. His wbc were 23000 after surgery, and surgery did not decrease his kidney values. Phosphorous and potassium also high. All non kidney values seem normal. Kidney values All the same two days after. His urine volume is low and he will not eat. He got an iv and antibiotics but is clealry depressed eventhough he accepts pets and purrs. Hes just spent. On his x ray after surgery looks like he may have fluid in abdomen. His kidneys look bumpy on x ray. Doc says additional tests like ultrasound and kidney biopsy will cost thousands and maybe not lead to a better prognosis or treatment values given his kidney numbers. I don’t want to.lose him but I think I have to.euthanize. I cant care for him at home. Hes nine years old and beautiful. I’m devastated. This happened over three days.

  110. Veronica says:

    I have a 19/20 yr old cat named Lilo. In December of 2011 they removed a tumor the size of a dime from his jaw. The vet stated it probably was squamous cell carcinoma. I did not have it tested due to various reasons. He is walking around with an open wound that he swats at with his hind legs. It is messy but I do not care because I love him. It is now June 2012 the tumors all came back with a vengeance. Lilo has lost a lot of weight, hides out, doesn’t sleep, is not eating or drinking normally. He is in what i can tell alot of pain. He recently started tearing out the fur on his front paws. Today is his last day and I am relieved he will no longer be in pain. He was the best cat anyone could ever want. After reading various posts I know I am making the right decision and do not feel anymore guilt.

  111. Doc says:

    Hello, Rita,

    The kidneys can really suffer from being shut down for a period of time (blockage) or from even a short period of poor blood supply (like a patient in shock after trauma).

    Other than continued high doses of intravenous fluids, I don’t know of much else to support a cat in this situation. The high doses of fluids help to flush the wastes if the kidneys have any capacity to recover.

    There can certainly be a point where we find that the best we can do just won’t bring those kidneys back.

    When you realize you have reached that point, then euthanasia is the kindest thing you can do.

    Best wishes.

  112. Doc says:

    Hello, Veronica,

    This is always a very difficult time. It sounds like you have made the right choice.

    I am sorry for your loss.

  113. rita says:

    Thank you doctor. Today my vet put in a catheter because he thought that his bladder might be temporarily flaccid from being distended. Now.a lot.of urine is passing and hes actually eating and more alert seems in less pain. We are checking his kidney values again tomorrow. I will let you know the outcome.

  114. Betsy Riedel says:

    I think today is the day to let my wonderful 18+year old kitty go over the Rainbow Bridge. Just reading all these posts (and watching her this morning)has made the difficult decision easier (although I know this has been coming for several weeks now).Harriet has been diabetic for years (well controlled) and then went into remission a few months ago. She is also hyperthyroid and in the last few months developed a large tumor under her tongue. Lyphome is also a possibility. Reading all of these posts this morning(as well as watching her today refusing food and water) has made my decision and sadly, I will be calling the vet this morning as soon as they open. I am so thankful t have found this site.

  115. Ericka says:

    Halfway thru these posts I received the call from my vet I wasn’t wanting to get. My baby is 15 and he’s dying from a nasal tumor. I don’t want to lose him. But I’ve been doing research on how to make the decision which led me to this site. Thank you for the advice. I can see that his lethargy, meowing when I pet him, staring at me, etc.. .instead of his normal purrs and loves and activities are all ways of saying he’s ready.

  116. rita says:

    Hi doc im updating about my cat mico’s urethra blockage /kidney dysfunction. His lab results after five days of intense diuresis were the not improved. Bun at 240 creatnine over ten. I was told his prognosis was grave. He still wouldn’t stand or eat much. I decided to euthanize him. I couldn’t bear to watch him suffer at home and I could no longer afford his hospitalization costs. He died in my arms yesterday. He was beautiful and sweet. I’m devastated.

  117. Doc says:

    Hello, Rita,

    You did the right thing, but I know that is small consolation, and you will miss him a lot.

    I am sorry for your loss.

  118. rebecca says:

    My jasmine is 21 years old. She no longer cleans herself so her hair is very matted and refuses to let me brush her or try to cut out the mats. I have to clip her claws or they grow into her pads. She will no longer let me do that either. She no longer uses the litter box and pees and poops on herself. I had to give her a bath to clean the poo off of her last week and she has hid under my daughters bed since. She has came out to eat recently but she makes a weird noise when she eats. Her back legs are weak and she does not walk any farther than she has to. I can’t keep her clean and don’t know what else to do for her. My husband says its just old age but I don’t want her to suffer. Taking her to the vet will put alot of stress on her and I am afraid I know what they will tell me. I don’t want to put her through anymore then she needs to be put through.

  119. Doc says:

    Hello, Rebecca,

    “Just old age” – old age is not a disease. You are a lot more likely to have a lot of diseases when you get old. For instance, kidney failure, arthritis, heart trouble, cancer, etc. However, not every old patient gets all of those, so they are not “just getting old”.

    Cats don’t tolerate many of the medicines we use to treat arthritis in other species. I suspect that Jasmine is having a lot of problems with this from your description.

    Sometimes moving the litterbox to a more accessible location, and using a shallower pan that is easier to get in and out of helps. Of course, it needs to be kept scrupulously clean or the cat won’t use it.

    It sounds like your cat really is in a lot of discomfort. While she cannot be made young again, it is certainly possible that a veterinarian can help her to have a more comfortable life.

    I would look for a doctor with a special interest in cats.

    Twenty-one is a phenomenal age, so I wouldn’t expect miracles. Still, it is possible that quality of life could be improved.

    If not, I certainly would not feel guilty about making the decision to let her die with dignity, rather than deteriorating gradually.

    Best wishes.

  120. Cindy says:

    Dear Doc

    Last week we had to make that heartbreaking decision. In January my Sylvester was diagnosed with the start of Renal Failure. We had him treated and gave him the correct foods. For a while he really did well, but the vet told us that we would be back with the Renal failure within a month year or so. Well it went relatively well. Although he did not always want to eat. Then all of a sudden things changed last week. He would just jerk and run and hide from us in a corner or under a cupboard although he let us touch him. But when we took him to the vet he said for some reason he was hurting – his back legs. So he gave him an anti inflammatory and asked us to come back 2 days later. Sylvester just hardly moved after that staying in his bed now not hiding but hardly eating or drinking and when he got up he would half walk half drag his back legs. They did a blood test on him after the 2 days and told us he was in CRF with his creatine levels being so high they could not be read. They also said that they could treat him again but he could not be put on any pain medicine because of his liver. It broke our hearts to have him put to sleep but I it also broke my heart to see him in pain. He was such a treasured companion. I still hope we did the right thing because I would give anything to have him with us still but could not bear to have him suffer either.

  121. Doc says:

    Hello, Cindy,

    Sometimes the best decision we can make is simply to take the “best” from among some hard choices (none of which are what we want to do).

    It sounds to me like there was nothing else you could have done.

    I am sorry for your loss.

  122. Cindy says:

    Your words are so kind. I just keep on replaying the situation in my head and keep on thinking did we do it too soon should we have given it another try. But I never wanted to look back and feel I should have done it earlier. Right now the loss seems unbearable I do hope that in time I will be able to see some light through the clouds. I also just want to thank you so much for your wonderful blog. The time and effort you give to each one of us is very much appreciated.

    A big thank you.

  123. Doc says:

    Hello, Cindy,

    You’re very welcome, and thanks for your kind words. It’s not wrong to grieve, but we need to concentrate on how many good times we had.

    You did the right thing.

  124. Vicky says:

    Hi, so I hope no one hates me for asking the by we are so lost on what to do. My mother just lost her house of 25 years and must be out in 2 weeks. She had 6 cats and a large dog. All rescues! We have been rescuing animals all of our lives. My mother has no means and will have to move across country to live in my sisters basement. My sister who already has a dog and is getting married next month agreed to take in my mother, brother the dog and two cats. We have found homes for 3 cats and are left with a very unthinkable decision being left with one very sweet cat that is 1 year old and two 15 year old cats. The 6th cat is my brothers and will be going no matter what. One of the 15 year old cats is in a very sad state and we have just spent the last couple years trying to keep her life comfortable and we know that now it is time to make the decision we knew needed making for a couple years but the other 15 year old cat still has his youthful look about him but does urinate blood and vomits after eating everyday now. He is a cat that would not do well in a rescue facility. He has lived afraid for his life since he was a kitten and watch 4 of his siblings eaten by a pack of dogs. To save his life he mAde his way to the roof of a 2 story house and then stayed up there with no food or water for 3 days until I climbed on the very scary roof to get him down. The one time we went to transport him he went to’s insane the cage that he broke out and disappeared for 6 months. My mom sat outside calling his name everyday and even for a while thought another cat was him and she kept stealing him from the neighbor wondering why he kept escaping. Then one day my mom sat outside for 10 hours just calling him and a unrecognizable immaciated cat fully visible ribcage finally came out of the bushes to her.It was him!! He won’t go near an open door since!! So this cat would not do well at a rescue center and we honestly don’t know that he would survive a flight from Miami to Seattle and we have to decide if the younger cat who adores my mom gets to go with my mom on the move or she gets sent to a shelter and my mom takes the older cat who’s only other option is euthanasia. We are positive he rather die then be placed in a cage. The is no question to us. Is it unethical to euthanize a 15 year old cat to save the life of the younger cat. If he were to be in the decrepit condition of his sister it would be an easy decision in a situation like this. I called no kill centers by the way and no one had room for either one of the cats. My daughters have had to live with their dad because I have no where to go myself otherwise I would have taken both of the older cats and cared for them.

  125. Doc says:

    Hello, Vicky,

    This is such a difficult situation, with no obvious happy solution.

    Sometimes the best choice we can make is not an easy one.

    If there is absolutely no alternative, and only one cat can receive a new home, then it seems logical to choose the younger cat. Logic doesn’t always make a difference in the way we feel.

    You have obviously wrestled long and hard with this. I can only say that anyone who disagrees with whatever choice you make should be prepared to offer you a better alternative.

    You just have to make the best choice that you can, knowing that it is impossible to be perfect.

  126. Raina says:

    I have a 10 y/o female cat, Snickers. She appears to be very uncomfortable in her mid-back. She still eats and loves us. She cannot groom the back half of her body and smells like urine most of the time. She can get on the couch arm with difficulty. She used to sleep with my daughter, not anymore. I have tried meds, on the assumption of OA of the spine. It is just so awfully traumatic for her. I don’t know if it is “time”. Can you give me some direction?

  127. Doc says:

    Hello, Raina,

    You do not mention what medications you have tried. It certainly sounds like this could be an arthritis problem.

    We are much more limited with medicine choices for this in cats than we are with dogs. There are so few medicines that they tolerate in the pain-killing class.

    If she is still having good days in many ways, then I would speak with your veterinarian about ways to support her.

    If she never has good days, then you have to consider euthanasia.

  128. Shannon says:

    All of the stories shared are so unbelievably sad and comforting at the same time. I’ve had my kitty cat since college… 14 years later, after having lived a completely healthy life with not a single issue, she was diagnosed with diabetes. She has an insatiable thirst, lack of appetite and obviously resulted in weight loss. I just found out that my girl has intestinal lymphoma. I’m just so sad! We all don’t want to be selfish for ourselves to get more time with our ‘family member’… But when are we supposed to call uncle??! I’ve seen the “4 good days n three bad”… What does bad mean? My biggest fear is that when it comes down to euthenizing, she’s not going get it… I just feel sick to my stomach. We drag humans thru treatments, probing, and other halacious practices til the bitter end… So at the end of the day, what’s the real difference???

  129. Victoria says:

    Our 14 year old cat has recently been diagnosed with congestive heart failure which was discovered after an attack of pulmonary edema. The x-rays showed that there is also a mass which is considered to be either an abscess or a tumor. My cat also has a heart murmur and arrhythmea. Her blood pressure at her last vet appointment was 220. She is showing signs of restlessness but she is still eating, drinking, visiting and purring. She has always been a nervous/scared cat but after her recent hyperthyroid treatment she became more relaxed. She is less relaxed now and has lost a little bit of weight. It is extremely difficult to give her medication – she won’t allow us to pill her, she won’t eat the pill pockets, we’ve had some success with transdermal ear gel, she is hating us for trying to administer her current medication with an oral syringe. We don’t want her to die in pain. We want her to pass with dignity and peace. We just don’t know if it is the right time/thing to do. What do you think?

  130. Doc says:

    Hello, Shannon,

    Good days are when your cat is doing the things she used to like to do. Bad days are when she is just “existing”, doing none of the things that she likes (or worse, being in obvious distress or pain).

    We do drag some humans through treatment. Others make the “living will” telling their family where they want them to draw the line.

    When we know that we have illnesses that won’t get better, and the pet is getting thinner every day, and you have problems you can’t control (like vomiting that you can’t stop), you have to look at making the decision.

    Are you living longer, or just dying slowly?

  131. Doc says:

    Hello, Victoria,
    It sounds like your cat has a good quality of life right now. If you cannot medicate her, it will probably deteriorate pretty fast.

    One other thing to try would be compounded oral medication. They can put almost anything in any flavor. Of course, if you’re using trans-dermal, you’ve probably already thought of that.

    At some point the stress of trying to medicate will outweigh the benefits. Unfortunately, when that happens, the CHF will get decompensated in a hurry.

    The next time she has an episode of pulmonary edema, you will have to confront where you go from there after she gets out of the hospital. That may be the “time”.

  132. Magic's Mom says:

    I have been struggling with deciding when it is time to euthanize my 19 year old cat. He was my best friend’s cat’s kitten, so I’ve known him since the day he was born. It appears that he suffers from IBD, and we’ve had him on a steroid for years. He’s gotten skinnier and looks stiff when he walks. For the last year or more he’s become more vocal at night, we discovered that he has thyroid problems and are now treating him for that as well. But despite medicine and trying fiber supplements and A variety of different foods recommended by our vet, he still has a very difficult time defecating and cries every time he has to do so. He always urinates in his litter box, but wot defecate in there anymore. He only stays in our bedroom and has lost all interest in playing or exploring. I often find that he has defecated on our bed and is sleeping on his own poop. He has difficulty jumping, so we put steps up to our bed to help him be more comfortable, but he seems to have lost his balance and will sometimes lose his footing and fall off the steps to the bed or will sometimes fall off the bed when trying to walk upto my head to snuggle (a big difference from the sure footed cat that used to make amazing jumps to our skylights). He sleeps all day and only seems happy when I am petting him while he is on the bed. He still occasionally grooms himself, but I am constantly getting rid of mats of hair now. Like many of the other posters, I have a hard time telling good days from bad because they are all the same, sleep all day, cry several times during the night, and then snuggle time first thing in the morning (our happy time). I am gettig married and my fiancé would like Magic to sleep in another room, since his night time crying often interferes with our sleep – for example I am writing this at four am since magic woke me upnat three and has cried itermittenly since. I don’t want to Put him in another room though, because sleeping with us is the only thing Magic seems to enjoy. I am going on my honeymoon at the end of the month and have made an appointment to board him at his vets office because I am afraid he will not do well at the house without me, and someone would have to be here twice a day to give him his meds. But I’m also terrified that if I board him for two weeks that it might be the last straw to his health and I don’t want him to sPend that time in a cage.

  133. Doc says:

    Hello, Magic’s Mom,

    This is a super tough situation, and I don’t envy you the decision.

    It is certainly true that he is unlikely to enjoy time in a cage. If he stayed at home, he wouldn’t get his meds, and would deteriorate rapidly.

    It sounds like Magic’s time is growing short. He really is approaching hospice care. You tell me that the only thing he really enjoys is a brief snuggle time each day. The rest of the time, he cannot do the things he used to and feels pretty bad.

    What would he say if he had a living will?

    With the timing of the honeymoon trip, I am sure you are thinking of “how it will look” if you make the decision now. At this point in Magic’s life, I do not think that anyone could consider this a “convenience euthanasia” if you were to make the choice now.

    What would he say if he had a living will?

  134. Alexandra MacKay says:

    Hi Doc,
    My sweet kitty (maybe 4-6 yrs old) had a hard life. His mom was a cat lady who died 2.5 yrs ago leaving him and about 20 others homeless. My neighbor and I fed them and got homes for most but he was super scared and swatty so he was last on the list. I wooed him and won him 1.5 years ago. We kept him b/c he was diagnosed with heartworms and therefore was not adoptable. He really thrived though. He’s beautiful and super sweet though still scared of everyone except for me and my husband. I had hoped we had cured the heartworm with love and good food.

    But 10 days ago I realized he was (and had been) breathing fast – about 68/min. We went to the emergency vet who diagnosed pleural effusion. Turns out to be chylothorax and lymphosarcoma.

    He weighs 9 lbs and is on 5 mg of Prednisone a day. He did breathe better (50/min) after the thoracocentesis but he’s still not his usual self. He’s hungry but doesn’t finish his food. He still runs some times but mostly looks like he can’t get comfortable. He does eventually put his head down, even rolls onto his back but also moans or chirps when trying to sleep. I’m not sure if that means he’s uncomfortable.

    Nights are the roughest but in the morning he’s hungry and wants to be outside.

    My question is: when is it time to do another thoracocentesis? I don’t expect him to survive his heartworm and sarcoma but he doesn’t seem ready to go yet. I know he might breathe better after a lung tap but there are risks to it (puncture and scar tissue) along with dragging him in the carrier to the vet. He’s breathing 50-60 times a minute but is restless. Does the sarcoma cause pain?

    Thank you!!

  135. Alexandra MacKay says:

    Update: Yesterday started good: ate breakfast and jumped onto the counter (energetic!) but breathing was more labored and became faster – 80/min. I got home from work to find he couldn’t/wouldn’t eat and was posturing with “elbows” back to help himself breathe. We quickly got the vet who pulled out another 90cc but serous, not chylous fluid. What’s up with that?
    BobbyJoe kitty had instant relief. Came home and ate a bit and slept and dreamt.

    We were hoping for more of an improvement though. He’ll eat a little if I coax him to but still not able to relax and not very active. He’s got a different look in his eyes. Not “help me” as much as “I’m sick of this.” Amazing how communicative they can be.

    Today has to be the day to take the upper hand with this. We were hoping this would give him more good days but this isn’t so good. Poor sweet kitty. This shouldn’t happen to anyone and it happens to so many. So sad that most are homeless without people to try to relieve their pain and suffering.

    Blessings,

  136. Doc says:

    Hello, Alexandra,

    Sorry to be so late in replying, but I’ve been out of email range for about 10 days.

    You are faced with the inevitable loss of your friend, and it is hard thing to face.

    It sounds to me like you are confronting this head on and will do the right thing, even if it’s not the easy thing.

    Thanks for reading and writing.

  137. Judy Long says:

    I too am struggling with all the care required by by my 14 old cat, and will have to make the hard decision fairly soon. One thing I’ve noticed on this site is that arthritis has been mentioned several times, which my cat also suffers from.

    I was using the glucosomine capsules that you sprinkle over food with limited results. But I kept searching online and found that there’s an injectible form of glucosomine that was originally developed for horses, now has a dog formulation, and has been used off-label in cats. (The brand name is Adequan, although my vet has a compounding pharmacy prepare a generic version at a reduced cost.) What a difference it has made in my kitty!

    The main thing is to make sure the “loading dose” is completed, which is two injections a week for four weeks. Then it’s one injection from then on every two to four weeks. My vet did the first injection, and showed me how, so I do them at home. It’s easy and no problem. The dose is calculated based on the cat’s weight.

    Apparently lots of people (and vets) don’t think about treating arthritis in cats. Maybe since cats aren’t taken for walks it doesn’t occur to people. Also, a couple of vets have told me that people will spend more money on a dog than a cat. Adequan / glucosomine injections aren’t cheap, but I’m so glad I’m using them.

    My cat stretches out again, and climbs more. It’s a subtle decline, but once it got better, I felt bad about how long it had gone unnoticed and untreated by me.

    If your cat suffers with arthritis, I can’t recommend it enough. I’m only sorry it’s not approved for human use, as my old knees would like it!

  138. Doc says:

    Hello, Judy,

    Adequan is not exactly injectable glucosamine, but it is a great product, and for some patients it does indeed seem like a miracle. Unfortunately, some patients don’t seem to respond to it at all, and then there are those “in the middle”. It is well worth trying, as it has no side effects.

    Thanks for reading and writing.

  139. 6 four legged kids says:

    I’m struggling horribly here. My 14 yo f/s I guess has a mental issue, has had box issues for a really really long time. Sadly it took me a long time to put 2&2 together. I’ve work closely with my vet trying EVERTHING at one point I had 7 boxes set up for my then 3 cats. When we lost “alfa” cat to tumor I hoped it would get better, it did not. For awhile she lived outside in a very secure yard with shelter out of complete frustration. When we lost our third cat making her now the only one I decided to try again to no avail. In a last attempt for her to have a good life indoors started with her confined to an extra room with 2 boxes set up ended up having to block access to bed because she was pooping on and under it. A little over a month ago I started her on Prozac, she gets “day passes” after I close all bedroom and bathroom doors then back to her room for bed. There has been some improvement but it’s still hit and miss, with just yesterday a pee and poop accident it seem like it is always going to be this way. I am emotionally and physically getting really burned out, I also have a dog with progressing dementia so I have more than 1 hard decision looming, both HATE taking pills so I am getting bit my 2 animals a day. This issue makes the quality questions so much more difficult. I’m really struggling with if and when.

  140. 6 fourlegged kids says:

    I should add she has minor arthritis can’t jump more than a few feet. Last blood test she was borderline diabetic I don’t think it has progressed however she does pee and drink a lot but that hadn’t started since blood work.

  141. Doc says:

    Hello, 6 fourlegged kids,

    Of course you are struggling. This is a super-difficult situation.

    Your cat is having a dismal quality of life and so are you. Despite your best efforts and tons of hard work, things are getting worse instead of better.

    Yet, you can’t bear to think that you are going to do a “convenience euthanasia”.

    Of course you are struggling. No matter which alternative you choose, it stinks. You either have to make a decision to give it up and let this cat try again in the next life, or continue the misery for both of you.

    Of course you are struggling.

    I wish I had an easy answer for you, and there isn’t one.

    I will say this. If you come to the point of euthanizing your cat, I do not think anyone is entitled to criticize you. You have already gone the extra mile (and then some), and they had better have a constructive alternative instead of just a criticism.

  142. 6 fourlegged kids says:

    Thank you. I’d also like to thank everyone visiting here for having compassion that we are all here because we desperately love our pets and are in our own really crappy boat haven’t seen any unnecessary criticism.

  143. Megan says:

    I am wrestling with the “convenience” issue. We have considered euthanizing our 15 year-old cat for many years. He came to us at age 6 with IBD which made him vomit all over the house (on the bed, on the couch, wherever my husband stepped that the morning). I got that under control through raw feeding (although it took a year to transition him – stubborn) and nutraceuticals. But just as we put down his “sister” who had been suffering from CRI for several years, Bailey developed it, too. That was 4 years ago. I swore I would not spend another 2 years getting and administering sub-q fluids. So he drinks about 10 oz. of water a day, pees it out so we have to change the kitty box every 3 days (there’s still pine sawdust everywhere), and yowls at his water bowl, and also to wake us up for his breakfast and for reasons unknown in the middle of the night. He still vomits food occasionally, but very often will vomit a lot of liquid and hair as he’s never been able to compact the hair he licks off himself into “balls.” He eats well and is maintaining his weight, but he seems mostly interested in getting us to feed him (and often, like a kitten). In the last year, he stopped coming to sleep on the bed or sitting with us at night in front of the TV. In the last week, he has begun to do so again. But he doesn’t really play and tends to sleep most of the time. He is relentless in bugging me for food, meowing, trying to jump on my lap (he’s always been a klutz), massaging me. He won’t stop until I feed him. And he only wants a little, then new food from the bag, and on and on. But once he’s full, he’s off to sleep on a chair under the dining room table. I thought he would have deteriorated long ago, as it has been over 2 years that his kidney values have been very high. He is dehydrated, but his weight is steady and about the same as it was before the CRI diagnosis. I know this disease does not have a good end, although it appears not to be painful. I guess I am just looking for confirmation that it is okay for me to put him to sleep while before he is completely debilitated. I have done all I could in the last 9 years to try and get (and keep) this cat healthy, even though it has been required a lot of patience (something I don’t have in abundance) and no small amount of work. I don’t know what his quality of life is, whether that yowling has any pain involved, or if he is going through the motions with little joy left in his life. I know it is impacting the quality of my life and that impacts his. How long can he go on this way?

  144. Doc says:

    Hello, Megan,

    If you’ve been dealing with this for nine years, I don’t see how somebody could say you would be making a “convenience euthanasia”. That would have to have taken place several years ago.

    How long could he go on like this? With most people, we wouldn’t be asking this question, as he would be long gone already. With your dedicated nursing care, he could survive for months.

    The question that is so hard to answer is whether “survival” is “living”. You know him best, and are the best judge of how he is feeling.

    Should you wait until he is so debilitated and weak that he is suffering constantly? I don’t think so. The decision may seem more obvious then, but it won’t be easier for either of you to do that.

    It gets down to the good-day, bad-day thing. You just have to make the best decision that you can.

    Thanks for reading and writing.

  145. Megan says:

    Thank you for this. I have been feeling so guilty about considering this seriously, but it’s been such a long time continually nursing this cat. He is endlessly demanding and I really think I’ve reached the end of my rope. He seems as normal as he’s been since his kidneys started to go, but he’s always been a sick cat so it’s hard to have a frame of reference. I keep questioning how long I want to keep this up. Every time I get 6 months worth of raw food for him, I think that this will be the last batch. But this has happened 3 times now and he keeps going on. I don’t think I want to spend another year this way, and I know he’s lonely when we go away every other weekend even though neighbors come in 3 times a day to feed him. We’ll be gone for 3 1/2 weeks in September on vacation, and I’d rather not come home to an emaciated cat that needs to be put down. Of course, he might still be plugging along. The question I’m having a problem answering is whether another year of this drinking/peeing/demanding food/puking is worth it for both of us. Can I let myself off the hook for not wanting to do this anymore?

  146. Doc says:

    Hello, Megan,

    You’re the only person who can let yourself off the hook.

    All the rest of us would have to be able to offer you a superior alternative if we are going to argue with your choice.

    Best wishes.

  147. em says:

    This has been incredibly helpful; tomorrow we are going to euthanise our beloved 15yr old Gpuss. It’s breaking my heart but he has managed nearly extra years with us, since his first diagnosis of kidney failure, thanks to Benazipril. He’s now wobbly and tired, and today has started being incontinent where he lies, and although he still loves us, I see he’s ready to go. There are no more good days in his future, so we are making it a last good day with lots of cuddles.
    Thank you for this thread, there is so much moral support here.

  148. Doc says:

    Hello, Em,

    I am glad you are able to come to terms with this difficult decision.

    Thanks for reading and writing.

    Best wishes.

  149. Ashley says:

    I found your website while looking for comfort and advice online. I have a fifteen to sixteen year old cat (not sure of exact age, I rescued her from abandonment as a kid), who has been struggling. She has not been drinking enough water for a long time and will only eat one can of wet food a day with almost no dry food. Her appetite fluctuates. She has been throwing up more frequently and several weeks ago started jumping in and out of the litterbox and dribbling bloody urine outside of the box. I took her to the vet where a feline blood panel and urinalysis were done. The bloodwork was normal except it showed hyperthyroidism, so I started her on tapazole. The urinalysis came back normal as well, except showed some red blood cells. Vet said to wait and see. One week layer Kitty pooped outside her box (an ongoing problem), and the next day started leaking bloody urine again. This time there was definite bright red blood where before it was pink-tinged urine. I honestly can’t afford an ultrasound and if it were something like bladder cancer or stones, I wouldn’t be able to afford surgery, nor would I put her through it at age 16. What else could it be? On her bad days she acts sick, but on her good days she acts normal although she is excessively grooming. I don’t want her life to become a series of medications and doctor visits (she gets so scared), but its hard thinking of putting her down when she still shows so much love! She sleeps most of the time, her appetite is poor and she had the litterbox issues, but is still purring and cuddly. Complicating things is the fact that we are moving out of state in a few months and I’m worried that the move will stress her. What do you think?

  150. Doc says:

    Hello, Ashley,

    The blood in the urine could be due to a bleeding disorder, but I think your veterinarian would have found something in the blood testing.

    As you have noted, it could certainly be caused by a stone or by a tumor, and ultrasound examination would be the most direct way to look for those things (short of exploratory surgery).

    The most common reason for blood in the urine and inappropriate urination is a urinary tract infection. Despite the fact that the urinalysis looked okay, this can still be the case. The urologists tell me that I can’t rule out an infection without culturing the urine. It is not uncommon to have a UA that looks pretty good and still grow bacteria.

    I am sure that there are lots of things I do not know about this case, as I am not the doctor seeing it. If we were coming down to considering euthanasia, I would certainly consider a trial therapy with antibiotics for urinary tract infection (if getting a culture first were not practical).

    I am sure that the move will be stressful. Heck, it will be stressful for you, and I doubt you are as old as this cat, or as sick. That by itself isn’t a deal-breaker, but it certainly isn’t a plus for this old, sick cat.

    The person best equipped to advise you is the doctor seeing your pet. You might ask him/her about doing a trial round of antibiotic therapy and see if it helps the urinary problem. It doesn’t sound like we have much to lose there.

    This is a tough situation, and the best we can hope for is to make this kid more comfortable in her final months.

  151. Ashley says:

    Thank you for taking the time to give me such a compassionate, detailed response. I appreciate your insight very much!

  152. Angie says:

    Hello and thank you for such a compassionate and insightful forum. I am looking for guidance in my decision to put down my best friend of 16 years, Emma. She has had a problem with diarrhea, and rarely makes it to the box in time, for over a year. Her kidneys are smaller than they should be and she weighs 5.3 lbs. we have tried meds several times but she won’t take pills or compounded liquids. It is a horrible experience trying to dose her. This month I had to board her at the vet’s while I was on vacation. They couldn’t medicate her either, and decided it wouldn’t matter since I can’t either. Two nights ago she was writhing and in such discomfort. It tore me up and I’ve been upset since then. I didn’t think she was going to make it. She is better now but I am questioning if it is time… She isn’t grooming herself and has poop on her coat and in her toes. She won’t tolerate a bath but I use a wet cloth as best as I can. She seems a bit lethargic but can easily jump to/from the bed. She is ignoring the two other cats that she used to hiss at (we adopted them 5 yrs ago as a pair). I am concerned about health issues for my husband, myself and the other two as she has had episodes of deficating on carpets, the stairs, on beds, on sofas and on the deck outside… I should invest in bleach and 409 cleaner, I am always cleaning, but I worry about this. It has gone on for over a year but she ( oddly) has made it to the box the last few days. She does strain terribly (it is painful to watch) when she deficates and there is usually blood drops or liquid mixed in too. The dilemma is that the vet thinks her health is otherwise just fine with two exceptions… Possible kidney failure or disease and poor eyesight. she is so sweet and loving but I don’t think her quality of life is what it should be – and honestly mine isn’t either, having to clean diarreah up off the floor or carpet several times a week. Like many here, I am struggling with the convenience factor more so the loss of my dear baby. Is there anything else’s to do or try? Feels like I haven’t tried enough. Any thoughts are welcome. Thank you. P.s. the vet just updated all her shots. I feel like they think she is okay.

  153. Angie says:

    To clarify- I struggle more with losing her and the finality of death more than anything. The convenience of no longer having messes is one thing, as I have dealt with that for over a year and still could. Also, she is still ‘with it’ as in knows what is going on.

  154. Megan says:

    I don’t want to add to your distress, but this is something you should know for the future. Vaccinations are only for healthy animals. It says so right on the package insert that comes with the vaccines. A cat that has diarrhea constantly and has trouble making it to the box is not a healthy animal. I would not want a vet (and I have encountered them myself) who insisted on vaccination when I have been bringing in cat they have been trying to medicate and treat without success. In addition to kidney problems and obvious digestion issues, this cat has enough strain on its system. If your cat has been immunized its entire life, then it is likely it is already immune to whatever it has been vaccinated for. There are no studies showing that immunity isn’t life long as it is with people, and the explosion of autoimmune diseases and cancers in companion animals is strongly linked to excess vaccination. Having dealt with a cat with inflammatory bowel disease who had no other symptoms than vomiting (many cats have symptoms of vomiting and diarrhea, who lose weight and waste away, which wasn’t the case with our cat), it is possible that your cat might be suffering from IBD. Diarrhea is another symptom of IBD. It is difficult to diagnose definitively. IBD is an auto-immune disease, and our cat developed it not long after yet another round of vaccinations. Since your cat is difficult to dose, I would suggest trying a raw diet (or at least one without any carbohydrates as that is a trigger, as well as chemical additives from commercial foods) as well as some Ambrotose made by Mannatech. It’s a nutraceutical that is extremely helpful with autoimmune diseases. It comes as capsules or powder and can be mixed in the cat’s food. That really helped our cat’s symptoms abate. You are very kind to keep this cat going with the diarrhea all over the house. It had been difficult for us to deal with cat puke all over the house. I think poop all over would have been the last straw for me.

  155. Vi Dwork says:

    My 15 year old cat has a large lump at the top of his left leg that has been there for about 1.5 years. Vet says it is probably sarcoma. He is slowing down, has to reposition himself due his leg, will often extend it in front of him while sitting down but can still tuck it under at times in a normal cat position. He walks up the stairs more slowly. He is a darling cat, loves to be with us all the time, purrs and kisses and head butts with us. His appetite is ravenous. He has always had IBS and vomits a couple times a week and is on prescription food (rabbit) which was just changed to Z-D. He does not cover his urine or poop anymore. It gets stuck on his feet or butt and he drags it around the house at times. We decided last year when he developed the tumor that did not want any aggressive treatment due to his age and not wanting him to suffer. He is a little hearing and visually impaired and also appears to be confused at times. Sometimes he looks at us as if he doesn’t know us when we come into the room but after a few seconds, he acts normally. Today while we were snugging and he was purring, he bit my face. This has happened before, but we usually can turn before skin is broken. Today, he I had a small bleeding bite mark. My vet thinks he is has some dementia and we do too. The vet thought that he would not live more than a few weeks after diagnosing him because the leg was very swollen, but she pit him on Cosequin and predisone and the leg improved. He is off Pred because it elevated his blood sugar. Til recently the leg looked stable but now it looks a little swollen below the tumor again. He seems a little uncomfortable. My family and I have mixed feelings about whether the time is here to put him to sleep. It is excruciating to think of it. I don’t know if it is time. The cat is still happy, sweet and lovey-dovey. How I can I put him to sleep when he is still his precious sweet self? , The the mess and smell in the house is becoming intolerable. I am feeling very guilty. I have 2 other cats, by the way. I don’t know what to do. Thanks for any imput you can give me.

  156. Doc says:

    Hello, Angie,

    While I am not big on the raw diet suggested by Megan, I must agree that inflammatory bowel disease or intestinal lymphoma or some other mysterious type of malabsorption disease certainly comes to mind.

    Some of these individuals will benefit dramatically from fiber added to the diet (like psyllium mucilloid), from a hypo-allergenic diet (like Z/D), from corticosteroid therapy.

    If the diarrhea is the main thing, I would discuss empirical treatment of the bowel disease with your veterinarian.

    With your situation, I’m not sure that I could hard-sell an exploratory surgery and intestinal biopsy.

    On the other hand, cats like this have a real chance of improvement with dietary change, B-vitamin supplements, fluid therapy, or steroids (or some combination of some).

    Empirical treatment means that you look at “the treatable” and try some things to see what (if anything) works the best.

    It is quite possible that you have already discussed this with your veterinarian. It is very difficult for anyone to give you accurate advice when they have not seen your cat and do not know its entire medical history.

    If you have not discussed this approach, then I urge you to talk about it with your veterinarian. He/she is the person best equipped to advise you. If they feel they have nothing left to offer, then ask for a referral to an internist.

  157. Doc says:

    Hello, Vi,

    This is a tough situation. There are so few pain medicines that cats can tolerate well. Oral buprenorphine is great, but expensive. Fentanyl patches would be another possibility.

    Metacam has been used a lot in cats, but the FDA made the manufacturer issue a warning that it should not be. It is still approved for cats in Europe, and many feline specialists still use it, as we have so few alternatives.

    The only other alternative I can think of for controlling your cat’s pain would be to amputate the leg. This is a major surgery. I went through this with a patient in February. He did great for 3&1/2 months. Now he has other tumors and just isn’t doing well at all.

    This is such a difficult situation, especially when the patient is elderly. With the apparent dementia-induced biting, it’s even more difficult.

    If your cat’s pain cannot be controlled as well as you would like, I don’t think anyone could criticize your decision to let him go peacefully.

    Best wishes.

  158. Vi says:

    Dear Doc,
    Thank you so much for your prompt response. I do not think his pain is very bad at this point. It is all his symptoms combined that makes me think it may be nearing the time. For example, when he lays down to rest instead of closing his eyes, he stares straight ahead. He cries for food when there is food in his dish. He walk away from his meal and we had to bring him back to it. He is not grooming himself anymore. Is it better to euthanize him soon before his pain gets to the point where he is in obvious distress? He still has quality of life as he is so happy to be with us and enjoys his belly rubs and being brushed or just sleeping next to us. It is so wonderful to be able to confer with an objective person. Thank you.

  159. Doc says:

    Hello, Vi,

    You know this is going downhill.

    When you feel that he no longer enjoys life, there is no point in prolonging it.

    He has some problems now, but you feel like he still is happy.

    One day you won’t think that. Then it’s time.

    Best wishes.

  160. Vi says:

    Hello Doc,
    Last night we took Rusty to his Vet and she said that he is not doing well and is in pain. Even since last night he is more subdued, and he is drinking a great deal and peeing more. It is time and we are taking him back tonight to put him to sleep. We are enjoying our day together. It is so bittersweet and excruciating. I appreciate your help with both my cats and I feel fortunate to have found your website. I will visit often. You have been very kind. Thank you.

  161. Margie says:

    I am another one struggling to make the decision for an elderly cat. Mario is 19 and a half, and I’ve had him since he was a kitten. He was the smartest cat I’ve ever known (and I volunteered in cat rescue for 4 years and have known hundreds of cats).

    He’s had many medical problems for the past five years or so, but my wonderful vet has helped me manage them. But now he is arthritic and completely blind (glaucoma). His kidney and liver functions are compromised. He has occasional seizures every 1-2 months. His last seizure left him slightly dragging one of his legs. Combine that with his arthritis, and I know it’s difficult for him to move around. He spends about 23 and a half hours a day in the bathroom, by his choice.

    Mario’s had blood in his urine for about the past 2 and a half months. It’s not an infection (urine was cultured, and antibiotics did not help), and ultrasounds have shown no stones or tumors. My vet believes it’s probably a tumor, but I’ve decided to stop looking for one because I won’t be treating it. He urinates outside of the litter box, but usually right next to the box, so I can easily handle this with puppy pads, but I assume urinating is painful for him. He has hallucinated on buprenorphine in the past, and my vet is reluctant to put him on a painkiller.

    He is senile, or perhaps the seizures have done some brain damage. He is frequently disoriented, to the point where sometimes he can’t find his way out of a corner.

    On the plus side, he’s maintaining his current weight (about 8.5 pounds, down from 12.5 in his prime), he still eats meat baby food with obvious pleasure, and he likes it when I take him outside with me for about 15 minutes before he’s ready to come in. He’s always responsive to me and still affectionate.

    I have such a hard time figuring out what is a good day and what is a bad day – they’re all pretty much the same.

    My sis, who loves Mario, told me maybe I should think about what kind of death I want Mario to have – to give him once last day with ice cream and baby food and outside. My vet will come to my house and will even do the euthanization outside if I want it. But Mario has been such a fighter his entire life; is it fair to give up the fight FOR him? Maybe I’m just being too selfish to lose him.

    See? I’m going crazy with this. I so much appreciate the compassion and understanding on this site, I’m hoping someone can give me some objective advice.

  162. Doc says:

    Hello, Margie,

    So here’s objective: what you’re telling me is that Mario enjoys having you hold him and pet him, and he enjoys eating. He otherwise may not know what is going on, and is either too painful to move around much, or is just not able to (or both).

    Since cats tolerate so little in the way of pain meds, it’s difficult to do a trial therapy to see how much different he would act on pain meds. One thing you could try would be a fentanyl patch (though this may make him dopey, as well).

    He likes to be held, and he likes to eat, and the rest of the time he’s just vegetating (at least we hope he’s not just sitting there hurting — it’s hard to say).

    I can’t decide for you. I’m thinking that when I get in that shape, I’ll be ready to go. Hard to say until you get there, though. We cling to life tenaciously, even though we hope for a better life to come after.

    Your heart is not going to let you make a bad decision. You care too much about Mario. Whatever you decide will be right.

  163. gary says:

    My guilt is tearing me apart for having to euthanize my 17.5 yr. old precious cat.I am wondering if I did it too soon?About a week earlier he was diagnosed with stage 2 kidney desease( even though he seemed fine except for his urnating more. ( and lost alot of weight over two years)So we gave Kd diet, appetite stimulants,and fluid hydration.He ate some of the food for a few days than stopped eating altogether for 4 days ( other than licking food off our fingers)He also had bad diarreha for about 4 days which appeared to be painfull for him, I think, because he kept crying out almost nonstop for 4 days.Within that time we went back to the vet 3 times to see what was really wrong.He also was on diarreha meds for 3 days which did not seem to help.Finally we had an ultra sound done about 5-6 days after first bringing him to the vet when he was diagnosed with kidney desease and they said they found 3 nodules on the liver ( which may be cancerous) and an inflamed pancreas.So the options were; biospy,maybe chemo, steriods or euthanasia given by our vet.WE opted for the steriods because we thought the other options might be too much for him to tolerate ( which I now regret not trying but he appeared to be too sick to do any of the other options.By the time we started him on the steriods( just one day giving to him)he had already not eaten for 3 days and by the time we had euthaized him he had not eaten for 4 days( not even his favorite foods like tuna and baby food)I can not help feeling that I should have given the steriods a few more days to kick in or tried other options but he appeared to be in so much distress, crying out alot, having almost constant diarreha,very thin and weak and lathargic and just not the same cat he was just a week ago.Did we euthanize him too soon because I selfishly coud not stand his crying out anymore( was a matter of convenience for me to euthanize him.On some rational level and even spiritual level I believe we made the right decision because he seemed so sick and he appeared to be suffering so much.( and was so skinny due to alot of weight loss over the past year.)I just can not believe that he could spiral down so quickly in one week. going from eating and doing his usual behaviors to not eating at all and not doing any of his usual behaviors other than crying most of the time and going or not going in the litter box due to consant distressful diarreha.Then please tell me why I am having alot of difficulty with the decision to euthanize him when we did as opposed to waiting longer. Please can someone give me some objective advice whether I did the right thing or not. I am being tortured with the decision we made to euthanize him when we did. Thanks

  164. Doc says:

    Hello, Gary,

    With the history you describe, the rapid decline isn’t that surprising. A patient in this state is using all the reserve functions to compensate for the continuing loss of function. One day, there is no reserve left.

    Also, a rapid decline generally indicates a poor prognosis, particularly in these circumstances.

    If the steroids didn’t help in the first few days, it is unlikely that a longer course of treatment with them would have shown improvement.

    I did not have the opportunity to see your cat, and I always feel that your best source of information is the doctor who does.

    From what you have said, I would consider that this was a bad situation that was getting worse, and could only have gotten worse.

    You did the right thing.

    I am sorry for your loss.

  165. Laura says:

    We lost our cat Swabby two weeks ago, as best we can figure from a copperhead or rattlesnake bite, or nabbed by coyotes, which neighbors say are more prevalent than ever this summer. (Since then I bring his siblings Angel and Teddy inside during the night, even in good weather.)
    Teddy has had a harder and harder time using his hind legs over the past month. I assumed it was due to his being overweight for years (others cats were normal weight, all fed same food), and that he was getting arthritis. Last week I noticed when I’d let Teddy out in the morning, he’d go a few feet beyond the door and plop down, and stay there quite a while. Then one morning, he couldn’t even make it out the door. His hind legs knuckled under. Normally I’d take him straight to our wonderful vet, but being a household of teachers with no pay in summer, we can’t afford it at the moment. So, poor but sometimes helpful substitute, online research, told me glucosamine/chondroitin may help Teddy. I started him on the liquid two days ago. The bottle says to give it two weeks to work; I can only tell tonight he was able to sit up (bottom down, forelegs up) for about 10 minutes and eat his special medicine mix. So I’m guardedly optimistic, but if he remains unable to walk, I know I have to put him to sleep.
    He still is making it to the litterbox nearby, and has a good appetite. He still gives me kitty kisses and looks to me for petting. I just can’t touch him past the midline of his spine, for it sends him into spastic caterwauling and attack-grooming of any hand near his head, for a good 30 seconds (indicative of spinal/nerve damage?).
    In addition to the arthritis problem, another possible cause of weakness in hind legs is diabetes (like me). However, with his good appetite and no apparent excessive thirst or weight loss, I didn’t think diabetes was likely.
    My question for the doc(s) is, should I put ramen on the family menu for the week, get Teddy to the vet for a glucose test, and not give him the liquid joint complex till results are in? If I become brave and want to test him myself (with my kit?), what should his numbers be? I don’t want to do more harm to him with the joint compound if he has diabetes. I also switched him a few weeks ago to Purina’s “diet” cat food, which he loves. Could that have any part in this? I want to give him the best care that my very limited funds can provide, which means extra TLC and minimal testing.
    Something I haven’t seen anyone address in this forum is the related grief management of the surviving household animals. Angel, Teddy, and Swabby looked for days for their mom after she was euthanized last year. I worry for Angel, who just lost one sibling two weeks ago, and may lose another one so soon after, her only remaining cat family. What, besides giving her extra love and attention when we’re home, is recommended? I know we’re not up for a kitten. We have a lab we also bring in at night, and they’re friendly, so I’m hoping maybe their friendship will deepen into cross-species step-siblinghood, with all the nurturing and nuzzling that entails.
    THANK YOU for this forum. I consider the hours and tears spent here tonight well invested, and appreciate the other posters’ experiences and Doc’s responses.

  166. Doc says:

    Hello, Laura,

    While spinal disc problems are uncommon in cats, they can certainly occur, particularly in an older very overweight individual. It certainly sounds like something is affecting your cat’s spinal cord, and a disc is one possibility.

    It could also be a stroke-like event, where something has stopped up a blood vessel to the nerve supply. FCE is fibro-cartilaginous embolus, where a piece of disk material clogs up a blood vessel. This usually has a very sudden onset. Prognosis is grave.

    If Teddy had a saddle thrombus (a blood clot stopping the circulation to his hind legs), I would expect him to be more painful. Also, the legs grow cool to the touch.

    Teddy may or may not have diabetes, but it is very unlikely to be the cause of his difficulty in walking.

    Teddy needs a full exam and a neurological evaluation to determine which reflexes are present and absent. He could even have a spinal tumor.

    The situation you describe does not sound like a good one, but I could be way out in left field.

    It is really impossible to give you good advice long distance. Wish I had an app for that. Good luck.

  167. Margie says:

    Doc –

    Thank you so much for your response about Mario. I had been unable to get past the fact that Mario’s appetite was so good, but when you wrote that you would be ready to go in Mario’s position, it made me think of my father, who died of colon cancer. Even when everything that made him an individual was gone, his body still fought to stay alive. It amazed me how hard that body fought. And that made me realize the biological reality – bodies fight to stay alive, and Mario was no exception. That doesn’t mean he had a good quality of life.

    I said goodbye to my boy today in our backyard with the sun shining and the squirrels chattering. Mario had a wonderful last day, with ice cream and baby food and neighbors stopping by to say farewell. This was the hardest thing I have ever done, and I hope it was the right thing.

    You are a gift to everyone in this horrible position.

  168. Doc says:

    Hello, Margie,

    Thanks for writing back. You remind me of the character of Old Lodge-skins in the movie “Little Big Man”. “It is a good day to die”, he said.

    Best wishes.

  169. Tammy says:

    hello i have a 13 year old dachshund who has nerve damage in his front feet, he is on pain medicine and steroids, just dont know if it is the right time to say goodbye or wait a while longer. can i get some assistance?

  170. Doc says:

    Hello, Tammy,

    You need to discuss this with the doctor who is seeing your dog. Many dogs with a bulging spinal disc pressing on the nerves will recover fully over a period of weeks. Some will need surgery, some won’t recover at all.

    I really don’t know the nature of your dog’s problem, so you need to discuss this with your veterinarian. If he/she thinks there is a chance for recovery, then I would stay with the program.

  171. Edie says:

    Hi Doc,

    We brought Cali home 12 years ago as a rescue cat when she was about 4 months old. She has always been ‘quirky’, to say the least if not downright neurotic. She was NEVER affectionate, almost seemed like she had kitty-PTSD, and would not associate with people or the other pets. Until now, that is.

    In the last 6 months we have battled with her constant loss of bowel control, more than occasional vomiting, and weight loss. She always had her own litter box, but lately she doesn’t seem to have the desire to use it. She eats and drinks well, but appears as skin and bones. I’m trying to watch that she continues to be well hydrated. Vet bills are a real concern for me.

    I’ve been considering letting her go for some time now but she doesn’t seem to be in pain, and the strangest thing is that she has become VERY friendly and likes to be physically near us. I cannot get over this personality change in her, but I hate to see her waste away. Maybe she’s just trying to tell me, “it’s ok”?

  172. Doc says:

    Hello, Edie,

    These are always such difficult decisions. If you have been dealing with this for six months, I don’t think anyone could call this a “convenience euthanasia”. That would have happened a long time ago.

    If you can deal with the clean-up and having to hand-feed her, I don’t see anything wrong with continuing do to so, as long as you feel like she is enjoying life.

    With the continuing weight loss, she will at some point have such muscular weakness that she just can’t get around. I would certainly let her go when you are getting to that point.

    If you see her just going down the tubes, don’t feel guilty about making the decision to end her life while she still has a little dignity left.

    I wish you the best in this difficult time.

  173. Edie says:

    Hi Doc,
    Thank you for the kind words. You truly uplifted my heart. I will keep an eye on her, and enjoy her company for awhile yet.
    Thank you for the insight,
    Edie

  174. Dulcie says:

    Thank you for this post and the comments from everyone. I stumbled across it searching for the answer of when to euthanize our 16-yr-old Calico. Two years ago we thought we were losing her, excessive drinking, urinating and had gotten down to skin and bones. The vet could find nothing wrong. We pampered her with canned food and extra affection and she rallied. The following year the vet was surprised she was the same cat. Unfortunately she is back to being seriously underweight and has also stopped grooming herself and has lost some control over urination and defecation. I know her eyesight is poor and so is her hearing. She still gets her canned food everyday and enjoys that but doesn’t eat a lot. She enjoys treats as well. But doesn’t socialize with the family or play. She’ll flinch and yowl when you pet her. All she wants to do is go outside and lay in the sun? I remember her so clearly as a kitten, picked out of a cage of “free kittens” at a local pet store. Where did the years go? I know what I have to do. It’s just hard.

  175. Teresa says:

    I am having a tough time trying to decide if it is “time”. My cat who is either 15 or 16 has hyperthyroidism,and lymphoma of the small intestine. She still eats, sleeps with me, and cuddles but she vomits two to three times a week and her stool is like water. She is also on meds for pancreatitis. She is getting to where she hates the meds and the injections. She threw up last night and made the most awful moan and just layed on the floor motionless for a few minutes. I don’t want to euthanize her prematurely, I think it is time, and just need other advice. My vet supports me and I have the appointment made for tomorrow, just need to be sure this is the right thing to do. She still eats! Still cuddles! Still greets me at the door! Please help.

  176. Doc says:

    Hello, Dulcie,

    Thanks for sharing your story. “It’s just hard.” No kidding.You do what you have to do, but it’s hard.

  177. Doc says:

    Hello, Teresa,

    You have been working very hard to maintain your cat’s quality of life. You’re still trying and so is she, but it’s not working anymore.

    If after all your work and care you think it’s time, then I’d say it is.

    If not now, then how bad would she have to get?

    You don’t need to second-guess yourself and feel guilty, not after the amount of care you have given her. Don’t beat yourself up. You don’t want to fight with her to give her medicine that isn’t helping very much anyway. That’s not life, really.

    It’s time.

  178. Heidi Warren says:

    I’m so torn about what to do with my 13-14 yr old Cloe kitty. I adopted her 7 years ago, she came to me as a beautiful but shy girl. The shelter had moved her to there thrift store because she couldn’t handle the stress of all the other animals, she has been my best friend and constant companion. Within the past year she has been aging very rapidly. It started with her no longer being able to jump onto my bed, I bought her some little steps to help her and she has not attempted to jump on in since, but uses her steps to get up every time, sometimes she jumps off the bed but stands there for a few seconds like it hurt before she walks away. Most recently she has started compulsive licking her belly, I had her treated at the vet for it and the meds almost killed her, labored breathing and seriously lethargic for several days, so worried I took her back in when she had the bad side effects. She wasn’t her self for about 2 weeks after that and within 3 months of the treatment she is back to licking. Within the past few months she has been swallowing her food whole, sitting in front of her food & water and crying loudly, avoiding jumping into her favorite chair and even the couch to cuddle, she still wants my attention and to cuddle and she purrs when being petted, but only in the bedroom on the bed. I also think she is loosing weight but have not been able to weigh her lately. I love her so much but cannot afford expensive vet treatments, and I have to move due to financial issues and am afraid the stress could be very bad for her because she is painfully shy and I may have to get a roomate. As far as good days vs. bad I would say she is 50/50 right now. I don’t want to cut her life short but also want her to go as peacefully as possible, and cannot imagine watching her dye slowly. Do you think if I had her put down without a bunch of expensive tests being done that it would be considered “convenient”? I have a vet appt. this wed. and am afraid they will think I’m a bad pet parent for considering putting her down.

  179. Doc says:

    Hello, Heidi,

    You obviously aren’t ready to make the decision to put her down.

    You want her to feel better, but aren’t sure if that can be accomplished, either because it just can’t be done, or because of financial limitations.

    When you see the veterinarian, just tell them that you feel that your cat’s quality of life is deteriorating. Tell them you financial limitations and ask what your options are. “This is all I can do financially. What are my options? I want my cat to feel good for as long as she can. I don’t want her to die a piece at a time.”

    The veterinarian who actually sees your cat and knows her condition is in a better position to advise you. Share your feelings and concerns with him/her.

    Best wishes.

  180. Sandy says:

    Hi,
    I wanted to say that this is a wonderful website, I wish I had found it earlier. I had to put our 15 year old matriarch of the family to sleep 3 months ago. She had kidney problems and more bad days than good days. The vet said it was possible to treat her. But I wanted to share two critical things that, in the end, had us choose to euthanize. One was a quote I read, it said, “Better one month early than one day too late.” As we talked to the vet she said something critical to our decision, “A 15 year old cat, with kidney problems such as hers, can be treated, unfortunately it’s a rollercoaster ride, one day she rallies and feels good, one day she seems to be in pain. But remember that although it’s a rollercoaster ride, you are always going downhill.” Although we gave our best friend a final act of kindness, and know it was the right thing to do, you just accept that it may never feel right.

  181. Jen Silva says:

    Hello. I, as so many others, feel so grateful to have found this site. My adorable best friend Gideon is a 14 year old calico who was diagnosed with lymphoma last October. She has been a real trooper this past year. Sadly, my little angel seems to be declining faster in the past few months ans the steroid injections, B12 shots and nausea medications no longer seem to last. She hasn’t eaten in 2 days and only seems to want to lay around. In my heart I feel that it is time to let her go and that she is telling me that she is ready (could she be hanging on just for me?) but I like so many on this site am struggling g with the question of “is it too soon? Should I keep trying other things?”. I am going to call my vet in the morning and am just trying to come to terms with the fact that this might be my last night with her. I dont know about good days vs bad but I know her quality of life is no longer what she deserves. Thanks in advance for any words of wisdom.

  182. Doc says:

    Hello, Jen,

    By this time you’ve already seen you veterinarian.

    “Should you keep trying other things?” For me, that depends on what the other things are. Are we going to feel better and live longer, or continue to feel crummy and die slower?

    I’m sorry that I didn’t get to this last night when you wrote it.

    When you said that you felt in your heart that “it was time”, then I felt that you probably knew best. Nobody else knows like the person who lives with the pet.

    Best wishes.

  183. Kate Wilson says:

    I know it’s way past time to put Spice down, but…..
    Sugar and Spice came to us as 6 week old kittens 17.5 years ago. At one time they were 11 pounds. Spice is now about 3 pounds. sugar had tumor cells in her urine and was put down this past April. Then Black Cat, the neutered tomcat decided to move in a year ago. He refused to stay with his dog-owners down the street, and was the most mannerly, social, polite, sweet cat that liked some independence and would tell you what he wanted. Last night, a couple of roving dogs got him, and we found him this morning on the doorstep with puncture wounds, a cantaloupe sized hematoma, punctured lung, quietly looking at us and allowing us to take him to the vet ER. They put him down today. Spice has one contracted and useless front leg, is very weak, can hardly stand, and doesn’t even go on the paper with cat litter piled on it 3 feet away from her. She eats, sleeps, and pees on herself. She has a smelly wound under her armpit that has been treated for 2 years now. Her WBC count is high and I suspect she is dying of cancer. We are leaving in 2 days for a 10 day trip, and our nephew will stay at our house to feed the cat, bird and watch the house… I don’t want to do it, but I think I must. like tomorrow… Can I do this???
    G’ma to Sugar, Spice and Black Cat

  184. Doc says:

    Hello, Kate,

    “Can I do this???” How can you NOT do this?

    I know how hard it is to give up a friend. It is even harder when you are piling this loss on top of the other losses that are so recent.

    Each new loss we experience is like adding a link to the chain of losses we have experienced throughout life. Events that we have put behind us tend to get pulled up with the whole chain when that new link is added.

    This would be no different if you were staying home instead of going on your trip. You know it’s time, even though it is hard to confront.

    It’s the right thing to do, and you would feel worse if you put it off. You care so much about this cat and, as hard as this is, you know that you don’t want her to suffer.

  185. Alex says:

    Hello,

    I appreciate all the comments and support offered on this board. My 12 yo cat, who I’ve had since he was a kitten, has wasted away from about 19 lbs to around 5-6 lbs. He was diagnosed with a mass in his abdomen, had blood work & an ultrasound. While blood levels point to an infection, after the ultrasound the vet feels that the mass is most likely a tumor, as his intestinal lining is severely inflamed & there is odd striation in his liver. There may also be renal issues. The vet thinks it may be worth letting him go… She gave an antibiotic injection two days ago which doesn’t seem to have done much for him… I can’t bring myself to do any expensive or invasive procedures because the prognosis isn’t great, so now I’m wrestling with the “when is it time” question.

    The problem for me is that he is eating & drinking (albeit very little at a time), vacating/using litter regularly, & was even sitting on my lap this past weekend as I was caring for him. He has ben living with my parents for the last year, & they feel that they would rather wait than put him down now, that if it was “really bad”, he would stop eating altogether, not be able to use the litter, etc.

    I obviously don’t want to have to face this situation & force him to “move on”, & if he’s able to give back a little love (sitting on my lap, rubbing lightly against things for pleasure like he used to), maybe they’re right & it’s not time… But I don’t want to just have him waste away because I’m too selfish *not* to help him along… If he’s doing these things, is there any harm in letting him wait it out until the bitter end?

    Thank you for your thoughts,
    Alex

  186. Kate Wilson says:

    Thanks Doc, I almost backed out but your support helped me do the right thing. A friend sent me this, maybe it will help others:
    If it should be that I grow frail and weak,
    And pain should keep me from my sleep,
    Then will you do what must be done,
    For this, the last battle, can’t be won.

    You will be sad I understand,
    But don’t let grief then stay your hand,
    For on this day, more than the rest,
    Your love and friendship must stand the test.

    We have had so many happy years,
    You wouldn’t want me to suffer so.
    When the time comes, please, let me go.

    Take me to where to my needs they’ll tend
    Only, stay with me till the end
    And hold me firm and speak to me,
    Until my eyes no longer see.
    I know in time you will agree,
    It is a kindness you do to me.

    Although my tail its last has waved,
    From pain and suffering I have been saved.

    Don’t grieve that it must be you,
    Who has to decide this thing to do;
    We’ve been so close,we two, these years,
    Don’t let your heart hold any tears.

    Author Unknown

  187. Doc says:

    Hello, Alex,

    I think it’s pretty obvious that your cat is on a downhill slide that is just going to get worse.

    On the other hand, it sounds like he is still enjoying life with your folks, and they are enjoying him.

    To me, that sounds like it’s not time yet. I’d let him live while he’s living.

    That being said, with the ultimate prognosis being poor, when he stops showing enjoyment, it WILL be time.

    This is never easy and you just have to do the best you can.

  188. Angie says:

    Hello Doc,

    I wrote to you about Emma (real name Ema) in July. There was more blood in her diarrhea and it was happening several times a day. Occasionally she made it to the litter box, but it was not a good situation and she was straining so hard.

    I had her on FortiFlora for the past 6 weeks, which seemed to help and stools were firming up, but then they turned to pure liquid w/blood in the last week.

    She wasn’t purring as much lately but was quick to shout for more food. I’ve reviewed your forum on several occasions over the past month and can’t thank you enough for your time, advice and concern for the animals we all love.

    I was starting to feel ill with the constant cleaning and exposure to poop in every room, and I was worried about my other two kitties. But mostly, I knew Ema was not going to get better and I didn’t want her to be in pain any longer.

    Yesterday I made the decision that it was time. She had some favorite treats, a bit of chicken, a taste of sardine, a sip of milk and licked some butter off my finger. These would be extremely rare treats but I had to spoil her. Last night I couldn’t sleep and was happy for it, because I was conscious that her little head rested in my palm.

    This morning an in-home vet came over. It is true that you can feel the tension and stress release and you know it was the right thing. The right time. And it was peaceful.

    Thank you again for being here.

  189. Eleanor Sundwall says:

    I would like to thank every one for their stories. Like all of you, I am struggling mightily with the failing health of my Petey and this thread has helped me feel not so alone. It is one thing to know, intellectually, that I am not the only human who has suffered a shattered heart at the end of a furry family-member’s life, but it is another to really feel the shared loss of others. Not that I am glad we’ve all had such a tough decision to make, but reading through these stories is helping me make the decision that needs to be made. So, thank you.

    Pete is only 11 years old and was diagnosed with CKD about 5 weeks ago. We picked up on it quite late because we spent the earlier part of our year worrying about our 2yo daughter’s health (she required surgery, then almost died from an infection she acquired at the hospital). By the time our heads had cleared from the ordeal with our daughter, we noticed that Petey was very light (down to 9 pounds from 12, now down to 8) and a bit wobbly.

    We took him to the vet and ended up having to leave him at the hospital for 5 days to be hydrated via IV. Since then, we have given him 100ml fluids and vitamins twice a day with a potassium supplement and some Pepsid every other day, but he hates all of it. The first week home from the vet, he was also on daily antibiotics and an antiemetic. We also had to force feed him wet food through a syringe, but that made him so miserable that we stopped and hoped for the best. He eventually started eating his KD diet, but his appetite is low.

    He’s gotten to a point where he likes to go outside (once an absolutely forbidden activity) for 10 minutes to roam the back yard and roll around in some dirt and he will come out to the front room to sit, but he is quite weak on his feet and no longer enjoys playing with his cat, Jack — yes, our cat Pete has a cat :). He purrs, still, and can be quite affectionate, but he has started urinating around the house and his vomiting spells are happening more frequently. He also becomes extremely agitated and as aggressive as he can muster whenever he sees we’re getting ready to give him his subQ fluids.

    Anyway. It’s a similar story to all of these stories. Pete is the love of my life and I would have left my husband for him if my husband weren’t so open to an alternative lifestyle 😉 I feel fortunate to have had him in my life at all, but I somehow thought we’d be together forever. We’ll look to the guideline of 4 good days to 3 bad days to help us find comfort in our decision, but I’m afraid there’s not much solace to be found anywhere.

    Again, I appreciate every story here and the kind words of the Doc.

  190. Doc says:

    Hello, Eleanor,

    It sounds like you are really going “the extra mile” to give Pete as many good days as possible.

    I can tell from your words that you will do the right thing for Pete when the time comes.

    Best wishes.

  191. H says:

    Hi.
    I need some advice. My 11 year old cat, Sketch, had a hyperthyroid issue. So, we gave him the popular radioactive iodine treatment. Ever since the treatment, he vomits almost daily. My vet had no idea what’s happening, and we are (frankly) out if cash flow and ideas (treatment was over $2k). Sketch is eating but doesn’t like to play and sleeps most of the time. He also has diarrhea regularly (outside of his box). I’m desperately hoping for some advice here. Is it time to let him go?

  192. Doc says:

    Hello, H,

    I really don’t have much expertise in this area. All of my hyperthyroid patients have been treated with methimazole daily, or the Y/D dietary treatment. None of my clients have been willing or able to spend the money on the radioactive iodine treatment.

    If I had this situation with one of my own patients, I would be consulting with the specialists who did the treatment (and others, say, at the University vet school teaching hospital).

    They would need to know how long it has been since the treatment and what else is going on with the cat.

    The hype for the treatment is that it’s a one-time deal and no muss, no fuss after that.

    Some hyperthyroid cats have poorly functioning kidneys. Oddly enough, the excessive thyroid function helps the poorly functioning kidneys.

    When the thyroid function is returned to normal, the kidneys no longer have that help. High levels of waste in the bloodstream (as in failing kidneys) could cause the nausea and diarrhea.

    I wish there were a simple way to just “look at” your cat and find out what is going on. Sketch really needs to have blood chemistry checked (at least kidney function). Your veterinarian may already have done this.

    I understand that you are financially at the end of your rope on this. More tests are not what you want to hear.

    Finding out that he has kidney failure would not be a happy time, but at least you could take steps to deal with it. Many cats with poor kidney function can be supported to live a pretty good quality of life for months to years.

    I wish that I had an easier answer for you.

  193. michelle gervais says:

    thank you, these readings have been very comforting. My Cat Marvin has had diabetes for the last 5 years. He is failing so badly. We had to carry him to the litter box today. We know it’s “time”. Probably way beyond “time” but after reading these heart felt accounts of pet care,it gave me the peace of mind to know how to accept this difficult decision.

  194. Kristy says:

    I just want to say I am blown away by your kindness and generosity, Doc. What an incredible service you are providing. I have read many of these stories and they’ve helped provide a different perspective. There is such a large continuum of beliefs around euthanasia, and many have advised that when an animal can’t eat or void, that is the time.
    My cat is 13 and in Stage 4 CRF, diagnosed 8 weeks ago. Hes on all the usual meds, sub q, and aranesp. He eats, drinks, and voids with no problem. But he sleeps all day and looks uncomfortable. When he does walk from resting place to the food bowl, his back legs struggle from muscle weakness. Our vet estimates he has 6-9 months before worsening (not able to eat, vomiting). But recently I’ve felt that he is just slowly dying, not living. I dont see him getting pleasure out of much, although he wants to be sleeping next to me all day.
    He doesn’t really have good vs bad days, they are all just “not great” – sleeping, waiting.
    I never thought I would euthanize until major “signs” emerged. But this doesn’t feel like good quality of life either. Is it “too early”?

  195. Doc says:

    Hello, Kristy,

    Nobody knows your cat better than you do. If you feel that he is not “living”, but “dying a slow death”, then you are the person best equipped to make the judgment about whether the time has come.

    This is a tough time and a tough decision. I often wonder if I will be aware enough in that situation in my own life to contemplate the fact that I am just waiting to die. I have an elderly aunt who has made that statement. She is in a very nice nursing home, but requires assistance to dress, rise, go to the bathroom, or feed herself. She knows it will only get worse.

    We cling tenaciously to life, both for ourselves and our loved ones.

    The right answer is the one you feel is right for you.

  196. Aaron Cohn says:

    My cat Mr. Sluggo is 22. He’d been doing well until perhaps 6 months ago when he developed an indolent ulcer. I’d been returning him to the vet every couple months for steroid injections for this & feeding some special hypoallergenic food which he didn’t seem to like & he ate less & less. He had been losing weight which was a good thing since he was quite heavy at 17 lbs. About a month ago, I saw a different doc who convinced me to bring him in every 3 weeks to try & clear it up. His weight was down to 12 lbs. 3 days after the second q3week injection he fell acutely ill, throwing up twice and refusing the cat treats he previously loved, he was lethargic & hiding. His behavior was completely normal & he loved life previously. I gave him some subq saline with little effect & brought him to the vet. He had a blood glucose in the 500’s an azotemia. Over the next couple days the azotemia, creatinine & hyperglycemia were corrected with insulin & IV fluids, but then he developed hypocalcemia and hyperbilirubinemia. He still wasn’t eating, and the vet stated most likely pancreatitis. I transferred him to a vet emergency facility where they’ve been more intensively force feeding him the past couple days. Still no interest in food, though they say he’s “stable”. I’m having trouble with what I think is coming because he was a pretty normal, happy, playing purring cat a week ago, even though he’s older than the hills. I feel the steroid injection may have been the culprit in the downward spiral & suspect maybe I should at least wait another week until that’s completely out of his system. Any thoughts???

  197. Doc says:

    Hello, Aaron,

    This is obviously a very difficult case. It sounds like Mr. Sluggo has been pretty close to the edge for a long time, but has been compensating. The body has a lot of reserve capacity built in.

    You won’t become azotemic until you have less than the functional equivalent of one half of one kidney. Thus, you could have a long term, gradual loss of kidney function, and still be feeling fine until you reach the tipping point.

    Marginal kidneys that are doing fine under normal circumstances wouldn’t have the capacity to handle even slight dehydration.

    Pancreatitis could cause a temporary (or permanent) diabetic state, producing the high blood sugar. It is also painful and causes nausea.

    When an overweight cat (possibly any cat, but especially the fat guys) quits eating, he can develop a fatty degeneration of the liver. This often requires implanting a feeding tube so that the cat can be fed regularly in his recovery period.

    Do steroid injections precipitate either pancreatitis or diabetes? There are certainly patients where this appears to be the case, but it is by no means considered an ironclad cause and effect across the board.

    In any case, your cat will probably continue to require some pretty intensive care if he is to get stabilized. The best case scenario is that he gets stabilized and you are able to nurse him at home for the rest of his recovery period.

    If you can stand the cost, I would definitely give him a few more days to get sorted out.

    It is also possible that he will have too many marginal organ systems that cannot come back.

    We can hope for the best.

  198. Bree Lemmons says:

    I am looking for an answer that I’m not sure is available. Yesterday I made the choice to have my 12 year old cat, Sox, put to sleep. I spent the day loving on him and he napped with me all day. I was with him until the end. He was diagnosed with diabetes about a year ago. It was almost 1000.00 for that. I am a single mother and just couldn’t afford the insulin and the testing. About 2 months ago I just couldn’t afford it anymore. He has lost a lot of weight since stopping the treatment and had started to walk with his hind legs down. His breathing seemed different. Yesterday he was a lot more lethargic and he hasn’t been eating for about 2 days. I did see him drinking some yesterday but he was just off. He hasn’t been himself. He would still come out and meet me and rub on me but he seemed to have such a hard time gettiing around. I never wanted him to suffer. I feel like I have let him down. He was my best companion and friend for 12 years and I’m heart broken. Did I make the choice too soon? Did I fail him by not being able to get him treatment? I am just heart broken and I can’t decide if made the right choice or not. It is overwhelming, the grief I have. He had no muscle left and the big lively bright eyed boy I had for so many years seemed to just exist.

  199. Frances says:

    Dear Bree:

    Thank you for your post. I am in the same situation as you and was looking for a similar post so it can help me decide whether or not I need to euthanize my 12 year old cat. My cat was just diagnosed with diabetes after he lost 3 lbs since his last physical which was just 1.5 mos ago. I have decided to treat his diabetes with diet and have switched him to a high protein wet cat food called Nature’s Balance. I hope this treatment works but, if not, I will not be able to proceed with insulin due to financial reasons and time commitment ( I have three children under 4 years old and we are a one income family). I have called several rescue orgs and called low cost vet clinics to see if they can help me pay for insulin treatment however, unfortunately, none could help me due to full capacity and no funds due to the poor economy. I have cried countless nights over this and hope that my cat gets better with diet alone. After feeding him, he still seems hungry, even after I feed him 3 x day. I am so torn and at a loss as to what I need to do. Does he have a good quality of life when he is constantly at my door waiting for me to feed him his next meal? Can anyone offer any helpful guidance in this situation?

  200. Doc says:

    Hello, Bree and Frances,

    Diabetic cats are not producing adequate insulin. Insulin moves blood sugar into the cells so it can be used. All of the body tissues (except the brain and nerves) require insulin to use sugars for energy.

    When they cannot use sugars from the diet for energy, they break down body fats to use fatty acids for energy. This is the same process that occurs during starvation. Diabetics without insulin are starving, as they cannot properly utilize the energy sources in their food.

    Thus, they eat voraciously in their search for energy, but they lose weight because they cannot properly use the food.

    They do better on high-protein, low-carbohydrate diets (as opposed to diabetic dogs who do better on high fiber, low fat diets).

    Without insulin, they eventually suffer the effects of starvation, even though you are providing excellent food.

    The sugars from their diet that cannot be used are excreted in the urine, pulling lots of water with them. Thus there is excess urine production, and the patient must drink lots of water to compensate for this.

    Eventually this functional starvation causes not only the hunger and weight loss, but damage to other organ systems.

    Some diabetic pets are so cantankerous that they refuse to let their owners inject them with insulin, and these folks have the same experience as you, even though finances are not an issue at all.

    In life, we have to make the best choices that we can. You can only do what you are able to.

    In nature, these cats would have died much sooner without the tender loving care that you have provided for them.

    In this situation, when the cat has become weakened by the disease-produced starvation, you will know that you are on the downhill slide, and it’s time to make the decision.

    When you have done your best, you can do no more, and need feel no guilt.

  201. Terri says:

    Hello Doc,

    Thank you so much for this support on such a painful issue.

    My 1 year old cat has been diagnosed with FIP after many tests and ultrasounds as well (so the diagnosis is about 90% definite).
    My vet refuses to provide her opinion on when to take this difficult step and insists that only I can tell and decide.
    So the tough question I still have after reading many of the comments here – what defines a good day?
    My kitty still has an appetite, but he stopped playing and exploring. So he basically sleeps and eats all day. He urinates and defecates in his litter box. He also still comes over and sits on my lap.
    So basically – the exploration and playfulness have disappeared, and there are no “good days” where he suddenly does those activities.

    I would really appreciate your opinion on this matter.

  202. Doc says:

    Hello, Terri,

    So your kitty has a terminal disease. He fulfills his bodily functions without difficulty.

    Having stopped playing and exploring, we know that he doesn’t feel as good as he used to.

    He still wants to spend time with you, so he still enjoys life to that extent.

    I think that when you see him no longer fulfilling basic body functions and no longer enjoying your companionship, it will be time to make the decision.

    You know he won’t be getting better. When he starts getting worse, it will be time.

    I am sorry you are faced with this difficult situation. Your cat is fortunate to be spending what life he has with you.

  203. Frances says:

    Dear Doc:

    Thank you for your response and guidance during this difficult time. When I read your post this morning and realized that my cat was starving or near starving, I phoned the vet and scheduled the appt. Today at 5:10, my dear cat Elko passed. I was with him during this time and was thankful that we could say our goodbyes to one another. I am completely devasted and the house seems eerily quiet although I still have two other pets to care for and three small children. I will miss him dearly and hope he is at peace now. Doc, without your guidance, I could not have made this decision alone. Your input is valuable and I appreciate your understanding of our situation. If I ever need further advice re: my other two pets, I will not hesitate to ask for your advice.

  204. Cin says:

    Hello,
    I have my 16 yr old cat, Baby, who was just diagnosed with diabetes. His glucose was 600 but his kidney and liver function is ok, just a slight possible urinary infection. He acts very normal, lost a little bit of weight and needs dental work which is why I took him in, then we find this out. My veterinarian has recommended lantus if I want to start him on insulin, she thinks possibly we could push him into a remission (with a diet change also); I have to say when I researched how expensive lantus is, that it has only a 28 day life, not to mention all of the problems that could go wrong, it has become a serious condition. You see, in December I just lost my beloved Oliver (10 yrs old) who battled his second bout of liver failure, yes, I went all the way the first time with feeding tubes, meds, supplements and he recovered and then it comes back last November and we put the tube back in and thought we had it licked and then he tried to throw up the tube so we thought it had just shifted position and would need adjustment. Not so, within 2 weeks a walnut sized tumor had developed (xrays before and after clearly showed it) and it was lymphosarcoma, my little one was gone within a week. Both of my boys who are left mourned for months and looked for him everywhere, they had been together since the day he was born and I held him in the palm of my hand.
    to say that I have spent MANY thousands of dollars would be the truth, not to mention the toll it has taken on me with my own immune disorder Fibromyalgia. Not to mention that I work 2 jobs and care for my 97 yr old grandmother.
    Needless to say I am like a deer in headlights and seriously considering more of a hospice-care type of situation. Do you have any thoughts on this?

  205. Fallon says:

    Hello, My little Thriller is 4 years old and was diagnosed with IBD about 3 weeks ago. Before that he was sick for close to 2 weeks, I took him to a cat specialist and he stayed with her for a little over a week! He had tons of blood work done, with no indication of anything serious! The vet gave us Vetalog tablets .05 at 1 two times a day for 3 weeks now! He isn’t doing anything he hides under the bed and barely eats or drinks! I have tried everything and now he is defecating all over the floor! He wont play or sleep with me anymore and is just skin an bones! About a week ago the tips of his ears started to droop! He is usually all over me, so for him to hide all day, and not play is way out of the ordinary! I feel awful even contemplating the decision, I want to believe that it is just the Vetalog, but his diarrhea is still happening along with a bit of blood! I can’t bare to touch him because every bone in his body bulges out! I don’t want to even be thinking about the end on account of his age! Do you have any advice? I am constantly cleaning up messes that are potentially ruining my house and my marriage! I don’t know how long it takes steroids to take affect on his IBD, or if it will ever?! He is my baby and I want to help him in any way!

  206. Doc says:

    Hello, Cin,

    First things first. Try to look at Baby’s problem in a new unit of time, not connected to all the previous losses you have experienced. When you tack this situation on to your past loss and pain, it becomes too big to confront.

    You tell me that Baby’s body is actually doing well except for the diabetes. That means that it shouldn’t be too hard to get him regulated. By “regulated”, we mean getting an appropriate dose of insulin that matches up with his activity level and diet so that his blood sugar stays within an acceptable range and he feels good.

    You need to get the urinary tract infection cleared up, as any infection or inflammation can make it very hard to regulate his insulin dose. This should not be difficult to do.

    It is true that the Lantus (glargine insulin) costs more than the other types. It is not true that you have to discard it in 28 days. Keep it in the refrigerator. Rock it gently to mix it before every dose (rather than shaking it hard). You can use the bottle until it is empty.

    Yes, lots of things could go wrong. On the other hand, Baby hasn’t gone very far wrong yet. You didn’t even know he had anything wrong with him until the blood tests were done. So, it is also possible that lots of things could go right.

    I won’t tell you that taking care of a diabetic cat is trouble-free. On the other hand, I have had diabetic cat patients who required very minimal monitoring and stayed stable with their insulin dose for years.

    I understand that you have a lot on your plate. It also sounds like you love your cat and are not ready to give him up. I think this is doable. Give it a chance if you can, but I can’t judge what you are able to handle. You have to make the best decision that you can.

    Best wishes.

  207. Doc says:

    Hello, Fallon,

    IBD is often a diagnosis of exclusion. It’s not “anything else”, so maybe it’s IBD. Without an full-thickness intestinal biopsy, you cannot really say for sure. Even then, you can make a mistake. Anything that causes chronic diarrhea is going to cause inflammation fo the bowels.

    I cannot really diagnose a pet whom I have not seen. In this case, I would definitely call your veterinarian to let him/her know how poorly things are going.

    I would also be very concerned that your cat actually has another disease in addition to the inflammatory bowel disease. Intestinal lymphoma (a type of cancer) would be high on my list at this point.

    Your veterinarian made the best judgment possible with the information available at the time. He/she deserves the new information.

    If this were uncomplicated IBD (if there is such a thing), I would have expected some response by now.

    This is a tough situation. Get in communication with the veterinarian.

  208. Samantha Gentrup says:

    Dear Doc,

    Thank you for having this blog. At 4:00 today I am saying goodbye to my good friend and companion of 10 1/2 years. His name is Albert and I found him on the side of the road when he was a kitten. He has occassionally coughed up hairballs throughout his life and I attributed this to his long hair. Then, in July he started sneezing and vomiting more frequently. As the vomiting continued it was mostly bile. Early August, I took him to our vet and they did bloodwork. His platelettes were low and he had high eosiniphils. They treated it like it was parasites and/or infection and gave me a dewormer and an antibiotic. While on the antibiotic his vomiting stopped and the sneezing stopped. He began eating again, then after about a week of being off the antibiotic, he started vomiting again. At this point I started trying different foods, specifically switching from dry to canned foods. I tried over 20 different brands without luck. He would act like he was starving, meowing loudly, and then when I put the food down, he would eat a little, then stop. I took him back to the vet and they checked his blood again, with the same results. I then took him to get an ultrasound and it showed a “mass” right next to his liver. They said that they couldn’t draw fluid from it to test because of it’s location, and they couldn’t remove it because of it’s size and proximity to the liver and a major artery. They suggested exploratory surgery. I said no. I then called a holistic vet to the house and she looked at all of the records and symptoms, and gave him vitamin B shot, something to soothe his GI tract, an antibiotic injection, and a steriod. She said she was going to treat it like IBD. He perked up a little and was eating the a/d food and I was also giving him 10 mg of prednisolone daily. Then he went back down and for 4 days has not eaten anything and is drinking quite a bit of water. He is not going to bathroom either. I think his body is shutting down and I feel in my heart it’s time to do what’s best for him. It’s still extremely heartbreaking to make this decision, and I have lots of guilt over whether I could have done more, whether I could have done something sooner, or whether it’s because of something I’ve done such as food, environmental factors, etc. He ate a middle of the road dry catfood his whole life because I couldn’t get him to eat anything else. He wouldn’t touch organic dry food, natural dry food, or canned food. My two dogs are on the best food possible and I will do everything in my power to not let them fall victim to the cancer and tumors that are affecting so many of our beloved friends and companions. Thank you again for having this blog. It is comforting.

  209. Doc says:

    Hello, Samantha,

    Thank you for sharing your story of this difficult time.

    I sincerely doubt that your cat’s illness is related to a lifestyle issue. It is much more likely that it is related to the mass that was seen on ultrasound.

    Would it have been a tumor that could have been completely removed? We won’t know. With my own dog, I was able to remove his large tumor by removing his spleen, where it had grown. Unfortunately, it had already spread throughout his body when I found the large mass. He wasn’t even feeling bad. I just felt it when petting his tummy one day.

    We can always think of something that we could have done differently. The question is, would it have been better, or just different? We have to go from where we are now.

    This is one of those times when the best decision we can make is not an easy one.

    Best wishes.

  210. Cin says:

    Dear Doc,

    Thank you for understanding, you are right that I can’t connect Baby’s problems with the loss of Oliver, it does become to large and I need to keep a disconnect between them. And I am taking your advice and starting Baby on Lantus, my veterinarian agrees that because Baby has not had any other issues (she reminded me that he has a slight heart murmur) that we may be able to get this into remission in the 4 month time period, or perhaps just down to a once a day dosage. He has had his loading dose of lantus and Wednesday we will do the curve on him. I really do feel much more hopeful and really think that I can make this work. My vet did agree that the 28 day life of Lantus is not accurate, she has clients who use a vial for 45-60 days, the key is to keep it refrigerated. I do plan on doing in-home glucose tests so that I can keep better track of it.
    So here goes, thank you for your caring and will let you know how it goes.

  211. Aaron Cohn says:

    It’s been 3 weeks since sluggo, my 22 year old tux got sick. A very long 3 weeks. He’s been off insulin for a week now. He’s just starting to eat a tiny little bit of Gerber baby food (chicken). I know it’s not nutritionally complete, but I was desperate to find SOMETHING he’d eat. He’s had a feeding tube & I’ve been feeding through it. Lots of purring, loves to be furminated. I’m beginning to think just maybe he’ll pull through.

  212. Doc says:

    Hello, Aaron,
    I agree that finding SOMETHING he will eat is more important than being particular about what it is at this point.

    Very well done on coping with the feeding tube.

    I’m pulling for you.

  213. Vee says:

    Hello,

    Last Monday 10/12/2012, I had to put down my precious cat, Maggie. She had abdominal mass and her condition was at its worst. She stopped eating, drinking, moving, and interacting with other cats like she normally did. She lost massive of weight and blood coming from her rectum. The vet recommended utlrasound, biopsy, and surgery. All procedures reguire a lot of money and I am not the best situation with finance. I spent sleepless night to stay up with Maggie with tears in my eyes. I knew she was in pain. The decision to have her euthanize was extremely difficult. After she passed away, I was sobbing for 4 days and felt guilty. Maggie was a special, lovable cat, and an Angel to me. I still having a hard time living without her. The question lingered in my head did I make the rigth decision? -Helpless guy

  214. Doc says:

    Hello, Vee,

    In a situation like this we cannot always make a decision that gives a happy outcome. Even if you had been able to spend big bucks on Maggie’s treatment, it sounds like this was a losing proposition. Some things just aren’t fixable.

    The decision to euthanize is always difficult, even when it seems the obvious right thing to do. When my own dog had widely disseminated cancer that was un-treatable, I still had difficulty when the time came.

    It sounds to me like you have done your best, and that’s all you can do.

    I am sorry for your loss.

  215. Embrace says:

    My beloved companion of 15 years was euthanized today. I agonized over the decision but now feel I waited too long. It is peaceful and fast and relieves a great deal of suffering. Unfortunately kidney failure, old age, hypertension can lead to a long agonizing death. She was unable to stand up for 4 days-I should have acted sooner. You will feel relief, not regret for assisting your friend, I found a local veterinarian who would make a house (or apartment in my case) call. It made a big difference-probably costs more. This is the first time I have had to do this. All the best to you in your decision and grieving process. P.S. if your employer resents your taking time off to spend with your friend on their last day ignore that and make your own judgment call. You will not regret that either,you couldnt pay me a million dollars to give up today

  216. Lani says:

    I am not sure how old my cat Meatball is, but we know he’s at least over 15 years old. Meatball is such a great cat but the last couple months have been painful to watch. He limps every where he goes, he has stopped cleaning himself and is tracking fecal and cat litter all over the house. When he eats he lays next to the bowl. He was recently diagnosed with diabetes and I am trying to control it with diabetic food. He has also become incontinent. He sleeps all day and can not jump up on our bed anymore. I am not sure if he is in pain. Is it time to let him go?

  217. Doc says:

    Hello, Lani,

    Sorry to be so late in replying.

    You are describing a cat with a pretty poor quality of life. He doesn’t feel well enough to groom, can’t stand up to eat, wets himself, and sleeps all the time, with no happy activity.

    This is a situation that can only get worse.

    I cannot make this decision for you, but the fact that you are asking the question tells me that you are already pretty sure of the answer.

    It is always hard to let go, but there does come a time when we are not so much living longer as just dying slowly.

    This is a tough decision, but it sounds like you will need to make it pretty soon.

  218. Aaron says:

    Been a long road back for my 23 year old tuxedo, “mr sluggo”. After 2 1/2 weeks being fed ground purina dm through a feeding tube, he regurgitated, and had the distal end coming out his mouth & was gagging on it. I quickly snipped the suture & removed it, but apparently taking a piece of skin. Since then, he’s progressed from a diet of chicken gerbers baby food to a 50/50 mix of that with Hill’s a/d. This morning, I tried getting him to eat the a/d alone & he did a bit, but after that refused to eat anything, but the baby food & it took the rest of the day to get back to 50/50. Occasionally he acts like he wants to eat his old eukanuba dry I feed the other cats. He puts some of it in his mouth, starts chewing it, but then spits it out… At his last check-up he’d actually put on 5 ozs. Blood sugars 130-260 no insulin. Today, I let him outside for a brief while. He was studying a lizard crawling on the screen outside, then suddenly jumped 3 feet in the air lunging at it & crashing into the screen. The old sluggo! So far, the decision to stick by him & not euthanize seems to have been correct despite his age & the enormity of his problems. So far…

  219. Maggie says:

    Hello Doc,

    On 10/22/2012 I had to make the hardest choice of my life and that was putting down my 9 years old cat, Maggie because she diagnosed with a large abdominal mass. The Vet said the mass was about 7cm long and she had large amount of fluid in her abdominal area. I was shock, emotional distraught. They recommended surgery but did not know the outcome of her life span after the procedure. Also the surgery was very expensive and I was in somewhat financial constraint. Prior taking her to the Vet, I noticed Maggie stopped eating, moving, or drinking. She had been like that for four days. I also noticed there was blood coming out from her rectum. All she wanted to do was to curl herself in a small corner of the room. I don’t know if she was in pain or suffering. But it broke my heart to see her not moving or eating. As a 12 years veteran working in the law enforcement, I never cried so hard. I stayed up all night with her and even took time off from work to be with her with endless of tears.
    Maggie was a special cat to me. As a 37 years old single guy with no kid and never been married, Maggie was my only kid.. . my precious. She made me laugh with her big googily eyes. She always waited for me by the door from work and always slept next to me. When she was a kitten she had more toys than kids at St. Jude’s Hospital and I would watch her play all day long.
    After her death, it took a toll on me and I found myself very difficult to move forward. I don’t know how to grieve or cope with the tragedy. I kept asking myself, did I make the right decision? Please help.

    I would appreciate anyone opinion.

    Vee (Maggie’s father)

  220. Doc says:

    Hello, Vee,

    From what you tell me, I think that you made the best decision that you could under the circumstances. I don’t see how anyone could criticize you for it. You did the right thing. Of course, knowing it’s right doesn’t make it easy.

    It is normal and natural to feel grief and loss at the death of a friend. It is not so good to be incapacitated by grief.

    You don’t need to feel ashamed that you have the feelings that you have here. On the other hand, we all have to move on at some point.

    Sometimes it just takes time. Sometimes we need to look at things in a different way. I don’t think you should feel guilty about your decision, so don’t waste time staying balled up in that.

    Sometimes we feel so profoundly affected because this loss chains on to other losses in our life. We experience not only the loss of this pet, but the restimulated losses of grandparents, or parents, or other friends. If you have this all pulled back up out of your emotional vault, it can make the new loss somewhat overwhelming.

    One very helpful thing is to consciously decide not to stay interiorized into this situation. Put your attention out into the environment. Get outside, get physically active, and do something constructive.

    I stayed depressed for two years when I lost my father. When I really began to put it behind me was when I began building my new office and making plans for the future.

    Everybody needs something to do, something to look forward to, and somebody to love. So look at those in your life instead of dwelling on your loss.

    You have great memories of your friend, and that’s good. Go out and make some new memories.

  221. Trish M says:

    Hi there,
    I am so grateful I found this site and it helped me immensely to take my adorable friend Bobby to the vet’s to be put to sleep yesterday. He was 16 and diagnosed with CRF about 3 years ago but with the help of Benazepril, he managed to make it all this time.
    I feel so lost today and miss him more than I can put into words but I do feel it was ‘his time’. Bobby was skin and bone, hardly eating, dehydrated and hated the sub cut fluids. I had been giving him Zantac and ondansetron to help with his stomach acid and sickness but on Friday he even vomited that back up so it couldn’t help him.
    Just to make matters more difficult he was actually having a good morning on Saturday and wanted my touch. I still have nagging guilty feelings because of that but hope I did the right thing because it stopped him having any more bad days where he would hide and flinch at my touch.
    I miss him so so much.

  222. Doc says:

    Hello, Trish,

    Thank you for sharing your story. I think you can put your doubts to rest. You did the right thing.

    Of course you will miss him.

    I am sorry for your loss.

  223. Katrina says:

    Hello – I just found this thread, thanks to everyone for it. I’m struggling with the decision of when is the “time” for my 14-yr old kitty. She has IBD, hepatitis, pancreatitis, extremely low appetite, and is very lethargic. Also, she has developed some strange head/forebody twitches. She is still loving, and has turned into a complete velcro kitty since we returned from Thanksgiving travels. I’ve – my husband, too – put a lot of effort into helping her keep going, but I feel like she’s just shutting down now, and that there is a sense of peace in her that is letting it happen. I’m struggling with the decision, since we have more Christmas plans that will involve us being gone, and I don’t want anything to happen to our petsitter and other cats while we’re gone. Right now, to keep our Sadie eating at all, she needs mirtazapine, and buprenorphine to make her more comfortable. On top of all this, we have two other cats – one of which is highly anxious, and would be very negatively impacted if something were to happen to her momma cat when we weren’t around. Even though Sadie could maybe make it a few/many weeks longer with drug therapy, I’m starting to feel it would be best for her and the other kitties if we made the decision to let her go in the next couple weeks, while her life is still good, and then focus on stabilizing the other kitties before the holidays. Thankfully, I know that if Rikki (the crazy cat) can start getting used to Sadie being gone with us around, once the cat sitter starts watching her, everything will be OK. This is 100% due to the cat sitter – she treats our kitties like her own, and keeps extra special watch on how they are all faring psychologically. But I feel like we need to settle things for everyone (Sadie and Rikkie, especially) before leaving for the holidays. I also worry that I’m trying to justify doing this out of convenience, but it doesn’t feel convenient to me. It just feels like I don’t really have any good options left. Thanks for reading – if anyone has advice, I’d really appreciate it. Thanks – Kat

  224. Katrina says:

    I just finished re-re-reading my post above, and feel like I should make one more comment. At the moment, Sadie isn’t in pain – that is all very well managed. Her box habits are the best they’ve been in years, too. But she’s fading away – down two pounds in about a month and just generally slowing down. And becoming more snuggly – I feel like she’s leaning on me for comfort. Thank you.

  225. Doc says:

    Hello, Katrina,

    This is a very difficult time. You can see that the end is coming, and coming fairly soon.

    If this were just a matter of adding up the columns on a balance sheet, we could easily see that we won’t gain much by our efforts to keep Sadie going.

    It’s not just the “math”, however. It’s a friend. There is nothing easy about it.

    You really do have to consider the big picture, as you have. What will this be like for Sadie while we are gone, and for the other cats when we are gone or she is gone?

    There is always a way to second-guess yourself. No matter what you decide, there will always be some way that it could have been different. Is different better, though? Not always.

    You just have to look at the whole situation and make the best decision that you can.

    You have been doing a great deal of work to keep Sadie feeling okay despite her many medical problems. A “convenience euthanasia” would have taken place a long time ago.

    I don’t think that anyone but you can be critical of whatever decision you make.

  226. Katrina says:

    Thank you for the response. I really needed to hear from someone independent of the situation. After discussing her condition with my husband, we’re continuing the mirtazapine/buprenorphine regimen and seeing how the next week goes. She’s eating again, has lots of energy for getting her food but is otherwise increasingly sedate. I’m very lucky I married a man who loves my cat and understands how important she is. He’s having a hard time with her getting sicker, and I feel extremely glad that he is involved and invested in making sure she stays comfortable and happy. Thank you again for your time.

  227. Doc says:

    Hello, Katrina,

    I am sorry that I could not give you a more concrete answer. This decision depends so much on being with the animal and knowing its moods.

    I hope that things go well with you and that Sadie’s last days are not difficult for her or for you.

  228. Sandizona says:

    For the past two weeks, I have been searching as many articles online as I possibly can to help me try to understand what is happening to our precious Furry Kid / our 9 year old, 14+lb.Maine Coon named Baxter. Our big guy loved to bat toys around, crunch on his hard kibbles in the quiet of the night, sit on his padded perch looking at the people walk by the front window, soak up the hot morning sunrays, hop up on the back of the couch to watch Hummingbirds getting drinks & a RoadRunner who comes daily for little raw meatballs. He would try to hide while watching these birds, but truly too big to stay hidden. : ) Can’t believe he isn’t able to do any of these normal, typical daily routines.

    On Nov. 19th, we noticed that Baxter was losing weight and sleeping more. My husband took Baxter in for blood work and was sent home after an brief examination. The Vet didn’t find any lumps, bumps, sores……so Baxter came back home.

    Back to the Vet on Nov. 27th, as Baxter was showing other signs and symptoms that we’ve never seen.
    *Continued weight loss
    *Not grooming himself
    *No interest in his food / or water
    *Peeing in his litter box, Not pooping
    *Eyes that don’t close completely when trying to rest / sleep….almost has a stare, yet looking no where : (
    *Fur on his back, rather greasy, and truthfully almost a urine smell : (
    *When being held, then wanting down….his back legs are not steady, like very unbalanced
    *Trying to feed him with the syringe, using the a/d wet food for critically ill cats (from the Vet)
    Baxter doesn’t allow us to squirt much food in. We even tried Gerber Baby Food Meat (Chicken, Beef)….no interest. Pure Pumpkin puree…I was able to get him to take a baby spoon full, yet when some puree dripped out, he wasn’t / isn’t able to lick his lips, chin, whiskers, neck anymore. We have to wash his face.
    *Stomach makes horrible grumbly noises when the tiniest bit of food or syringe of water enters.
    *Breathing is fast, deep, labored. I noticed his nostrils spreading with each breath he takes.
    *Can’t seem to get comfortable when trying to rest. One time a blanket, one time the cool wood floor, one time the cool stone tiled shower floor, but not on our laps or on our bed as he always has slept before.
    * No sounds, he cannot mew-or meow, cry, nothing…..its beyond sad to not hear his talking.
    ***Baxter has been on Clavamox (antibiotic) twice daily since Nov. 27th. Prednisone tabs 2, twice daily….to help with wraspy breathing. He has been on Prednisone three other times in the past years.
    ***On Friday evening, Baxter wouldn’t allow us to pry his mouth open one more time. Nope, not happening. We are allowing him to try licking food / water on his own. Today….he “licked” water 3 times, on his own. I was so happy, but was bittersweet because the licks were not actually giving him anything to swallow.

    I am still trying to search these symptoms, and read from other cat owners how they are dealing their sick cats….and bottom line, is that we want to know when its’ “time” to let go.
    One quote I found ….said something like…..If out of 7 days, 4 are good and 3 are bad; it’s “time”. If I were living like Baxter is now, I would want to hide too, and not be bothered. Maybe he is trying to tell us to please say our good byes now.
    *I have been gently petting him often, telling him how much I love him, and how thankful he brought us so much joy for these 9+ years. I tell him I will miss him terribly and he will be able to play at The Rainbow Bridge with so many other furry, feathered, scaled, all sorts of animals, many many very loved family pet members. This is just so hard.

    * (YES…..I’m crying as I’m typing on this blog….so glad I have a place to share the struggles we’re having about knowing “when” its time for The Sleep in Heavenly Peace Shot.

    ***planning to call the Vet first thing tomorrow morning. I’m sure Baxter can be seen right away, and the Vet & tech’s will help us with our decision.

    (I will probably post here again, …. when my eyes can focus)

    If you’re reading this long post, …. I know, you know what we’re going through, and what our special Baxter is going through.

    Sandi & Dave ….and =^~~^= Baxter
    (Fall / Winter / Spring snowbirds in AZ….Summers in WA State)
    Sunday, Dec. 9, 2012 11:15pm

  229. Sandizona says:

    We decided it was “time” to take our Baxter in for his Sleep in Heavenly Peace Shot this morning at 11:00am. Very very tough day.

  230. Karen says:

    Hi Doc,

    I have a 9 year old cat JJ who became sick with urinary problem when I was pregnant. He was diagnosed with urinary tract urolithiasis. He is on special diet and unfortunately he is still incontience and doesn’t urinate in the litter. My friend looked after him over last 6 months and kept him inside the bathroom. Me and my husband working full time and need to look after 5 months old baby without any help from family who are overseas.

    Me and my husband having difficulty care for JJ who urinate everywhere with poor hygiene. JJ doesn’t seems to have quality of life as he is kept in either a bathroom or in a cage.

    I tried to rehome him but no places accept him. They said he is likely to be euthanized. I feel very bad about it. But at the same time I feel bad to keep him in a cage at the backyard. I don’t let him inside the house but to his incontinence and poor hygiene which can affect baby.

    Would you give me some advice and your thoughts please.

    Thank you so much.

    Yours sincerely,

    Karen

  231. Doc says:

    Hello, Karen,

    If you haven’t already done so, the first thing is to have your veterinarian recheck the cat’s problem. If he still has a urinary tract infection, then that has to be handled.

    If that has been fully handled, then you need the services of a behavior specialist.

    This website is a really good resource if you cannot see a specialist.

    http://indoorpet.osu.edu/cats/

    If none of these are helpful, you might also consider looking for a home as an outdoor cat. It is not as safe as an indoor cat, but it’s not dead.

  232. Frances says:

    Hi, Doc! You have been a great help in giving advice to me in the past and hope I may again request your guidance. My 12 year old cat has begun throwing up daily, sometimes twice/day. I stopped giving her fancy feast wet cat food and have given her only purina beyond dry cat food without corn or wheat. She is still throwing up and her stomach is constantly gurgling and loud. Please note that about one month ago I only had her on dry cat food and no fancy feast and her throwing up was only once a month. Two months ago I brought her in to the vet because she was throwing up twice a day. My vet checked her blood and urine and said all came back normal. He suggested going for an ultrasound to check for cancer but we did not get one due to cost and the fact that we had to travel out of town to get one. Besides stopping her wet cat food, what else can I do for her that is low cost? I had her on a high protein wet cat food from petco before but she would not eat it. Also, please note that sometimes I see her fall backwards when startled and wonder if there may be more to this. Just to give you more info, her bathroom routine/output is normal. Your thoughts? Thank you SO much for your time in responding to this message.

  233. Doc says:

    Hello, Frances,

    If your veterinarian has not already checked your cat’s thyroid level, that would be worth doing. Hyperthyroidism can do a lot of different things in an old cat.

    I have also seen this with Inflammatory Bowel Disease and intestinal lymphoma and with chronoic pancreatitis.

    These things cannot be diagnosed from the outside of the cat.

    The Texas A&M GI Lab has a panel of tests that can be very helpful (blood tests) in sorting out some of these problems.

    Sometimes you cannot tell without an exploratory and biopsy.

    Some are cheap to treat, some are impossible to treat.

    Sorry that I do not have a quick fix for you.

  234. Alex Bowen says:

    Hi, this is a great site. I think my decision is nearing. Our cat, Harry is 21.5 years old. I’ve had her since she was 8 weeks old. She’s a super cat.

    She used to be 6 to 8 kilos in her prime and now she doesnt register 2 kilos. She is a bag of bones. She was diagnosed with Hyperthyroid about 7 years ago. We did medication for a long time but it made her sicker so we stopped it.

    She eats like a horse, vomits at least once a day, pees and poos everywhere other than in her box, seems disorientated regularliy and does not stop talking….all the time. Bad teeth. She also seems to have a lazy back leg now and sleeps most of the time. She always wakes up now around 4am and cry outs like she is sleep walking. We pick her up and put her in bed with us until it all starts again at 6am.

    It can’t be good for her. She was active and fun loving. Now she moves slowly from food bowl to bed.

    She is an amazing cat and has been around in my life for over twenty years.

    Is it time?

  235. Doc says:

    Hello, Alex,

    I hear a lot of things that sound bad, and really nothing that sounds good.

    After more than 21 years of a SUPER CAT, I can see how hard it would be to let go.

    If you were describing anything that sounded like Harry was enjoying life, then dealing with the rest of the tough stuff could be worth it.

    I’m not hearing anything but tough stuff.

    Francis Bacon once wrote that “a healthy body is a guest-chamber for the soul, and a sick one is a prison”.

    It will be hard to let her go, but I wouldn’t feel bad about helping her break out of jail.

  236. Karenna says:

    Our 13-year-old Cher was starting to poop on the rugs. Vet diagnosed her with a spinal cord injury. Her tail was down and didn’t respond to pinching. Vet put her on oral steroids and after a few rounds she had a miraculous recovery. Then she relapsed. We moved her and the two other cats to the basement, which is our TV room and my workspace. Now Cher is completely incontinent – drips and poops on the floor and wherever she is sitting. Never makes it to the litter box. Put her back on prednisone but she’s only worse. She has ruined two sofas and a rug. We keep a bucket and mop in the bathroom and clean up after her on the vinyl part of the floor a dozen times a day. I wash slipcovers and pillows and clean the rug and stairs carpeting over and over. Still, the basement reeks. We can’t go anywhere because we can’t leave this mess to a pet-sitter. Cher is a sweet girl, jumps up to her perches despite shaky walking, and does not seem to be in pain, but we do not want to live like this. I hate to think of putting her down and don’t know how to tell my daughter, who lives in another state and adores this cat. I feel as if I’d be putting Cher out of MY misery but I’m afraid the time has come.

  237. Doc says:

    Hello, Karenna,

    This is a terribly difficult situation. Given what your veterinarian has seen and tried, and the response, it seems unlikely that Cher (or your quality of life) will improve.

    While it is possible that an MRI might reveal a lesion that would respond to neurosurgery, the odds of a happy outcome are vanishingly small.

    So you are left with the choice of confining the cat to an area that can be adequately cleaned (not much life for the cat), continuing to live as you are (not much life for you), or euthanasia.

    From your post, it sounds as though you ave been dealing with this for quite some time. If you are finally at the end of your rope, I can certainly understand that.

    The person who criticizes whatever decision you make at this point had better be prepared to offer you some better alternative for both you and Cher.

    Sad to say, I’m not really seeing one.

    I wish I had something helpful to offer, but I do not. This is a tough situation.

  238. Karenna says:

    Doc,
    Thank you so very much for your understanding response. You’ve capsulized the whole situation beautifully. Now I have to muster up the strength to say good-bye.

  239. Robin says:

    This page has been helpful. As much as I don’t want to do it, I may have Simba put to rest tomorrow. He is 19 CRF kitty. We’ve been treating with Subq for almost 22 months. The treatment has prolonged his life greatly. But two weeks ago, he went blind High Blood pressure, etc. New round of bloodwork shows his kidney values are worse than they’ve ever been. He just sits in bed and sleeps or sits in the meatloaf position. I love him so much, he is the center of my universe. I keep thinking I need to wait until he doesn’t want to eat any more. That will be my sign. After reading this site, I feel like he needs to be set free. He doesn’t seek me out for affection at all. He was the most affectionate boy. I think I just need to let him go. These past few days have been tough on me, watching him just sleep or sit up in meatloaf position. And now recently blind. This is no life for him. He is the center of my universe. This is so hard.

  240. Doc says:

    Hello, Robin,

    “This is so hard.” So simple, yet so true. I hear more emotion in that simple sentence than in most paragraphs.

    You have made your decision, and you are doing the right thing. But it is so hard.

    Best wishes.

  241. Cathy says:

    Just read all above & whilst sad it is heartening to know so many people care so much.
    Jess is 15 & has a golf ball size tumour on his kidney.
    He has lost nearly half his body weight in 6 months.
    He still eats a bit of chicken & drinks.
    He sits on his cushion all the time & manages to walk outside for 10 minutes to toilet.
    He vomits most days.
    He purrs a bit when stroked.
    2 weeks ago Vet said bring Jess home & love him & let him go when he has no good times.
    But I don’t know.
    He is still aware – I had hoped his consciousness would fade before I let him go.
    Torturing myself wondering if he is suffering & when is right time.
    Any opinion would be appreciated.
    Thank you!

  242. Karenna says:

    When is it time? This is the question we are asking here, isn’t it? I knew it was coming but then everything came together: Doc’s thoughtful response to my posting here, a horrible dream involving a cat, the worst mess ever the next morning, and then a call to the vet. After some discussion, they asked, “When do you want to do it?” I heard myself saying, “Today.” Just one hour later, after spending some time with dear old Cher, we packed her off. Yes, it was very sad and difficult, but now that it’s behind me, there is a sense of relief. The time had come, and I was able to recognize all the signs pointing in that inevitable direction. I should add that my daughter got a kitten less than a week later!

  243. Doc says:

    Hello, Cathy,

    This is always such a hard time.

    I’m hearing from you that Jess eats a little, can make it outside to use the toilet, but most of the time just sits on his pillow doing nothing but “existing”.

    You know better than anyone what Jess enjoyed doing. I don’t hear you mentioning anything like that.

    So, does he hurt all the time, or does he just feel crummy? That’s a question that we have a hard time answering.

    I had a good friend whose kidneys failed him in his old age. He had dialysis twice a week, and felt pretty decent after the procedure. Four days a week he felt pretty crummy. No energy, no enjoyment in his life. He ate because it was time and he felt hungry. Except the days he didn’t feel hungry because he didn’t feel much of anything.

    He never asked me to smother him with a pillow (like my mother did when she was dying of cancer). He just weaker and finally his spirit gave up, or his body did. Maybe both.

    It’s pretty depressing to visit a friend and hear him say “I’m just waiting to die”.

    Is that what Jess is doing?

  244. Craig Harrison says:

    Hi,

    We are very glad to have found this on running blog as it has given us the strength to make the ‘right’ decision with regard to our little girl Whisper.

    We think she is about 15 years old now and we have had her for 11.5 years having adopted her when a work colleague was going to get rid of her to an animal shelter at Christmas time. My girlfriend (now wife) and I had only just bought our house together and as such it was the start of our new life together and as it turned out when we adopted Whisper her she was already pregnant and had 4 beautiful little kittens after only 6 weeks of being with us!

    Since then she has been with us to see us get married, move to a house with a beautiful big garden, the birth of our first child and the impending birth of our second child as well as a multitude of other happy and sad times. She really means the world to us and we cannot imagine the house without her in it.

    About five years ago she was diagnosed with hyperthyroidism. She has had two separate operations one year apart to remove the two thyroid glands as the symptoms came back. Sadly the symptoms remained and our vet said he believed that she had ectopic thyroid tissue somewhere else in her body. She has had more tests than I wish to care for.

    So for the last 3.5 years or so he has been on Felimazole tablets broken up into her food, starting off on one 2.5 tab a day and now two 5 tab per day, and has done really well, but we were always aware that hyperthyroidism (more the side effects caused by it) would eventually claim her.

    We took her to the vet on December 6 for a check-up and he discovered that her heart rate was erratic which showed classic signs of heat diseases. She was/is also drinking a lot of water which apparently pointed to possible renal issues. Sadly since then she has lost half of her body weight, is having trouble walking and climbing stairs and more heat breaking for us and her she has developed chronic diarrhea for the last month which she often does on the floor near her litter tray as she overshoots when she is stood in the tray. She has been such a clean cat all her life and she looks at you apologetically when she makes a mess.

    She is so skinny you can feel every vertebrae in her spine, every rib, joint, etc. She is so weak as she has no muscle left hardly and importantly to us her eyes look sad and tired. She hardly ever wants to go outside and cannot appear to get comfy when sat or laid down. She hardly ever sits with us or sleeps on our bed, which she has done for 11.5 years……….it feels like she is just existing, which cannot be right can it?

    So, it is with heavy hearts, that having read you advise on ‘good and bad days’ and ‘keeping her alive or just making her die slowly’ that we have arranged for the vet to come to our home on Monday 18 February to euthanize our beautiful little girl in a place she loves with the people she loves and who love her by her side rather than let her probable pain and suffering carry on.

    It is a decision that we have not wanted to make and my wife and I have spent many hours talking about it, many sleepless hour thinking about it and even now I keep thinking we will wake up one morning and she will be okay or the vet will have a ‘magic’ shot to make her well again.

    I must admit I am struggling with ‘acting like God’ and deciding when she dies…….but deep, deep down in my heart I know we are doing the right thing and we owe her this one last show of love to end her suffering.

    I feel sick to the pit of my stomach thinking about the actual day, which is arriving all too fast.

    Many thanks to everyone who has contributed to this blog……..you have all helped to assure us that we are making the right decision for our beloved Whisper.

    Craig

  245. Doc says:

    Hello, Craig,

    Wow… that’s quite a story. Thanks for sharing it with us.

    As difficult as it is, you know you are doing the right thing.

    Best wishes.

  246. S says:

    I am so thankful i found this webpage. everybody else’s stories have helped me see that many of us have the same fears and questions and go through the same pain. I’ve been sat up most of the night reading these posts whilst feeding my newborn and agonising over whether I am making the right decision regarding my beloved boy cat – L. We’ve had him 9 years (he was 8 when we got him from the animal rescue). Throughout the years he’s had many ailments – skin cancer (completely removed), suspected IBD (thickening seen in small intestine many years ago but no symptoms), hyperthyroid, mild renal insufficiency, asthma (we used an aerokat inhaler to avoid oral steroids). All are treated and he was a happy cat until a couple of months ago. He started losing weight rather rapidly about 8 months ago. He also had constipation. The two weren’t really linked by us or the vet due to his other conditions. A couple of months ago we realised he had tenesmus (the feeling of the need to empty the bowel frequently but not producing a stool) and when he did produce a stool there was some blood too. More weight loss accompanied this (he’s gone from 8kg to 4.8 kg).A rectal examination revealed what the vet described as a mass the size of a squash ball in the colon, just after the rectum. Obviously this is highly suspicious of a tumour. We were offered surgery or palliative care. We opted for the latter as surgery wasn’t really recommended at his age and with his conditions. I felt that it was likely to have spread after all this time and thought putting him through surgery to buy a few months life, only for it to return again, would be more for my benefit than his. Also I couldn’t bare the thought of him being PTS on the operating table if it was inoperable as I didn’t want his final thoughts to be bad ones of being at the vets. He was given prednisolone and lactulose. 4 weeks on and he is a shadow if his former self. He now spends the majority of his day in a cardboard box in the spare bedroom (he used to like boxes anyhow but wouldn’t stay in all day). He no longer sleeps on the bed with us as he used to as I think he is too uncomfortable – he takes a few mins to settle in his box as seems uncomfortable (he has arthritis too). he comes out of the box to eat and drink, sometimes greet us for a pat and some catnip and to use his litter box. Once or twice per day he will go into garden to use water fountain then its pretty much straight back upstairs after a brief scratch of his post. He is no longer grooming other than cleaning his face briefly. He stopped grooming quite a while ago. He still has tenesmus, which is distressing to watch as he must be so confused,and is still losing weight.
    Our vet who has been treating him for years has suggested that we should be considering euthanasia this week. We have scheduled a day this week for the vet to come here but I am scared. All I want to do is what is best for my boy, but like others here, I struggle as he is still alert when we enter the room, still going outside briefly, still eating and still sometimes responding to a stroke although he rarely comes to us for it (never was a lap cat though). He seems in discomfort when laying down and rarely happy anymore, but what if i’m wrong and he wants to carry on? What if he doesn’t want to die yet? I always thought that I would wait until my cats stopped eating before making that decision as that is when you know for sure. However I am now thinking that this is when things have gone too far? Is it kinder to end his life before he gets to this stage or am I taking away his last few days/weeks when he might not want that? It’s breaking my heart every day as I want only what is best for him. As much as i’d like to hang onto him, I can’t bare the thought of letting him become that ill that he can’t get up or eat, just as a means of confirmation to myself. I just need to know that he’s ready to go, but without prolonging his possible agony.

    S

  247. Doc says:

    Hello, S,

    I lost a dear aunt this past year. When I went to see her in the nursing home in July, she was glad to see us. We ate lunch with her and talked for a couple of hours. She greeted her friends in the nursing facility. She had lost her independence, needed a walker, had to wear an adult diaper, but she seemed more or less happy.

    Her condition deteriorated rapidly in the next few months. She fell a number of times. She had to have help to do anything at all — eat, go to the bathroom, dress, anything.

    When her son visited her, she told him, “I’m just waiting to die.” And within a couple of months she did.

    You know your cat better than anyone else can. Does it seem to you that your cat is just “waiting to die”?

    I like to think he’ll be leaving that worn-out body behind, and headed for a new start somewhere.

    Do we know? Not really. We just have to make the best decision that we can.

  248. Tammy says:

    Thank you all for contributing to this forum. I have been wrestling with this issue for SO long (years) and you have all helped me to ease my mind. It is comforting to read so many people with the same emotions that I’ve been feeling. I have given my 15 year old little buddy a good life but I’m just unable to continue to cater to all of his needs properly and when he wants. My health and quality of life (along with his) has diminished greatly and is just getting worse. I feel like I’m dying a slow death trying to keep up with his issues when he is constantly hollering at me at all hours of the morning or defecating on rugs, dog beds and clothing left on the floor and then continuing to care for myself and my dog who has epilepsy. With continued sleep deprivation and increasing irritability, I don’t always have the best reactions to him and it’s not fair and makes me feel even worse when I snap and yell at him. I seem to always feel stressed and anxious now and I think it is time.

    A woman dumped a box of kittens in the canyon 15 years ago and he was the only one that we were able to catch and rescue. I’ve tried to honor my little fighter and provide him with care and a loving home and I think I succeeded but, now, I really need to release some guilt and get back to feeling healthy myself because I just can’t do it anymore. Again, thanks everyone.

  249. Doc says:

    Hello, Tammy,
    This is never easy, and you have to look at the pros and cons. Everyone’s situation is different.

    We can’t always find an easy solution, so we have to look for the best decision we can make.

    When you have made your decision, you don’t have to feel bad about it. Sometimes there just is not an option that is a “feel good” option.

    Best wishes at this difficult time.

  250. sharnie says:

    yesterday my cat (5yrs old ) was diagnosed with a malignant tumour in her intestine , i am absolutley devastated , so hard to accept , her symptoms at the moment were vomiting just the once early hours of the morning , vets sent me home with some steroids in hope to slow it down and some anti sickness meds , ive cut out her dry food and feeding the id feline which is easier to digest , touch wood she hasnt been sick .. shes very much herself at the moment and i think the cancer is an aggressive one .. was diagnosed solely with xray and ultra sound only .. its just so hard to accept her being so young .. i dont want to see her go down hill , as i say at the moment she is clinically well but when will i know when she starts to go down hill and when i have to face the heartbreaking decision , i wont see her suffer in anyway , im so very upset and at the moment still trying to take it in .. shes my baby 🙁

  251. Doc says:

    Hello, Sharnie,
    I suspect that your veterinarian has already spoken with you about doing an exploratory surgery for biopsy.

    It is possible that one might find a tumor more responsive to specific chemotherapy, if doing surgery were an option (and if doing chemotherapy were an option).

    Unfortunately, even when funds are unlimited (which is usually not the case), intestinal biopsy does not always give you a better option. Sometimes it just gives you more certainty on how bad things are. They can also have poor healing.

    Be sure to stay in good communication with your veterinarian. Let him/her know how your cat is doing with the treatment, whether you are having problems giving the medicine, any new outward signs that you notice.

  252. Suzanne says:

    We are wondering when it is time to let go our 10-yr old cat Sparkle. A bit of background info although probably not relevant. About 3 years ago she had several fits where she would make a different sound to normal and then would stop in her tracks and drool for a bit and sometimes pass urine too. Afterwards she always rushed off to her food bowl. She was quite a large overweight cat (however much we restricted her diet) so I think food was her “comfort blanket” after this happened. The vet said it would probably turn into epilepsy but gave her an antibiotic injection. She had another fit later that day but never since.
    Then about a year later she developed a pus filled lump on the side of her chin/neck area which we only discovered when it burst (she has quite long hair so we hadn’t spotted it as she is not a cat who wants to be stroked too much and never a lap cat). Another anti-biotic injection cleared it up.
    Possibly these things are totally unconnected but just thought I should mention them as background.

    Eight months ago we noticed she was getting thinner and was wondering if us restricting her food (we have another cat too) was finally taking effect. But as it went on we decided it was more than that when her stools became messy & light coloured and she started drinking more plus she started getting knotty as she obviously wasn’t grooming her back legs and chest properly. We went back to feeding her whenever she wanted it as she was always hungry it seemed.
    We took her to the vets who could see or feel nothing wrong but she had lost over half her bodyweight. We discussed all the tests but decided that as even the vets could not give her pills, anything that the results would diagnose would mean daily pills which could not be crushed either so would not be possible to administer. So we decided against putting her through the tests. I read up on her symptoms and thought it most likely to be hyperthyroidism and found that Lysine helps. So I have been giving her that. It seems to have helped for a long time. Back in October we could not get under some really big matts under her belly so took her to the vets for a dematting shave. I asked them to weigh her and she had put a kilo back on. So we have been rather confused as to whether she was getting a bit better rather than just maintaining on the Lysine as the vet had indicated that there was nothing that could really help her without daily pills and to take her back “when she was ready”.
    I had started her on 500mg of the Lysine and then gone down to the maintenance dose of 250mg. She is now letting her fur get knotty again and started a sneezing/coughing noise quite a few times a day. Although she still wants food a lot, she now doesn’t eat what you give her (as I said before – I think it is her “comfort blanket” as she is not particularly affectionate and so does not come to us for cuddles when she feels bad). Today she sneezed blood which sprayed everywhere too. We are wondering what would be “the time” as she has always been a lay around cat who is not particularly affectionate, so it is so hard to tell what a good day is from a bad day. Are there any other signs to look for to know when or to tell if she is in pain – she is still wanting food all the time but not eating much. She can walk around fine (but sleeps most of the time) and she can still jump the stairgate if it is closed for the dogs.

    Our other cat is a Birman with inappropriate urination behaviour (well all elimination behaviour actually) and he is older at 13 but they haven’t really played together for at least 3 years and he just sleeps all day too so I can’t really say their interaction is any different from normal as there isn’t really any.

    I wish I knew if she was in pain or uncomfortable as I don’t want to feel I have put her through that unnecessarily as I can’t tell a good day from a bad one.

  253. sharnie says:

    hi doc ,
    firstly thank you for your reply , theres been no mention of any biopsy , also the vet said surgery could be an option but as you mentioned its the healing time and she said it would grow back , also that it would not be fair to put her through the chemo as once again chances are it would re occur . im keeping a diary on her eating and general well being , as i mentioned earlier she seems to well at the moment in herself , but just dreading when she begins to go downhill and having to face that decision , im still trying to get my head around it all , so upset i cant even eat .. i dont even know what type of cancer it is only its on her intestine . just totally out the blue , and as i mentioned shes only 5 🙁 have found this site helpful and its nice to know theres support out there ..

  254. Doc says:

    Hello, Suzanne,

    I have seen lysine recommended (and used with fair success) for feline herpesvirus. I am not familiar with using it to treat hyperthyroidism (which is very high on our list – even the nose bleed could be secondary to high blood pressure from the thyroid).

    While giving daily methimazole may not be practical, there are alternatives. At this point we don’t know whether you have hyperthyroidism, diabetes, cancer or what.

    Hyperthyroidism can also be treated with radioactive iodine treatment (expensive, but once and done), and with a special diet, Hill’s Y/D. This diet is very low in Iodine and has controlled a lot of cats with thyroid problems.

    I am concerned that even if hyperthyroidism were the underlying problem, you now have other issues.

    That really can’t be sorted out without doing a thorough diagnostic testing work-up.

    I appreciate the difficulty of assessing the cat’s activity level when it was not active while feeling GOOD. Cats are famous for concealing outward signs of illness. Many times we don’t realize they are feeling bad until they have been sick for quite a while.

    Feel free to write with more information as things progress.

  255. Kathleen says:

    Hello, I found this site by asking.. how do you know when it is time……
    My cat, Cali, is 10 years old.. about 2 weeks ago she quit eating, still drinking water.. and nothing I offered her would entice her to eat. for 10 days.. off to the vet, they kept her for 3 days/ two night.. did blood work, xrays, tube fed her, medicated her with valium (to increase appetite) depo (to make her happy) and pain meds.. nothing showed up, blood work normal, no blockages or anything.. I took her home.. she ate some for about 4 days, not enough.. but some, and now she has quit again, day 5 now, she sleeps most of the time, kneeds her blanket lots.. and right now is cuddling with me and purring.. she has horrible breath.. lol.. and I know it is time, but wanted to say thank you for this site, it has made it easier to do this… (crying(

  256. Doc says:

    Hello, Kathleen,

    I would suspect that Cali has the type of cancer that just hardens the bowel wall and makes it non-functional without blocking it.

    I am sorry that you are faced with this difficult decision. I know you will do what is best for you and your cat.

    Best wishes.

  257. Bb says:

    It’s never the time! Euthanizing is murder! People should do their best to treat their pet’s condition and make their pet feel comfortable and in the least pain with medication, but killing isn’t the answer. It isn’t legally done with people and it shouldn’t be done with pets. So many people think they’re doing the right thing, but they’re not – they’re only playing “god” with a beloved animal’s life. Don’t be Dr. Kevorkian for pets!

  258. Doc says:

    Hello, Bb,

    It’s obvious that you have very strong feelings.

    What about the cat with squamous cell carcinoma that has turned it’s tongue into a painful,bleeding mass? Would you put in a feeding tube until the cancer ate his entire head off?

    What about the animal with kidney failure who has been maintaining with frequent fluid therapy while losing weight until she can no longer walk?

    I don’t believe in convenience euthanasias and do not perform them.

    I also do not think it is any kindness to watch an animal die slowly and painfully when you have exhausted all alternatives for treatment.

    When you hear someone promoting hospice care, it sounds like people are just dreaming away on pain-killers until their body gives up. As my mother wasted away with cancer in hospice care, she repeatedly begged me to smother her with a pillow. I couldn’t do it.

    Every situation is different. None of them are easy.

  259. Sam says:

    Hello,

    I read through many of the answers you provided, Doc, and am amazed by your dedication in comforting distressed cat owners for years. My 15ish-year-old cat Tyrone has had a squamous cell carcinoma for some time and only in the last few days has stopped eating enough and started losing weight rapidly. Just the week before his appetite had picked up again and I was optimistic. But still he seems happy to spend time with me and not in constant pain, although he does not look well and his jaw is dislocated. It’s such a hard decision. Even worse, I am going to a wedding that is a 7 hour drive away this weekend, so I either have the choice of putting him to sleep before then or bringing him with me, since there is another cat in the home with a voracious appetite who would devour any food left out for Tyrone right away (although he is very friendly in every other way and does his best to keep his buddy clean). I almost wish he was more clearly in pain so that it would be easier to decide. But I am thankful for every good day he has. Perhaps it is better for him to go now before it gets too much worse… but I don’t know. I think he looks worse than he feels, but it’s so hard to tell. Thanks for what you’re doing here.

  260. Doc says:

    Hello, Sam,

    Hey, tough call here. On the one hand, you know this doesn’t end well. It appears that he is on the downhill slide with the big drop in appetite and the weight loss.

    On the other hand, you feel that he is still enjoying life a little bit.

    Cats are very stoic and famous for concealing signs of pain and illness. Sometimes we do a trial therapy of pain medication, just to see how much (or if) the cat’s behavior improves. It is very hard to assess their pain level from behavior. They typically do not cry or shy away from pressure unless the pain is excruciating. More chronic pain is often manifested simply as less activity, less appetite, and so forth.

    I’m sorry I don’t know how to make this easier for you.

    Best wishes.

  261. Tanya says:

    Hello

    This afternoon I made the heart-wrenching decision to put my beautiful 16 year old girl to sleep. She had been off her food for a few days and had lost a great deal of weight. We took her to the vet last week and it was revealed that she had an exceptionally high white blood cell count and an extremely high urea count. The vet gave her an antibiotic injection as it was felt that she might be suffering from a bacterial infection.

    She rallied by Friday and Saturday and I was hopeful that the antibiotic was working. By Sunday she could hardly walk. Whilst she was still hungry and drinking a lot of water (we had known for some time that she had some issues with her kidneys but it was not interfering with her quality of life)she was less responsive and could barely walk from my bedroom to the kitchen. Every time she drank the water was cloudy, and when she went to the toilet she could barely stand. By late Sunday she was unable to hardly walk at all – she was most comfortable when lying down and was able to eat and drink when hand fed, but I felt that she was growing more distant from me. I was awake on and off all night encouraging her to eat and drink, talking to her and telling her how much I loved her. Early this morning at around 3am, she crept up to me in bed and sat close with her paws on me. I think she was telling me that it was time to let her go. We sat together for over an hour and I talked to her about the wonderful life she had had, and how much I loved her. This morning she seemed to be in a different place. She listened to my voice, but didn’t have the strength to respond (although I felt that she wanted to).

    Early this morning I rang the vet still hopeful that something could be done to help her, yet at the same time realising that the best thing I could do for her was to let her go. I spent a long time with the vet reviewing her blood test results and he examined her carefully. He was caring and thoughtful, leading me through the process of what tests could be done with the likelihood of the same result – all of her major organs appeared to be shutting down, with renal failure the most likely cause. I knew in my heart that this was the time to let her go. The vet left the room while I spoke to her and stroked her and I knew she was ready to go. The whole process was gentle and loving and I stayed with her throughout. I think she is now happy and pain free, and although I miss her desperately and will grieve for a long time I hope that one day we will be together again.

    I am writing this blog to share my appreciation of your beautiful site which I happened upon this morning when I was feeling overwhelmed by grief and guilt having to make a decision that was the right one for my girl. This site helped me enormously in coming to terms with the stage that we were at and the decision that I needed to make. I am still overwhelmed by grief but I am relieved about my decision knowing that my girl is at last peaceful and happy in place where she can run free. I only hope she remembers us from time to time.

  262. Kathie says:

    I would like to thank each of you for sharing your stories and offer my sympathy for the loss of each of your beloved fur babies.

    I have been struggling for almost a week over making the decision to euthanize my Kiss cat. She is 17 years old, was diagnosed with diabetes a little over a year ago which we seemed to have under control with dietary changes.

    About a month ago she started to distance herself from me. Then a few times I thought it looked like the right side of her neck was a little swollen. I checked and didn’t feel anything so I thought maybe it was just me. I didn’t rush over to her vet because she gets so upset when I put her in the carrier and always makes herself sick by the time the car hits the end of our block and I didn’t want to put her through that.
    Last week I noticed she was eating a lot less than usual. I offered her a little of her favorite people food on Tuesday night and she spent the whole night vomiting so I decided to make the call to the vet on Wednesday morning. Initially they thought it was a tumor. They took x-rays which showed that all of her organs were fine, nothing abnormal except for a mass in her neck. They took blood to see if there was anything else going on and those results showed that not only was her blood glucose level back up to 241 but she has also developed hyperthyroidism. The vet said that normal thyroid hormone levels are .8 to 4.7 and hers are 8.2.

    While I know that both diabetes and hyperthyroidism can be treated and I would be more than willing to give her insulin and try to give her pills I just don’t think she could handle the stress of not only the pills but also the regular trips over to the vet to get blood work done.
    I decided to take the weekend to spend with her and really pay attention to her. She’s eating very little and vacating very little. She is still keeping herself clean for the most part but she is just laying around and looks sad.

    I think I am faced with a quality of life issue since I don’t want her final months or years to be constant fear of me shoving a pill down her throat or making her go in the carrier for a car ride to go to the vet. I think I am going to have to let her go gently and I hate having to decide when…. if I take her tomorrow is it too soon? If I wait and see am I prolonging any discomfort she is feeling? I do know that I love her and only want the best for her and no matter when I take her in THAT is the right moment and I cannot allow myself to feel guilty over wanting her to have a peaceful and pain free parting.

  263. Doc says:

    Hello, Kathie,

    You are right in saying that both of these diseases are treatable. However, with the advanced state of the disease, and the advanced age of the cat, it is unlikely that you will achieve a good quality of life for the patient.

    As difficult as this decision is, I think that the time is near at hand.

  264. Tanya says:

    Hi Kathie

    My thoughts are with you at this difficult time. I still cry every day, and I know that you too are experiencing the same pain and loss. I am focussing now on the beautiful memories of my precious girl and this brings me great comfort.

    You made the right decision. Quality of life is what matters the most. I find the following helps me a great deal when I am praying and thinking about my loved one, “I loved you too much to force you to stay”.

    Take care and best wishes
    Tanya

  265. Rose says:

    Hi I have a 16 year old cat who was just diagnosed w hyperthyroid, slight renal failure. And elevated muscle enzymes. He’s lost about 10 lbs in a year or 2. I assumed he would just die soon naturally, but he still eats and plays. He does have frequent diarrhea and vomiting. Last week he was bitten by a groundhog. He has several breaks in his back paw and is developing an infection. They can’t splint the foot because of the infection. We are doing the abx and started the anti hyperthyroid medication. How much further should we go? The vet said his foot may require surgery, they want to see him frequently for wound checks…the bill and hassle for my baby are adding up. I not want him t o be uncomfortable, but can’t see doing all this yo an old cat. What do you think?

  266. Doc says:

    Hello, Rose,

    I can understand your reluctance to make a huge investment if your cat isn’t going to get better. I would certainly try the medications, though. I have seen hyperthyroid cats make amazing comebacks once their disease was under control.

    If he is not responding to treatment, that would be a more difficult decision. But give it time to work. It takes at least two to four weeks.

  267. Cameron says:

    Hi,

    I have a 18 year old cat that I adopted from the animal shelter just under a year ago. Her previous owner had to go to a nursing home and the home didn’t allow pets. I saw her and fell in love with her right away. I knew that adopting her would be more of a place for her to live out her last few years, but now the time has come that she doesn’t seem to be doing well and it is breaking my heart.

    I keep thinking to myself, “well this cat has lived this long because the owner took care of it, have I not done enough to give her a good life?”. I find myself getting mad at myself because I can’t figure out if it is just her time or not.

    She still eats all the time, and drinks water regularly. However, she will only go into her litterbox to go poop and if she has to pee she just does it on the floor. She seems to have trouble standing on her hind legs, and today when I gave her a bath I found raw sores on both of her back legs from them laying on the ground so often.

    She’s the sweetest little girl ever and never meows or complains, and it’s so hard for me to decided what to do. I can’t really tell if she’s having bad days or good days because all she ever has done is slept since the day I brought her home.

  268. Doc says:

    Hello, Cameron,

    Sometimes an cat with arthritis will have this kind of behavioral change. Cats don’t tolerate many medicines of the anti-inflammatory nature.

    Some do really well with Cosequin for Cats added to their food daily, and your veterinarian could try Adequan injections. Neither of these have any side-effects.

    Metacam is used by many cat specialists. The USA label now says, “Do not use in cats”, but it is approved for cat use in Europe. The margin of safety is narrow, but it could be the difference between walking without pain and just not walking.

    The raw sores are troubling and do need some type of protection.

    I do not know whether your veterinarian will be able to help you extend the cat’s life with a GOOD quality of life. Sometimes you don’t know until you try some things whether they will help.

    18 years is pretty phenomenally old. While some cats do live longer, 16 years is huge.

    You really should let your veterinarian examine her and help counsel you. Long-distance, it’s just too easy for me to make a mistake.

  269. Rose says:

    My cat was bitten by a ground hog last Wednesday night. It broke its hind right foot in 3 places and dislocated its first toe. It developed an abscess wich is draining serosanguinous pus. He is on day 8 of zeniquin. It’s not getting better. I have been fludhing w betadine diluted BID since monday. Bailey is 16 years old has hyperthyroid ( 10 lb weight loss) and some renal failure. The vet wants to do surgery. Should I or is this just the end for bailey?

  270. Doc says:

    Hello, Rose,

    This is something you will have to discuss further with the doctor who is actually seeing your cat.

    It sounds like the foot will not heal without surgery. The question is, what is the prognosis for healing if you do have surgery?

    I cannot answer this for you.

    Obviously there are other complicating factors, but I really cannot evaluate this from a long-distance perspective.

  271. Robin says:

    My best friend is a 19 year old Maine Coon. He is a diet controlled diabetic with hyper thyroid ism, renal kidney failure and chronic constipation. Despite all of these illnesses which I can no longer treat without making at least one of them worse he has much personality. He doesn’t do much but sleep, eat and drink water and suffers from incontinence to the point where I can no longer pick him up or hold him without him urinating on me. I’m constantly cleaning up urine, feces and vomit and find myself becoming very resentful despite my love for him. I’m also due with my first child in two months and I’m finding it incredibly hard to keep my house clean and sanitary. At this point I’m wondering if this is any kind of life for him or if I’m being selfish for wanting a clean house for my baby. At the same time I know his health is slowly deteriorating and will only get worse. I think about euthanasia everyday but then decide I can’t live with myself for thinking it. How do you make that decision, especially when they still have so much love to give?

  272. Doc says:

    Hello, Robin,

    This is always a very difficult decision.

    I am wondering if the diabetes is actually being controlled. Most diabetic cats require insulin injections twice daily. Diet certainly helps, but as the disease advances, it may not be enough.

    Since one of the concerns is urinary incontinence, decreasing his urine output might really help that. If his diabetes is out of control, then he would be producing excessive amounts of urine, requiring excessive amounts of water to replace the lost fluids.

    Uncontrolled diabetics may have high ketone levels in the blood (a breakdown product of fat metabolism, when you excessively use fat for energy because you can’t use sugars and starches). This can cause nausea.

    It certainly doesn’t sound like either you or the cat are having much quality of life at this point.

    If this is not his diabetes, or his diabetes cannot be controlled, then I don’t think anyone could criticize you when you finally have to make the “final decision”.

    Best wishes.

  273. Cristie says:

    My 14 year old boy is frail and old, and over the last few days lost most of the use of his back legs, he drags them like they are not connected. He does not seem to be in pain, but looks worried like he doesn’t understand ( none of us do). The very gave him a cortisone shot yest in the hope it could be his arthritis or an injury, it has not helped. Vet said it is likely nuerological due to his age and it will progress, how quickly is not known, weeks to months?
    I don’t want him to suffer, yet he eats, drinks and seems ok. My mum is a vet nurse and thinks “it’s time”.
    I’m agonising on this decision. I would prefer to release him before he is in pain or lacks quality, but what if he comes good again (unlikely given the shot has had no effect… But what if)
    🙁

  274. Doc says:

    Hello, Cristie,

    The things that are likely to occur with neurological degeneration:

    Lack of bladder control, resulting in leakage, and urine scalds.

    Poor bowel control, possibly with incontinence, possibly with constipation.

    If he keeps dragging himself, he may produce sore places on his legs that require constant treatment (like bedsores).

    If you see these things developing, then I would consider that the decision needed to be made soon.

    It is very hard for anyone else to really judge the dog’s quality of life. You know him best.

  275. Rayni says:

    I am really struggling to make a decision with my little kittyface, Maggie. I found her as a stray about two years ago. I took her to the vet right away because she was having coughing firs, but otherwise seemed okay. The first (of many) vets I talked to estimated her age at 1-2 years old. So she is roughly 4 now. The vet did some blood work and took x-rays. The blood work showed she was positive for corona virus but was otherwise healthy. Her x-ray showed what appeared to be asthma, only the area was localized rather than diffuse, so the vet thought it was more likely some kind of infection. We had her dewormed and started her on a course of antibiotics. The cough didn’t get worse but it certainly didn’t get better. So we tried a steroid shot. Again no worse, but no better. Four months later the cough started getting worse so I took her to a different vet. More inconclusive x-rays, more antibiotics (two different kinds) more blood work and nothing. Took her to a third vet. Same thing. Three different courses of antibiotics over the next few months. No results. So we started her on prednisolone. She started to do a bit better but when she did cough it was worse than ever, so we upped the dose. Repeat a few times to the point that she was on an exceedingly high dose (5mg twice a day). She has never eaten much and never made it past 7 pounds. Meanwhile each consecutive x-ray looked worse than the previous one. We had the x-rays looked at by radiologists and specialists and none could agree what was going on. Finally went to an internal medicine specialist who ran an echocardiagram as well as more blood work. The echo came back normal so we did a trach wash. Nothing grew in the cultures. Maggie got worse. We tried an inhaled steroid as well as a bronchdialator which only exacerbated the issue. Meanwhile Maggie started to limp, had a poor appetite still, and started to lose her fur. We went to another internal med. specialist. More blood draws, more x-rays. Lungs look horrible, her breathing is very bad (recently switched from pred to dexamethasone) with no appreciable results. Her blood showed sever pancreatius (off the charts) as well as elevated glucose. She is spilling glucose in her urine so we started her on insulin. She is also on an oral bronchdialator twice a day as well as atopica (the vet thought it might help with inflammation to help her breathing. So at four years old, she is diabetic, she has arthritis which she gets a monthly shot for, she gets three pills twice a day (.5 mg dexamethasone, aminophalyn (sp), and atopica 10 mg am and 25 mg pm, she also gets .75 units of lantus twice a day.) she also gets 1ml of bupinorphine twice daily. currently she lays around the house and for the last week has had diarrhea, she still eats some, and sometimes wants attention but usually she just lays around. She is also developing cataracts from the steroids. I don’t know what to do. She is so young but I feel like I’ve tried everything to no avail. I don’t know when to stop trying. She’s a lover and likes to lay on me and purr and give me a bath for hours but she is in the vet more often than not. And all these pills… I don’t work at the moment because all of my time is devoted to her. I feel horrible because I can’t deferentiate between my desire to not have a suffering kitty vs my desire to not suffer with her. I love her with all of my heart but it kills me to see her like this. I just don’t know what to do. Sorry that was so long… any thoughts or suggestions would be appreciated. Thank you.

    Rayni and my Maggie

  276. Rayni says:

    Me again, Maggie’s mom. I forgot to mention about two weeks ago (prior to starting the insulin and the atopica) Maggie had a seizure. She was sleeping with me and suddenly started barrel rolling across the bed. I jumped up and stopped her from rolling before she fell off the bed. Once I stopped her she smashed her face into the bed and started convulsing for about fifteen seconds. She didn’t lose control of her bowels or anything and seemed okay, if confused and scared. I rushed her to the vet and the neurologist examined her but didn’t find anything. They thought is was maybe from high glucose levels in her blood. She also recently had an abdominal ultrasound due to the elevated pancreatic enzymes in her blood. They found what they suspect are benign cysts on her kinds and liver as well as a benign nodule on her pancreas. She does not appear to be dehydrated nor has she been vomiting so they didn’t think any treatment was needed for the above. Thanks again.
    Rayni

  277. Doc says:

    Hello, Rayni,

    I cannot really make your decision for you. I can see how torn you are.

    It is obvious that you have been willing to “go the extra mile. And not only willing to go, but have really been doing everything imaginable to help your friend.

    The quality of life for both of you has been awful, and isn’t likely to get better. Only you really know how bad things are.

    With all that you have done, nobody is really in a position to criticize any decision that you make.

  278. Kristen says:

    Hi,
    I would love your take on my 9 1/2 yr old cat, Jasmine’s situation. She has had bowel continence and bladder continence issues for years, mostly constipation. I took her in last week for increased bowel incontinence, but now diarrhea,, and frequent vomiting, and she was diagnosed with chronic pancreatitis (Lipase was 35). She has never done well with change. My vet gave me a treatment plan with steroids and an antiemetic, but is unsure that it will help her because of the length of time she believes Jasmine has had this undiagnosed (previously the diagnosis was IBS). The catch is that I have to move in a month and she will have to go live somewhere else temporarily. After discussing it with my vet she agrees that it will probably be in Jasmine’s best interest to euthanize her and not put her through the trauma of moving, being without me, her only owner, and new meds, etc. She doesn’t seem in excruciating pain all the time or even act sick lately other than the stool and vomiting. She is still eating normally but starting to lose weight.
    I am just curious what your thoughts are. I am feeling very guilty for even considering a convenience euthanasia, but don’t really know what else to do. She is the first cat I’ve owned more than a few months. I know that I have to make the decision, but would like to hear your thoughts or other suggestions.
    Thank you so much.

  279. Doc says:

    Hello, Kristen,

    I am assuming that this was a fPLI test (feline pancreatic lipase immunoreactivity), per this website: http://vetmed.tamu.edu/gilab/service/assays/pli

    A plain lipase test is not meaningful. 35 would certainly be on the high side for fPLI.

    While she may have chronic pancreatitis, she may still have IBD.

    It’s important to understand that pancreatitis can occur concurrent with intestinal disease in cats. So, if you want to control pancreatitis, one of the most reasonable methods to do so is to diagnose and treat the concurrent intestinal disease. Cats with GI disease often have pretty normal labwork.

    Definitive diagnosis of pancreatitis in a live cat (rather than at autopsy) is pretty difficult. The cat specialists (which I am not one), want an expert ultrasound examination, and they coordinate that with the cat’s clinical signs and the fPLI test.

    Some of this stuff cannot be sorted out without exploratory surgery and biopsy of intestine and pancreas.

    These cases are frustrating and difficult to live with, even when you aren’t contemplating moving, and the cat is very cooperative. Not to mention the other situations with incontinence.

    There is no simple way out of this. Even if you do the exploratory and biopsies, it doesn’t guarantee success.

    The anti-emetics and steroids should help with the IBD, maybe with the pancreatitis. Hard to say.

    You just have to let your conscience be your guide. If someone wants to criticize your decision, then they have to offer you a better alternative.

  280. Kristen says:

    Thank you so much for answering. Yes, it was the fPLI that was 35, sorry I didn’t have it right. Her vet is a feline specialist and who I have taken her to for the past 3 years. She did offer the ultrasound, biopsy, and surgery, as well. Jasmine has never done well with change, being around new people, new environments, or other animals. We’ve moved 3 times in 9 years and she has always been with me and still not done well. The place she would stay after the move would have 3 other cats.
    Over the weekend she started hiding, was moving slowly, had difficulty getting up on the bed. It may seem quick to others but I felt she was trying to tell me something. I discussed it with some animal loving friends who told me they wished they never started treating a chronic illness in their pets and both advised me to just put her down now. I am also very much a praying woman and had the most peace about just letting ber go. I had her put down yesterday. She looked so peaceful and I have felt so much that I did the right thing for her. It was not easy but I am so much at peace with my decision and I am truly confident that I did the right thing for her. I sincerely appreciate your blog and your answers to me. It did help me gain perspective on what the next few months medically would probably look like for Jasmine and I don’t think she would have responded well just on the behavioral end alone. Who could say what the physical response would have been.
    I am very thankful for your site and your feedback. You have helped countless others who have not posted but gained insight and direction from your site, I’m quite sure. Thanks again.

  281. rosa says:

    I had a cat who was sick. He had severe asthma. He was on puffers. After the vet doctor took x-rays, and after he examined my cat, the doctor told me that my cat should be put down otherwise he will have a bad death. That same day, a friend told me not to put him down because as long as a pet eats and drinks, he should not be put down. So, I did not put my cat down. Well, a month after that, my cat was in severe pain. I rushed him to the vet, and had to put him down. Lesson learned… Always listen to your vet. They know what is best for your pet. I did not accept that my cat needed to be put down. I wish i listened to my vet, so my cat would not have felt pain. To all you pet owners, please listen to your vets advise. I never did, and i regret it. I cry over it every week. I loved my cat. I never put him down sooner because he had his good and bad days. I always hoped he will get better, but he didnt.

  282. Kimberley Bennett says:

    Hi, im really going through a tough time in deciding whether to put my cat to sleep or not. Im so heart broken and I feel so guilty. My cat is 8 years old and it has recently been discovered that he has a severely deformed heart (the worst the specialist vet has ever seen). As a result of this. ..my cats lungs constantly fill up with fluid. He is on heavy medication at the moment to prevent him from effectively drowning. The vet also told me that the medication my cat must take for his heart will eventually lead to his kidneys failing. My cat has lost only a little weight and he is still eating and drinking well. He is not as active as he used to be but he does move around and he still demands cuddles. My head tells me that the humane thing to do would be to euthanise. But my heart wants to hope that he will pull through. I know it sounds so selfish of me but I love this cat such. We have been through everything together. Im just so scared of making this decision and then regretting it for the rest of my life.

  283. Rosario says:

    Kimberley, I understand how you feel. My roommate and I have been struggled for weeks with this decision. My Eddie, my angel and I have battle with his kidney disease for years. His kidney numbers are stable but all of the sudden (don’t know how sudden) he got sick, vomiting. Not unusual for him. I thought his wasting muscle was his kidney disease. I consult a couple vets. Turns out he has lymphoma. Two weeks ago he was his old self. Then he started to hide and eat less. Two days before the ultrasound/biopsy that sound the cancer he was acting like himself. Afterward, he needed hospitalization. After coming home the next day he got worse.Distanced himself from me and the sweet angel was never the same. Stopped jumping on me to sleep. Used to sleep with me on my chest! I don’t know if he’s in pain. But the cat I knew for 10 years left last week. Now I have this cat that does nothing but lay around and hides. He eats but then seems sick afterward. I have him on pain meds. I don’t know if we will ever know if we did the right thing but if I spare her 1% of pain then okay. I want to be the only one feeling pain. The pain of losing her. I know she is just a cat but she is my heart. How do I live without my heart? I feel for the decision you have to make.I’m comforted by the fact he gave my life joy. I’m so grateful I knew him. So lucky. To Eddie: Thank you Eddie for filling my heart with love and joy. My angel. My Eddie. In a few hours you won’t feel anymore pain. You are going back to the angel planet you came from to fill someone else with love.

  284. Rosario says:

    I forgot to mention in my previous post. Eddie has high grade lymphoma and it has spread all over. We were advised by the oncologist that the 6K chemo might work, might make her feel worse, may keep her where she is at now – lethargic and seemingly miserable. It’s not that she has changed that made us make our difficult decision.Or the money that will put me in debt. That is okay. I’ll go w/o. It’s not wanting him to feel an ounce of pain. He gets skinnier every day even though he eats. But eats very little. I feel in my bones it’s the right choice but it’s still impossible. I don’t know how I’m going to cope. I have to I know but how? I have 3 other cats, one diabetic and one deformed with feline herpes to care for. I’ll keep remembering the first time I saw him in the animal shelter. In a tiny cage. He got up and started prancing back and forth, as if he were selling himself. Irresistible. We needed each other. For over 10 years we helped each other. Eternal love. I feel him in my heart right now. I hope I always feel that twinge in my heart when I think of Eddie.

  285. Helen says:

    My tuxedo cat Noah, has a tumor in the roof of his mouth. After alot of testing I decided not to have him go through surgery and chemo or radiation. I really appreciate the vet who talked me out of all that. At first Noah could eat fairly well. Then he could only lick the sauce off the top of the cat food. Then he was eating baby food (licking it off of a teaspoon). He lost alot of wt. Then I read that KMR was good for convalescing cats. I mixed KMR with the baby food, chicken with gravy, and he liked it. He can only lick it off of a spoon. As his swallowing got worse I diluted the baby food with more KMR. After I started him on the kmr he stopped losing wt. He has done very well until yesterday. He ate very little. Today is worse. He had about one tablespoon of the mixture.
    He has not let me wash him or groom him for a few days now. My vet is sometimes in on Sundays (tomorrow). I want to ask him to order a fentanyl patch for Noah, so he can go to sleep at home with me holding him, when it is time. I think soon. He became terrified of the vet because we have been going there so much. Has anyone ever asked a vet for this patch?
    I have 10 other cats. Noah never associated with them, but as a little aside one of my cats, Wolfie, was grooming Noah the other day. Animals do have personalities and Wolfie is a kind soul.

  286. Doc says:

    Hello, Rosa,

    Thanks for sharing your story. I agree that it is important to listen to the veterinarian, but it is also very important to “listen” to your pet. After living with a friend for a long time, you have a pretty good sense of whether he/she is enjoying life or not. You know the things your friend likes, and know whether or not these are still providing enjoyment.

    These decisions are always difficult, and we as veterinarians have to listen to you, too.

    Thanks again for reading and writing.

  287. Doc says:

    Hello, Kimberly,

    If your cat is still demanding affection and cuddling, then you are not wrong for continuing to treat him. There will come a time when the treatment is no longer effective, and you will see that he is no longer enjoying life. You know that there is a severe underlying medical problem that is causing this, and that it is not going away.

    When the time comes that the problem is no longer responding to treatment, and your cat is feeling so bad, you won’t need to feel any guilt about letting him go.

  288. Doc says:

    Hello, Rosario,

    It is obvious that Eddie has been a very important part of your life for a long time. I know that you will miss him greatly when he leaves his body and goes on to his next adventure, whatever that may be.

    “Listen” to him and let him go when the time comes. Francis Bacon once wrote, “A healthy body is a guest-chamber for the soul, and a sick one is a prison.” Don’t regret Eddie’s release from prison.

  289. Doc says:

    Hello, Helen,

    Sorry to be late in answering, but I have been traveling and had no access to the internet. We often use the fentanyl patches to manage post-operative pain in cats. You have to shave the hair so that the patch can contact the skin directly. We usually use the back of the neck for this. Often, you have to wrap a light bandage over it to keep it in place.

    Fentanyl is a good pain reliever, though it will take about 12 hours before it starts working. Then it lasts about 3 days. Its sedative properties are inconsistent. Usually by itself it is not very sedative.

    Your veterinarian could certainly prescribe a patch and other sedation. This would not accomplish euthanasia, but would probably make the trip in very tolerable. With both, the cat would be quiet and comfortable, and not very aware of the doctor’s office.

    You could also ask for end of day scheduling so that the office is quiet, rather than full of barking dogs.

    Best wishes.

  290. Susan B says:

    Thank you for this resource. My husband and I just had our cat, Autumn, put to sleep a couple of hours ago. She had large cell intestinal lymphoma that was diagnosed in early March. We tried two chemotherapy protocols, which extended her life for three months, but after her last treatment, we couldn’t get her to eat much more than a few bites of food each day. She lost a lot of weight, was hiding for long periods of the day, and couldn’t get comfortable. She would still occasionally purr, and even did at the vet this afternoon, but she seemed so sad. I think we did the right thing for her, even though the decision and the reality of losing her are very painful and hard to accept.
    Autumn, a beautiful and loving tortie, was around 10 and we had her since the Fall of 2004.
    Before we made a decision, I read the other comments and it did help me.
    The vet and the other staff were so kind and considerate. We are grateful that they could help us say goodbye in as humane a way as possible.
    Thank you for letting me share my story.

  291. Brenna says:

    Hi doc. I came across these posts while searching ‘when is it time to euthanize’. They have given me great comfort. My cat is 19, almost 20, and I think she is now quite uncomfortable. She throws up daily, her hind legs seem to be bothering her a bit – I notice they are a little stiff when she walks or is going up the stairs. She can still jump up on my bed but seems to have some difficulty getting down. I’m struggling with some guilt as it is difficult to clean up after her daily as I have a baby and a toddler and I don’t want to ‘convenience’ euthanize her, I’m mad every time I have to clean up after her but when I think about putting her down, I cry and cry. She has been such a good girl to me but I don’t want her to go all the way downhill because I wasn’t brave enough to give her a peaceful ending. All she does is eat, sleep and throw up. She doesn’t play anymore at all with my other cat – she hisses and swats at him, however, she does follow me around the house a bit more than she used to, and it makes me wonder if she is trying to tell me something. She’ll meow at me and paw at me, often when I’m nursing my baby. She’s had one pee accident, and she throws up on her pillow and will lie in it…that kind of tells me that she is ready to go. I guess I’ve already answered my own question. This is just so hard. My poor girl.

  292. Doc says:

    Hello, Brenna,

    I can appreciate your dilemma. It is difficult to treat arthritic cats, as they don’t tolerate a lot of the medications that we use in people or in dogs. Cosequin for Cats added to the food can help, as can
    Adequan injections (currently in short supply). Some feline specialists are still using Metacam, despite the fact that it may cause other problems.

    That being said, it sounds like your cat has a lot more going on than just arthritis. I don’t hear you describing any “good days” at all.

    This decision is always very difficult, even we know that the animal has a terminal condition that is untreatable. It is even more difficult when one has any degree of uncertainty.

    It sounds to me like you are confronting the finality of the situation. I know you will miss her.

  293. Helen says:

    Thank you Doc for your descriptionn on how fentanyl works. I called my vet who told me that he can no longer order it..some more state controls due to a shooting in a pharmacy. However, the vet will come to someone’s home. Noah is still with me. He is amazing. He is eating fairly well again. Though now his eyes are always dripping and I believe the tumor is growing into his nose. How can I tell whether or not he is in pain? Thanks

  294. Doc says:

    Hello, Helen,

    I don’t keep these in my hospital. I work with my local pharmacy, and write a prescription for the patches.

    Cats are very stoic, and it is their nature to conceal pain. It is very unlikely that you will find him crying.

    Generally, we just see less and less activity, less interest in life. Sometimes your reading of the cat’s expression tells you as much as anything, at least when you’ve know a cat for as long as you have.

  295. Paul says:

    Yesterday, I had to make the gut-wrenching decision to euthanize my beloved 14-year-old cat, Obeah (OH-bee-ah). This page, with all of the heartfelt comments left over the years, really helped me to know when it was time for my cat to go. I thought I’d add a few comments about my own experience in trying to decide when it was time to euthanize.

    Obeah had begun losing weight earlier in the year. We’d taken him to the vet about one year prior, and his urine and blood tests showed that he was quite healthy at that time. So we initially chalked up the weight loss to old age.

    But his appetite continued to wane, and after awhile I became concerned that it might be dental disease that was causing him pain and making him not want to eat. I tried Obeah on a dental health prescription food, and he liked it and began eating more.

    Unfortunately, he continued to lose weight. As he did so, I noticed one day that he had a mass or large lump on the right side of his ribcage. My wife and I initially thought that perhaps his ribcage was just lopsided (sounds ridiculous, I know, but he’d always been a bit plump, so we felt that maybe his weight had hidden this lump until now) so we delayed taking him to the vet, but eventually we took him in. The vet tech immediately noticed the mass as she was weighing Obeah. His weight had fallen from 13 pounds to 9 pounds.

    We didn’t have a biopsy done – due to the location, there was no way to surgically excise the mass in such a way that would get all of the cancer – but our vet believed the mass was fibrosarcoma, an aggressive cancer of the soft tissue. Chemo and radiation really weren’t viable options, and even if they were, I don’t think we’d have wanted to subject our cat to those treatments. So Obeah was prescribed a glucocorticoid steroid to help his metabolism and promote his appetite. Blood tests again showed that he was healthy other than moderate anemia. We brought him home and hoped for the best. This was at the end of June, and I hoped he might live out the summer.

    But what an aggressive cancer it turned out to be. Obeah’s appetite did improve markedly, but he lasted only 3 weeks after the visit to the vet. He simply could not get comfortable any longer. He’d lie on his side with the huge tumor looking like half a softball imbedded in his flesh, but he’d have his eyes open – he was often unable to sleep. We tried him on pain meds including buprenorphine, but it didn’t seem to affect him one way or the other. Generic xanax just made him woozy and wobbly. During this time period, Obeah began losing interest in things he’d always loved, like scratching his post, sitting in my lap, and playing with a ribbon wand. His grooming habits, always meticulous, also waned quickly until he was no longer doing much more than washing his face after a meal.

    So, even though he was otherwise healthy, he was no longer having good days. It became clear to me that he was trapped in his body, and the only humane thing to do was to free him. We paid for a vet housecall (not cheap, but worth it to spare Obeah a last car trip. He hated riding in cars) and had him euthanized at home yesterday. He died peacefully. But it was very, very hard to let him go and to say goodbye.

    So I want to say thanks to all the previous posters and to Doc for contributing and maintaining this website. It was a comfort to know that I was making the right decision. I miss Obeah terribly – I doubt I will ever have a better cat, and I could spend many pages describing why he was so special – but it would have been selfish to keep him here as he slowly died, just so that we would be spared the pain of losing him.

    Good luck and good wishes to everyone else facing this situation. No two cats are alike and no two situations are alike, but you know your cat best, and if you’ve read over all these comments, you probably already have a good idea of when the time will be right to say goodbye to your beloved cat.

  296. Erin says:

    Hi Doc, I think you are doing a great service spending your time to reply to each person on here. Thanks!

    I have two female litter-mates who were born under my bed and have lived with me every day for more than 15 years now. They have been wonderful, charismatic companions and I want to continue to do right by them in their final years but it is getting difficult and I find myself considering the end.

    For one thing, I do happen to be allergic to the cats and 15 yrs of them in my bedroom has led to chronic sinus infections and I am looking at a surgery to remove an infected bone cyst in my sinus which may or may not be related. However, even though I probably should consider my own health first, I would never dispose of my cats for this reason alone. No one wants to adopt elderly cats and anyways I will not leave their final days to the fate of any agency so with me they have stayed and will stay to the end.

    My first cat – Bitty – has mobility and pain issues from an accident some 10 years ago which left her with no tricep muscle in a front leg. There were some who thought her end should have come then and there but she has lived a full life despite her disability. Now in her old age, she is showing signs of deterioration. She still loves to eat and will happily accept affection but she almost never seeks it out. For the most part she stays in the same place, asleep all day. She moves slowly and I don’t see her grooming herself much or playing anymore. Most troubling to me is that she has been missing the litter box although she does try to use it. Every day now, I am faced with sweeping, mopping, and resetting the box and mat which is NOT pleasant for me or her.

    My second cat – Zima – has always been more ferel than not. She loves to prowl around and scavenge whatever she can at night (and throw up often as a result) and she doesn’t care much for human attention, although she is affectionate to me on occassion. Zima has been diagnosed with severe cataracts and I’m not sure if this affects her quality of life or not but I do know she has been eliminating in places other than the litter box more recently of late. Zima is certainly not having any problems with mobility but her accidents have led me to confine her to the bathroom along with her sister as I just cannot sacrifice the carpet my children crawl on or send my husband to work smelling of cat pee to accommodate her desire to roam.

    I am convinced it would only be for convenience if I did put them down now because I truly think they could live many more years in just the state they are now. However, I also love them enough to know that a life on the floor in the bathroom is no life for my sweet, smart girls at all. I have even considered turing Zima loose outside to enjoy her last days in the sunshine she loved when she was young and still spent time outdoors (although this would not be an option for Bitty). I know I have to make the decision but any advice would be appreciated.

  297. Doc says:

    Hello, Erin,

    You have probably already considered using a very shallow litterbox, so that the cats don’t have trouble getting in and out. A high-sided box is really an issue for some of these old, arthritic cats.

    When the weather is moderate, I have had clients who built outdoor roofed runs for the cats to be outside (not all the time, thought). It doesn’t take very heavy construction, minimal lumber, and screening. It’s not like they are going to be trying to claw their way out in their condition.

    I agree that being locked in the bathroom with another cat who doesn’t use the litterbox doesn’t sound like much of a life.

    I also agree that you can’t put your family’s health at risk by letting them foul the home on a daily basis.

    There will come a time when you will look at these guys in their “cell” and decide that they can’t be very happy, and that they probably feel bad every day.

    That time is time to let them go.

  298. karen says:

    Our kitty is 16. Just diagnosed with jaw tumor and pancreitis. Still wants food, enjoys the sun, sleeps above my head. Eats and disappears for 1-2 hour, then wants more. No weight loss yet. I am terrified that the tumor will break her jaw before we know to say goodbye. Vet said there would likely be cleare signs before it got to that extent and that we would see these changes. Kitty is feisty and stoic. She is just starting to have her tongue out more. Still grooms self, hangs out except immediately after meals, no vomiting at this time, uses litter box. When do you know when it’s time? I really don’t want her to suffer but don’t want to give her up too soon if there are still good days. Tumor is large. This decision is excruciating but I fear her jaw will break before we know to say goodbye. Idon’t want her to go through that. Thank you for all of this support you have given so many. Kitty is on antibiotic, was on painkiller for pancreitis but has finished that. Will she show more signs of pain or discomfort before the tumor potentially breaks her jaw? I do not know what to do. 🙁

  299. Jane says:

    My 4.5 year old cat was diagnosed with widespread inoperable abdominal tumors in February. We rescued her about a year and a half ago and she has been a wonderful cat. She weighed 8 pounds at her heaviest and is down to 5.8 pounds. She still eats, but not that much. She doesn’t play anymore, but is still affectionate. She still uses her litter box, but her walking is pretty wobbly. She vomits about once a week, sometime food and sometimes just white foam. I am thinking that it is time for pain medication, but not euthanasia yet. It is so hard to tell and I don’t want to let her go.

  300. Doc says:

    Hello, Karen,

    If she is still grooming, that is a really good sign. They generally quit that first when they feel bad. Guys don’t shave, ladies skip the makeup, and cats quit grooming.

    There are no hard and fast rules, but I definitely think that you will see more signs of pain before the jaw is in danger of breaking.

  301. Doc says:

    Hello, Jane,

    I would definitely talk to your veterinarian about pain medication. Buprenorphine is not cheap, but works well. You might also ask about Fentanyl patches. They last for 3 days.

    Mirtazapine is a medicine that stimulates appetite in cats, and has some anti-nausea properties. It just has to be given once every 3 days.

    You should discuss these questions with the doctor who knows your cat. That knowledge makes him better equipped to advise you than some bozo on the internet.

    Best wishes.

  302. karen says:

    Thank you for your kindness to strangers during these difficult times. I will continue to keep a careful eye on my little cat. She is a faithful and good little cat and I struggle with the inevitable. Your advice is much appreciated. Thank you.

  303. susan hodos says:

    Our kitty, Jimmy, is truly the sweetest cat I have ever known, and I have had many many cats. Hes always followed my daughter and I around the house like little lamb.very cuddly, very related to people kind of cat.
    He was diagnosed a month ago with intestinal lymphoma with mets to the liver. My Doc said he had 1% of making it, if I were to try chemo. He has probably 5 good days and 2 bad days a week, where he hides under the bed, I’m assuming from the pain and not wanting to be bothered, altho even on those days he will eat. he is on a fentanyl patch and has developed a voracious appetite. So my question really is, do you wait until the cat goes into this torturous
    painful place, knowing that will be the end, or do you do it sooner to prevent that. I just don’t want him to end up leaving this earth in horrible pain. Am I right about the description of ‘the end’ ?

  304. Helen says:

    I think my post was not posted yesterday because I went into too much detail about Noah’s condition, which is very poor. He stopped eating yesterday, but is still drinking water. I know it’s time and yet I don’t want to do it. He is still so alert. I cry every time I look at him. I have to force myself to call the vet.`

  305. Doc says:

    Hello, Susan,

    I don’t think that you will be seeing your cat screaming with pain.

    It is more likely that you will see a gradual transition to less and less activity, less appetite, more weight loss.

    There may be vomiting if the lymphoma closes off the intestine.

    The onset of vomiting, or complete loss of appetite would be signs that “it’s time”. Also, when he gets into an obvious “wasting condition” (looking terribly thin), I would be looking at decision time.

  306. Doc says:

    Hello, Helen,

    While I don’t have any details, it is obvious that you are in a lot of distress at seeing Noah’s sad condition.

    I know this is a hard time. Talk with your veterinarian about what is going on.

  307. Helen says:

    Thank you. Noah was so sick, but was still doing many things. He stopped eating and I knew now that it was time. The tumor in his mouth and nose had gotten much larger. He could still drink water and his breathing was o.k. I spoke to my vet yesterday. His vet. hospital is open for 4 hrs. on Sundays. He came over with a tech when he finished his appts.. It was a peaceful death. My vet tranquilized Noah in my arms. Noah jumped down to look out the front door. In a few minutes he started swaying and I picked him up and held him for a while, then put him on a chair. My vet gave him the injection and Noah was gone. I feel very sad, but he doesn’t have to suffer. He is buried in my back yard. I am going to grow flowers near him and have a large rock painted by a friend with his name and my love. I never really understood all the things people do for their friends and relatives who die, but now I understand. I need these things and do wish Noah was aware of how much I loved him.

  308. Cathy says:

    Belated thanks for your comments Feb 14th re Jess.
    We did take him to vet that weekend – he was just existing.
    He sat on my knee in the car & miaowed.
    He was still interested in the birds flying over the car park – but his body had failed him.
    We knew really but this site is like a good friend – we needed reassuring it was best for Jess.

    Many tears were shed but we also felt relief –
    Witnessing suffering is so draining if there is no hope of recovery.
    So thank you for your support & love to all those hurting at the moment –
    of all species.
    RIP Jess – you were a Top Cat & our Best Boy! X

  309. Cathy says:

    Helen,
    Just read about Noah.
    I have tears in my eyes –
    I am sure Noah was aware how much you loved him.
    You did so much for him, including the hardest thing,
    letting him go in peace.
    I have found that at first I could only focus on the sad time at the end with Jess, but as time goes on I can see his life in its entirety & realise he had some great years lived in love.
    Hope you can see Noah’s good times outweighed the suffering overall.
    With sympathy for your loss. X

  310. LB says:

    Good afternoon- I think I’ve read all the posts on here from beginning to now. What a wonderful blog. I am seeking about the 3rd opinion regarding the state of my near 20 y.o. kitty, CC. Her birthday is this Sunday and we are going to do it up for her!!
    For a couple of years now she’s been on medication 2x/day for hyperthyroidism. Her weight is down to between 8-9 pounds from a typical 14. She has a lot of muscle wasting in her shoulders and rear and her front paws are like flat feet…something to do with her tendons being so loose due to her age.
    She has had problems peeing in the box for a few years and recently I’ve used pee pads around the pan because she doesn’t seem to use the pan anymore (we have a very low sided one for her), and I find poop scattered along the floor in the litter area, and sometimes still in her bum, that she has not been able to get all the way out (?).
    She has a cough, she is on adequan for arthritis, she’s wobbly when she walks sometimes. She has a mass in her lung, though we don’t know what that is or if it’s affecting anything.
    Just recently she has begun peeing on the bathmat in my bathroom. She also sleeps all day, usually tucked in a corner, though sometimes in her favorite spot. She does climb the stairs I got for her to get on our bed a few times a week to sleep, but she does not stay long (like she used to).
    She still eats, though it takes many nibbling sessions to finish a 1/4 cup portion. She has forgotten to come for dinner a few times, but not within the past month or so.
    I don’t think she’s actually in pain aside from arthritis, but she is not ‘doing’ anything anymore and seems to exist. I just have no idea if we are slowing down death, as you say, or if she’s got some quality time left. Is this quality time, I guess is my question. She accepts affection, but does not seek it any longer. I would love some objective input. I love her with all my heart. Have had her since she was 8 weeks old, and I just would like to give her the respect she deserves. Thanks so much for any insight…

  311. Doc says:

    Hello, LB,

    You have done some amazing care to keep this cat doing so well for so long.

    Even without the excess thyroid output and kidney disease, cats of this age typically tend to lose weight. Their digestion is less efficient. They eat less, and utilize what they do eat less well.

    The excess thyroid function often causes damage to other organ systems before it is controlled. These cats frequently get high blood pressure and detached retinas.

    With compromised kidney function, the cat generally becomes accustomed to having a considerably higher than normal level of waste in the blood. Even though they tolerate it, it still makes them feel less well than they would if the kidneys were functioning normally.

    Some cats with chronic kidney disease feel much better if they are better hydrated. This often requires giving subcutaneous fluid therapy. You hook them up as though you were going to give intravenous fluids, but instead the needle is inserted under the skin in several places, and the fluid can be given rapidly , over about a 20 minute period. These guys often do not drink enough water, and stay a little dehydrated all the time (which makes them feel bad). The subcutaneous fluid therapy helps them “catch up”.

    Arthritis in cats is difficult for us to manage, as they don’t tolerate most of the medicines that we use in other species. Adequan is very safe, but when you get down to bone-on-bone (as you may at such an advanced age) with no cartilage, it doesn’t seem to help as much. Same with glucosamine, like using Cosequin for Cats.

    If she has a mass in her chest and a cough, one would have to suspect some connection (though that may not be the case).

    If she is still eating on her own, and still accepting affection, she may be like my 100-years old aunt. She didn’t have much endurance, but she still enjoyed the company of visitors.

    You will at some point see that nothing seems to make her happy any more. Then you really must make the decision.

  312. Kaelstra says:

    I have a 14 year old cat who has gradually started always going outside his box. My efforts to encourage him to use the box(es) have been futile.

    He came from an abusive situation where my ex was mean to him, so now my kitty is afraid of other people. The other three cars in my house are mean to him, so he spends most of his time hiding under the bed. He’s afraid of everything that isn’t me. I can’t imagine his quality if life is good anymore, and I worry something is wrong, but my husband is strongly against the idea o spending a lot of money on a pet to take him to the vet, because at his age, he’s convinced it will be something serious and expensive. I am not above the idea of rehoming him so his life situation improves, but I can’t imagine anyone who would take in a 14 year old cat that poops and pees all over the place.

    Taking him to the vet to diagnosis him is sadly not an option, the tests to find out what’s wrong would cost a lot, and the ultimate answer would likely be to euthanize him. I’m wondering if I should fight harder to find out what’s wrong, or if my husband isn’t right, and seeking a diagnosis at his age is largely just a very expensive and pointless venture. I’m heartbroken and frustrated and not sure what to do.

  313. Helen says:

    To Cathy, I have re-read some posts and propbably will for a while. Many are very sad and many very comforting. Thank you for your post.

  314. Terry says:

    My cat Sid has been on methamazole for hyperthyroidism since July 2010. He continued to drink lot and vocalize, then last summer he had an episode where he started going to the bathroom on the living room rug, and throwing up. I took him into the vet for an utra-sound, which showed a thickening in his jejunum. I was told that it could be either IBD or lymphoma, and the only way to tell for sure would be to cut him open and get a full-thickness biopsy. I thought, and the vet agreed, surgery would be risky because he was 14 years old at the time, and also that if it was lymphoma I would have to have his bowel re-sectioned, and then bring him to a hospital twice a week, once for blood tests, then for chemo, and I thought that that would be too much on him. I also thought that it would only extend his life for a few months, so wouldn’t be worth it. We decided to treat him for IBD and hope that’s all it was. He started to lose weight in the winter, and I brought him to the vet in January and April for check-ups, and to try new meds, b-12 shots, fluids, and a depo-medrol shot. Finally in June I brought him in for another ultra-sound. This time the thickening in his bowel was a large mass. I had read up about lymphoma in cats and decided to try Leukeran, with prednisone, because I read that a high percentage of cats on those meds together go into remission, and average 2 years in remission. Sid started on Leukeran and prednisone on June 17, Leukeran Monday, Wednesday and Friday, prednisone at first 1 1/2 daily then 3/4 tab daily.

    It’s now August and he has not gained weight. His appetite is on and off. He throws up from time to time. He had diarrhea, but it resolved with metronidazole. I give him sub-cutaneous fluids once a day, 1 mil. He gets mirtazapine every three days for appetite and cerenia for nausea. I also give him a topical pain med if he seems to need it, I’m never sure (can’t remember off-hand whether it’s torbutrol or tramadol).

    I thought that if he was still eating and acting interested in food, coming out sometimes to sit with me, purring when I pet him, sitting next to my husband when he’s eating and begging for food, that he’s not ready to go yet. Now reading this column I’m not so sure. He’s lost almost half his body weight, down from almost 14 pounds to 7 pounds 14 oz. I think part of the weight loss is from muscle loss from the prednisone. Am I kidding myself or is there still a chance that the Leukeran could turn things around and it’s taking longer to happen? Sid has been very cooperative taking his meds, and even letting me give him his hydration.

  315. Doc says:

    Hello, Terry,

    You should really discuss this with your regular doctor.

    Having said that, I have two thoughts here.

    First is that it is unlikely that Sid is going to return to health. I don’t think that this is the prednisone making him worse. I think it is his disease.

    Second is that you are the best judge of whether or not he is still enjoying some things about his life, despite his continually weakening condition. If you think he is, then he probably is. When you can see that he is not, then you have a decision to make.

  316. Karen says:

    Hi,
    I posted earlier about my 16-year-old cat with the jaw tumor and pancreatitis. The latter seems to have cleared up or at least she no longer disappears after eating. She still lies down after eating but place of choice is beside the food dish… (always wants more food… no weight loss.) However, she is clawing at her jaw more and today she was having some twitching on the side of the tumor. Still not hiding; just sleeping a lot. Still grooming to some extent. How do I know when to put her on pain medication? Is this something I should do now? I can’t imagine that a jaw tumor is anything but painful. 🙁 The pain medication is buprenorphine. Question 2: Is a variety of food bad for pancreatitis in cats? She is on hypoallergenic food now, which has completely cleared up a skin condition (flaking); vet suggested low-fat because of blood tests and weight. She is not picky eater and eats anything. Thank you for any assistance you can give (again) and my heart goes out to others going through this with their animal.

  317. Doc says:

    Hello, Karen,

    It sounds to me like your veterinarian is giving you excellent advice on the diet, with a history of pancreatitis.

    If the cat is clawing at the jaw tumor, then that surely sounds like it is painful. Try the pain medicine and see how her behavior changes. I suspect you will see less clawing.

  318. Mara says:

    I’ve read through so many posts that are similar to my situation. My Greta is 12, and has lymphoma and is being treated for it. However, she down to 6 lbs., and has eaten nothing in almost a week. She’s had two injections of fluid from the vet and is also on anti-nausea meds. She just vomits everything she eats. I have even tried force feeding, but that also comes right back up. She drinks a tiny bit each day. She still sleeps with me at night, and looks for affection, but does sleep all day. The hardest part is that she still purrs when she’s on my lap. I know the end is near, probably this week, but the guilt I feel is what if there is something else to be done? What if the inability to keep food down is something simple and it’s just being overlooked? I trust our vet, but is it worth a second opinion? I never imagined this decision would be so unbelievably hard.

  319. Doc says:

    Hello, Mara,

    It sounds to me like the only diagnostic test that might give you more information would be an exploratory surgery of her abdomen.

    Given what you have said, I think it is very unlikely that this would turn up anything treatable.

    You know she has lymphoma, and tumor growth is probably closing off her digestive tract.

    If it will make you feel better to get a second opinion, then do so. Be sure and get copies of your records from your veterinarian so that the other doctor doesn’t have to “reinvent the wheel”, and put the cat through a lot of duplicate tests.

    From what you have said, I think it unlikely that you will receive any “new” news.

    Look into her eyes each day. You know her better than anyone else.

  320. Kim Fisher says:

    Dear Doc,
    I hope you read this today. I am struggling with the decision to put my beloved Mr. Sweetie (13.5 year old cat) to sleep. I have been putting it off for months hoping he would get better but I made an appointment with the vet for tomorrow. About 4-5 months ago, Mr. Sweetie came home with a limp. The limp got progressively worse. We took him to the vet, they did X-rays and found narrowed disc space at C3-4 and diagnosed him with radial nerve damage. We got a second opinion and the same diagnosis was made. This cat cannot be medicated – even the vet tried and could not get liquid or pills down his throat. We opted for sterriod (cortizone) shots once a month. The first three shots worked pretty well and allowed him to walk a little although he was very unstable. After his 4th shot – the sterriods no longer worked. My cat has been laying down for about 4 months, only gets up to use the litter box and eat but about three weeks ago he could not even do that anymore. He is very hungry and cannot get to his food without assistance. He had an accident outside the litter box. He can move his two front arms enough to put one paw on my cheek when he is laying next to me but he cannot walk. His quality of life has to be horrible as he just lays in one spot all day long. I am sick inside. I am a single mom to a young toddler and i cannot spend much time with Mr. Sweetie so he is alone a lot. The guilt is eating away at me. The vet said she thinks he has healed as much as he is going to. His eyes are dialated all the time. He has lost so much weight. The other day i saw him get out of the litter box and he landed on his face because his arms could not hold him up. He looked at me like, “see what has happened to me?”. My mom said that Mr. Sweetie just does not want to live anymore. I’m pretty sure she is right. He never does any of the things he used to. No playing, no walking, no sitting. Just lays there. I don’t want to put Mr. Sweetie through back surgery – i cannot afford it and I just don’t want his suffering to be prolonged. Please tell me what you think? Mr. Sweetie is the best cat I have ever had. I cannot stop crying.

  321. Doc says:

    Hello, Kim,

    I can hear your pain through your writing.

    From what you say, I can also hear that you know Mr. Sweetie is suffering and cannot get any better.

    He can only get worse as this continues.

    It is so hard to say good-bye to a friend, but even worse to watch him suffer. He has passed the point of living longer and is now just dying slowly.

    Let him go. Francis Bacon once wrote, “A healthy body is a guest-chamber for the soul, and a sick one is a prison.”

    I know you will do the right thing.

  322. Kim Fisher says:

    Dear Doc,
    Thank you for responding so fast. I’ve read through most of your posts and I think you are helping a lot of people get through a very difficult time. I’ve been scowering the internet looking for a less painful way out of this for a while, but I cannot find one. Your kind words have brought me some peace inside, and that goes a long way for me right now. Thank you so much.

  323. Taniab says:

    Dear Doc,

    We have a 7 year old cat. about three weeks ago she started urinating in our bedroom. She has never done this before. We took her to the vet and they did a urinanalysis and they said they did see she had a UTI, blood and crystals in her urine. At that point there was no bacteria. She was on antibiotics twice a day. On Saturday I will take another urine sample in for retesting to see if it worked but if it didn’t, the next step is XRays to check for stones, or if they aren’t stones, further tests to guess what may be the problem. She has had an amazing life. But we have had to keep her locked in the basement for the last two weeks so that she didn’t urinate all over the house. We wouldn’t want to put her through surgery, especially with the costs associated with them. Then to have test after test after test the vet bills would just add up. Some people may think that the thought of euthanizing at this point may be cruel, but I don’t know what other option we have. If we give her to a rescue I think she will be miserable. I can’t keep her locked in the basement forever. How much longer can I do test after test to not resolve the issue? I don’t know what to do. It breaks my heart. This isn’t a life for her.

  324. Doc says:

    Hello, Taniab,

    I understand your frustration. I would highly recommend that you look at this website.

    http://indoorpet.osu.edu/cats/

    After antibiotic treatment, cats that eat a diet formulated for urinary tract problems, like Hill’s C/D often have no further problems.

    There are cats who have recurring urinary problems that are stress related. The website at OSU has lots of stuff about enriching the cat’s environment and providing “safe” places that relieve this.

    Please take a look at this material. I think it will help.

  325. Michelle says:

    Hi, Doc –

    We chose to euthanize our beloved 16-year-old kitty, Zippo, on Friday. I have been DEVASTATED. Sometimes I’ll feel like we did the right thing, and sometimes I have doubts.

    Zippo was diagnosed with CRF in May 2012, and in August 2013 bloodwork showed creatinine of 7.8, which put him in stage 4, or end stage. We started administering 100 ml of sub-cutaneous fluids a day at home.

    Fast forward to last week. On Tuesday, we accidentally gave a little more fluid than we were supposed to – maybe about 133 ml. I pray to God that this had no impact on the fact that on Wednesday, it was apparent he was breathing in a more labored fashion.

    Friday morning, a chest x-ray revealed a pleural effusion. Everything happened so quickly after that. Our vet said that most likely, the cause was his heart. And that medications to treat the heart are not good for the kidneys, and vice versa. And that’s not to mention the invasive and stressful procedures/tests required to diagnose the reason for the pleural effusion. I asked the vet whether he thought it was “time.” He said yes, so we chose to let him go peacefully.

    Please tell me an extra 33 ml of fluid once couldn’t have made a difference. I can deal with the fact that fluids in general exposed a pre-existing problem, but it being due to one simple mistake would be awful.

    Too, the “what-ifs” persist regarding the cause. What if it was just overhydration? Could we have drained it, brought him home, administered fewer fluids and continued on? We’ll never know because we didn’t put him through the diagnostic procedures.

    His quality of life at home was mixed. He was sweet and alert, but frail and anemic. Stomach acid/nausea was getting harder to manage, and he was spending a lot of time lying by the water bowl. Occasionally, he would retch loudly and fruitlessly. But then sometimes he’d solicit affection, or lie in his favorite spot by the front window.

    Please tell me I did the right thing and didn’t let my baby go too soon.

  326. Doc says:

    Hello, Michelle,

    If the fluid were actually in his lungs (pulmonary edema) rather than around his lungs (pleural effusion),then one might attribute it to a fluid overload. Might.

    Don’t beat yourself up on this. Sometimes patients die of their diseases rather than from their treatments and nursing care.

    You worked very hard to give him additional time at home. Give yourself some credit.

    I know you will miss him.

  327. Michelle says:

    The vet said he didn’t hear any fluid in his lungs. I didn’t look at the x-ray extensively, but I am pretty confident we were talking about fluid *around* the lungs.

  328. Cali says:

    Hi Doc,

    My 22-yr-old cat has SCC, a large tumor under his tongue. I have been giving him buprenorphine, and just upped the dosage today with the vet’s approval. Coincidentally, he has just decided to stop eating entirely, even though he ate well this morning, and he has been laying in my lap purring loudly.

    I so wish that he would fall asleep and never wake up; this decision doesn’t get any easier no matter how many times I have been through it.

    Is there anything that I can give him to help him die comfortably at home in his sleep? I will ask my vet in the morning. But I’m asking here because obviously this site has brought some reassurance to many cat owners; I wish I had thought of this question earlier in the process.

    Thank you,
    Cali

  329. doc says:

    Hello, Cali,

    I can’t give you much help on this. I have certainly made house calls to do this. We don’t really have a good oral anesthetic.

    When I do this in the office, I usually give the cat a quick injection in the muscle of a heavy sedative/painkiller. This stings for second, but requires almost no restraint.

    Then they go to sleep. After they are asleep (as for a minor surgery), we give the final injection so that they don’t wake up. That injection is not painful, but it has to be given directly into a vein, which does require some restraint. These guys usually have lousy circulation, so I do not want to make a big production out of hitting the vein. After they are already sleep, it’s no big deal (technically, that is — obviously the whole difficult situation is a VERY big deal).

    I feel for you. Oral tumors are the worst.

    Best wishes.

  330. Tina J. says:

    Hello,

    I got my elderly cat nearly 16 years ago when she was a kitten. She has slept on my belly with each of my pregnancies. She has lived in every one of our homes with us. She has been here for all of it. About 5 years ago she became very picky with her cat box. It couldn’t have any urine or feces in it or she wouldn’t use it. I also have another cat who is 15. I’ve had them both all their lives. So, I have two cat boxes upstairs, and two downstairs. That seemed to work for a while.

    About a year ago, the oldest cat, the one I am writing in regards to, started getting some arthritis in her hind legs. Nothing too bad. If she would get startled they would lock a tiny bit. Everything seemed okay on a day-to-day basis. About 6 months ago she started vomiting (hair balls and the like) all the time, every day. We switched her to soft food and she does it far less now. She has a hard time eating more than 1/4 of a can of food at a time even if she is hungry. She is literally skin and bones. No muscle mass left at all.

    She still “wiggles” around on the floor and purrs, but she can’t move more than 5, maybe 10 feet at a time before sitting down to take a break because her hind-legs have gotten really bad over this winter. When I say bad, I mean: She struggles to pick them up, and sometimes if she is startled they fall beneath her and she has to lay there for a minute or so. We try very hard not to startle her. I know that I would be in pain if I was her, but she doesn’t call out, or cry from pain. She gets very excited to eat and moves around in a circle when I’m about to feed her, all-the-while trying to keep her hind legs in check.

    What is becoming devastating to our quality of life now is that she no longer uses the cat box. She will use the “pet pads” only about 50% of the time, and I have them all over my house. She does not like to be picked up so putting her in the cat box is very hard. Her back-end hurts. Today was the last straw when my son was playing cars in the dining room and he ran it through a puddle of fresh cat urine. Even though there was three pads for her to choose from all from 10 – 25 feet away. My house is smelling so horrible. I have pads in my daughter’s room, by my back door, by my front door, at the base of the stairs. And the dining room was added to the list today.

    It makes my heart hurt to think that I will be putting down a cat that has been with me longer than my teenage son. I don’t want to do it if she is still … I don’t know… if she still has “life” left? If she didn’t wiggle around and want to be pet still I would not have an issue with this, but she does still enjoy the closeness of her humans.

    I am extremely poor, living below poverty level at this time due to several extreme life events. So economically I am in no position to have a myriad of tests run on her, and I wouldn’t be able to treat her if the vet said I had to. If she were to give me any indication that she was in serious pain I would take her in somewhere and try to make payments. But she never makes a peep, although her legs do have to be sore.

    Thank you for listening

  331. doc says:

    Hello, Tina,

    I understand that you are in a very difficult situation. It is obvious that you love your cat dearly, and I am sure that she feels the same way about you.

    As hard it is to confront, you must know that her quality of life is very poor right now.

    I don’t wish to make you feel bad about this, but cats are generally very stoic. They are extremely unlikely to cry with pain unless they are acutely injured.

    The chronic pain of arthritis in legs and back may be excruciating and incapacitating, but it is not very likely to cause any crying.

    I am not in a position to give you specific advice without seeing your cat. However, you describe to me a cat who is too painful to get up to go to the bathroom, and who is wasting away to nothing.

    This sounds more like slow death than living. That’s pretty blunt and crude, but that’s what it sounds like from your description.

    I cannot make this decision for you, but it sounds to me like you are practically there already.

    Best wishes.

  332. Christine says:

    Hi Doc, my 17 yr old is skin & bones. He eats from a bowl in our kitchen and poops & pees in his liter box, no vomiting. Paid to have his urine & blood tested and everything came back normal for diabetes & thyroid but early renal failure. Vet said this shouldn’t be causing his weight loss & it could be cancer but no way to detect. He’s barely 5 lbs. Doesn’t seem to be in pain despite I feel every bone in his body. He does eat pretty decent amounts but not voracious, still enjoys catnip, sleeps with us, doesn’t seem lethargic or want to hide. He seems pretty normal except for his 50% body weight loss and old age but nothing out of the ordinary. Any ideas on what we could do to help increase his weight? I’m not confident in my vet as something is definitely wrong w/our boy & spending hundreds of dollars to find out ‘nothing’ is wrong was unacceptable. I know at 17, there’s not much I can do for him but to watch him waste away is sad. I don’t feel it’s time to euthanize him as he still seems very content & happy to be with us, he eats and enjoys a run outside. When he isn’t active anymore, I will take him for that day. Any comments, recommendations or advice would be much appreciated. Blessings, Christine

  333. doc says:

    Hello, Christine,

    First, I agree that it is NOT time to euthanize. Your buddy is still enjoying life, and that’s the bottom line.

    I can appreciate your frustration when the tests have not revealed a definitive cause for the situation, much less a way to help him.

    Certainly cancerous diseases cause a wasting condition. Some are undetectable without sophisticated imaging, like a C-T scan or MRI. Others are very diffuse, infiltrating things like the intestinal lining, and cannot be diagnoses without exploratory surgery and biopsies.

    Sometimes a cat food with a higher fat content will help maintain weight in an older individual who has poor efficiency of digestion. It also just puts more calories in the system (cancers really suck up the nutrients, beating the rest of the body in the race for nutrition).

    You might ask you veterinarian for dietary suggestions.

  334. Christine says:

    Thanks Doc, I took Tyler to a specialist and she feels it’s a GI lymphoma but today was not the day to let him go! She started him on Prednisolone & feels it will slow any growth inflammation and keep him out of discomfort. Mite help put some weight back on. Vet was amazed how lively he is yet so skinny. His fur looks great & he’s still grooming. Said the nutrients are getting sucked up by the cancer. But I think we’ll be able to slow that down and he’ll be able to put some weight on. I started him on a high quality cat food the he finally likes! BFF is the name of the food and also giving goat’s milk; it seems like he’s already putting a few ounces back on. We know he’ll die as every living thing does but now is not the time, he has way too much life in him and we are going to keep him comfy until the time comes. Blessings and a second opinion is well worth the cost!

  335. doc says:

    Hello, Christine,
    Thank you for the follow-up. It sounds like you are doing everything possible to extend Tyler’s quality of life.

  336. Karen Hammer says:

    Hi-
    My 18 year old cat, Tony, has a cancerous tumor in his ear that is infected, necrotic, and bloody. The surgeon said that it is possible to remove it, but that surgery would not be curative. There is also risk because Tony has a hematocrit of 20, a heart murmur, and signs of renal insufficiency. In other words, he might not make it through surgery, and if he does, it will buy him some time, but not very much. Behaviorally, his litter issues are no worse than they have always been (he hasn’t used litter in years), except that he is more often urinating right where he sits on the bed in the guest room. He still eats and drinks, and we have a two or three hour cuddle every evening. He is very aggravated by the tumor, shaking his head and trying to scratch his ear. I think the surgery would be very hard on him, as would the recovery. So…I am in the same boat with so many posters here. He still purrs like mad when he’s laying on me, he still eats, but his ear is a bloody mess and causing him discomfort. I know that I am theoretically the only one who will know when it is “time,” but I would really appreciate your thoughts.

  337. Doc says:

    Hello, Karen,

    We are so limited in the types of pain medicines that cats will tolerate. Buprenorphine works well, but is expensive. Fentanyl patches also work well, but for constant use, again can run into some money. Both are controlled substances – narcotics and must be used with care.

    You have put the situation very clearly. None of your alternatives are clearly a great choice. He “feels okay”, but has constant annoyance and probably a little pain with the ear. The surgery may or may not buy you time.

    There just isn’t a “right answer”. I don’t know how to make this easier for you. Feel free to re-post if something new develops, or you have a specific question (and don’t forget to talk with Tony’s regular doctor about these things, too).

  338. Karen Hammer says:

    Thanks so much for your reply. I will ask my vet about pain management. In the meantime, we’ll have our evening cuddle, and I’ll keep a close eye on him. Good luck to all the other kitty caregivers on the site.

  339. Bryan says:

    Hi Doc,

    Our kitty girl Sam, who we rescued as a baby kitten and who has slept curled up next to my wife’s heart for the past 13 years, has a squamous cell carcinoma around her left upper jaw. The vet told us about 3 months ago that the cancer had eaten away a section of bone in the upper jaw, and recommended that we euthanize her during the diagnostic surgery (to tell whether it was cancer or an infection). We were shocked – Sam’s quality of life had been great, we saw no signs of pain or behavior change other than occasional long strings of drool and a funny squeaking noise from a loose tooth when she ate kibble. There was a slight swelling on the left side of her face.

    The vet proceeded with dental surgery, removed almost all of the teeth on her left side and a couple on her right, and taking a biopsy to diagnose the type of cancer.

    Once Sam had finally recovered from the dental surgery, her appetite was better than ever – probably because we fed her only wet food, so we saw her eat more than when we left out kibble all day in addition to wet food twice a day. But over time, the swelling got bigger.

    Now the left side of her face is severely swollen, she drools frequently when she purrs, and her left eye is very squinty and usually looks extremely bloodshot and the pupil seems to be rolled upward. She has been sneezing after she eats, and lately has started sneezing sometimes when she hasn’t eaten. There’s always a trail of mucus from left eye down across her nose to her mouth. The left corner of her mouth looks a little twisted, I’m wondering whether she might have trouble closing it before too long.

    But… her quality of life still seems pretty good. She eats voraciously. (She used to be very finicky, I suspect her sense of smell isn’t what it used to be.) She grooms fastidiously, except for the mucus and drool around her left eye and nostril. She almost never paws at the cancer area, which the vet told us would be a sign of pain – I’ve only seen her do that once in the past month. She sleeps a lot, but I think she did before… She still comes out and looks at things with interest, still loves to go outside, still loves to climb into bed and snuggle with us at night. Overall, she seems to enjoy life.

    A couple of days in the past couple of weeks, she seemed to be in pain – her sitting posture was huddled, rather than stretched out – but giving her buprenorphine didn’t seem to make it a better day, whenever we give it to her she goes and hides under the bed for the next few hours. Still, almost all days are still “good days.”

    I don’t want to “put her down” just because she looks bad and might die soon, as long as she still enjoys life. But I’m concerned about how sudden it can get very bad for her. At some point, she’ll have trouble breathing, and if that happens before other problems, it will be time. I’m concerned about her eye – not sure what the cancer will do to her eye before it interferes with her breathing, or how painful it will be. Also not sure whether it will get to the point where she can’t close her mouth. I’m assuming that she’s feeling more-or-less OK since she still eats very heartily and behaves mostly normally, but I’m wondering if we should preemptively let her go so she doesn’t have to experience the horrors to come.

  340. Laura says:

    My cat Violet has lymphoma. The vet did aspirated the swelling in the lymph nodes in her neck and the cytology was highly suggestive of lymphona, but I am unable to afford the further CRF test to know ‘for sure’. Her dr is pretty certain it is. I won’t put her through chemo. She is on prednisolone now and even though we recently upped the dose, she still seems uncomfortable. She develops edema in her mouth and has some trouble eating (although she still seems to be managing-at quite a bit overnight last night) and she seems to be struggling a bit with breathing.
    I am agonizing over the idea of ‘convenience euthanasia’ myself. I put together a photo album on my Facebook the other day. I know that the time will come to say goodbye and I wanted to do that before I lost her because I’m afraid I will fall apart. While I was looking at the pictures I realized how long it has been since she seemed to be actually enjoying life. In the past month she has had a few days when she was very close to seeming like her old self, but mostly she just lies on the floor looking out the sliding glass door or lies on the rug in my bathroom. The idea of ending her life takes all the strength out of me. I watched my cat Elvis deteriorate from his own cancer about 6 years ago and I know I held on too long before letting him go. I don’t want to do that to Violet but I don’t want to take away any good time she might have left.
    I can’t decide if what she’s having are bad days or not. There doesn’t seem to be any pain, just discomfort. She’s not hiding under the bed like she does when she has pain. She hates taking the medicine twice a day, drools for a while after and doesn’t want to be touched. I can’t decide if she’s having bad days, good days, or just ok days. I feel selfish because I don’t want to deal with this..don’t want to go through this again. I know it will be a relief when I can let her out of this body that’s not working right anymore but I’m scared of doing it too soon.

  341. Doc says:

    Hello, Bryan,

    The fact that she is still grooming fastidiously makes me feel like her pain level must be quite low. This is usually the first change we see when a cat gets sick. They are great at concealing signs of illness, and I often find that the first thing people noticed (when questioned) is that the cat was “looking scruffy”.

    Guys don’t shave, ladies skip putting on their makeup, and cats quit grooming.

    That may be your early warning.

  342. Doc says:

    Hello, Laura,

    It sounds to me like you see that the end is coming. This is always such a hard call to make.

    With my own dog deteriorating with cancer last year, it was very hard for us to take the step. She would still eat a little, but she just sort of shuffled across the floor and lay down. She got thinner every day. One day we just decided that we weren’t going to wait until she couldn’t get up. It was indeed a tough decision, as it always is.

    It’s hard, but we have to make a distinction between living longer, and just dying slowly.

    You know your cat better than anyone else, and you just have to make the best decision that you can.

  343. Patti Otto says:

    Hi Doc, our 16 year old cat stopped using litter box 2 yrs ago. She stays in our basement, which she likes. She urinates constantly on paper or floor, poops different spots in basement. She eats and drinks alot and sleeps. She can no longer stand up very well and walks hunched. She no longer can take care of herself and smells like urine. She is skin and bones and even though I brush her, coat looks unhealthy. When I take her outside she becomes very scared. She meows alot, not sure why. We love her so much but do You think she is suffering? We thought she might just go to sleep one night and not wake up, not happening. Shold we have her put to sleep, she has no quality of life.

  344. Doc says:

    Hello, Patti,

    You are describing a cat who has lost so much weight that she can no longer walk well. She either physically or mentally cannot groom. She vocalizes all the time, either from mental disorientation (afraid of outside) or possibly arthritis pain or other painful conditions.

    This is something that is no good, and getting worse, and will not get better.

    I cannot make the decision for you, but I don’t think anyone could argue that euthanizing her would be a wrong choice.

    It is always tough to say goodbye to a friend. It’s also tough to watch them suffer.

  345. Patti Otto says:

    Hi Doc, thank you so much for getting back to me right away. Everything you said is exactly correct. I cannot watch my longtime friend suffer anymore. You helped me so much in deciding what is best. This will be a extremely hard vet visit,but I have to do what is best for my Sashamay.

  346. Patti Otto says:

    Doc, I cannot even call my vet clinic-tears, too many tears. My Sasha has been with me 16 yrs after finding her along the roadside while riding my bike. I thought it was a chipmunk and told myself to keep riding-I then looked back and saw a tiny kitten peeking out of the tall grass in field. I carried her on my shoulder for the 15 mile return to my house. I thought my husband would be mad, but he loved her right away. We took her to a Vet 30 miles away as our vet could not see her asap. She was so young but very healthy. She has always been very healthy. Even since living in our basement for about 2 yrs, we made her a comfortable home. She would jump on the table, walk up a ramp, we just had to keep her down there because she would pee where she stood-believe me we gave her alot of chances. She has a small light on at all times. We use to live next door to our vet, but have since moved. Our vet in our hometown would come to our house when our pets were beyond help. I will see if our new vet will come to my house to put down my beloved Sasha. Since she is so scared to go outside I cannot bare putting her in the car and driving 30 minutes to my vet. She hates the car as well. Needed to vent, thankyou for listening. Sincerly,
    Patti

  347. Patti Otto says:

    Hi Doc, My Vet came to my house this A.M. I decided to have her put down in her favorite spot, in basement near her cat bed. She went behind my washer when seeing strangers, my vet is so gentle and kind so easily lifted her from behind the washer. I did have my vet ck her over just to be sure it was time. He said she has extremely bad heart murmur and most likely many other issues. He ageed this was the best thing to do, but of course it was up to me. I could not let her suffer anymore, so proceded with euthinizing. She seemed relieved after the sedative, she looked around her favorite room, my vet left for a few minutes so I could spend time with her. When the final injection was given it was very peaceful. I am sad to see her go, but I know this was the right choice. She is finally at peace. I would of never been able to make this decision without your help. Thankyou from the bottom of my heart.
    Patti Otto

  348. mr.tipps says:

    im having to euthanize my cat today. he raised hell for 20 yrs, i got him when i was 4. the past two days hes taken a turn for the worst, and has been stumbling to the food dish, litter box, and water dish. this is the awful part about little companions. prayers for everyone dealing with this.

  349. Karen says:

    Our beloved 12 yr old Cheezal was diagnosed with squamous cell carcinoma a week ago. He is still eating vigourously and playing and grooming.He does however drool and occasionally has blood coming from his mouth. Our vet said he wasn’t in any pain, but is this the case as the research I have done claims this to be the opposite?. I don’t want him in any pain. We have decided to euthanise him before he can’t eat or groom himself anymore,but we don’t want to do this prematurely, how are we going to know when the right time is? We love our baby to bits and want to have as much precious time with him that we can. Our vet said the cancer is very aggressive and has only given him 3 months.

  350. doc says:

    Hello, Karen,
    I don’t think that the simple existence of the carcinoma is painful. When it begins to damage other tissues, the situation can certainly become painful.

    The fact that he still eats vigorously, plays, and grooms suggests that any discomfort is quite minimal.

    Usually the first sign that a cat is not feeling well is a lack of grooming. People will note that he started getting “scruffy looking” days before they noticed any overt sign of illness.

    When these normal behaviors stop, you will know that your buddy is not feeling well. That will be the beginning of the end.

    You will have to decide how much is too much (pain-wise).

    Best wishes.

  351. Karen says:

    Dear Doc, thank you so much for replying so quickly.This gives me comfort to know that he isn’t in agonizing pain(yet).We will continue to monitor Cheezal regularly and when he starts to suffer then we will know it is the right time.

  352. Joe says:

    We just had to put our cat to sleep yesterday. It is so difficult. We had him for 14-1/2 years. He was a Birman. He was so faithful and devoted to me. He was always at the door when we arrived home, he sat on my lap every monring for comfort and everynight. He would cuddle with us whenever he could. I can’t get over thinking about the look on his face. In the end his belly was filling up with fluid and his lungs were too. He was having trouble breathing. The vet told us they could drain both and he may be OK for awhile, but he would soon be back for the same thing in perhaps a week or a month. He had heart and liver disease. I feel so empty having to put him to sleep. He depended upon us. He had never been outside. We were his whole world. I feel in the end I abandoned him since I did not take the step to make him better. My wife felt if was best for him since he was in distress. The vet did not comment is she agreed, but it seemed so. Why it is I cannot get over this feeling that I abandoned him and should have taken whatever steps necessary at whatever cost to keep him around longer. Everyone says he is better off this way. We took on the responsibility to feed, enjoy and take care of him when we bought him. I am normally a strong guy, but feel that I gave up on my friend. Is my feeling one of selfishness – thinking of me and not him ? Why is it I cannot deal with this ?

  353. Doc says:

    Hello, Joe,

    It sounds to me like you have done the right thing. Francis Bacon once wrote, “A healthy body is a guest-chamber for the soul, and a sick one is a prison.”

    There comes a time when you are dying slowly, not living longer.

    You need to be aware of a phenomenon called restimulation. When you have an emotionally traumatic experience, it restimulates earlier losses and upsets in life. This added emotional charge makes it difficult to see the situation objectively.

    There is nothing wrong or abnormal about feeling grief and doubt. Realize that much of what you are feeling comes from past incidents that are similar in some way, yet not directly related.

    This loss is significant in and of itself, and that can certainly be hard to deal with. Adding the chain of previous losses makes it much harder.

    Sometimes just knowing this data makes it a little easier to confront and deal with the present situation.

    Don’t beat yourself up.

  354. Bonnie says:

    I stumbled upon this blog after an online search and am grateful to have found this. Thanks Doc for responding to so many reader’s questions and comments. I lost my 20 1/2 year old cat today. It was heartbreaking and I’m trying to tell myself that she is resting and in peace. I am very disappointed with the vet staff and how they were disorganized and insensitive given the nature of our appointment. I didn’t realize that the tranquilizer injection doesn’t do crap for cats. It was painful and my cat was really crying as the doctor injected her. I wish that I had known that it would have been better just to administer euthanasia only since the tranquilizer was painful. What an awful experience at the end. 🙁

  355. Doc says:

    Hello, Bonnie,
    I am so sorry that you had a bad experience with the euthanasia. That certainly doesn’t help with this difficult decision and difficult time.

    I must say that we usually see no more than a little sting with the injection, and the patient goes peacefully to sleep. I am not sure what happened to make things go wrong. Unfortunately, not every patient responds like the majority.

    The final injection has to be given directly into the bloodstream. This means putting a tourniquet on the leg, and restraining the cat, and having to hit the vein. In such an old cat, we often can hardly find the vein, much less hit a moving target. This is why we usually sedate these patient first with an injection into the muscle – big target, little restraint.

    Again, other than a little sting and maybe a growl, this is usually not a big deal, and the patient can go to sleep in mom’s lap.

    It is always a nightmare when anything happens to make this difficult time any more difficult.

    I am sorry for your loss.

  356. JB says:

    Not sure if this is still active, but worth a try. I have had my cat for 12 years, I believe my mom had her for 2 years before I did and she wasn’t a kitten for either of us – I guess she’s around 15. She has so much personality but HATES being picked up or in a kennel – for this reason we have limited her vet visits to only when she has a major issue. She has been on Y/D food for 2 years. She is a very close companion to our 9 year old, has always enjoyed being right in the middle of things and petting us if she felt like she needed to be pet (this was basically every time anyone was sitting on the couch or in the bed). She’s very sweet and needy (in the good sense) – just don’t pick her up! 🙂
    6 months ago, we took her to the vet because for about a month she had been throwing up regularly, peeing in irregular places but really it came down to the fact that she stopped coming upstairs to sleep or be with us at all. She was very lethargic and withdrawn. Since she’s old, I assumed this is what happens to cats as they age. I took her in because she seemed so pathetic and unhappy – I thought it may be time. They ran several tests, all of which came back fairly normal except she has very bad teeth. We brought her home to think about what we needed to do and since the test said there was nothing specifically wrong, we figured we would wait it out. I’m not sure how or why (we didn’t change anything), but she seemed to get better the following couple of days.
    Fast forward 6 mostly normal months – she has started the same progression. Throwing up, peeing in random places, and now after 3 weeks of that with increasing frequency, she is becoming more and more lethargic. She also is eating less and appears to be over grooming (she has several bald spots now). I do not want her to get as bad as she did before. I appreciate so much what you said about don’t wait until there are more bad days than good and I feel like we are now at the down side of that hill.
    My husband and I talked and plan on taking her in on Friday. I have some guilt because there are convenience reasons for us to euthanize Kitty: we have 4 busy kids as well and we don’t have time to constantly clean up after her or can possibly imagine going through more tests and administer some of the things I’ve read people have to do if it’s diabetes or renal failure, ect – and for this reason and only this reason I feel guilty, because it is in the back of my mind. The reality is that she isn’t having many good days. In the last 7 there have only been 3 where she neither threw up nor peed outside her litterbox. She has had a good life and brought us much happiness and love. Is it wrong for me to put her down and not go through a bunch of tests again? Will she just snap out of it again?

  357. Doc says:

    Hello, JB,

    I wish that I had some great answers for you. With all that you have gone through, it certainly doesn’t sound like you are doing a convenience euthanasia.

    This is always a difficult decision, but it sounds to me like you are doing the right thing.

    Best wishes.

  358. michele mullins says:

    I have a question. I had a 10 year old olde English bulldog. 105 temp, throwing up, unable to drink or eat, and lethargic. The vet told us there was a mass in his abdomen. I saw the xray and it was huge. However, he isn’t sure what the mass is. His blood work looks like a leukemia pt to me. I made the decision to put him to sleep. Was this a good choice? I need a vet’s opinion. I’m beating myself up about this. Was this the right choic!e..or could he have been saved? I need peace of mind.

  359. Doc says:

    Hello, Michele,

    It sounds like your dog would not have been a very good candidate for surgery.
    Big masses like that usually are wrapped around something that you can’t live without, so you can’t just take out the mass. With the other bad signs, it sounds like the mass was probably a malignant cancer. If it was huge, and bloodwork was bad, it had probably spread to other parts of the body.

    There’s no way that I can tell you exactly what would have happened, but I don’t think that anyone could argue with your decision.

  360. Audrey says:

    Hello Doc, thank you for this amazing thread that you have kept alive for the past few years. I am hoping you could shed some light on what you may think is best for my cat “Kitty” who is 15 years old.

    Back in June, Kitty was taken to the vet because she started walking with her back arched and seemed to be in pain. X-rays and sonograms revealed she has an enlarged liver and gallbladder, an inflamed pancreas, and thickened intestinal walls. The vets suspected cancer(lymphoma) but need to do more expensive tests to confirm. I have chosen not to go on with the tests. She was given subcutaneous fluids and a week’s worth of antibiotics as well as some pain medication. She seemed to have improved until the past few weeks. She’s very picky about her food- I’ve gone from dry to wet and back again. Also, she has been drinking a lot of water. She mostly stays to herself and sleeps more.

    Due to her increased thirst I had started to wonder if she may have Diabetes so I took her to the vet again, about 2 weeks ago, and asked them to perform blood work. The blood work showed high levels of reticulocytes, BUN, Calcium, and GGT. Also, her weight had dropped from 9 to 6 pounds. The vet seemed very concerned and didn’t really offer an explanation regarding the lab work but just said its really bad and that she has a few days left.

    For the past week, I have been giving her Denamarin to protect and support her liver. Her energy and appetite have seemed to improve a little. Her balance seems off because she can’t jump up and down onto higher places like she used to. Her joints don’t seem to be as strong as they used to be. Lately she is crying and whining hysterically to go outside-she was a former outside/inside cat prior to her health problems. I let her out yesterday and she went into the neighbor’s yard and couldn’t jump up a wall she had jumped down from to get back home. Now I won’t let her out on her own, just to a sectioned off porch outside. My husband thinks that reason she wants to go outside so badly is to die. I am not sure what to think. She is sitting outside as I write this now.

    I still do not know what is actually wrong with Kitty don’t know what to do. I keep going through these stages of hope thinking that she might be trying to fight this sickness off versus stages of guilt wondering if she is suffering and if I should just put her down. I want to do the right thing for her. Any advice you can give will be greatly appreciated. Thank you so much.

  361. Doc says:

    Hello, Audrey,
    Reticulocytes are immature red blood cells. Finding lots of them in circulation usually means that there is ongoing blood loss somewhere. The body can’t make them fast enough to replace all of them with mature cells, so it kicks out reticulocytes ahead of their time. The blood loss could be just tiny amounts in stool or urine, so you wouldn’t necessarily be seeing blood.

    High calcium can accompany lymphoma, but could be related to the kidney problems, especially if you have high phosphorus. High BUN means that the kidneys cannot remove waste as effectively as they should. Patients in this situation often lose concentrating ability, so they pass too much water in their urine (they can’t save it). Thus, they may become dehydrated, even though drinking a lot. Sometimes they will benefit from subcutaneous fluid therapy.
    The drop in weight from 9 to 6 pounds could be due to the liver disease, and could certainly go along with a cancerous disease. I suspect that her jumping problems have more to do with the loss of muscle mass than a loss of balance. If she has lost that much weight, she has to be physically weak.
    I can’t really say why she wants out so much. Pets who feel really bad often seek a secluded place. It is instinctive to hide out when you feel weak and vulnerable.

    The dramatic weight loss you describe, along with the other problems, makes it sound like Kitty is nearing the end of the trail. It doesn’t not sound like she is going to get well.

    If she is having more bad days than good, then it’s time to start thinking about letting her go.

  362. Katya says:

    Thank you for this really helpful site – I’d appreciate some advice. My cat – an ex-feral who’s now a lovely friendly cat – has been battling a nasal squamous cell carcinoma for the past 4 years and has been on Metacam since Dec 2013. It’s now eaten right into his face, I don’t know how he’s still breathing and he’s periodically in distress, sneezing blood and shaking his head, then a few minutes later seems to be OK. He’s also really worried about the other cats bumping into him – I have five and most of the others tend to bully him, but one is his best friend. He can’t smell but still eats which is unusual but he’s a fighter, so he’s not going to slip away easily. I know it’s not going to get better and could get very nasty at any minute, which would be a horrible way to go, but my young daughter is adamant she doesn’t want me to “murder” him, even though I have tried to explain it’s about quality of life, not quantity. I feel he’s put up a good fight and deserves a peaceful end. How can I reconcile my daughter to this?

  363. Doc says:

    Hello, Katya,

    The best person to advise you would be a doctor who has actually seen your cat. That being said…

    I can guarantee you that this cat is in constant pain. He is functioning at some level despite that, but this is no good.

    I can understand your daughter’s feelings, but this isn’t living — it’s slow death.

    I would feel no guilt at letting this guy leave his suffering body.

  364. Danielle says:

    First of all I must say what an amazing site. You are obviously a special person to offer this unique help to us animal parents in dire need. Can i ask your opinion on my beautiful rescue siamese tortie point Cassie. I originally enquired about a pair of black oriental kittens which were adorable as all kittens are of course, but came home with her instead despite being told she had diarrhea. I thought it was due to stress and would resolve itself. How wrong was i ?!
    Cassie came to me in june 2013 and i lost her in Sept 2014. The diarrhea was chronic but there werent any other obvious symptoms apart from she was very slim but
    siamese are slim right? I tried her on hills i/d thinking it may be an allergy since she was only 4yrs and had been checked for infections at vet by a prior rescue client who then returned her as they couldnt cope with the mess. I tried her with loperamide and slippery elm with no luck. I tried her on
    a chicken only diet then a raw food diet still no luck. So i tried her on metronidazole for 6 wks and saw a temporary improvement.
    In April 2014 i took her to my vet who gave her penecillin then prednisolone after bloodtest which again saw a temporary improvement before she deteriorated with watery stools and weightloss in Sept. She suddenly stopped eating and became wobbly within hours so i rushed her to vet only for her to fit while being checked in and went into comatose state. The vet gave her a 5% chance of even surviving that since she was so thin and dehydrated. He suspected it was lymphoma and advised against putting her on a drip as the prognosis seemed so hopeless so i had to let her go. Obviously now i am thinking i should have insisted they try and bring her round . Does it sound like lymphoma to you as opposed to IBD that i thought i was dealing with originally ?

  365. scott says:

    My 17 year old cat started limping badly about 3 weeks ago ( he has had a limp on and off for about 3 years), 2 weeks ago he was barely able to move and i noticed some puss coming out of his eye, i took him to the Vet and was told that he has bad teeth.
    The Vet gave him an injection of antibiotics and he seemed to improve slightly, 3 days ago an abscess formed under his eye which the Vet said was most likely caused by his teeth, the abscess has been drained and given more antibiotics.
    I asked the Vet about extracting the teeth but he doesn’t want to do it because my cat is 17, he wants me to put him down instead.
    This has really been causing me a lot of grief over the last couple of weeks because iv’e had him since he was a kitten and the idea of putting him down makes me feel like i’m murdering him, the decision is not helped by my anxiety disorder which is causing me to feel very sick as i am constantly worrying about him.
    I’d hate to put him down and then have to wonder forever if there was bacteria from his bad teeth that was causing him to be struggling to walk.

  366. Kelley Matthews says:

    Hi,
    I just came home from the vet. My cat is a ‘miracle’ survivor of the 2007 melamine tainted pet food. She is 14 now and is stage 3 CRF. Now she has an ulcerated breast cancer larger than a quarter. She is inoperable – not only because of CRF, but newly discovered diabetes – numbers in the 400s, protein in urine, elevated blood pressure, etc. Additionally, the X-rays, while not 100% accurate, do show several possible masses in her lungs.
    My question. The vet says there is no way to bandage the open ulcer based on where it is etc. I am afraid it will get infected quickly or that she will chew on it and make it horrendously worse within hours. She has already started to do so and this is day 6. I have a new job and have no time off after friday. Today is Tuesday. The wound is much worse than it was Wednesday and even more worse than it was on Saturday when the opening doubled in size. It now is smelling bad. She is obviously picking at it. I know I need to euthanize. Right now, she is still active, eating, exploring etc. My dilemma: I work an hour away -which means 10 hours away from home and I cannot come home to check on her. I do not know anyone who can check up on her and even if I do, she will not allow anyone to get close enough to her to check her underbelly.
    I don’t know whether to schedule the euthanization now, i.e. friday, when she is still eating and fairly active, or if I should truly give it more time… My fear then would be that I return to work on Monday, and come home to find her suffering tremendously – which means I waited too long. I love my cat dearly but it would truly be awful to let her suffer. My vet is telling me that it is a tough decision, but she would likely do the same were she in my shoes. My own conscious has a hard time because I’m worried about cutting my cat, Lil, life short especially since she is still active, exploring, etc. But my vet says she is concerned about the changes in the wounds and infection setting in quickly. (For a whole bunch of reasons, oral or injected anti-biotics are not an option.) I’m looking for advice on whether its in my cats best interest to euthanize early, or whether I should wait until the proverbial ‘more bad days than good’.
    Thank you in advance for any advice you offer.
    Best Regards,
    Kelley

  367. Doc says:

    Hello, Scott,
    I doubt it is the tooth abscess causing his difficulty in walking. I would be more suspicious of bad arthritis in a cat this old. They can also be anemic (low on red blood cells) which will make them weaker, too.

    Antibiotics won’t cure the abscess, though they make lessen the severity temporarily. The affected teeth need to come out.

    Extracting the teeth would certainly require general anesthesia, and with a sick cat who is 17 years old, the risks of anesthesia are considerably greater than young healthy cat.

    It sounds like your buddy is miserable, so you’ve got to make some hard choices.

    The doctor best equipped to advise you is the one seeing your cat, not “doctor internet”.

    To start treating such a case, I’d be doing some diagnostics to assess my anesthetic risk factors. You also want to know what other medical conditions are there that need to be dealt with.

    Then I’d do my best to support the cat through anesthesia while the affected teeth are removed.

    Assuming success there, we would deal with as many of the co-existing medical conditions as we can, trying to improve the cat’s quality of life.

    All the while, we have to realize that we’re not going to make him young again.

    It’s a tough situation.

    The one thing you know is that letting him continue in this kind of pain is not what you want to do.

  368. Doc says:

    Hello, Danielle,

    IBD can certainly cause chronic diarrhea, or vomiting, or both. Weight loss would certainly be a feature.

    It is really impossible to differentiate IBD from lymphoma without a biopsy of the intestine.

    The Texas A&M University GI Laboratory has great tests to help diagnose where the poor absorption of nutrients is taking place (and confirm that is what is happening), but the test won’t tell you the why.

    We usually get to that with a biopsy, or sometimes a good response to therapy lets us know we were treating the right thing.

    The collapse you describe would be very unlikely to occur with IBD. I would be much more suspicious that the cat had lymphoma and it was affecting other body parts besides the bowel.

    It sounds to me like you did the right thing.

    I am sorry for your loss.

  369. Doc says:

    Hello, Kelley,

    With the multiple problems you describe, I would expect this to deteriorate very quickly.

    The tumor has grown in such a way as to cut off circulation to part of the mass. This died, then rotted, then broke open. This opening lets other stuff in, which is not good.

    Due to the other problems, you have poor circulation, so body defenses are lousy in their ability to handle something like this, even if you could bandage and give medication.

    I can’t predict the future, but I doubt it’s going to be “more bad days than good”. I think it’s going to be crash and burn.

    As difficult as this is, I’d be opting for euthanasia before the crash.

    No easy answers here, I fear.

  370. Susan Highlund says:

    Hi Doc,
    My kitty is 22. He and I have been through much together, him an amputation, me, major health issues. However, he is now often confused, can’t tell his litter box from his bed, and seems to be lost at times. He rarely grooms himself. My kitty sleeps almost all the time except to eat, drink, and eliminate and never plays anymore. He has accidents daily. It looks like it hurts him to walk on the linoleum so he prefers to go on the rug. His back leg, which he has hopped on for at least 20 years, since the other was amputated, has given out several times as of late. My cat never goes up stairs anymore, plus he whines and vocalizes loudly as he travels to and from his food and water and when he sits up. He vomits at least three times weekly, enough that my husband and I have napkins available to catch it to prevent him soiling the pee-pad he now sleeps on so he won’t soil the couch. His decline has been fairly rapid the last six months but the last three weeks on fast-forward. His quality of life is not getting better; it is getting worse and isn’t going to improve at his age. I adore my kitty. He is such a love. My fur-baby still puts out his paw for pets, wants to curl-up in my lap, cuddle, never scratches, or bites, or does anything aggressive. But, this isn’t what makes his quality of life a good one, he no longer has that. I feel like it is his time. When he does get up, he now just sits in front of the back window looking sad. Although there is love, there is just no more sparkle in him. He looks like he’s ready too.

  371. Doc says:

    Hello, Susan,

    You are describing a rapid decline from a quality of life that is already pretty poor.

    When I read what you have written, your affection for your cat is obvious. So, too is your recognition that he is dying slowly, rather than living longer.

    You are doing the right thing.

    Best wishes.

  372. scott says:

    Hi Doc thanks for responding to my question.
    Since i last posted my 17 year old cat has had his bad teeth removed.
    Before the surgery he had a geriatric blood test done and the vet said the blood test showed he has kidney disease but everything else was good and he thought the surgery was the way to go.

    When he came home he seemed much happier and was walking better and wanting to eat, that lasted for 1 day and he is now limping badly again and just licking the gravy off his food and leaving the meat.

    The Vet now wants to put him on Metacam but says that it will shorten his life because he has kidney disease and he doesn’t have much time left.

    I’m really upset because i thought i was buying him a decent ammount of time and reasonably good quality of life, but now after spending close to $1,000 i feel like i’m back where i was before.

    Any advice would be really appreciated.

  373. Doc says:

    Hello, Scott,

    I’m guessing that your cat was on some narcotic pain meds after the tooth extraction, so he felt a lot better.

    Now he has no pain meds, so his arthritis is really giving him heck.

    Cosequin can help, but it’s slow to kick in, and limited in its effect.

    Metacam may in fact accelerate the kidney deterioration. Unfortunately, we just don’t have a lot of options for pain medication in cats. The only other thing I could recommend would be fentanyl patches, which have to be replaced about every 3 days.

    The thing is, if Metacam relieves his arthritis, it makes his life good, even though it might shorten it.

    Without something for pain, his life stinks.

    Don’t feel like you wasted your money on the teeth. Not only was that dental condition painful for him, it was seeding infection into his bloodstream all the time. That is something that is hard on his kidneys, and every other organ system, too.

    Talk to your veterinarian about the pros and cons of fentanyl. If that’s not a good option, I’d go on the Metacam.

  374. Jollimon's Mom says:

    Thank you for your column. We have been struggling with when is the right time. Jollimon is 14 and has oral cancer. After reading the Post from Penny’s Mom, I know that we have our decision and today we will ask to have Jolly given the freedom from his pain. He has lost so much weight and his eating is exactly as what Penny’s Mom wrote – what he liked one day he no longer would eat. He stopped eating completely 3 days ago even though he looks at the food bowl. He drinks water but that’s it. His mouth bleeds even without eating. It tears me instead to know he hurts but yet he seems mentally as he’s always been. I know we are doing what’s best for him – he’s suffered with this long enough. I will miss him so very much. He was 6 weeks old when he came to live with us. <3

  375. Doc says:

    Hello, Jollimon’s Mom,
    Thank you for sharing your story. This is such a hard thing to do, even when you know it is the right thing.

    Best wishes.

  376. Classy's Mom says:

    Wow. I started reading this and feeling bummed that the comments were from 3 years ago and I wouldn’t be able to share my story but unbelievably, you are still reading and responding to these messages.

    My beautiful 13.5 year old cat, Classy is the first pet I’ve ever had who is all my own. He is white with green eyes and until he got sick he was what I would call a puppycat — following me around the house, playing tug-of-war and even fetching his toys. In August he stopped eating and became less social so I immediately took him to the vet, but unfortunately she was focused on his very slightly elevated Kidney levels and did not investigate further. For 3 months my boyfriend and I forced supplement pills down his throat, administered fluids, fed him by hand multiple times per day, and took him on many stressful visits to the vet, only to find out we had been treating the wrong condition… in late October I got the awful news that he had Lymphoma. The vet mentioned that the mass she had felt in September had gotten larger. I couldn’t believe my ears considering how many times I’d been in to see her and how many questions I’d asked… why didn’t she mention this mass and how serious it could be sooner? Why did she focus on his kidneys when it was clear that nothing along that line of treatment was working? The feeling of guilt I have over not pressing her to do more tests is unbearable.

    That day I called a new vet, one recommended by a family member. She is about a 20 minute drive away but is wonderful and has been very patient with me. Since the diagnosis Classy has been on prednosolone, B12 shots, mirtazapine and fluids every few days. He was responding pretty well for much of November – eating a bit more, being social, his jaundice cleared up… but at our last weekly check up the vet mentioned that the mass was starting to feel larger and I just lost it. The feelings of sadness and torment I’d felt when I first learned of his diagnosis came back and the magical thinking that maybe this steroid would help him stick around for as long as 6 months to a year disappeared. The reality is kicking in now that soon he will be gone.

    I, like everyone else, found this website by searching for information about how to know it’s the right time. He is not immobile. He is still waiting by the door when I come home. He moves slowly throughout the house. He still urinates and passes stool in the litter box. He does sleep or lie down most of the day, but he is eating bits and pieces of food, drinks a ton of water (I know that’s part of his illness and a side effect of the pred), and responds well to petting. He wants to be near us almost constantly when he’s awake. The thing I can’t shake is how he seems to move around a lot when he’s sitting/lying… I’m guessing he’s trying to find a comfortable position and it breaks my heart to think that he can’t just sprawl out and relax like he used to. The vet told me to watch his respiratory rate to be sure he’s not struggling due to fluid in the lungs – it’s still roughly 30/min. I watch for these signs like a hawk. I guess hoping that a significant, medically relevant representation will give me that “moment” where something tells me “it’s time”… but to be honest, I don’t know if I even want to let it get to that point. If I can visibly see him suffering, isn’t it past his time?

    We’ve decided to have the vet come to our home and euthanize here. I’m not sure when, but it will happen in our living room, on our couch – the same couch he destroyed by shredding the upholstery down to the foam – and when it’s over I’m going to finally get rid of this couch and buy myself the kind of fancy couch a person who doesn’t have a cat owns. Of course I’ll probably get another cat someday, because I can’t imagine my life without one, but for a while I’ll have a couch without scratches and claw marks.

    I am rambling here… I guess the reason I’m writing is because although I know it’s the right thing to do, I can’t imagine scheduling the death of my best friend. It is likely that it will be this week… but I keep sobbing when I think of myself at work, doing some mundane task, knowing that night, or the next day, will be when it happens. How does anyone cope with this? Even the thought of it sends me into an excruciating state of sorrow.

    Thank you for providing this place to share these feelings. So many pet support boards are for people who have already made the decision and have already lost their beloved pets. A safe place to express the grief from the time of diagnosis – and the stress of treatment/not knowing – right up to the “decision”, is so very necessary. I sincerely appreciate this.

  377. Doc says:

    Hello, Classy’s Mom,

    Even though I don’t often find time to write on the blog, I look at every comment, and reply if I think I can be helpful.

    It doesn’t sound as though you need any help making your decision. Sometimes we just need to talk about these things.

    You know more about how this cat feels than anyone else can. As hard as this decision is, you will make the right choice.

    Best wishes.

  378. victoria says:

    My cat was diagnosed with gi lymphoma. He is pooping All over the house. He is still eating and drinking but his pooping is terrible and his poop is like mud. I hate to put him down but Im not sure how much more poop i can clean up, plus my house stinks. Feeling heartbroken and confused.

  379. Doc says:

    Hello, Victoria,

    This is such a difficult decision. I sense that you don’t want to feel that you are doing a “convenience euthanasia”. In other words, you don’t feel it is right to put him down because he is messy, providing he is still enjoying life otherwise.

    My guess is that he is not enjoying life all that much at this point. With the situation you describe, he may last quite a while, but I doubt that he is feeling very good.

    If he is not responding to treatment, you are looking at a downhill slide for this guy, seeing his quality of life deteriorate.

    You have to decide (independent of the mess, though that is certainly something you have to consider for your OWN quality of life) whether he is really living longer, or just dying slowly.

    Nobody can really make this decision for you, nor is anyone in a position to criticize you for your decision. You just have to do the best you can.

  380. Phil says:

    I am really devastated, yesterday my best pal, a 17 year old male cat got put down. But the worst part is, I really don’t think it was his time to go yet.

    Two weeks ago I went to the vet because my cat has been losing weight. He felt his tummy and found a big lump. He took a sample out with a suringe and it contained lots of pus and some blood. He gave antibiotics for a week and my cat has had a decent appetite but after the antibiotics his appetite was even better,eating loads. After tests turned out to be a cancerous tumor. So he suggested doing an operation, and my family agreed. It seemed to make sense to do it, might as well try right?

    I wasn’t concerned and thought the worst case is the operation fails and we get him back. He didn’t mention consequences.

    On the day of operation he calls my while operating, and says the tumor is on his intestines and its the size of a golfball, it will be a major procedure to take it out as it involves cutting intestine. So he suggests we put him down on the spot, this came to me as a huge suprise and didn’t know what to say, my mind went blanc. From what I understood he will have a tough time recovering? I don’t understand why he didn’t warn us this could happen.

    I told him stich him back and we will come ASAP. Once we got there my cat was all drowsy and drugged up. I asked him can I take him home, but he suggested it’s best to put him down cause from his experience he doesn’t hear positive stories. So I listened to him and agreed to put him down. But I wasn’t aware of all the symptoms of such diagnosis and how it affects cats.

    It all seemed unreal, from my cat running around the house to being put down. Once I got home it really kicked in and realised what really just happened. Been feeling miserable for past two days, thinking I made a bad choice, was trusting the vets opinion.

    But after researching on the Internet, I read that cats with cancer start suffering when they stop eating, low energy, hiding etc..

    The only symptom my cat had, was weightloss and vomiting like twice a month. For the rest he was super social and active. No signs of being off.

    I feel so bad for listening to vet, I had such an artificial moment of saying goodbye to my cat, I love him to bits but the way he went down felt so empty….

    Now that I read about it, he probably could still live for some time. (I read one story like my cat had, intestinal tumor, was going through an operateion to take it out but it was so intertwined they left it, one year later the cat still lives, skinny but eating. Like my cat.) My vet was suggesting a month or so to go. But I think longer since his character was normal. Fair enough if I would see him slightly suffering then I would put him down, but this just seemed wrong. Did I do the right thing? I know I can’t blame myself but still…

    Also don’t get why he didn’t suggest an xray, would have avoided the operation.

    If I just had researched before hand I would have known what decision to make. Was my cat really in such a bad state? He didn’t seem to notice the tumor. From what I felt the vet meant is that he will get really sick in a month from now and because of the operation too.

  381. Doc says:

    Hello, Phil,

    I can appreciate how you must feel.

    First, without the exploratory, we could not have known whether the mass was a tumor or an abscess or what. An X-ray or ultrasound would have shown us the mass, but not what it was.

    While it is possible that your cat might have lived for quite a while as the tumor grew slowly, there is no way to know that. It might have grown very rapidly indeed.

    I do understand that you wish you had waited to see what was going to happen, and how fast.

    It sounds like you would almost certainly have been facing the same decision before long. Sometimes it is easier when you have no doubts (because the pet is in such terrible shape), but sometimes it seems to be just as hard. I have been through it with a lot of people in the last 36 years.

    It is difficult to communicate as well as we would like when we are in a state of emotional upset. I sincerely doubt that either you or your veterinarian wanted anything except the best for your cat.

    I am sorry for your loss.

  382. Phil says:

    Thank you for the response!
    What I still find a but odd, when he extracted a test with a needle from the tumor, it contained lots of pus and he was surprised. To me it seems then maybe it was something else, I read that common disease of cats that cause chronic inflammation produce clusters of lymphocytes that could be confused with lymphoma. Is it possible it can be wrongly diagnosed? he did say its cancer from the tests.

    It did sure seem he was eating more after the antibiotics. (Which can help against IBD?)However I did not communicate this with the vet that he ate more, neither did he ask me questions. I feel if that was communicated the final decision would have been different.

  383. Doc says:

    Hello, Phil,

    There are so many unknowns in this case. I cannot really give you any definitive answers.

    It is always possible to make an error – we are only human.

    IBD often progresses to become intestinal lymphoma, so it is VERY easy to have some confusion there.

    I wish there were some way to give you closure on this.

  384. Phil says:

    Thanks again Doc!

    Last question, the vet diagnosed my cat with cancer after he tested the small sample of blood and pus he collected from the tumor. Is it possible to get that wrong too? That it was pre-cancerous, or lymphocytes to be confused with inflammation or something?

    I was thinking of emailing my vet about all this? Is that oke to do?

  385. Doc says:

    Hello, Phil,

    Diagnosis from small samples can be confusing. I have sent whole tumors to a pathologist and had them just give me a general class of cancer, rather than a specific diagnosis. “Sarcoma, possibly liposarcoma” And this when they had the whole tumor.

    Emailing your veterinarian with your questions should be fine. You are more likely to get meaningful answers if you ask questions for understanding, rather than accusing the guy of screwing up.

    Ask about specifics, ask to clarify your understanding. It’s okay to tell him/her about the second thoughts you’ve been having, and let him/her know you are looking for closure.

  386. Sandra says:

    My husband and I have grown up with cats all our lives. We currently have 5 indoor and take care of 3 outdoor feral cats. (We have insulated houses and feed them daily)

    Indoor cats:
    Sonny 16 – alpha male…he very much carries himself as the pride leader. Very regal and demanding. Always takes care of the new babies whenever we have any. Trained VERY well.
    Syrus 15 – scared, loaner, never has liked to be held. Trained pretty well.
    Sawyer 4 – Super affectionate, loves everyone, very laid back. Trained pretty good
    Darla 3 – very quiet and stealthy, she is indoor/outdoor, didn’t plan to keep her. Feral/fixed- she just decided to like us one day. Goes outside to eliminate mostly. Will use box though. Not very well trained but never causes any problems.
    Selana 2 – Fat and happy, does not like to be held but loves being loved on. Not very well trained but never causes any problems.
    All of them were bottle baby rescues. Except Darla
    (We also have 6 Extra Large liter boxes in our house.)

    Syrus that is 15 years old. For the past 2 years we have struggled with him. He started peeing outside the box about a year and a half ago. He will pee on anything…including the bare hardwood floors. He has even peed in our bed with us in it. He most recently jumped up on the couch crawled up on our son’s lap and peed on the blanket my son was covered up with….straight though my son’s pants and down to the cushions.

    He also walks around confused and crying…mainly at night. He won’t go into a dark room at night. He hides from every little noise. He loves to be loved on but recently started biting viciously.

    We had him to the vet again 6 months ago. The vet said he has feline dementia. We have confined him to a large 3 tiered cage in our great room. He has his own litter box and food bowls in it. Vet also prescribed Anxiety medication that we rub in his ear every day. He seems pretty happy in the enclosure. Uses the box just fine. We get him out several supervised hours per day to “play” (he does not really play much anymore.) He typically just lays on the floor about 2-3 ft from the cage. If he gets scared he goes back in on his own. He will also go back in the cage on his own if I tell him to.

    But in the past 2 weeks he started losing his hair on his back half…Lower back, back thighs and legs. If you try to pet him anywhere but his head he will bite the worst I have ever had a cat bite. (He has NEVER been a biter.) He is not walking well at all, the past 3-4 nights he cries most of the night in his cage. He has never done that before either. When we do let him out of the cage socialize the oldest cat, Sonny, will attack Syrus viciously. They have been together for 15 years.
    (we put Sonny in another room while Syrus is out in the evening…But Sonny huffs and stretches because he knows Syrus is out)
    I am at a loss with him. Not sure what else to do for him anymore. I know he hurts, he is so stressed out and scared all the time. He is losing hair and does not clean his hind end anymore. He seemed really happy in the enclosure till about a week ago. Now he is frantic. When he is out of the enclosure he lays by our front door like he wants outside. He hates being outside….plus there is 2 ft of snow on the ground!

  387. Doc says:

    Hello, Sandra,
    It sounds like Syrus is disoriented and painful. We are SO limited in our ability to treat cats for pain. I have had some success with Fentanyl patches, but these have to be changed every 3 days, and are not cheap.

    It sounds like you have been working hard to preserve some quality of life for Syrus, but it just isn’t working any longer.

    If all his days are bad days, then he isn’t really living, as much as dying slowly.

    It may be time to let him go.

  388. Andrea SIMIONE says:

    Hello so today is the most sad day ever! I had to have my belived riley put down. He was 19 yrs old, but what I dont understand is why he had perfect blood work 3 months ago checked for everything. It started with him urinating on my rugs, vet checked everything said he has asthma maybe stressed gave him prednisone, he started eating aggresive, but losing weight, drinking a lot, still woukd not use box. He was still so happy, affectionate, and always with me. Today he had trouble walking, so we went back to vet, he weighed 4 lbs. She got down on two knees and said, u would be giving him a gift and pleaded this was best. It was not even an option to run more tests, his temperature was low she said all we would do is buy more time, maybe? His breath was a horrible odor I did not think he was in pain. Please I need closure what does this sound like? So sad and depressed I miss him already! !!!!!

  389. Doc says:

    Hello, Andrea,

    The horrible odor makes me think of kidney failure. As long as you have one half of one kidney functioning, your blood tests will be normal. If there is a continuous loss of kidney function, you start to get very sick when you get below that level. It seems that everything is okay prior to that, even though there has been ongoing disease.

    At his age, I would also be worried about cancerous disease.

    I hear how you are feeling, and I know you miss him. Bodies just don’t last forever, and sometimes the spirit needs to move on.

  390. Nugget's Mom says:

    On Feb 9 I went ahead and had my beloved Nugget put to sleep. He was 18 years old and was basically a walking pharmacy! I know he was sick – really sick but on that last day he looked mighty fine. Even in the photos I took of him and he NEVER looked good in photos.

    Nugget was diagnosed with diabetes about 2 years ago. He already had arthritis, asthma, was being treated for ongoing constipation. He was on prednisone, appetite stimulants and we were managing OK. His BGL started to be extremely erratic and we were having to test at all sorts of times of the day and offer food accordingly. It didn’t matter, we loved him, he was a fabulous cat and we could manage.

    About 4 months later his blood work results were not great. Not drastic but we were advised to give subQ fluids twice a week. Again, while The Nugster was not keen, we all managed and he definitely felt better. We could tell. Soon though we were giving fluids every 2nd day. Still OK and he was very tolerant. All was well. He did his thing during the day moving about the garden on nice days catching rays and sleeping on my daughter’s bed when raining and at night. He would still wake us up in the middle of the night for attention by patting us with his paw. Very demanding habit that was!

    In Jan we took him to the vet to have a cyst looked at as it was getting bigger. While unsightly – it was fine but they did find another tumour on his tummy that was thought to be easily removed.

    Although terrified at the thought of having surgery at his age we went ahead with booking the procedure. The vet did routine blood work before surgery and the news was not good. He rang to say that he felt that surgery at this time for such a small lump would not be a good idea with his kidneys showing such a high level of deterioration. He said at the time it was a conservative approach and would go ahead if we wanted. We chose not to. Our vet recommended to increase his fluids to daily to see if things improved.
    The last week on Jan Nugget suddenly started sleeping on our bed – he used to do that but for the past 2 years was inseparable from my eldest daughter. Alarm bells immediately went off!! The next two days he was sleeping funny. Sitting in a hunched position and always looked like he just couldn’t hold his head up. I could tell he did not feel well. But he responded to us, seeked attention like normal and did his “rounds” in the garden every day. He seemed to want to eat and would try but then would stop. Back to the vet we go. This was Jan 29th. Blood work even worse. Potassium levels super low. Creatinine at 5.8. BUN low. Our amazing vet said in the nicest possible way that this was the end but we can try to make him feel better. We went home armed with potassium supplements and a list of medications to drop (what was the point and he hated taking them) and ones to keep. We started giving fluids twice a day. The potassium supplement took about 3 days to work but it did seem to help however in the mean time he was so dehydrated that one of his eyes got “stuck” open. Once again our vet who is always available via email said don’t panic – eye drops should help – he was so dehydrated that it will take some time for his twice daily fluids to work. It did and he did look better – slightly. I knew it was the end but just was not ready to face it. He was having trouble jumping on the beds (falling 40% of time and you could tell it hurt when he jumped down) so I made up a bed on the floor for me and as soon as he realized I was there and he did not have to jump he slept with me.
    As I write this I am thinking OMG and you are questioning your decision???
    We had scheduled euthanasia on Feb 6 at home but I just could not do it and made a tentative appointment for Feb 9 for Dr G to come around to our house. The weekend was meant to be nice and Nugget loved being outside with us all. We did just that. We had a BBQ and sat on the porch in the sun. Nugget was lethargic though and did not walk over to the kids to see what they were doing or sit in the middle of their ball game as he usually did. He kept sneaking off to a spot in the garden I had never seen him in before. On the Monday I took him to the vet for one last blood test — just maybe … please, please just maybe … he had put on weight. I found that hard to believe and made the tech weigh him on another machine — he hadn’t eaten that much how could he have gained weight? Blood work came back potassium was good – supplements working. BUN improved slightly but creatinine was 7.8. Weight was more likely the build up of fluids. I cried. I cried a flood in the waiting room, Strangers offering me tissues. I didn’t care. How could this be happening? I so wanted him to pass away in his sleep. Why do I have to make this decision? Is he REALLY suffering? He doesn’t act like it. He was still the sweetest cat. Came downstairs at the same time every day to go outside. You could set your watch by him. Still sat on his chairs on the porch. We don’t have porch chairs, Nugget does. Sure he was a bit stiff when he walked but he had been for many, many years. Our vet, who I know loved Nugget, said that this really is the time. He said that he was very concerned that Nugget would crash so suddenly that we may not be able to alleviate his distress. He thought 24 to 48 hours at the most. He said that rarely do cats in Nuggets situation just die in their sleep and it can be a very distressful time that can some times go on for hours. With a heavy heart I agreed to keep our appointment at our house later that afternoon.

    At 4.55pm on Feb 9 my beloved Nugget passed away on his favourite chair on the porch. Vet, vet nurse and myself all crying. I’m not sure it was peaceful but he was not distressed. I am certain of that. He didn’t close his eyes. I found that disturbing in the extreme. Did I do the right thing? I ask that of myself almost every minute of the day. Did I want him to be in such distress that I had to take him to a strange 24 hour vet clinic to finish it all. NO! But then again maybe. That way I would have been sure without a doubt. I feel so guilty. He trusted me. Could we have had a week more together? One more good day? That afternoon he looked GOOD. didn’t move much so hard to tell (putting on my reality hat there) and even cleaned himself.
    I love him so much. My grief is overwhelming and all encompassing. My husband is at his wits end with me. My daughters think that Nugget died in his sleep. They are too young to have to think about euthanasia. They knew Nugget was very, very ill so his passing was not a surprise.
    Did I do the right thing? Did I take his life too early.
    I love my cat and miss him so very, very much.

  391. Nugget's Mom says:

    On Feb 9 I went ahead and had my beloved Nugget put to sleep. He was 18 years old and was basically a walking pharmacy! I know he was sick – really sick in the end but on that last day he looked mighty fine. Even in the photos I took of him and he NEVER looked good in photos.

    Nugget was diagnosed with diabetes about 2 years ago. He already had arthritis, asthma, was being treated for ongoing constipation. He was on prednisone, appetite stimulants, insulin, adequin and lactulose but we were managing OK. His BGL started to be extremely erratic and we were having to test at all sorts of times of the day and offer food accordingly. It didn’t matter, we loved him, he was a fabulous cat and we could manage.

    About 4 months later his blood work results were not great. Not drastic but we were advised to give subQ fluids twice a week. Again, while The Nugster was not keen, we all managed and he definitely felt better. We could tell. Soon though we were giving fluids every 2nd day. Still OK and he was very tolerant. All was well. He did his thing during the day moving about the garden on nice days catching rays and sleeping on my daughter’s bed when raining and at night. He would still wake us up in the middle of the night for attention by patting us with his paw. Very demanding habit that was!

    In Jan we took him to the vet to have a cyst looked at as it was getting bigger. While unsightly – it was fine but they did find another tumour on his tummy that was thought to be easily removed.

    Although terrified at the thought of having surgery at his age we went ahead with booking the procedure. The vet did routine blood work before surgery and the news was not good. He rang to say that he felt that surgery at this time for such a small lump would not be a good idea with his kidneys showing such a high level of deterioration. He said at the time it was a conservative approach and would go ahead if we wanted. We chose not to. Our vet recommended to increase his fluids to daily to see if things improved.
    The last week in Jan Nugget suddenly started sleeping on our bed – he used to do that but for the past 2 years was inseparable from my eldest daughter. Alarm bells immediately went off!! The next two days he was sleeping funny. Sitting in a hunched position and always looked like he just couldn’t hold his head up. I could tell he did not feel well. But he responded to us, seeked attention like normal and did his “rounds” in the garden every day. Albeit slowly as his arthritis was clearly getting worse. He seemed to want to eat and would try but then would stop. Back to the vet we go. This was Jan 29th. Blood work even worse. Potassium levels super low. Creatinine at 7.8. BUN low. Our amazing vet said in the nicest possible way that this was the end but we can try to make him feel better. We went home armed with potassium supplements and a list of medications to drop (what was the point and he hated taking them) and ones to keep. We started giving fluids twice a day. The potassium supplement took about 3 days to work but it did seem to help however in the mean time he was so dehydrated that one of his eyes got “stuck” open. Once again our vet who is always available via email said don’t panic – eye drops should help – he was so dehydrated that it will take some time for his twice daily fluids to work. It did and he did look better – slightly. I knew it was the end but just was not ready to face it. He was having trouble jumping on the beds (falling 40% of time and you could tell it hurt when he jumped down) so I made up a bed on the floor for me and as soon as he realized I was there and he did not have to jump he slept with me.
    He was clearly having trouble negotiation the stairs but when we tried to block his access he was so miserable we gave it. We put a litter tray in our bathroom so he did not need to go downstairs to the normal one. He ignored it. Ifhe was about to go upstairs he would often climb the two steps to the landing and have to sit down — I started carrying him upstairs if I was about to get to him in time. Would have like to carry him down and sometimes did but once he started the decent it did not seem safe to try and pick him up mid momentum. He was much slower going up. Going down was kind of a slide / rabbit type hop. The downstairs litter box has a higher side as my other cat (19) likes to wee “spray” style and the high side catches it – mostly … If Nugget went to that litter tray we would often have to sit down afterwards as I think the effort of getting in or out was tough. The one we had upstairs had very low side and was basically walk in and walk out.
    As I write this I am thinking OMG and you are questioning your decision???
    HIs BGL were crazy and would respond to insulin in a just as crazy way – dropping to scarily low levels with half the normal dose.
    We had scheduled euthanasia on Feb 6 at home but I just could not do it and made a tentative appointment for Feb 9 for Dr G to come around to our house. The weekend was meant to be nice and Nugget loved being outside with us all. We did just that. We had a BBQ and sat on the porch in the sun. Nugget was lethargic though and while he joined us he did not walk over to the kids to see what they were doing or sit in the middle of their ball game as he usually did. He kept sneaking off to a spot in the garden I had never seen him in before.
    That day the little mat he insisted on sleeping on on our camp bed smelled really bad and I had to replace it. On the Monday I took him to the vet for one last blood test — just maybe … please, please just maybe … he had put on weight. I found that hard to believe and made the tech weigh him on another machine — he hadn’t eaten that much how could he have gained weight? Blood work came back potassium was good – supplements working. BUN improved slightly but creatinine was still 7.8. Weight was more likely the build up of fluids. I cried. I cried a flood in the waiting room, strangers offering me tissues. I didn’t care. How could this be happening? I so wanted him to pass away in his sleep. Why do I have to make this decision? Is he REALLY suffering? He doesn’t act like it. He was still the sweetest cat. Came downstairs at the same time every day to go outside. You could set your watch by him. Still sat on his chairs on the porch. We don’t have porch chairs, Nugget does. Sure he was a stiff when he walked but he had been for many, many years. Our vet, who I know loved Nugget, said that this really is the time. He said that he was very concerned that Nugget would crash so suddenly that we may not be able to alleviate his distress. He thought 24 to 48 hours at the most. He said that rarely do cats in Nuggets situation just die in their sleep and it can be a very distressful time that can some times go on for hours. With a heavy heart I agreed to keep our appointment at our house later that afternoon.

    At 4.55pm on Feb 9 my beloved Nugget passed away on his favourite chair on the porch. Vet, vet nurse and myself all crying. I’m not sure it was peaceful but he was not distressed. I am certain of that. He didn’t close his eyes. I found that disturbing in the extreme. Did I do the right thing? I ask that of myself almost every minute of the day. Did I want him to be in such distress that I had to take him to a strange 24 hour vet clinic to finish it all. NO! But then again maybe. That way I would have been sure without a doubt. I feel so guilty. He trusted me. Could we have had a week more together? One more good day? That afternoon he looked GOOD. didn’t move much so hard to tell (putting on my reality hat there) and even cleaned himself a little bit – had not seen him do that for some time.
    I love him so much. My grief is overwhelming and all encompassing. My husband is at his wits end with me. My daughters think that Nugget died in his sleep. They are too young to have to think about euthanasia. They knew Nugget was very, very ill so his passing was not a surprise.
    Did I do the right thing? Did I take his life too early?
    I read what people say about quality of life with the question is that are they still doing the things they love. Well yes, he still sat in the sun and did his “stuff” but if try to be objective I know he also was having trouble moving about, was having trouble eating but wanted to (could only lick fluids / broth in the end); barley drank any more (he was always a big drinker) BUT he still wanted to be with us. I was terrified he would fall down those stupid stairs he insisted on negotiating or suddenly all his organs would just say “we give up” and did not want him, me or my family to go through that terror even for a moment and for those reasons I know I did the right thing. But even with that I have a constant niggling thought that I should have waited just a few more days. You hear stories all the time that cats rally forth.
    I love my cat and miss him so very, very much. Please help me.

  392. Doc says:

    Hello, Nugget’s Mom,

    I wasn’t there, I didn’t know Nugget. However, from your story, I have no doubt that you made the right decision.

    Sleep well.

  393. Nugget's Mom says:

    Thank you for taking the time to respond and read Nugget’s story. I have OK days and very bad days – often breaking into tears at crazy times.

    Deep down I know it was his time and the greatest gift we can give our pets is letting it end without fear and distress. Some-thing we don’t give ourselves for fear of people abusing such a privilege. Watching my mother suffer the last 16 hours of her life, unconscious but gurgling as she slowly drowned by fluids in her lungs in indescribable in its horror. So I get it. But it doesn’t change the fact that scheduling the death of my best buddy who has been with me the last 18 years – even moving countries with me (like literally across the other side of the world!) – seems like such a betrayal.

    Nugget was such a gentle soul – he deserved a gentle death which was, from what I understand, at the most 48 hours away any way but by all accounts would not have been so gentle and stress free by then.

    But even so …

    Grief is the price of love … and we all have to pay up at some point.

    In loving memory of Nugget. May you be hanging in the sun just over the rainbow bridge until we meet again. And when we do I promise not to shove one single tablet down your throat! 🙂

  394. Janie Stoddard says:

    We have a 10 yr old rottie who was diagnosed over 1 yr ago with a soft palate tumor that we have had removed twice. Well, now she is losing weight and body mass. Is it time to euthanize her? Help!

  395. Doc says:

    Hello, Janie,

    Tumors in the mouth are terribly hard to deal with, because you cannot perform a wide removal of tissue. You can’t amputate their head.

    The oncologists usually recommend some type of radiation therapy for follow-up, but the long-term outlook is poor for recurring tumors in this location.

    I cannot tell you if it is time, but it sounds like she is on a down-hill slide. That is to say, it sounds like she is going to just keep getting worse. If that is what is happening, and she is not enjoying life, then you need to look seriously at making this decision.

  396. Lori says:

    I have a 13 year old female cat who started showing symptoms about three months ago including one teary eye, sneezing, not eating well and pawing at mouth slightly only when eating. Not sure if all these symptoms were related so I took her to the vet a few times and she was given medication for a possible respitory infection, which the medication did nothing. Bloodwork all came back normal and she was very healthy overall per the vet. The only obvious thing left to do was take care of her teeth, so had three of her teeth removed. Immediately after the surgery she began vigorously pawing at her mouth all the time and was eating even less and stopped showing almost all affection and doesn’t play anymore, hides under the bed alot, no quality of life, etc. I took her back to the vet several times where they gave steroids, pain medication and clipped some of her stitches, nothing helped. I took her to a Dental Specialist who said she does not have Stomatitis, but the rest of her teeth behind her fangs needed to come out for multiple reasons, so I had that done. Two surgeries and still she has the same symptoms $4000 later. I am sure there is other things to “try”, but I don’t have unlimited funds and really think the best thing to do is to put her to sleep to put both of us out of suffering. Seems like all of the treatment is a guess based on their symptoms since the cat cant talk, which if I continue trying things could quickly add up to be $10K or more. Any experience with something like this?

  397. Doc says:

    Hello, Lori,

    I understand your frustration. I think if your cat were at a teaching hospital, they would probably recommend a C-T scan or MRI with a neurological examination. You have ruled out a lot of things, but there could certainly be some type of growth impinging on a nerve.

    I am just speculating, of course, and I am certainly not an internist or neurologist.

    It is possible that even if they did find such a thing, it wouldn’t be operable.

    I wish that I had good answer for you.

  398. D says:

    We’re struggling with whether or not to consider euthanasia for our poor old cat. He’s 13. His eating has been decreasing for some time. At first we just thought it was a bad tooth and we eventually did surgery, which the vet said he recovered from just fine. But apparently there was some mystery underlying problem. His eating kept decreasing, and we kept trying with more and more food options, including i/d, and now a/d from the vet.

    We ran blood tests, which didn’t show anything much, not positive for severe pancreatitis, no liver failure. But the vet suspected slight pancreatitis and we gave aggressive meds to treat, including buprenorphine for the pain. It didn’t really seem to work. So the next step was to get X-Rays. and they found something in his lungs. Blood tests ruled out heartworm, lung worm was suspected as well as cancer, and we decided not to do the lung biopsy tests as too invasive. We’re still weaning him off the prednisone and have added a laxative and lung worm medication. But it appears clear that breathing is difficult for him, as he makes these straining sounds unless he’s completely asleep. poor guy. and now they tell us he does have pancreatitis.

    I’m trying to wrap my head around euthanasia. On the one hand, he has something in his lungs, he appears to have difficulty breathing, and he has pancreatitis, he is pretty much starving, as we can only get him to eat tiny amounts, and none of us want him to be in pain. But, on the other hand, he still grooms himself, still uses the litterbox, still eats a little bit, and does snuggle and purr. I don’t want to give up on him. I guess I’m trying to look for signals from him that he’s done, such as not trying to eat at all, or not snuggling or just hiding. What if we never get such signals? But what if we gave up on him too early? It’s so depressing.

  399. Doc says:

    Hello, D,

    I wish I had the perfect answer for you, and I certainly do not.

    From what you tell me, it seems that your friend is at the beginning of the end (if not farther along than that).

    The fact that he his still grooming suggests that his pain is not great. Failure to groom is often the first thing that we see before other signs of illness become obvious. Ladies don’t put on their makeup, guys don’t shave, cats don’t groom.

    You are going to get to a point where you realize that he is dying slowly, rather than “living longer”. Don’t feel badly about releasing him from the prison of a painful, non-functioning body.

  400. Chantel Sandbach says:

    My 10 year old female cat (Callie) was recently tentatively diagnosed with lymphoma that is affecting her CNS as she was demonstrating neurological symptoms (no blink reflex or the ear twitch reflex on the left side of her head as well as discharge from her eyes and a strange sort of plantigrade stance, among other general symptoms like lethargy and losing weight). Our vet is confident in his diagnosis and indicated that she likely has weeks and not months. He also told me she is likely blind due to a lack of pupil response or dilation. Anyways, we are a few weeks past the initial diagnosis and she’s had a couple of courses of steroid shots and a multivitamin, and then the vet prescribed prednisolone to be given transdermally (apparently she is the stereotypical calico who fights every effort at medicating her otherwise). Long story a little less long…..the meds initially perked her up a bit and she had a better appetite for awhile but has since stopped eating, unless I put straight tuna from the ca right under her nose. Today that’s decreased. She hasn’t been drinking much water either and today has had none even when I tried to help her. She sleeps all the time and is not interested in anything, not even seeking out food or affection (although she will briefly wake up and purr to acknowledge us petting her). She can’t see, bumps into things when she does get up (today she hasn’t gotten up or even gone to the litter box – just sleeping on the couch and rouses a little when I pet her). I don’t see obvious signs of pain but possibly have seen signs of maybe focal or partial seizure activity. She’s just not really “present” anymore and doesn’t even groom, other than her face, which appears raw and scratched on her nose and one spot on her mouth. I think it’s time – I read this entire commentary and one thing hit me hard – you told a commenter that “good days” were when she did her normal activities and things she liked and bad days were when she didn’t. If that is the case, I don’t think she’s had a good day in a couple of weeks. I’m afraid to say this to the vet and have him think I’m rushing things, but it’s so hard to see my girl just NOT be my girl anymore……..any advice would be greatly appreciated.

  401. Doc says:

    Hello, Chantel,

    I cannot imagine that your veterinarian would be judgmental in this case. You are the best judge of how your friend is feeling — you live with her.

    I believe that when you tell your veterinarian what is happening, he will be very understanding.

    I don’t believe that anyone is in a position to argue with your decision in this case.

    Best wishes.

  402. Diane says:

    Is this column/forum still open? My 5 year old female gold kitty went from 11 lbs to 6.7 lbs when she went into Animal intensive care, 4.4 lbs when she left there diagnosed with chronic and acute kidney failure, sky high creatinine, 7.5% kidney function and no specific gravity to her urine. That toxic smell was coming off of her and she was skin and bones. Hoe did I let this happen to her? I also have her brother, a big strong tabby who himself survived an episode of near total kidney failure a year ago. The vet gave me suvQs to give at home and his wishes for good luck – and I rehydrated him and he seems fine. Not so the girl.

    I put her down. I was sick myself at the time. She was a good girl, a lady who took the long walk to her litter box every day from her hiding spot in plain sight under my bedroom desk. She was ravenous for kibble which wasn’t any good for her, then curled up next to me for the first time in a while and I took this to be our one (last) good night. That’s what I told the vet the next day and she understood. I spent a long time crying and holding her at the vet before and after. I didn’t want her to have a seizure or vomit up foam or bile. She had stopped grooming. Even though I feel I did the right thing, her brother is acting up now, chasing his tail, etc, and I am painfully lonely for her, the house feels empty of her special self and energy. I get confused reading these sites. But that’s what I did and I have to live with it. I think it was the necessary humane thing to do, but so hard to live with and to be missing her, as well as to witness mortality, literally in my hands, in my arms, my sweet special Goldie. Only 5.

  403. AmyGurman says:

    My cat recently jumped off the bed and SCREAMED…he couldn’t lift his back end and bunny hopped down the hallway. Then hid. The 1st vet misdiagnosed it as a sprain. 2 days later I rushed him back to the vet because he couldn’t control his bladder and was in obvious pain. The top vet examined him, diagnosed with spondylosis & an arthritic fracture. The vet is going to monitor him for a week and see if they can help him stand again. That was 2 days ago. He still can’t stand & support his back end… but hops to the litter box and into it (it’s very low)the vet says he’s not in any pain, but I want to know if it’s fair to make him live like that- Not being able support his back end. The vet says we just have to keep him comfortable and see if he regains use of his back legs. He can move his legs when he lays down, but can’t stand his back end up… I don’t know what to do…….

  404. Doc says:

    Hello, Diane,

    It is always so hard to understand when such a young pet dies with something that you think is a disease of the very aged.

    It’s never easy to give up a friend, but so much harder under circumstances like you describe.

    I am sorry for your loss.

  405. Doc says:

    Hello, Amy,

    This makes me think of a “saddle thrombus”, a blood clot that cuts off the circulation (at least partially, and sometimes completely) to the hind legs.

    I’m sure that your veterinarian had checked for this, and I don’t mean to question the diagnosis of someone who has actually seen the cat.

    I understand that you are concerned about your cat’s quality of life. Give him a few days to see how this plays out. Sometimes recoveries are surprisingly rapid.

  406. scott says:

    I lost my cat to kidney disease, it’s been 9 days now and he is still all i think about.

    He was diagnosed with kidney disease 8 months ago and i had been worrying about him the whole 8 months.

    I took him to the vet the day he died to get blood tests done and see if i could get medications to make him feel better as he had been vomiting, he was still eating but not much, but after the blood test the vet told me he was very sick and his kidney disease was now quite advanced.

    The vet said he could admit him to hospital and try to buy him another few months but the treatment in hospital and medications would be very expensive and it would only give him more time not cure him.

    The vet thought that euthanizing him would be kinder, after many tears i decided to euthanize him, i stayed with him and looked into his eyes as the procedure was perfomed telling him goodbye and that i was sory for what was happening.

    I have spent the last 9 days constantly thinking about him and second guessing my decision, i keep thinking he may have had more time and that i ended his life too soon, i know with kidney disease their breath is supposed to smell realy bad at the end but my boys didn’t, i keep thinking that i should have been able to do something to help him and am constantly wondering if anything i did caused his kidney disease or caused it to get worse.

    It feels like i will never feel ok about my decision and i will never forgive myself for taking what ever time he had left away from him.

    I have had people tell me i should get another cat but i am definitely not ready for that yet and i don’t know if i ever will be, i never want to lose another pet or worse still have to make the decision to end another pets life.

    I hope one day i will be able to remember him for all the love he gave and funny things he used to do, and not as a sick cat that had his life taken away by me.

  407. Doc says:

    Hello, Scott,

    The bad breath is not exactly a reliable indicator of prognosis.

    The long-term nature of the problem, coupled with the descent into vomiting problems, suggests that your cat had indeed come to the end of the road.

    I know that you are second-guessing yourself at this point. You have to realize that a pet can get to the point where it is dying a slow death, rather than living longer. This is no kindness.

    Wait until you have been through the grieving process and feel that you are actually ready for another cat in your life. Don’t let other people tell you what’s best for you. What is true is what is true for you.

    Best wishes.

  408. Lena says:

    Hi doc, thank you so much for providing this website and keeping this thread going. I have been reading this thread for the last two days. My little girl Roady is 15 years old and actually adopted me as she road underneath my dads truck and ran into our garage and the rest is history! Around a month ago, my husband and I started noticing that she was losing weight and that she wasn’t eating her dry food. We switched her to soft food and she was kind of eating that but we weren’t quite sure how me of that she was actually eating as we have another cat. About a week ago I decided to take her to a vet as nothing was changing and her appetite was still slowing down and she seemed to be getting more picky with her food and we realized that she was missing one of her teeth (we have no idea when she actually lost the tooth). At the vet office last week they did blood work (came back fine) and suggested we do an ultrasound and gave an appetite stimulant. I wanted to think about the ultrasound just because I wasn’t sure if it was something tooth related or not. Well the appetite stimulate didn’t work and she stopped eating altogether and starting tearing, wasn’t really drinking water, we realized that we hadn’t really seen her groom herself in awhile, she couldn’t get comfortable and she was starting to have trouble going up the stairs and jumping on the bed and her favorite chair. I made another appointment at the vet.. This would be a week from the other appt (yesterday). The prognosis was not good. She had lost 4 lbs since her last visit. Roady who typically meows up a storm at the vet was lethargic and laying down, so we definitely knew something was wrong. The vet said we could take her to an emergency place to get an ultrasound but that more than likely what she was battling was more than likely lymphoma and it was taking over her body at a rapid pace. I felt really selfish because I took her home that night as I couldn’t bear to euthanize her right then and there as I had been at work all day and hadn’t been with her. I didn’t want her to think of her last day of being by herself and then getting grabbed and put into a car and then going. But we spent the night with her and took her to the vet this morning. They were great and the process was seemed quick and painless for my little roads. She seemed like she was at peace with it. And I feel better knowing that it was better to do it now before it got worse and possibly for painful and uncomfortable for her. I just really wanted to thank you for providing a place for other people to ask questions and share their experiences as well as thank you for your advice and knowledge. It’s really helped me the last day or two with making this decision and has giving me comfort in knowing that I did
    the right thing.

  409. Doc says:

    Hello, Lena,
    Thanks for taking time to share your story. It certainly sounds like you made the right decision.

    I am sorry for your loss.

  410. Carol Anderheggen says:

    Dear Doc and all the owners who posted about euthanasia: I wish to thank you all, reading the blog last night helped me to let go of holding onto my 12 year old cat Angel who was in renal failure, had stopped eating and had no quality of life left.

    This morning a big fat robin perched on top of Angel’s favorite outdoor chair and stared straight at the window I was looking out of–he did not fly away until I said “ok, I will send Angel to the Rainbow Bridge today.”

    My heart is sad but full of love for having read this blog. ~~ Carol

  411. Doc says:

    Hello, Carol,

    Thank you for sharing your story.

    I am sorry for your loss, but it sounds like you made the right decision.

  412. Tina says:

    Our youthful 15 year old indoor-outdoor tabby Sammi never had any medical issues until he recently stopped eating. After a pricy blood test showed “off the chart”count of white blood cell count along with additional xrays found nothing other than he was dying but we didn’t specifically know from what. If he had ultrasound may find what he is dying of- additional $1000. We chose to keep him comfortable by giving him subcutaneous irrigation injections, every 1-2- days. That was 5 weeks ago. Sami is still alive because of these at home injections of electrolyte fluids. He eats fairly well-( not like the old days) after he gets his injection. He is getting slower but still jumps up on the counter, purrs and rubs against our legs, even chases laser lights & checks out gopher holes in the yard. It’s been an emotional roller coaster for my husband & I knowing his days are numbered. We believe that as long as he is enjoying life, and we have the fluids getting into his system, let him live. Until he has more bad days than good, we will enjoy our little buddy- one day at a time.

  413. doc says:

    Hello, Tina,

    I can appreciate how difficult this is. It sounds like he is still having relatively good days with the supportive care you are giving him. Your philosophy sounds good to me.

  414. Tom says:

    Dear Doc,

    Today we put our Beloved feline friend Scamper to sleep. About three months ago we noticed blood in her stool. After 3 trips to the vet in 3 months my vet finally recommended we have an ultrasound done. We had the ultrasound done Wednesday, and was told she had a tumor in her rectum. The vet sent out samples for a biopsy and while we waited for the results, Scamper stopped eating and drinking, used our bathtub as a litter box , would vomit after deficating and generally withdrew from me and my spouse. Today I got the call I dreaded, the results found carcinoma in a swollen lymph node. My vet said prednisone would have very little hope of working, and that surgery wasn’t really an option. Part of me feels like we did the right thing euthanizing her , while another part feels like I should have tried just one more thing ( perhaps chemo or radiation). This wasn’t a choice I was hoping to make but felt I owed it to her to end things before her life became constant suffering. I hope I chose correctly…..

  415. Doc says:

    Hello, Tom,

    Radiation works best when you are targeting a very specific area. If this was in the bowel and in the lymph nodes, that suggests a widespread problem, and radiation would probably not have been appropriate.

    As to chemo, cats have a lower tolerance than dogs. I don’t know what type of carcinoma was found, but there are some where we really don’t have good choices of effective drugs. Some have a better prognosis than others, of course.

    I feel that your veterinarian would have advised you of any treatment that had a reasonable possibility of helping your friend.

    I am sorry for your loss.

  416. Jim says:

    Tomorrow, Sep 4 2015, I will take my best buddy Joey, to the rainbow bridge. I will cry and morn as any caregiver does. But, I know that the last few months he graced my life, were joyful with the friendship between a human and feline could have. God, please watch over him until we meet again. Kate, your brother has missed you, now time for some catnip.

  417. Lori says:

    Me and my husband are having a hard time deciding if we should have our 19 year old cat Mirage ‘put to sleep.’ For the past few years she has been pretty thin. But she ate just fine and would even get little moments of the kitty crazies and really loved to cuddle. If you laid on your side she would climb on you and sleep. Or just cuddle with one of our other cats.

    But a little less than a month ago she was having trouble peeing and when she did in a place she wasn’t supposed to we realized it was tinted red. We took her to the vet and they found that she had a tumor in her bladder. She had been to the vet back in June and there was no sign of it then. The vet told us that they could do surgery but with as aggressive as it is and the size it would probably come back and they might not even be able to get it all. And that it’s highly possible that it is else where. Not to mention with her age that surgery alone might be dangerous. She said if it was her cat she wouldn’t do it. So we decided to take her home and keep her comfortable. But this week even with us giving her the medication they gave us she has gone down hill. She no longer sits to pee and getting her to eat anything is really hard. She comes to eat at dinner time but then just takes a couple of bites. Then over the next couple of hours I’m lucky to get her to eat a couple more. She sleeps pretty much all the time. And even though she still likes to cuddle she doesn’t lay on you an more and it’s only with me. Not my husband or the other cats.

    I know that it is probably time but I’m finding it hard to make the decision. I’ve had her since she was 6 weeks old and she’s my baby. I don’t want her to be in pain but I also find my heart hurting when I think of loosing her.

  418. Doc says:

    Hello, Lori,
    It sounds to me like you already know that it’s time, and what you need to do. You’re having trouble confronting the finality of it, and the loss of your friend. Your friend is nearly lost now. She is trapped in a dying body. Let her go.

  419. Christine says:

    I am unhappy because my 18 1/2 year old cat is dying of lung cancer, but he is in the grey area of whether or not it’s time to put him down. He has stunned all the vets by living as long as he has – he was diagnosed with FELV and lung tumors at 15. They also suspected small cell lymphoma, but I opted not to get the endoscopic biopsy because he was already on prednisone, which can mask test results, and I wasn’t sure he’d survive the surgery he seemed so frail. His medical charts are all labelled FRACTIOUS in capital letters, so he wasn’t a good candidate for chemotherapy. We went for ‘hospice’ care and an in-home vet to spare him the trauma of travel and the smell of the vet’s office. That was over 3 years ago, and everyone is surprised he has done so well.

    He is lame in the front legs which makes it hard for him to walk or to go down the stairs, and in settling down to sleep. His back legs are still strong, and he makes all his jumps. He is on predisolone, amlodipine for blood pressure, and a medication to treat overactive thyroid. He has some thyroid nodules. (I think it was the thyroid that caused the rapid weight loss that led to the tests that revealed the other problems.)

    I know I will have to put him down soon, but exactly when has a very hard decision. He won’t give me any of the clear or classic signs of distress. He is eliminating appropriately. He has a litter box on both floors, and he uses the closest. He has a lot of muscle wasting, and he is wobbly and unstable. I give him Adequan injections for the lameness, but they don’t seem to have an effect any more (he used to zoom up the stairs the day after an injection).

    He also doesn’t hide. He has never hid. He does not pant, or have increased respiration. He can sleep comfortably in a ball and doesn’t do the hunched position that I know would indicate breathing problems or fluid buildup. 2 months ago he started drinking a lot of water, and blood work showed increased BUN and Creatinine, but not too high, only just outside of the normal range. We are giving him 100cc subq every other day. The vet says heart and lungs sound good. So all his stats say things aren’t bad. BUT, he just sleeps all day, and has not played since February. He often just sits and looks confused. His voice has changed, the meows have become whiny and demanding. He calls me upstairs so that he can lay in my lap, about 6 times a day (I work from home and can accommodate that). His weight is holding steady at 8 pounds. I feed him about 7 times a day – straining the gravy from Fancy Feast for him.

    Today he was in my lap and I scratched his cheek hypnotically, and he squeezed his eyes in pleasure and purred, and his body was relaxed. But other days his body is stiffer and his eyes stare out at nothing and he shows no joy. Sometimes he doesn’t seem to want to be touched.

    He just doesn’t seem to be enjoying life. I cannot tell if he’s in pain. I don’t want to put him on buprenorphine because that really zoned out our last cat when she went through renal failure. A zoned out life is not what he should have.

    When he was a kitten he was so active and playful. I worked at an animal shelter and knew the energy of kittens, but this little guy was AIRBORNE. Now he has withdrawn to the guest bedroom mostly. Good days are when he comes downstairs and goes out to the patio to sleep in the sun. He seeks out heat sources – the sun, my lap, the heating pads. His saliva has become very sticky so even though he is grooming, it clumps the black fur together and exposes the white skin so he looks unkempt.

    He has been my constant companion for over 18 years, and if I leave for more than 2 days he goes downhill very fast. We all think if I left for a week he’d die, which would be the worst thing I can think of. I want to give him a good death at the right time. And I should be there for it.

    I guess what is really putting the pressure on is I’m called for jury duty October 20. I had already requested 1 postponement back in February, because I was afraid to leave him alone all day and a pet sitter cannot give him his meds because he is combative with everyone but my husband and me. I was absolutely convinced he’d be dead by now, and I could serve, but here were are and my Terminator Kitty continues on. I am playing out the future conversation with the judge in my mind, trying to argue dismissal for Hardship or for Caregiving for a cat they probably have no sympathy for. Many people don’t think of pets as real family members. But I refuse to kill him early for convenience, and I won’t serve until he’s dead, and if I draw a long trial he probably will die (I live in the bay area and the commute alone is 90 minutes). I’d be gone from 6am to 7pm.

    I think I’ll have to put him down in about a week or maybe up to two months. But he is the Terminator Kitty and I’ve been wrong a dozen times now. How bad is too bad? I’m scheduling the vet to come out again Monday, when she’s back in town from the veterinary convention this weekend. But she was here only 2 weeks ago, and he was so full of fight she needed to put him in the confinement bag AND use the face mask in order to get blood and urine samples. He screamed like he was being murdered. Should you put down a cat that is so full of fight? Honestly I don’t know how she would get the first injection into him without serious restraint. That doesn’t seem right.

    Urine was dilute, culture was negative. Blood looks pretty good, stage 1 renal failure. Maybe the cancer has metastasized to his leg bones and that’s why he’s lame? I wish I knew what to do. The vet thinks he will deteriorate quickly once the cold weather sets in. But highs for next week are 85-90 degrees. Jury duty looms. I am getting very distressed. Any advice at all??

  420. Doc says:

    Hello, Christine,

    I think you are correct on all counts, including how difficult your choices are.

    Which is obviously not helpful at all.

    Your choices are putting him down before you are ready, seeing if you can get out of jury duty again (pretty iffy), or taking a chance on leaving him by himself all day while you are at the courthouse.

    I think the real questions is, when will you be ready? What is your benchmark? What does the percentage of bad days have to be? 100%? 50%? How bad do they have to get? It sounds like his best days are mediocre, but his bad days aren’t agony — just lousy.

    What would it take for you to feel like the time has come? Screaming? Immobility? Incontinence?

    With the data you’ve given me, it sounds like your best shot (if you can’t duck jury duty) is to see how me makes it through the days while you’re gone. That is, unless you can come up with your benchmarks so that you can actually make the decision that you don’t want to make.

  421. Christine says:

    Thanks for your comments. To update you, Monday morning he fell off the bed and landed badly. He began licking all the hair off the front of his chest and legs. The vet arrived by noon and found a mass in front of his heart that she knows was not there two weeks ago. It appears the cancer is metastasizing, and quickly. He was limping so we put him on buprenorphine. He ate heartily – 3 helpings of Fancy Feast and this was before the pain meds. Seems this cat is not one of those who goes off his food when in pain. My husband is coming home early, and the vet is arriving, and we are putting him down tonight. So I got my clear sign – I know he’s in pain. Actually, two clear signs – he hid under the bed for the first time in his life. By the way, I might have given the wrong impression when I said he screamed like he was being murdered. That’s NORMAL and he has done this to vets for years when they apply alcohol to his skin in prep for the needle. It’s the reason he transitioned to a home-based vet – by the time I got him in the carrier, and to the vet 7 minutes away, he was already panting and growling so wound up he was ready for a fight. I love this cat and he is very gentle to me. I have a great in-home vet with a big heart and we’ll give him release tonight.

  422. Blythe Caldwell says:

    I have an 18 year old kitty that I got when I was 11 and he was 2 hours old, I bottle raised him. He is currently 9-10 lbs ( he has been around 15-18 his whole life). About 3 years ago he started losing control of his bowels while sleeping due to IBS. I have dealt with it thoughout the years and in January of this year he lost all control of his bowels. In Spring he wondered away and I could not find him for 36 hours. When I found him he was curled up on the porch of a house for sale down the street. His eyes lit up when he saw me and I honestly believe that he got lost. However, since the day I brought him home he has been very arthritic and the back end is never really there and he has lost the ability to control his bladder. My Vet took his condition to heart and began researching. Currently he is on injections that are given to race horses and he can walk again! He is always pretty talkative and happy. He follows me around and is always happy to see me. I’ve let him be outside on the back porch all summer to lay in the sun and he comes in at night in our mudroom. The problem is that the weather is turning cold here in Ohio.
    As of today he is chirping, purring, and following me around (with the occasional stumble). He is eating and drinking a lot (hard and soft food). He generally is in good spirits, but has no bladder or bowel control. I rotate through washing beds to try and keep him sleeping in a new clean one every day and I bathe him once a week. My vet seems to get upset everytime I say that my fiance is pressuring me to let him go. It has become a burden on our relationship and a fighting point. We are going out of town next week and I am embarrassed to ask anyone to come deal with his mess. My biggest issue is that he is always so happy to see me and is so sad when I have to leave. I feel guilty because I don’t give him the time I should and usually when I do spend time in there I am cleaning up his messes. I feel that being trapped in a room all winter is no way to live, especially when you are bladder and bowel incompetent, but he seems so happy with me. Am I just blinded by love? Any advice would be great.

    Thanks!

  423. Doc says:

    Hello, Blythe,

    I try to answer questions when I can. Many times I cannot give any specific advice when I have not seen the patient.

  424. Doc says:

    Hello, Blythe,
    Not sure how I missed this before.

    This is a really difficult situation. Your friend has a sort of okay quality of life, but only with regular medication and a lot of nursing care. If that were your grandma, nobody would think twice about it, but it’s your cat.

    If you can’t be there 7 days a week (maybe not 24/7, but 7), things get funky pretty quick, it sounds like.

    I must say that I can see your fiance’s frustration and having to arrange your lives around a cat, in order to keep him going along sort of okay (but not great).

    This is obviously a situation that won’t continue indefinitely, as the cat’s aging process will inevitably cause something else to fail.

    Unfortunately, that may be weeks or months (though probably not years). It is also likely that it won’t be “he died in his sleep”, but rather “Is this the time?” and you have to make a very difficult decision.

    I think it would be easier to find a friend or pay someone to clean up after the guy while you’re out of town than to tell your fiance that your old cat’s personal hygiene is more important than your relationship.

    I doubt you feel that way, but I can hear overtones of that in the way this is playing out.

    Find someone who does pet-sitting and pay them extra because it’s an extra messy job.

    Or, if you think that the cat’s quality of life is gone, then make the hard decision.

    There just isn’t a super-easy answer on this one.

    I wish you the best.

  425. Phyllis says:

    My former stray, Tommy, is probably 20+ years old and has what the dental specialist thinks is oral SCC on the outside of his gum. He lost an ear to this many years ago. When diagnosed, it had apparently been there a while. He has had severe periodontal disease for years which likely contributed. He has lost quite a bit of weight. We opted not to do a biopsy because with his age, we would not have done chemo or radiation or even subjected him to the post-op pain. He is on Buprenex twice daily and that seemed to help. He sleeps all the time and eats only the gravy I express from canned food with gravy. He will occasionally eat a treat or two but then stop. He is so thin but still seems to like it when I come in and lie with him and he sleeps on my pillow at night, then on a heated bed the rest of the time. I’m struggling with when ‘it’s time’. I feel it’s getting close.

  426. Doc says:

    Hello, Phyllis,

    I agree that it’s getting very close to time. It sounds like he wants to be with you as much as you want to hold onto him, but that he is basically starving to death. Tough decision.

  427. Samantha Sullivan says:

    Hi. My cat is 15 years old and has diabetes and Intersticial cystitis. She suffers from severe constipation as well. Over the past few years my cat was diagnosed with diabetes and we were treating it with glipizide pills. Then she began urinating and defecting outside of the box. We got a few different litter boxes and she was back to peeing in just one eventually. Now however, she is peeing outside the box but also on the wall to wall carpets and wiping her butt on the carpet daily which she’s been doing for years. She constantly poops outside the litter box. No matter how clean I keep the box it doesn’t seem to help. i have now noticed her having trouble jumping up places and with her back legs which is new. I am now wuestioning if it is her time. But I don’t want to let her go and I also don’t want to act prematurely. However, I also suffer from intersticial cystitis and to know my cat has this and could be suffering and can’t tell me is awful! I don’t want her to suffer yet I can’t exactly tell if she is. She’s never been an active cat she spends her time in bed sleeping with an occasional visit. What is the humane and right thing to do? This is my first pet I’ve ever had!

  428. Doc says:

    Hello, Samantha,

    Since she is having trouble with her hind legs, it is possible that she just cannot get into the litterbox. I would definitely try a litterbox with very low sides. I might even cut the front of it out so there is no hurdle to overcome.

    If her diabetes is not under control, it is very common to have secondary urinary tract infections. Many cats require insulin injections, and do not have good control with oral medicines.

    It is certainly possible that she is losing so much function that her quality of life cannot be restored. However, I would want a urinalsysis, urine culture, and a re-evaluation of her diabetic control.

  429. Shari says:

    I have a 18.5 yr old, Coal that has gone from 7lbs in November 2015 to 5.4 lbs 01/25/2016. he was diagnosed with megacolon and we got that under control with cicipride and miralax, but with him sleeping all the time he has lost so much muscle mass and he is wobbly on his hind legs. he has started walking on his ‘haunches.’ he is skin and bones and stopped eating yesterday and his eyes were cloudy. I made the dreadful apt to have him put to sleep tomorrow and when I got home from work today he ate quite a bit and now I am having second thoughts. there is no way that he will rebuild his muscles is there? and if I did the calculations of how many good days compared to how many bad days…well, I know what to do…but I keep thinking…he ate…maybe he wants to hang on a little longer. I am stuck.

  430. Doc says:

    Hello, Shari,

    I understand how hard this is. You see your friend wasting away before you and hurting and you know this is wrong. Yet just as you reconcile yourself to this difficult decision, he eats a hearty meal.

    I wish that I could tell you what is right for you, but I cannot. I do think it is unlikely that his quality of life will improve, given the circumstances you describe.

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

    Sometimes this is a liberation instead of a loss.

  431. Debi Morrell says:

    My love of my life is Rosa is 13 years old cat, (I got her when she was around 6) that on Thursday (2/4/15) was told she had bone cancer and liquid in her chest. I decided to take to her to a highly recommended vet which was absolutely wonderful and explained her x-rays to me. She has a tumor that has occupied her heart area and looks to be breathing out of only a small portion of her lung and so her breathing is strained and she breaths very rapidly. The doctor was concerned because she did not see any fluid in her chest. I took her in on 2/4 because I could feel the bones on her back and this huge bump that I though was her chest bone and that she had lost so much weight that I was able to feel her bone….turns out it is a tumor consuming her area. Looking at the x-rays a couple of her bones are deteriorating due this tumor attacking her bones.

    At the beginning of the year (2015) she as at 13 lbs and when I took her in to see my vet (the second week of December 2015) because of sneezing, she was 10 lbs…he said he saw liquid in her chest but felt that antibiotics would fix this and hopes it would fix the liquid in her chest. Her sneezing quit and took her back in the next week and all he did was listen to her lungs (even though he never heard anything in there to begin with) and said she was fine – I had gave her a lot of wet food and was about to put .25 pounds her. However, now it is my understanding that the tumor was there in December (6 weeks prior)and it could have possibly been removed and chemo might have saved her.

    I love my girl so much, she was my god-send sent to me and my mother two months before my mothers passing and helped me through the difficult time of loss.

    I want to do what is right with my girl, but she is sleeping a lot, not eating much (I am now feeding her gerber—which she really likes and treats). Anything that I can get her to eat. I have ordered that cancer cure kit from wellbeings and will receive it on Wednesday. I am hoping (from what I read in the review will help her).

    From reading your post – it has helped me so much hearing all the different decisions. I too like one of the readers is consumed by this…I don’t eat, I’m up and it is 4:47 am. All I do is cry when I look at her and the thought of having to make the decision to send her to heaven. I too, don’t know when is the right time. This is one of the most heartbreaking and difficult decision that I have to make. I will continue to monitor and see if she just continues to sleep and hardly eat and her breathing gets worse…I asked my vet (the wonderful one) to please tell me when is the right time, because I am afraid I cannot make decision in good conscience.

    Any thoughts would be great. Thank you for this website.

  432. Debi Morrell says:

    More to the post I just posted. My finances like so many others limit me from being about to do serious surgeries, just my vet says that she feels it would not help at this point…but it still makes me feel so awful that at one time I had a lot of money to take care of any and all situations — family situations used it all up and now I am faced with these decisions and it hurts my heart so much!!! I love her so dearly and wish I could do anything and everything possible..

  433. Doc says:

    Hello, Debi,

    I understand that you feel guilty for not finding the cancer sooner. This is foolish. If the first doctor did not detect it, how could you?

    The second doctor is seeing a completely different picture than the first. It’s easy to second-guess the previous doctor when things seem so obvious now, but the second doctor really doesn’t know how it looked when the first doctor saw it.

    Cancer that invades bone is very unlikely to respond to chemotherapy. If your second wonderful doctor is a board-certified veterinary oncologist, then I would defer to her assessment. Otherwise, I think that telling you this could have been fixed the first time is something unproveable. Considering how the case has developed, it seems unlikely.

    I looked at the Petwellbeings cancer support kit. I don’t think it will hurt anything, but it looks like about $50 for about nothing.

    I wish there were some way to make this easy for you. Work with your vet to find the time when you feel that there are no good days, and only bad ones. That means you are dying slowly, not living longer.

  434. Debi Morrell says:

    Thank you so much for the quick response. It is so hard to see like this. This happened so quick. Before going to the first vet in December she was doing great except the sneezing and since putting her on steroids she has deteriorated. I asked my current vet if perhaps we should cut back to once a day rather than the twice a day for the last 5 days and she said, okay let’s try that.

    Please don’t get me wrong, I’m not trying to blame anyone…it’s just that my heart is breaking. Tonight (Tuesday, she jumped on her kitty condo and she was breathing through her mouth, something I have never seen before. I am so scared that the time is coming….I love her to much to die slowly.

    I stopped by my vet tonight and she gave me some can food to add water put in a syrine and feed to her..but because I don’t know what I’m doing she as gagging. I will never do that again, she about chocked on the syrine because she turned her head to the side where I had the syrine….

    She really likes the Gerber 2nd Beef and Beef Gravy. Does it hurt to give her this. She actually came down to see me and talk to me when I came home from work and I go and do that to her. My guilt is killing me – just trying everything. Sorry for the long letter.

    Do you have any suggestions and am I okay this late In the game to go ahead and feed her Gerber? I think it is what gave her the strength to come down the stairs.

  435. Doc says:

    Hello, Debi,

    The cat is terminally ill. I think it is okay to feed her whatever she likes. You’re not going to make her worse. Starving makes her worse.

    Stay in contact with your veterinarian and let her know what is going on.

  436. Leslie says:

    I had to euthanize my sixteen-year-old cat yesterday and I have been absolutely sick and heartbroken over it. Having to make the decision and wondering if it was the right thing is eating me up. Reading these posts has eased some of my anxiety and I thought I would share my story. My cat, Maizy, was always overweight. He was an indoor cat in a multi-cat house and just grew in size. He wound up with very bad arthritis. I put him on a prescription diet and many meds for arthritis and pain including gabapentin, adequan, burpex and glucosamine/chroindroitn. He developed pnemonia about 6-7 months ago and was treated but never seemed exactly the same. He started to lose the weight but his arthritis just got worse. Everytime he would get up his bones cracked. He finally got to the point where he struggled to get up and just seemed misreable. He then had a seizure last Sunday night. I took him to the emergency room and they rattled off a list of possibilities and tests. My feeling was that regardless of what it was he was still in tremendous pain from the arthritis. I started to doing research about when to euthanize a pet. I read that “better a week too early than a minute too late”. Well, I agonized for days. All of my friends and family felt I had waited too long as it was. However, I have this cat for sixteen years and he was like a child to me. My decision came because I could not bear to see him in pain and just laying around and sometimes not even being able to sleep but not really able or wanting to get up either. Yes, he still purred but his eyes were always huge and his years laid slightly flat. As I write this the decision I made still haunts me, but I know deep down in my heart that I did the humane thing. I felt that I was keeping him around for me not for him. I guess that is the question we have to ask ourselves. I believe the seizure was a sign.I wish it still didn’t bother me and that I was more at peace with it, but hopefully that will come with time. Thank you for your site as after reading it I feel not so alone.

  437. Doc says:

    Hello, Leslie,

    These decisions are always difficult. I agree that you did the right thing, though I know it wasn’t easy.

    I am sorry for your loss.

  438. AJ says:

    so happy I found this site! “THE” decision is never easy, every situation different. “Tweety the hound dog cat” was willed to me 12 years ago.My first cat and I really agreed to take her because she has zero claws and I knew I could keep her in. I didn’t even know what type of cat she was. Last year she was diagnosed with cancer and has been on prednisone. My beautiful Maine Coon has gone from 10 pounds to maybe 4. Yesterday she wanted to play all day. She still jumps up to the sill to look out the window I have opened for her. She still uses the litter box and still grooms. But she is restless, hardly sleeps and has little interest in food except for constantly begging for her beloved treats. Hard, Hard decision because of all the many things she still DOES…but after reading so many of these write ins and answers I have discovered that her bad days must outweigh her good and that, quite frankly, I am letting her starve to death. THE decision has been made. Thanks to all who crossed to the Rainbow Bridge before Tweety-The Hound Dog-Cat.
    and, thanks so much for the questions and heartfelt answers on this site.

  439. Sarah says:

    I am very grateful for finding this website. A few weeks ago I found out my sweet 15 year old orange baby has squamous cell carcinoma in his mandible. He has been my best friend for 15 years and it tears me apart to think about losing him. What prompted me to end up here was that tonight I started smelling a horrible rotting smell coming from his mouth. He has been drooling more and I’m pretty sure that smell is an infection. He is not on any pain meds but I called my vet earlier today to see if I could get something for him. He is still eating and drinking, but I think it is starting to bother him more since he isn’t eating as much as he was late last week. He still comes to the door when I get home and even cleans my other cats on occasion. His drool is tinged with blood and I can’t imagine what kind of pain he may be in even while he isn’t showing it obviously himself. He is laying next to me as I write this and bough I don’t want to lose him, or put him down too early I just don’t know what is best. Thank you to everyone who has posted here. My heart goes out to everyone dealing with the pain of this decision.

  440. Doc says:

    Hello, Sarah,

    I’ve never had bone cancer of any kind. I am told that it is quite painful. However, that was referring to osteosarcoma, a primary cancer of the bone tissue, rather than something else invading the bone.

    The bottom line is that this is going to get steadily worse. You can’t amputate his head to get rid of it, and other treatments are unlikely to be effective.

    I wish I could give you a simple rule of thumb to make your decision. I look at the good days versus bad days, and how many of his favored activities does he still perform, and how often.

    Best wishes.

  441. Ken Dalton says:

    I have an 18 year old cat that lost her hearing a couple months ago, now recently her eyesight. She lost a lot of weight and I changed her diet to soft food because she has trouble eating the hard stuff. She roams the house at night, meowing loudly and that has kept my wife and I awake. Is it tme to have her euthanized?

  442. Doc says:

    Hello, Ken,

    I cannot decide this for you. It sounds like she doesn’t have much quality of life. You just have to decide when she has made the transition from living longer to slow dying.

  443. Nik says:

    Hi Doc, thanks for keeping this thread open through the years. I just found it and it’s what we need at the moment. Our Maine Coon cat is 11 and has IBD his whole life. We always took care to mind his diet. In the last few months, he’s lost a lot of weight and things at the litter box are painful. Catnip, mice, and string no longer excite him – only crunchy food does. He still has an appetite, enjoys chasing and eating centipedes, and talk talk talking.

    We asked ourselves, is he suffering beyond litter time? He has good days and bad – but is that any quality of life? So yesterday we made the decision that we will put him to sleep next week. I turned to the Google God, looking for approval for our decision. We will stay the course.

    Thank you doc, and all the contributors.

  444. Doc says:

    Hello, Nik,
    This is always a tough time. None of us have so many friends that we feel okay about losing one. On the other hand, seeing someone you love suffering is no good either. We just have to make the best decision we can.
    Best wishes.

  445. Wendy says:

    Thank you for this place to share. I found out recently my beloved 12 year old cat has a lung tumour and was encouraged to have lung removal to cure her but I have been wracked with guilt from not being able to do this painful invasive surgery on her. (Costs could run up to $7,500 w/o complications but I would do this if the surgery was not so invasive and painful). I feel guilt and although she is currently ok eating and playing with pregnizone injection, I feel like I have given her a death sentence by not doing this surgery. Like some others have indicated here, I am not eating, sleeping, and am crying a lot and beating myself up for not doing this surgery which scares me. I feel like I’ve given her a death sentence. She is my communicator and is so intuitive, I cannot bear to think of her not being physically there in my life. I appreciate reading that others have experienced health issues with their cats of similar age and also similar emotional reactions.

  446. Doc says:

    Hello, Wendy,

    I hear what you are going through. Truly, it is not your decision to forego the lung removal surgery that will cause your cat’s passing. It is lung cancer. It is possible that removal of the lung would be curative, but it is also possible that there has already been spread of microscopic cancer cells to other body parts, and the surgery would not be curative.

    You are doing your best to give her a good quality of life in her final days. This is nothing to be ashamed of.

  447. Tracy says:

    We’ve been struggling with the decision to let go of our wondeful puddy for some time and I know in my heart, he is ready. My husband is taking painfully longer to come to the same realization. So maybe my story can help all of you struggling with the right one for you.

    At 21, you can’t argue our cat has lived one hell of a great life. He’s been a part of ours for such a long time you can’t help but want to do everything for him to stay around. The question is, are you doing it for him, or for yourself? My husband recently said, “if I can give him one more afternoon in the sun, lounging on the deck, cuddling in my lap, watching the birds, I will”. But he is hoping the cat will just fall asleep and move on. Life is rarely that kind.

    At his prime, he was a 20lb big tom cat (not super fat). Now he’s maybe 6lbs. Pretty much skin, fur and bones. He gets as much wet food as he wants but he’s still wasting away. He gets regular vet visits to the house and his blood levels have never shown anything acute. He spends most of the day hiding behind window curtains He never looks like he got much sleep. He no longer goes outside. We have to put him by his litter a few times a day to ensure that he uses it (instead of somewhere else). He doesn’t purr anymore. He’s either on pain meds that affect his ability to move, or he’s off them and feeling every step but more “chirpy”. He has very little control over his limbs for regular walking. I sometimes see him not quite lying down, not quite crouching, head low, staring blankly for what seems like hours and it breaks my heart.

    So I wait, for either the end, or for my husband to reach the same conclusion.

  448. Doc says:

    Hello, Tracy

    This is tough. Your friend is imprisoned in a dying body.
    That is no kindness.

    Yet it’s always hard to make that decision.

    I feel for you.

  449. Amber says:

    My 12 12 year old Olde English sheepdog had had severe arthritis on her hips for sometime now. She can rarely get around without assistance anymore, including going to the washroom. She still other than one occasion has not had any accidents in the house. I have tried most medications for pain relief and as much as they relieve her discomfort they have not helped her mobility. She is still the same goofy dog that owns my heart nut it breaks everyone she struggles and falls. The help em harness has been a lifesaver over the past year but it only used to be used to get her off slippery floors. Now we use it to get her every where. The vet gave me a quality of life space which tore me to shreds. She also has some concerning masses but they don’t seem to be affecting her. She also has chronic bronchitis which also pains me to listen to her. The only time she makes her own effort to get up is if I am gone out of the room to long or if food is involved but she struggles so much. I don’t know what to do. My head says one thing but my heart says another once I look at how happy she is with me. Anyone have advice. I don’t think my heart csnt handle losing thus piece of my soul when she still seems to happy.

  450. Doc says:

    Hello, Amber,
    I cannot make this any easier for you.

    If you were imprisoned in this dying body, would you want to stay in it, or move on to the next adventure?

  451. Athena says:

    I know this thread has slowed down over the years but I wanted to let everyone know how incredibly helpful it was to read all of this. As I read through the scenarios and the responses, it became very clear to me that my precious kitty was no longer living, he was just dying slower. We chose to put him to rest before he got painful. He had lymphoma and could barely breath. We had a choice to do a second chest tap or let him go. We let him go with his dignity, he had not made one mess in the house even though he could barely walk 10 feet at a time. Of course I cry and I miss him terribly, but thanks to this site, I have no doubts or regrets about the decision to let him go sooner than later. Thank you so much for your insights.

  452. Leigh says:

    Hi,
    I have a 15 yr old cat that has diabetes, found out about a month ago. I have 3 cats and they are my world, well I’d say my 3 yr old granddaughter is first, lol than my cats. I am living with my parents & they both have terminal illnesses. I tried doing the 2 shots, diabetic wet and dry food. She is nothing but skin and bones…she used to weight 18lb… she is now 6lbs, I know it’s an answer you really can’t give people other than it’s a tough decision. She is just not happy anymore. She doesn’t like the simple shots & I hate to disrupt her life when she is already 15. I don’t want to put her down but all she does is eat her food, drink for hours, is wetting outside of boxes and just lethargic. I think after Thanksgiving I’m going to make the appointment. I’m losing my family & now my very 1st kitty,… why can’t they live to be 100? sigh

  453. Doc says:

    Hello, Leigh,
    It sounds like you’ve already made your decision, and it sounds like it’s the right one.

    It would be nice if we could all just enjoy our life until the meter runs out, but that is seldom the way that it works.

    You’re doing the right thing.

  454. David Koski says:

    This past week our 12 year old cat stopped eating and drinking. She also became very lethargic. We took her to the vet right away. The vet took xrays and found evidence of bronchitis or asthma in her lungs. The xray also showed two tumors which we don’t know if they are malignant or benign. The vet was most concerned with her lung issues and prescribed prednisone, antibiotics, and an appetite inducer. It has been five days now and her breathing seems more labored. She is also barely eating or drinking and is very lethargic still. My girlfriend and I are beside ourselves with worry. How long can we wait for her condition to improve before having to make a decision on what we should do. I don’t want her to suffer needlessly and feel lost.

  455. Doc says:

    Hello, David,
    Sorry I’ve been out of touch the last two days and just saw this.

    I would think that if there is no improvement in five days of treatment that it is time to do something different.

    If there are tumors in the lungs, they may be growing or spreading. If there is an infection and the antibiotic is not working, then you would need to try a different one.

    I would also be concerned that she would likely be somewhat dehydrated, and that alone would make her feel bad.

    If you haven’t yet contacted your veterinarian to give him/her feedback about what is going on, I would do that right away.

  456. Antoinette Kasica says:

    My cat is 14 years old. Diagnosed with sublingual cancer one year ago. Went through 2 different chemo drugs. Tumor grew, stopped chemo. Cat eats and purrs. No trouble jumping or walking. Comes when called and sleeps with me every night. He takes lactolose for large stools. Recently he has lost control of bladder and wet on bed. He goes in litterbox but nothing happens. Iam so attached to him.

  457. Doc says:

    Hello, Antoinette,
    I hear what you are saying. It sounds like the cat’s quality of life is fair, though not great. Unfortunately, as his body deteriorates, it impacts your quality of life, too. Washing the sheets every night is a bit of an extra chore, plus cat urine is pretty potent. I’d sure get a rubber mattress cover or your mattress will be ruined.

    This is one of those things that nobody else can decide for you or judge you for. You are the best judge of when the cat’s quality of life is lousy and it’s time to let him go instead of watching a slow death.

  458. Kay Voclain says:

    Hi, I have a 15 year old male tabby, Weezer, we rescued him when he was just a few weeks old if that.. He has always been a very skidish cat running and hiding from everybody and staying hid, not sociable at all. He would get in my lap sometimes and let me pet him but not for long before he would give me a little warning bite and jump down. He has always been a little on the heavy size with a very good appetite. He would love to go out on the porch and sun bathe. About 5 months ago he started losing weight and I noticed he was scattering his food everywhere. He also had patches of bare skin on bottom of both feet. I thought maybe his teeth were hurting, so I tried him on wet food. For a couple months we tried different flavors but I was having a hard time to getting him to eat. Vet said he is hypothyroid cat and not sure about the missing hair on feet. He gave me some medicine for the hyperthyroid problem but it didn’t seem to make a difference. Steroid gel for bare spots. He started shaking his head and rubbing the hair off his ears they became red and hot and he scratched his head all up trying to scratch his ears. Went back to vet he said not mites, gave him a strong antibiotic it did not help and he has patches of hair missing all over now. His hair just seems to fall out. I put him on limited ingredient dry food and he loves it, eats all the time and drinks plenty of water. He does vomit up his food a couple or more times a week and has diarrrea quite often. Has has gained a little more weight, some of his hair has grown back but he still shakes his head vigorously and he won’t let you touch them, it looks like he has a little dried blood around his eyes and nose. I can tell his ears still itch. His personality has completely changed he wants to sit in my lap constantly. I can hear his stomach churning all the time. The vet feels his immune system is no longer good and he has contracted some type infection that’s causing the ears to itch and hair fall out. The skin where hair falls out is thick and scaly. He has been on the LI food for a couple months. I can’t tell if the quality of his life is bad enough to put him to sleep. Like some many have said he moves around good and purrs. It just seems like there can be a fix for his ears. I don’t mind cleaning up his messes but I can tell his ears are making him miserable. He looks awful he doesn’t groom himself anymore. I don’t know what to do.

    Kay

  459. Doc says:

    Hello, Kay,

    It is common for patients with other illnesses to have low thyroid output secondary to the other illness. It certainly sounds like your cat could have more than one problem here.

    I really cannot advise you as to diagnostics or treatment with a cat I haven’t seen. I would suggest you speak with your veterinarian about possible referral to an internal medicine specialist.

  460. Anita says:

    Hi I’ve just stumbled across this website after just typing in a short sentence in Google as to some of the symptoms of my nearly 20yr old female cat called Daisey, Who I love with all my heart, She was the first kitten to be born from her mum,which we also had until she was 20yrs old, I was there when daisey was born, and also kept her brother too, but unfortunately I like many others on here and clingy on to hope, and feel so quilty. She drinks lots of water and doesn’t eat a great deal, but meows all the time, she doesn’t all mess in her litter tray, and is very very thin, she still likes a fuss, but not much, her back legs seem weak, but then still manages to get about wemhave tried her on different special foods hoping she will put weight on, but hasn’t, she is in a confined space away from the dog, who wants to play,and doesn’t understand that daisey doesn’t want to, and had to keep her food separate as the dog would just eat it, the cat never eats a who sachet of food, I just don’t feel right about taking her to be put to sleep, when I look in her eyes she still looks at me with a spark, but she doesn’t groom herself properly and looks very disheveled, I’d hate for her to be in pain and me just prolonging her aganony ? Thanks for any advise x

  461. Doc says:

    Hello, Anita,
    We are very limited in our choices for pain medications for cats. There isn’t really anything that is affordable and safe for long-term use in an older cat (and nothing actually approved even for a younger cat).

    However, if you want to know how much of her situation is due to pain, I would talk to your veterinarian about a trial with buprenorphine. It’s affordable for short term, and if you find that she is much more comfortable, resting better, not crying, etc. while she is taking it, that would let you know that she is really painful. That won’t make it easier to let her go, but may help you with your decision.

  462. Trisha says:

    February 20, 2017 I woke up to see my 15 year old cat laying very still and just staring like a zombie. I tried moving her and she just slid where I moved her. I was also noticing her having a hard time swallowing and then when I got ready to put her on a towel so I could put her in the car to take her to the vet she didn’t want to stay on the towel and tried getting up but all to fall over the opposite way. She had also been peeing alot around the house but I thought that was because of the stress of a new cat that of course wasn’t new anymore but thought she was just doing this out of hate for this cat. So when she looked like this today I knew it was time she go to Kitty heaven. I cried soooooo hard and I still cry every so often because I wish it was a dream and that she would come back all better. But I know it’s not. I said goodbye to her and that was one of the hardest things I’ve ever had to do in my life.

  463. Doc says:

    Hello, Trisha,
    Thanks for sharing your story. This is never easy, but neither is it easy to see a friend suffering.

    You did the right thing.

  464. Ajs92099 says:

    I am currently struggling. I put my baby down on Friday night/Saturday morning after she suffered from a seizure. I am thankful that I was home.

    One week prior she woke up with severe ataxia, circling, and overall weakness in her right side.

    Godiva was 18. Godiva was the runt of the litter and battled with URI’s the better part of her life. I ran the humidifier for her, I wiped off her face and I didn’t care because she was my baby. She still is.

    Godiva was a seal point Siamese. The runt of the litter, as I mentioned. She would weigh anywhere between 7 & 7.5lbs.

    In one month that weight decreased to 5.6, the day of her stroke. The following Monday, at our follow-up visit, I was encouraged because she nearly had her full balance back. Godiva had been struggling with kidney disease for about a year, and because she was recovering her balance, they thought it may have just been a blood pressure spike that caused it.

    I was given Sub-q fluids and taught how to administer them at home. She was 5.5 lbs.

    Last Friday, after I got home from work, she had a seizure. It lasted 30-45 seconds and it was a harrowing experience. I couldn’t help her and I was terrified. She had been doing better.

    In the emergency vet after her stroke they told me if it was kidneys it would improve. Option number 2 was that she had a possible brain tumor in her cerebellum which we would have to give anesthetic to scan her. Giving that to an 18 year old wasn’t a great option so I asked how I would know.

    If it was kidneys, she’d improve. If it was cancer, I’d see rapid weight loss, seizures, lethargy and change in behavior. I was told this would happen within 2 days so you can imagine that when a week passed and there were no signs, I though we were in the clear.

    Friday morning, Godiva didn’t eat. Friday night, she had the seizure.

    We took her back to the vet and they wanted to do tests and scan her little body for tumors. She was 4.8 lbs. my 7lb cat had lost over 2lbs in one month. 30% of her body weight, gone. Even though she was eating (except that morning) and drinking.

    I went through the process. I tried to be logical and not emotional, and we lost Godiva that night with the help of the vet. The cat I lovingly called my “purr machine” didn’t stop purring until she was gone.

    Is my thinking right that it was cancer? That after a stroke then seizure there was no coming back? When they picked her up I noticed that her tail was big, like when a cat is scared. I broke down thinking that the last thing she felt was fear but I keep being assured that it was nerves.

    My heart is broken. Her sister (also 18) won’t stop looking for Godiva and all I can do is love her and try to calm her down.

    I question everything. If she was in pain, if she was ready, if she was scared. I want to think I made the right decision for her.

  465. Doc says:

    Hello Ajs92099,

    It is obvious that you take great care of your cats. Few cats live to be 18 years old.

    The rapid deterioration that Godiva suffered leads me to think that she would have very soon had a miserable quality of life. Cancer certainly would be the top of the list.

    You can “what if?” yourself to death. Don’t do that. You spent a lot of time and effort making the best decision you could make with the information that you had, in a very difficult situation.

    You did the right thing. Be at peace.

  466. Karen says:

    My cat is 11 years old. Had a back injury a couple months ago (not the first time. She did flips in her healthy time). Vet put her on pain meds which she takes daily. She is also very arthritic now. Hasn’t had a normal bowel movement in about a month. Doctor says she has stress diarrhea because of the back pain. Now she won’t eat or drink, her legs are weak and she continues to try and poop in her box with no success. Has incontinence at times. Bloodwork taken about a month ago showed kidneys and liver were good. Everyday now seems to be a struggle for her and she is so sad. I seem to think there is an underlying problem but vet says it is her back. Dr thinks the weather is causing havoc on her. When do we know we should put her down?

  467. Doc says:

    Hello, Karen,

    This is always a difficult decision. Certainly one can have arthritis problems after an injury, and cool, wet weather can aggravate that.

    Talk to your doctor about this. If he/she doesn’t feel things are likely to improve, then you have to decide if her present quality of life is worthwhile. From your description, it doesn’t sound good.

    If she is just enduring pain and disability, that’s not much of a life.

  468. Karen says:

    Update on my 11 year old cat, Skoochie. We now have been feeding her through a syringe to get food in her. Last night, she ate on her own whe I put it in front of her while she was lying down. She drank k water too in this position. For the first time in days, she jumped on my husband and was kneading his neck, which she did every day when she was better! This gave us a glimpse of hope! Very concerned about her weak legs though. Am I wrong to wait a little longer and hope for the best? We are thinking about putting her down, but if there is a chance she will get better, I don’t want to rush into it either. I can’t help but think it is something other than a back injury a d arthritis. What do you think? The doctor did say once that she may never get better. She is on Metacam which, we were told, can make kidneys worse if the cat already has kidney failure, but the bloodwork showed kidneys were good at that time. Thanks for your advice.

  469. Doc says:

    Hello, Karen,

    If she is showing improvement, then there’s no reason to stop.

    It is true that long-term use of Metacam may aggravate kidney problems. However, if the cat is too painful to move or eat, it is certainly worth the risk. If using it for several weeks or longer, your veterinarian will want to monitor her kidney function.

    Stay in good communication with your veterinarian. The doctor actually seeing your pet is the best person to advise you.

  470. Linda Seidel says:

    Iam owned & loved by a very sweet, male Tuxedo Cat. After his German Shepherd went over Rainbow Bridge 7 years ago, Tio then attached to me, and is so very affectionate & does not like me to be away for more than 3 hrs. this past year, the third year of his Stage 2 Kidney Disease and Hyperthroidism.

    He is playful like a kitten at times, however he is now vomiting his digested K.D. food 1 to 2 times a week. I notice that he does not like to eat as much as he once did. He continues to stay well hydrated, with my constant providing 2 bowls of fresh water daily.

    With my German Shepherds I knew it was time to let them go over Rainbow Bridge.

    But this is my first indoor cat and at 14 yrs. he is still affectionate, but sleeping more and he meows loudly at me if he wants me to sit in our recliner to snuggle.

    I have spent over $3,000 the past two years. $2,500 on care credit since December 2016.
    It will take me 2 years to pay this bill off, as Iam 70yr. & retired with health issues myself.

    I wish I could determine if my dear Tio is suffering, but I just cannot.

    I suspect vomiting his food 1-2 times a week must not be pleasant for him!

    He is all bones now, once a fat cat of 27 lbs. now 14 lbs. & loosing. He is a large cat, long, tall fellow! Now, though bones.

    Sincerely,
    Heartbroken in Salem.
    Linda

  471. Doc says:

    Hello, Linda,
    You don’t mention what type of treatment is being given for the excess thyroid. Methimazole tablets?

    Sometimes the hyperthyroid condition increases blood flow through the kidneys, and controlling the thyroid makes the kidney disease more difficult to manage.

    On the other hand, failing to control the hyperthyroid condition causes many problems.

    If both problems are being addressed, we know that these are things that will shorten the cat’s life. Even with treatment we can have continuing weight loss and deterioration.

    When he has more bad days than good, it is time to look at making the decision.

  472. Lori Bianchini says:

    My 17 year old fell down the stairs three weeks ago and had lost weight. Took him to the vet and had tests done. Doctor couldn’t pin point anything. Put on steroids and antibiotics . Doctor says she has seen this numerous times. He is not happy anymore and sleeps and drinks and eats a lot. Still is unstable on his feet and urinating on the floor. I don’t even thinks he poops? Vet shaved his rear. This is the worst thing ever for me. I love him more than life! What do I do? Lori Bianchini Duluth MN April 2017

  473. Doc says:

    Hello, Lori,
    Sorry to be so late in seeing this.
    I wish I had some good advice for you. The doctor seeing your pet is best able to advise you as to the medical conditions.
    If your friend does not make progress, you are the person who knows him best. When you can see that he is having only bad days, you will need to think about letting him leave a body that won’t support his spirit.

  474. jennie eddy says:

    I’m racked with guilt and terrified I made the decision to put my cat down too early. He was only 8yrs 4 months and went downhill rapidly. He started to get very lethargic and went off his food and after2 days I took him to the vet. They thought it was an infection and gave him antibiotic and anti inflammatory injections. 2 days later he hadn’t improvedone so I took him back to theat vet. They suspected pancreatitis and admitted him for 36 hours on a fluid drip. They also took blood tests and did an ultrasound. Apparently the ultrasound showed a large fast growing inoperable mass at the top of his intestine with a couple of further masses in different locations. They waned to put him to sleep that evening which was only 5days since he first started showing any symptoms. I asked about chemo but they said this would only likely extend his life by a few weeks. I brought him home for only a day and a half before I got the vet to come to the house and put him to sleep. The vet sent us home with buphranex which gave him a small appetite. But despite urinating frequently he couldn’t or didn’t defecate in that time. He couldn’t go up or down the stairs anymore and just laid on the floor looking like he was uncomfortable and his breathing Was getting more and more shallow. I the final hours before the vet came he started to omit a really strong smell also. It was only 7 days between start of symptoms and putting him down and now the shock has worn off I am torn apart that I feel I didn’t fight hard enough for him. I’ve only now realised no biopsy was ever taken and all the diagnosis was just the ultrasound. Did I jump the gun and end my best friends life too quickly without demanding specialist referrals ?

  475. Doc says:

    Hello, Jennie,

    In retrospect, you could have asked for the ultrasound images to be seen by a radiologist (someone who specializes in interpreting the images).

    Without having seen the images, I cannot speak to whether an exploratory surgery would have made it possible to remove masses that were evidently causing blockages.

    A slow-growing mass could take a long time to get to a point where it began to close off the intestine. As long as things could get through, the cat might feel pretty good. Once things were closed off, he would deteriorate rapidly.

    An exploratory might or might not have been able to buy some time. With several large masses visible on the ultrasound, it is very likely that there were small masses in other places.

    With cancer that is spread widely through the body, you cannot surgically remove it all. Many of these things are not responsive to chemotherapy. Also (aside from the expense), cats are not as tolerant of chemo drugs as are people and dogs.

    I don’t think you should beat yourself up about this. You made the best decision you could make, I think.

  476. Carla Locarno says:

    I have a 14 year old male cat. He developed pancreatitis three months ago in March 2017. I have been to three vets locally. He has had subq fluids, buprenorphine, Gabapentin, Cerenia, B12 injections, Sucralfate when his stools turned black with black thick liquid which was assumed to be bleeding upper GI ulcers and the Sucralfate worked. He’s had Orbax antibiotic just to make sure there wasn’t an infection in his pancreas. He had a senior panel of labwork and a Spec fPL that was 5 (normal 0-3.5) but the vet didn’t know he was supposed to be fasting 6-12 hours before that test according to Idexx Lab. I’ve tried pet herbal formulas as well. Neither of the pain medicines blocked the pain he gets immediately after every meal. I add digestive enzymes to all his food and have since April 10 when I read online to do that. Every single meal he eats he goes into pain right away. I have read with humans having pancreatitis that it’s excruciating and described as sharp, stabbing pain. I have a friend that had pancreatitis and he said he doubled over in pain and it was the worst pain he’s every felt in his life. Every time my cat eats he lays down and squeezes his eyes and if I look at him I see him shuttering every so slightly as he blocks the pain. He eats well as he has his whole life. He’s off all medicines now except B12. He hates all medicines and is glad to be off them. Cerenia was giving him tremors/seizures so I had to stop. My cat really just eats, goes into pain, tries to sleep. That’s his life. He will lay next to me but I know he feels bad from his pancreatitis. I have been close 4-5 times in these three months to saying goodbye because I feel like he’s suffering from this horrible illness. I don’t know if it’s right for me to make him go on day after day and feel pain from every meal especially because he’s a cat who eats about 8 times a day small portions. He won’t eat twice a day so every time he eats he goes into pain and just when he seems to be better he’s meowing for food again. He only eats canned food because he has had his molars removed. He is on Royal Canin PR (rabbit & green pea protein) as he’s allergic to all poultry, doesn’t like fish, threw up beef and pork formulas and it was the lamb canned food with too much white fat in it that triggered the pancreatitis. He used to projectile vomit a lot and now only vomits if he has a lot of hair in his stomach. I don’t feel my cat wants to die but I feel like he wishes he didn’t have to block this pancreatitis pain. Should I release him from this pain? His kidneys and liver are fine and he could go on 3-5 years living like this suffering after every meal. I guess I’m wondering in your experience with cats with severe pancreatitis that doesn’t get well since it’s such a painful illness and it’s a vital organ do you usually recommend euthanasia so the cat no longer suffers?

  477. Doc says:

    Hello, Carla,
    I can appreciate your frustration and pain. It seems obvious that your cat’s quality of life is rather poor, despite very intense efforts to improve the situation.

    In a case like this, I would certainly feel out of my depth as a general practitioner. With as much effort as you have expended, it would seem that seeing a specialist would be worth while.

    That being said, these are VERY challenging cases, and even an excellent specialist may be offering management rather than cure.

    If no improvement can be made, then euthanasia would be a very kind and reasonable decision.

  478. Carla Locarno says:

    Dear Doc,

    Thank you so much for your immediate reply which I saw this morning. So kind and generous of you to help so many people on this website. In trying to help my cat I was emailing a vet in Nebraska (I’m in Missouri) who handles only felines in her practice. She was reassuring to me that the medicines I was giving him were the right treatments. I also emailed a holistic vet in Canada that said she strongly suggested I take my cat to a holistic vet near me for treatment. She said in one of her emails that some practitioners do intra-abdominal pain injections. She said if my cat has IBD then acupuncture could help. She mentioned Chinese herbs. I found a pain management vet office in my town and spoke with them. They have a laser that is supposed to help with pain but I asked if they’ve ever used it for pancreatic pain and the woman said not to her knowledge but I could ask the vet if I came in. I called three holistic vet offices that are closest to me. One in Arkansas and two in Kansas. Both are three hours away. They told me they can provide nutritional supplements and homeopathic drops that the vet mixes herself. I contacted a pain management vet practice in Wisconsin and was told Cerenia is the most important medicine to control inflammation and that it provides pain relief. The three vets I saw here in my town all were saying the same thing. In the first two weeks of his pancreatitis the Cerenia was very helpful with his nausea because he had nausea very bad. The first vet prescribed 6 mg every 24 hours. It took an hour to start working and controlled his nausea for 18 hours then wore off. I contacted my former vet in Florida that was my cat’s vet for seven years. He said with pancreatitis in cats all you can do is keep him hydrated, control the nausea, give him something for pain and make sure he eats. Beyond that you have to wait for the pancreas to heal on its own. The third vet I saw said I need to have him on a food that is no more than 2-3% fat or else his pancreas will never get rid of the inflammation. All of the lowest fat prescription formulas are chicken based and my cat is extremely allergic to chicken. Putting him on chicken would make him scratch all day and cause further inflammation in his GI tract. The Royal Canin PR says 4.5% minimum fat but I called the company and they said the actual fat is 6%. Other vets including the vet in Florida said with cats the fat doesn’t make a difference but in dogs it does. My concern is the pea protein and pea flour in this PR formula. To me that’s a lot of carbs to put on his pancreas to make insulin for. Three months ago with his senior panel his glucose was normal. (To be continued)

  479. Carla Locarno says:

    (Continued)

    I have read that a pancreas produces digestive enzymes as soon as a human or animal salivates or is hungry or smells food and that biologically the enzymes are released by the pancreas in an inactive state to protect the pancreas from damage and the enzymes are then sent through a duct to the small intestines where they then become active. But it said for some unknown reason if the pancreas is inflamed then the digestive enzymes are released in an active state and end up spilling out onto the pancreas and can destroy the pancreatic tissue and even scar it badly. I’ve read the enzymes can start to digest the pancreas because it’s made of protein, carbohydrates and fat. What I don’t know is how bad my cat’s pancreas is. The only 100% sure way to know is to have him in surgery to have a vet look at his pancreas and I’m not willing to put him through that. You mentioned a specialist. I was told to call the university in Columbia, Missouri and see if there’s a GI specialist there. Surprising the vet hospital there only has Internists. They don’t even have a vet who is a GI specialist. Last night I found a blog on people that had cats with pancreatitis and for the very first time I finally found someone that commented and said their cat took a very long time to get healed from the pancreatitis. This person said it took many months very close to one year. None of the vets have given me a timeline as to how long I should expect my cat’s pancreas to take to heal. The first vet told me if he wasn’t better in one week I should think about putting him down. I saw a second vet then a third. I wish I could find a lower fat food for my cat just to see if it would help the inflammation simmer down and get that fire out of it. The third vet said I could make homemade cat food out of tuna, cottage cheese and hard boiled egg whites in a food processor just for a short period of time and she’d tell me what nutritional supplements I’d have to add plus taurine. I would definitely soak the tuna in water to remove the salt and use chunk light versus albacore because it’s lower in mercury. I tried to find unsalted cottage cheese that was fat free or 1% fat but was not successful. I’ve tried my cat on Wild Calling rabbit pate but it’s loaded in guar gum and two other gums and it’s so gelatinous that my cat gets sick. Evanger’s rabbit is the same. I tried Nature’s Instinct rabbit which has no gums but is loaded in a type of clay that my cat would not eat. The only other alternative might be to look at raw rabbit medallions in the freezer at pet stores. I’d have to look at the ingredients. My concern is I read if you suspect your cat has IBD inflammation then it could be dangerous to feed raw. I have read though that a cat could get well from pancreatitis on a raw diet. (To be continued)

  480. Carla Locarno says:

    (Continued)

    The big question is how badly damaged is my cat’s pancreas? Did activated digestive enzymes spill onto his pancreas and scar it? Is that why he still feels pain after every meal as his damaged pancreas struggles to make enzymes or does he just need the right remedy to get rid of inflammation? Doc, this has been the most soul searching experience of my life and I have cried more tears than I ever thought imaginable. I have spent literally days on end online searching for vet articles, published articles, etc. I found a website that showed pictures of cat’s pancreas from autopsies and they showed how the pancreas looks with the scar tissue and damage from inflammation. I searched for a pancreatitis expert and found a vet in Cambridge, England at the university there who also has her PhD and runs a lab. She couldn’t provide medical advice but said an ultrasound would rule out a bile duct issue. The third vet I saw here said there’s no way to see the bile duct with ultrasound to see if it is compressed nor on X-ray. She said my cat shows no indication of any bile issue or jaundice and all his labwork is fine in those areas. She really feels we just need to get him on a diet to get the inflammation to go away. I’m the one who wonders how much permanent damage has been done. If you have any opinions on any of this information in my email I’d love to know what you think especially on holistic treatment if you think any of that could help. So far I have not found a pain management vet that does intra-abdominal injections. The vet in Canada told me that but did not provide any names. Thank you so very much for all your knowledge and wisdom and for caring so deeply about animals and trying to make them well. Carla

  481. Doc says:

    Hello, Carla,

    I have emailed you a review article that just helps emphasize how difficult it is to diagnose and treat this disease.

    As far as homeopathy, I think it is harmless. Some believe it to be beneficial, but it is a difficult treatment modality for which to devise experimental proof of effectiveness.

    I have posted a query on Veterinary Information Network about possible resources for you.

  482. Carla Locarno says:

    Dear Doc,

    Thank you again so much! I will be checking my email from you on that review article. I checked my spam folder. Not in there. Nothing has come through yet. It could be my internet is slow.

    I’ll let you know if I don’t receive it by tomorrow and then hopefully you can email it to me again. I would love to read that article. Any knowledge I can get is so helpful.

    Also thank you for posting on the Veterinary Information Network for resources.

    I just now checked to see where you are located. Are you in Missouri? I had no idea!

    I looked at the town I believe you are in and you are four hours from me in Springfield.

    The holistic vet that was referred to me in Arkansas was P J Broadfoot in Alma. Or Van Buren. I was told she was excellent. Three hour drive from Springfield.

    I just need to be sure my cat is up for a six hour round trip drive.

    I just don’t know what to do.

    This Royal Canin PR canned food my cat has been on for a month is making him scratch his ears and neck. It might be the pea flour and pea protein.

    I ordered new food for him this afternoon online by First Mate. It’s salmon and potato and vitamins and minerals. No carrageenan or guar gum or any gums at all. Gluten free and grain free.

    It says minimum fat 3% so hopefully the actual fat isn’t over 4.5% to 5%. The Royal Canin PR is 6%.

    I hope my cat eats it. I’m going to gradually take him off the PR.

    Salmon and tuna are the only fish he’s ever liked but salmon isn’t his favorite thing to eat as he likes meat not fish.

    I’m hoping his scratching will stop and the fat being lower will help his inflammation.

    Do you have an opinion on Cerenia helping pancreatitis? Is it a good anti-inflammatory and does it help with pain?

    That Wisconsin pain management vet practice told me it’s similar to morphine in blocking pain. I didn’t find that but he wasn’t on it too long.

    My cat was having what looked like tremors or seizures in his sleep when on Cerenia and they stopped once I took the medicine away.

    Do you think it’s worth me giving him a smaller dose every other day or 3-4 days on and 1-2 off to help get rid of inflammation?

    I was scared of him shaking his head and legs in his sleep.

    Until we communicate again …

    Carla

  483. Carla Locarno says:

    Hello Doc,

    I have no idea why but the email you sent me with the review article on pancreatitis has not come through to my email.

    Whenever you get a chance if you could please email it again I’d greatly appreciate it.

    I checked my spam folder again and I re-typed my email address on your post a comment section using all small letters.

    Have a great Sunday,

    Carla

  484. Doc says:

    Hello, Carla,

    I have resent the article to the email all lower case this time.

    Here is first reply from VIN.

    While there are some internists who are “sub-specialists” in the area of GI disease (Marks at UCD, Steiner at A&M, Jergens at Iowa State, etc.), internists are as a whole are more than qualified to treat pancreatitis.

    I did a quick search to see if there are any focus groups or memberships for those with interests in this area, she might see if the Comparative Gastroenterology Society has any advice:

    http://vetmed.tamu.edu/cgs/about

  485. Carla Locarno says:

    Thank you, Doc.

    I will contact them tomorrow.

    The article has not come through to my email as of 1:40 PM CST.

    I don’t get it.

    Is there a link to the article?

    If you get any more response on VIN I will follow up on all responses.

    I’ll check this website everyday to see if you’ve posted.

    If you are a father of children or animals I hope you are having a Happy Father’s Day.

    Carla

  486. Carla Locarno says:

    Dear Doc,

    I emailed the Comparative Gastroenterology Society this morning. Couldn’t find a phone number on their website but did see an email address.

    Do you have a link to that pancreatitis article so I can pull it up because I haven’t received it by email?

    I put my cat on Cerenia again starting today and will do 3 days on and 1 off and watch him closely for any shaking in his sleep.

    Waiting for that salmon canned food to arrive Wednesday. Called the company and it ranges from 3-5% fat so I don’t know if it’ll help.

    At least it’s only 3% potato so getting rid of all that pea protein in RC PR and no carrageenan or guar gum or any gums is an improvement I think.

    The less carbs to tax his pancreas for insulin and no gums to irritate his GI tract and lower fat should help I hope so badly it’ll make a difference.

    Carla

  487. Carla Locarno says:

    Dear Doc,

    I just created a brand new email address and it’s filled in below. If you don’t receive it let me know. It’ll be an Outlook not Yahoo.

    I just added your mail@kennettvet.com to the “safe sender list” so it’s saved and anything you send should be directed into the inbox.

    Hopefully I’ll receive the article now. Thank you for all your efforts.

    No word from that CGS that I emailed. It was a gmail address.

    I decided to do Cerenia every other day 6 mg instead of 3 on 1 off. I’ll give him his second dose this afternoon.

    Yesterday afternoon was 24 hours from the Cerenia pill I gave him and I saw my cat shaking while sleeping. His head and front legs.

    Maybe it’s the Cerenia or maybe it’s something else?

    Do you have pet patients that are affected that way by Cerenia? Do you prescribe Cerenia to cats?

    Carla

  488. Doc says:

    Hello, Carla,
    I note that the second try I had goofed up the email address.

    I sure hope the next one gets there.

  489. Carla Locarno says:

    Hi, Doc,

    Just checked the outlook inbox and nothing in there.

    I’ll put my yahoo back on there because I always get everything in there that people send.

    You’re in my contacts in yahoo as well.

    I don’t get this at all other than the second attempt you said my email address was mistyped.

    So far then every Vet I’ve contacted uses Cerenia for cats.

    Carla

  490. Carla Locarno says:

    Hello, Doc,

    I received the pancreatitis article in my junk folder in outlook even though I added your email to direct it to my inbox.

    Thank you so much. There was a great deal of information in that article that I had not read online.

    My cat seems to be in more discomfort after meals and the discomfort is lasting longer.

    It may be that this is the time of his life and mine that I’ve always dreaded that I would have to face one day and for his sake I need to do the right thing for him and let my sweet Kitty be at rest and release him from this horrible devastating disease that is so painful.

    It is my guess that this acute pancreatitis he’s dealing with has done substantial damage and that’s why I’ve seen minimal improvement.

    The only improvement is the nausea went away from what I can tell. There’s no way to tell if his pain is less than the first couple weeks or if he’s just gotten used to having it and dealing with it.

    I just notice that he seems to lay down for longer periods after eating every meal and appears to be hurting.

    His only enjoyment is laying on the windowsill early in the morning talking to the birds or laying on the windowsill late at night. I open the windows so he can feel the air and smell and look around at the trees and bushes and flowers and cars going by.

    Other than that I play with him with his toys when he’s feeling well enough and I give him lots of kisses and pet him and he purrs.

    I haven’t been able to cradle him in my arms like I did his whole life because it’s too uncomfortable for him to be held that way these past three months even with pain medicine.

    I cuddle with him when he’s laying down and he purrs. He has his good days and his bad days but even his good days are painful after every meal.

    I believe he has too much inflammation in his pancreas and swelling and probably scar tissue from this horrible disease and I don’t believe he will recover.

    Obviously now it would have been better if I’d said goodbye to him right away in March to have spared him all this pain. I thought I could help him get better and no one told me he wouldn’t recover.

    I only know that number one I don’t want him to continue suffering on a daily basis with a pancreas that isn’t going to get well.

    And number two I know if I had the same illness as him and had to suffer after every meal that I would wish my life would end and let my body be out of pain.

    It’s up to me to be strong and relieve my Kitty from this disease. It’s kind of like his heart keeps beating but it’s keeping a dead body alive because his pancreas has long since quit on him.

    I’m very grateful to have had this communication with you at the end as it’s helped me a great deal to face what I need to do for my Kitty.

    One last question … is it best for him to have a sedative before the injection is administered? I’m sure vets get asked this many times because we don’t want our beloved pets to feel a thing or sense a thing.

    My sincere thanks to you for the wonderful and kind person you are.

    Carla

  491. Doc says:

    Hello, Carla,

    It is always difficult to come to this decision, but at least you know that you’ve left no stone unturned.

    The reason I give a sedative injection first is that I can give that anywhere in a muscle mass. The target is big, and very little restraint is required (if any). The final injection is an overdose of anesthetic, and they do go to sleep, but it must be given directly into a vein. If the pet is already pretty well asleep, they don’t care if you put a tourniquet on the leg and hold them still.

  492. Carla Locarno says:

    Hello, Doc,

    Thank you for that very helpful information. I had called the third vet’s office yesterday that I saw on May 9 who prescribed Gabapentin and Orbax and changed Kitty’s food to Hills ZD. She wasn’t in yesterday.

    I asked if they do a sedative first and they said yes. They said they then do a catheter to be sure the pentobarbital or whatever they use gets into the vein.

    This was the girl who answered the phone. I didn’t get this from the vet.

    Is this something you do not use? A catheter? You’re saying a tourniquet.

    And is pentobarbital the right medicine or should I be looking for a vet’s office that uses something different?

    Thank you for your help.

    Carla

  493. Doc says:

    Hello, Carla,
    A tourniquet is used to slow the blood returning from the leg. This causes the vein to fill and be more prominent, and thus easier to see and to find with the needle.

    A catheter is a small tube that is inserted into the vein like a needle. It is soft and flexible, so that if the patient were to move, it won’t poke through the vein. If a needle were to poke all the way through the vein (instead of threading up inside it), this would let the drug out under the skin instead of going into the bloodstream where it needs to go.

    If the patient is heavily sedated, you don’t always need to use a catheter. It is an extra measure to ensure that things go well.

    Pentobarbital is the drug of choice for humane euthanasia.

  494. Carla Locarno says:

    Hello, Doc,

    Thank you for explaining all that to me. I didn’t know any of that.

    You know, I’ve been a person that believes God gives me signs in life.

    Three times very recently I’ve called the third vet’s office that Kitty saw on May 9.

    I thought he seemed in pain squeezing his eyes for awhile lasting too long for me to think he shouldn’t go on with the pain.

    Once she wasn’t in that day. The next time she’s booked up. Then today some woman calls me and says if I want Kitty euthanized then the vet said I can drop him off.

    I said, “Drop him off? No, I want to be there.”

    She told me the vet said I can’t be there. I told her I’ve never heard of a vet office not letting you be with your pet the entire time.

    She got really rude and said, “You can either drop him off or go find another clinic.”

    Meanwhile I’m still giving Kitty 6 mg Cerenia every 24 hours and he’s on his new salmon food without any gums or starch other than 3% potato.

    I think his pain seems maybe less than last week. I’m not sure but today he was wide eyed a lot even though he did squeeze his eyes some.

    Is this a sign from God that I should drive to Arkansas and see the holistic vet? And not give up yet?

    Carla

  495. Nicola Hassall says:

    I can empathise with all the comments above. We are all devastated in out house as we have had a wonderful and weird little cat that, unlike her sister never seemed to behave like a cat! She waited for us to come in after work, sitting by the window, it wasn’t just about food she followed us whenever we went, waited to follow us up the stairs to bed, always wanting to climb into your arms wherever you sat, you could pick her up at any time and she would curl up and want to stay with you. Such a happy little cat, you would never have known she was 15, she was still like a playful kitten. We noticed that something wasn’t quite right with her a few weeks ago and she started shaking her head and trying to lick some irritant out of her mouth, her little face looked a bit of a different shape so we took her to the vet who said she had some split teeth and we should sort them to save them getting infected, she said we could give her some of the painkiller drops we were giving to our other cat who has some arthritis. We did this and booked her in to have the dental work yesterday, waiting to pick her up at 4pm. The vet phoned after they had removed one spit tooth to ask if they could do an x-ray as they had found she had a fracture in her jaw on the other side and suspected a tumour had caused it. They did the x-ray and phoned back saying bad news , they had discovered a very large, aggressive tumour that had practically taken over her jaw on that side, you could see the straight while line of the jaw on one side and just nothing – sort of bits on the other side. She then asked us if we wanted to not bring her around from the anaesthetic due to the tumour being fast growing and Minnie’s quality of life would be very poor. We all went round and stood there trying to make this decision, it was just awful – we had expected to have our little Mins back with a sore mouth – but not this. The thing was, Minnie did have quality of life and was rolling around that morning purring and was still eating, we just weren’t ready to let her go without saying goodbye but knew that she now faced waking up with not only the tumour to cope with but the sore mouth on the other side and the vet said the tumour could spread in days. In the end we agreed to let her go to save her any more pain, but today it’s just excruciating wondering if we did the right thing – she wasn’t having diarrhoea or extremely thin, she was jumping in and out of boxes that morning and just wanted to be with us all the time playing and purring – we felt pressurised because she was lying there under anaesthetic and we had to make a decision we never expected to have to make, it just doesn’t seem to have been the right time to let her go and we are all just trying to cope with the loss of a very special little cat – did we do the right thing – we feel we didn’t and miss her terribly – we also don’t understand why they didn’t take an x-ray before they started with the dental work as if we’d know about the tumour we would have just kept her at home with painkillers until it looked like she was not happy and didn’t want to eat – we didn’t want her in pain but feel robbed of time with her to say goodbye?

  496. Doc says:

    Hello, Carla,

    I am not equipped to interpret the will of Almighty God.

    You will have to be the judge of how your cat is feeling. If you want to see the holistic doctor, then you should do it.

  497. Carla Locarno says:

    Dear Doc,

    I appreciate that.

    Can you give me your best guess as to why my cat seems in pain as soon as he eats and immediately afterwards and it lasts for awhile as he lays down and raises his head up on the side of his scratching bed?

    Do you think that’s because activated digestive enzymes are being released as he’s eating and spilling out onto his pancreas and burning it?

    Or do you think it’s because his inflamed and swollen pancreas is being forced to try to produce digestive enzymes every time he eats and that causes pain?

    The main thing is either of these questions I’ve asked you concern me greatly because they sound permanent and that worries me because I don’t know how much pain he is in.

    Just now as I write this he woke up and yawned and jumped off my bed and ran to his dish to eat food.

    I know in about 5 minutes he’s going to lay down on his cardboard scratching bed and raise his head onto the raised up side of it and begin squeezing his eyes in pain. It must be sharp stabbing pain like humans describe when they eat with pancreatitis.

    You seem like such an amazing and intelligent person and Vet as I read the story on your website of the dog you did surgery on with large raw holes on his side from a gunshot.

    I trust your best guess on this with my cat because all three vets I went to here in Spfld just looked at me dumbfounded like they had no idea as to the answers to those two questions and they seemed intrigued and extremely focused on my description of my cat’s behavior and symptoms like they were trying to learn something from me.

    It said online that for a Spec fPL to register out of normal range a cat is not in mild pancreatitis. It said only moderate or severe pancreatiis will produce an out of normal range level.

    That also might’ve been in that article you sent me also.

    Just would like your educated guess.

    Thank you.

    Carla

  498. Dee says:

    Hello Doc,

    I had a beautiful young 2yo male cat who was loving and extremely bonded with me. He was not healthy though, had mucousy, bloody diahrea often, and outside the box, he hid from other family members (who never would mistreat him) and as time went on he was insatiable and started nipping my feet at night to get fed more and more. He’d also vomit quite regularly, one time bright green, but none the less, I loved him so and was prepared to look after him and make him as comfortable as possible. He was on steroids and flagyl for life. The vet has checked him numerous times and he’d been given Iv fluids etc. the vet said he could feel inflammation, but he tested negative for lukemia and feline aids. He did have increased white blood counts. He was a street kitten who I had raised since 8 weeks old. Thoughts were he might have had triad disease, irritable bowel or colonitis.

    Anyway, he did not seem to happy often and although loving to me, the hiding got worse. So one day I let him out for the afternoon, as he went out occasionally with no problem. But this time he jumped a six foot fence and was promptly attacked by a bull mastiff and 2 other dogs. I manage to get him back inside and he had no open wounds but had big black eyes, was panting heavily and limping on a hind leg.

    I tried to clean off the dog saliva the best I could, but decided he did not seem ok so I took him to the emergency vet (it was a Sunday). The vet immediately took him for an X-ray and then advised he has a herniated diaphragm with his stomach up near his lungs and had gas on the right side of his body. They said there were two options, exploratory surgery at a cost between $3000 and $5000 or he needed to be euthanised. I was shocked. I was 8 months pregnant and had just finished work. I did not have the money readily available. I asked to take him home for the night, so I could then take him to my regular vet who may be cheaper, but they said that would be cruel. They could not give me a good reassurance that he did not have organ damage. I felt that they were pressuring for a decision, so I elected to put him down.

    I have since read online that cats with these injuries do have a good chance of surviving and I could have scrimped the money from somewhere. But I was shocked and so upset at the time.

    I have never felt so terrible for this situation. Another factor in my deciding at the time was his existing problems, the feeling that he seamed unhappy in his house (with everyone except me) and I was worried he’d not cope mentally or physically with the operation and aftercare.

    I miss him so much and am full of much regret. I think 2 years is too short of lifespan and feel like a huge failure as his owner. He loved me so much, and I loved him deeply. What do you think in this situation?

  499. Doc says:

    Hello, Carla,
    I am no expert in these matters. The thing that speaks to me is that the cat seems in pain every time that he eats. I have doubts that this is going to get better, considering the other things that you have told me.

    The enzyme leakage after eating is what I was taught 40 years ago, but that is no longer considered to be rock-solid data.

    It is a complex and poorly understood disease. I wish that I could help you more.

  500. Doc says:

    Hello, Dee,

    “What do I think…” I think it was a terrible situation to have to deal with. Your cat’s previous problem was unlikely to be diagnosed without exploratory surgery and organ biopsy, intestinal biopsy, etc. Even though testing negative for the viruses, I would have been concerned about a cancerous disease. St. Jude’s hospital is full of children with cancer. It’s not always just a disease of the elderly. There are also diseases (rare) like histoplasmosis or pythiosis that can affect the intestinal tract in this way.

    While it is true that I have seen cats who have been living for a long time with a diaphragmatic hernia, they aren’t living all that well without fixing it. Having your abdominal organs up in your chest putting pressure on your heart and lungs, and restricting circulation to those abdominal organs is not a great situation.

    It is impossible for me to say what might have occurred with good nursing care, taking your cat home with pain medication, but it sounds like the situation was pretty dire.

    I certainly don’t think you should be beating yourself up about this. The cat was in very serious condition with a very uncertain prognosis even with heroic surgery and nursing. You made the best decision that you could with the information that you had.

    Any time that things don’t have a happy ending, we always look for something we could have done differently. Even if we could go back and change, it might not be better… just different.

    I am sorry for your loss.

  501. Doc says:

    Hello, Nicola,

    Veterinarians who specialize in dental work generally x-ray the entire mouth before beginning to work on the teeth. Others may only x-ray areas that they feel are a problem. It sounds like your doctor addressed the obvious problem that they knew about, then noticed something suspicious that they couldn’t see when the cat was awake (very hard to do a good exam on the back of a cat’s mouth when awake).

    Bone cancers are known to become very painful. It sounds like this one had already done so much damage that the jaw was disintegrating (a “pathological fracture”).

    With a lower jaw, there are animals who have had one whole side of their jaw completely removed to control a cancer. Pretty major, but some adapt well to it. Some don’t. removing the front half of one side does pretty well. The whole jaw can be problematic.

    Without such a surgery, you were headed toward a tumor outgrowing its blood supply, dying, and becoming a rotten sore. Her quality of life would have been terrible at that point.

    Sometimes the questions and answers seem different in retrospect than they did at the time. You might very well have had some more good, or at least “okay” days. It might have progressed so rapidly that you would have regretted taking her home.

    You made the best decision that you could with the information that you had. I think that your doctor was giving you the best advice that he/she could at the time.

    I am sorry for your loss.

  502. Ella says:

    Hello all,
    I came across your website just to find some help, support. I have had four wonderful cats up and until April. In April I had to let my beloved tabby of 20 years go. He was blind and deaf for a year and then developed epilepsy. In his case it was very clear as he didn’t recover strength after one fit. It was very upsetting as you can imagine but I knew it was time and I felt at peace. Only four weeks later I let my black lady go. She had suffered from CKD and wasn’t able to eat anymore even though she wanted to. She was a tough lady still wanting to go out but she was fragile just weighing under 2 kg. I felt like I am murdering a being as she was still full of beans yet it was also awful to see her scream from pain when she tried to eat. This time I had the vet come home. Now only a month later I am in the same dilemma. My third cat started of having breathing problems and at first I thought grass might be stuck in his throat or he has asthma. Unfortunately a month later and him breathing heavily and some b-day and ultrasound, I have been told that he most likely has lung tumor. I thought I see how it is going but now constantly ask myself if he’s not suffering as his breathing seems laboured and he looks sad just laying around really, not eating much. I think it’s time to let him go too but I feel so angry and frustrated. I know that’s life, I know they had a proud age with two being 20 and the last fur ball turning 16 this month but still they have been an important part of my life. Anyway, I just had to let this out as it really got to me. It really feels like walking on a tight rope. Who am I to decide about a life?!
    Lots of strength to everyone else who has had to ‘let go’. They’ll always remain in our hearts

  503. Doc says:

    Hello, Ella,

    It is always difficult to give up a friend,but to have to go through this multiple times in rapid succession has to be incredibly hard.

    Who are you to decide?

    You are the person who knows the cat the best, who knows when the days are good and when they are bad. You are the person who knows the cat and knows when he is enjoying life, and when he is just marking the tie checking off one more day of suffering until the end.
    You are the person who sees him living longer or dying slowly, as the case may be.
    You are the person, who (like it or not) has the responsibility to decide.

    It’s not easy. You just have to do your best.

  504. Ella says:

    Hello Doc

    Thank you for your comment which was a surprise. 🙂
    I called my vet this morning and arranged for her to come to my home tomorrow so Patch can go in peace. I know it is all part of the life cycle and I am grateful for having had all of them in my life as they’ve been great teachers too. It is not fair to him to have him struggle with breathing like he has started now and he doesn’t feel like eating anymore since last night.
    Thank you again for your reply it was helpful and I wish you a lovely day.

  505. Tiffany says:

    I am struggling so hard right now. I have a cat, Smokey, who I have had for at least 23 years. She has lost weight, had issues with her hind legs, but has been doing well until I got her new food and she had a bout of diarrhea. I took her to the vet with that. The vet felt something. It wasn’t my normal vet and I didn’t trust her. So I took her to my vet. He confirmed she has a tumor in her spleen. She’s too old for anesthesia. I can’t put her through chemo or anything being a cancer survivor myself. I keep hoping she’ll just go to sleep one night and not wake up. I pray for that. She still gets up every time I walk in the room. Still eats voraciously and drinks and drinks. She just isn’t putting on any weight. And it’s not just me. My mother is dead set against letting me take my little MooBear to the vet to let her go. I don’t want to but I don’t want her to suffer. I am still giving her the food which caused the diarrhea cause it’s all she will eat and really the vet said she had a couple of weeks so I really don’t think it will matter. Smokey is not the first cat I have had to help to get to the Rainbow Bridge but this is the hardest decision I have ever had to make in my life. And how do you manage when you have another person in the household dead set against it? I just don’t know what to do….

  506. Doc says:

    Hello, Tiffany,

    A tumor in the spleen is very likely to eventually cause the spleen to rupture. This will cause internal bleeding, and the cat would become rapidly weak, go into shock, and lose consciousness.

    If the cancer has spread elsewhere, that would help explain the weight loss and failure to gain weight.

    I don’t see anything wrong with feeding her and letting her go on as long as she doesn’t seem to be in pain. When that changes, it is time to let her go.

  507. Tiffany says:

    Doc,

    Will the spleenic rupture be enough for her to pass or will I have to take her to the vet after that to help her along? What do you usually see?

    Thank you!

    Tiffany

  508. Doc says:

    Hello, Tiffany,
    The internal bleeding would most likely make her go into shock and lose consciousness, and just not wake up.

  509. SandyCo says:

    I confess that I haven’t read all of the posts here, but you are providing a wonderful service for pet owners!

    I have two cats. The 14-year-old cat, Jasmine, is the oldest. She is hyperthyroid without any kidney disease. She was diagnosed 3 months ago, and has been on Methimazole ever since.

    She has responded pretty well to the medication (no more running around my bedroom in the middle of the night!), and yet she intermittently defecates outside the litter box in random places at random times. It doesn’t happen all the time. She can be fine for a week or ten days, and then it happens again. She has done this three times in my bedroom when I’m sleeping, so now she’s banished to the living room (which breaks my heart, since she has always slept next to me on my bed). She has also done this all over the living room and dining room; my apartment isn’t that big and she seems to want to cover all of it!

    She’s thin, but is still alert, jumps in my lap when I’m reading, rubs up against my feet, etc. However, she is also moody and easily annoyed (she has always been this way to some degree, but it seems to have gotten worse). I think she’ll be “fine” for another year or two. Not great, but okay.

    I, on the other hand, am a nervous wreck. I live by myself, and I’m tired of cleaning up cat messes, tired of the 2x/day doses of Methimazole (5:30 a.m. and p.m. because I start work at 6:30), and I feel like “it’s always something” these days. I’m at my wits’ end, I can hardly sleep at night, and my performance at work is suffering. I can’t take a vacation; I feel like my life revolves around her.

    I’ve had her for 13 years. With her health and behavioral issues, it’s doubtful anyone would adopt her, and she’d be miserable at a no-kill shelter. Noises startle her, and she crawls *into* my bed (under the covers) when she’s very stressed or upset.

    I really don’t know what’s best. If I look only at how she’s doing, it’s probably not time yet, and I should just put up with this for another year or however long she has. If I look at my own emotional well being, though? It’s so difficult. This indecision is bad, and of course, in this situation, even the indecision is still a decision! I do love her,and that means I can’t be as logical as I should be.

    I feel like I’d be killing her for my own convenience, but is that really the case? Do you have any words of wisdom, please?

  510. Doc says:

    Hello, SandyCo,

    I wish I could give you an easy answer. Unfortunately, you are the person who has to make the decision and live with it.

    It is hard for me to have any knowledge of how your cat feels, or how miserable you are.

    It is a very personal decision. I don’t think that anyone could criticize you for whatever you decide. You are in a difficult situation and must make the decision you can live with.

    With all you have done to care for the cat over this length of time, I don’t see how anyone can accuse you of “convenience euthanasia”. If that were your decision, you would have done it a long time ago.

    Best wishes in this difficult time.

  511. SandyCo says:

    Thank you! I appreciate your kind words. I have a mobile vet who is coming to put Jasmine to sleep tomorrow. It’s going to break my heart, but I think this is ultimately the best decision possible in these circumstances. Thanks again.

  512. Helen says:

    We have a beautiful 12 year old who used to be the most cuddliest cat you could wish for. He’s never been the most active, but he was diagnosed with asthma three months ago and in the last few weeks has had a number of asthma attacks which are really scary to witness. Despite having several steroid injections at the vets and us giving him an inhaler daily, he now does little more than collapse on the spot and stay there for hours when it’s clear he has no energy and/or is struggling to breathe. He is still eating to a point and making it to the litter tray, but other than that he’s taken to hiding behind the sofa which is really not him. The vet has suggested if the injections aren’t working then there’s little more they can do. Has anyone else had experience of cats with asthma? I’m just finding it difficult to accept he could go downhill so rapidly and worried there is something more we could do. He’s seen a few different vets at the same practice, but they always say something slightly different which also worries me.

  513. Helen says:

    I forgot to mention, his heart rate is up to 60 beats per minute and you can visibly see his chest wall rising and falling far more than it should. He has also gone down from 6 kg to 4.5 kg since being diagnosed, so is still not a skinny cat by any means but I do worry I’m being selfish by thinking he’s okay. He still purrs when stroked, but nothing like he used to. I just don’t know what to do for the best!

  514. Doc says:

    Hello, Helen,

    My experience with these cats is limited. I have a patient who has done well for several years on occasional oral prednisolone and using the inhalers with the Aerokat chamber.

    From my consultation with the specialists, I know these cases are challenging. Not all of them can be successfully managed.

    If you are not comfortable with how the case is being handled, ask your doctors for referral to a specialist.

  515. Lisa says:

    Hi Doc. Thank you so much for this website. I have an 11 yr old male cat, Beamer, who has recently been diagnosed with bone marrow cancer. He is the sweetest boy, and is still greeting me at the door, eating well, drinking lots of water, and going for walks when I get home. Since he is drinking so much and peeing very large amounts, does this mean he has begun to be in kidney failure? Is that painful? Is the bone marrow cancer painful? He has a little limp, as the tumor began on his right forearm. Sorry my thoughts are so jumbled. Can you please let me know when I should know that it’s his time to go to the Rainbow Bridge? He is taking Prednisone and will be on an IV Drip starting next week. Thank you so much ahead of time.

  516. Doc says:

    Hello, Lisa,
    Prednisone causes the patient to produce a very dilute urine. Thus they need to drink lots of water to make up for that. This is a common and generally harmless (though potentially messy) side-effect.

    If the tumor is destroying only the marrow, it may not be painful. If it is beginning to disrupt the structure of the bone, that is reported to be painful in people with bone cancer.

    Eating well and going for walks sounds like he still is enjoying life.

    When he quits enjoying life, it’s time to think about euthanasia.

  517. alice says:

    When I started reading these posts earlier tonight, I didn’t think you would still be responding is it 7 years later? I read through most of these to get some perspective and didn’t plan on including my 20 y/o cat Balkie in the mix, but since you are still here…

    When I was 12 I got the kitten I had begged for my whole life. He was always the perfect cat. I grew up with him, but my grandma did a lot of the work. When I moved out, he came with me. When I moved back in with grandma years later, he came too. He didn’t come with me last time though. I was 23 with an uncertain future and an unstable living situation. I planned reclaiming him again someday, but as they grew old together, it became less likely. I knew she loved him, but I thought she wanted to give him back eventually and be relieved. Even though I offered to take him when I got more stable, I knew he had the good life with her, and at the time I thought he was probably in his last years. I was glad she didn’t want me to take him from her. For both their benefits. And I also thought I wouldn’t have to handle the eventual end of life stuff. I still visit them almost weekly. I missed having pets at home terribly, but I vowed not to get a new cat until Balkie was gone. It just felt too much like I forgot about him, and I felt guilty. But though I knew it for a while, it became clear when he was around 17 and moved with my grandma out of her house and into an apartment I wouldn’t take him back. And he was just as healthy and sweet as always. I started fostering kittens when my husband was in the hospital, and ended up with a couple of the sweetest kittens ever. I was worried I might have been spoiled by Balkie and not all cats would be as nice. They are both past their 1st birthday now, and my thoughts often drift to Balkie. I was 12 when I took him home. I wanted to play with him and enjoy him and he was gracious. But he was there for me. Im in my 30s now. My new cats are completely in my care. And as I fuss over them getting the right diet or having a clean box, I think of my first boy and wish I took care of him better. My grandma was pretty on top of his care while i was with her. When we moved, it was a party house with other cats, but we all got along. He was always such a good boy. He never even got sick until last year when grandma was out of country for 3 weeks. My brother was house sitting, and was worried he wasn’t eating. I thought he was sad my grandma was gone, and wasn’t too worried. But after a few days I got another call and drove right over. I bought a bag of treats and he gobbled them up! I had to cuddle him to drink water, but he did. The next day he was checked into the vet for a few days. He had pancreantitis. I always loved cats, but was ignorant about their health issues. He got better and came home and I thought that was that. Over the next couple of months he got really stiff hind legs and his breathing was loud and wheezy. He was having a hard time getting around, so I made him an appt. They did a senior panel and determined he was stage 3 ckd and possible diabetic. Further tests would imply he was, but they said he might have been stressed. They perscribed him purina dm, which he didn’t like, so we have been trying similar canned food at the store. I wanted to remove all his dry food, but my grandma says he isn’t eating much so we should keep it out. He eats a spoonful of canned a few times per day. He gets liquid opiate for his legs. His back legs and breathing have seemed to go back and forth. I keep buying him high protein low carb wet food, which i see him eat when i give it too him, but grandma is worried about his appetite decreasing, so she doesn’t give him much time to get used to anything and gives him his old fancy feast. I would be fine with that, except she is leaving out dry food for him too.

    Yesterday I had a mobile vet come by to check his levels and see if there was more I could do. They confirmed he has diabetes. After the last visit, i was more concerned with the CKD. He was on a diet plan only, so I was hoping he would show improvement. No results in yet. Now im coming to terms with the diabetes. They perscribed a daily medication, and suggested B12 pills, along with some other foods for his diet. I was hoping to avoid this. I can not be there to administer pills more than once per day. Even if I could, I hate the idea of forcing my age 20 cat who has never been sick to swallow pills and endure vet visits. An ex nurse family member lives there too and is willing to help, but im not sure if he will allow it. I still hope his levels will improve or be stable if we can get him eating right, but im not there every day and the woman who has taken care of him most of his life keeps leaving out kibble. Now I am worried he will need oral medications and insulin shots if his diet doesn’t work. I don’t want to ask my family to do this unpleasant and difficult task. I cant drive there every 12 hours to try it myself. And I don’t know if it would work, or if we would be torturing him nonstop. I would still be able to take him in to try to give him shots, but that would turn his whole life upside down. Plus, I have failed pilling cats before. Im not sure I can.
    He seems like his old self is stuck in there, and if he could just walk normal again he would be fine. He tries so hard to keep moving, and still loves our attention. I feel like I am at this critical point where maybe we can turn this around, or cure his stiff legs while he is still eating and trying to walk. But I also worry that anything drastic could make him worse, or upset him in his final years?…months? Grandma thinks daily meds will only buy a little time, and will be unpleseant for him. I still want to try for a bit and see if he gets better, but I dont know if they or I can coordinate such a big task. And will it just be an unpleasant end to a long healthy life?

  518. Doc says:

    Hello, Alice,

    As always, it is best to talk with the doctor actually seeing your pet. I can only give general advice.

    Lots of problems here, so I’ll try to address them all as best I can.

    Opioids are your best approach to pain in cats for long-term treatment. Nothing wrong there.We are very limited in our ability to treat old cats with arthritis.

    Wet food helps to increase water intake. When kidneys are having trouble filtering waste, more water equals more filtering cycles, equals more waste removal.

    With a cat in this situation, I’d just be tickled if he ate anything well.

    M/D and DM are both available in canned and dry. While it is well accepted at this point that diabetic cats do best on high protein low carb food, the best diet for this guy is probably the diet you can get him to eat.

    Diabetic cats usually wind up needing twice daily insulin injections and glargine insulin (Lantus) appears to work the best. The injections are very small with a very small needle, and most cats tolerate them really well.

    Vitamin B12 can be given by subcutaneous injection just like the insulin, and once weekly does well. It is inexpensive.

    Grandma knows and lives with him. She may be right about wrestling medicine down him every day being worse than letting him enjoy what time he has left without being molested. It’s hard to say how well he would tolerate it.

    I have had more than one elderly friend who felt that their quality of life was better in the progress of their disease than in enduring heroic treatments in attempt to prolong life.

    If everyone is willing, there’s certainly nothing wrong with trying meds for a while, but there’s also nothing wrong with giving that up if it’s making everyone miserable.

    Twenty years is an amazingly long life for a cat. I know that doesn’t make you happy about losing him, but you already know you are looking at the beginning of the end with these multiple problems. None of these problems are curable, but only manageable, and the kidney disease and arthritis are progressive, and can only get worse.

    If everyone is agreeable with giving it a try, I’d say go for it. If it’s miserable, I’d say to let him enjoy what he can while he can, and not beat him up in his final days.

  519. Michelle says:

    I just has my Niska, almost 15yr old Birman euthanized on Friday. He was my Soulmate and Baby. He had IBD and everyone told me that the fact he lived for this age while on the prednisone is a testament to how well I cared for him.
    He had so many challenges over the year. They wanted to right him off an 2 and I would not have a bar of it. OF course he was impossible to give a pill too and it was over a decade of new ways and power struggles to administer it, but I stood my ground, I loved him and on everything else he got away with it, but this was keeping him alive.
    Then last month, or maybe the one before that he went down fast.. but that’s life with an IBD Cat.. I used to rush him to the emergency Vet on a Sunday or Public Holiday… he had a great sense of timing.. and they would put him on fluids.. some antibiotics and he would bounce back and look at you like “why am I here”..
    This time was different.. his blood test came back anaemia.. a new evil. I was lucky to have moved and found a loving Vet/Vet Hospital that loved him as much as I did.. only one negative person talked euthanasia then and they got the best of me and avoided me after that..
    We did every test but a biopsy.. and every evil that should have happened after more than a decade on prednisone came back all clear.. it was a mystery.
    We did the fluids, and he bumped up a bit.. he truly became impossible to give the pill too so we opted for the depo Medrol shot.. anguish on my part .. you read the evils on the internet about negative reactions.. at this time he did have a little mass on the lining of his stomach and no one thought it was sinister and we didn’t do a biopsy as it was too intrusive at his age..
    he continued to drop weight and we did the dance of fluids and antibiotics and he still ate and wanted to go into the garden.. I had just moved into my boyfriends house with an awesome safe garden and Niska claimed it as his.. having lived in an apartment with only a balcony for most of his life.. watching him on the astro turf (everyone in WA Australia has fake grass due to heat) was like watching them walk on the moon.
    After his 3rd or 4th Depo shot – he came home ate and still used his tray but would hide under the dooner and was so skinny to hold that I felt like I was hurting him.
    Then on Monday or Tues he came into my study here (I work from home) and I lifted him on my lap and held him and he looked into my eye’s and I know he was saying how much he loved me and that it was his time (I am crying now as I type).. I watched him, begged him and then found this site and I booked the Friday appointment.
    I spent Friday midday onwards just laying with him, thanking him and he hadn’t purred in over a week and as I brushed him he did and then when I woke up from a nap his paw was on my face.
    When we went to the Vet, Dr Emily told me she could sedate him first so I could hold him and he could drift on and remember I was the last one he saw and then she could take him to the other room for final injection so I didn’t have to witness it. Awesome soul this Vet. As she took him to set up his canula you could here all the staff greet him and ask how he was and then their voices would lower and you could hear them say their goodbyes.. when she brought him back I held him and the sedation worked so fast as he was so weak and frail. Then when she took him to give him the final injection she was back within the minute to tell me he had passed.
    I am devastated because he was the reason I got up everyday and the first thing I said to him as a kitten now we have each other to love we will never be lonely.
    Making that choice was the hardest decision ever, but I guess I am fortunate that I got to make it on my terms and my experience at the Vets was very loving and caring

  520. Doc says:

    Hello, Michelle,
    Thank you for sharing your story.

    I am told by the specialists that IBD can progress to intestinal lymphoma over a period of time, so your long-term care was a real triumph.

  521. Dorothy says:

    Thank you for this wonderful blog, and your heart-felt responses to folks on this thread. I’m hoping you will respond to my comment.
    My 12 year old Julius, an orange and white long hair domestic, was diagnosed via ultrasound last month showing gastric carcinoma, lymphoma, and only 30% of his kidneys functioning. The symptoms leading up to this was a month or so prior of regular and increased vomiting and eventually he stopped eating (which is significant as he has a major food number!)
    The vet showed me the ultrasound and his stomach walls are centimeters thick and the lumen is almost non-existent. The lymph glands are quite swollen.
    We put him on daily Cerenia for nausea and 100-150 ml of SubQ fluids every other day. It worked like a charm and the past month he’s been his old self and eating again, albeit, doesn’t like to play quite as much.
    I’m aware the prognosis is not good for him but I can’t help thinking he still has some months in him, especially since his energy and life force are still pretty strong.
    Four days ago he took a dive in his energy again, just like a month ago when he was first diagnosed. He stopped eating (he acts like his mouth and throat hurt) and hides under my bed, with periodic walks around the house, very weak and obviously in pain. Yesterday he had a hissy fit when we tried to administer his subQ fluids, which I know would have really helped him.
    My concern/question is regarding next steps and the use of Prednisolone in this situation. I am definitely requesting pain meds for him, but regarding my vet’s suggestion of Prednisolone, I have this feeling like using the corticosteroids will actually be too hard on his system/liver, etc. and reduce his quality of life that is left. But then I hear stories of how it has added months to a cat’s life in a similar situation. Am I being unnecessarily concerned about side effects? Would the use of some pain meds, Cerenia and SubQ be sufficient to extend his life a bit? Appreciate any of your wisdom. Thank you!

  522. Doc says:

    Hello, Dorothy,

    I cannot really prescribe for patients I have not seen, but generally speaking, I would be fine with the prednisolone.

    It can reduce swelling due to inflammation, and if there is lymphatic type cancer it can shrink that temporarily.

    The side effects are minimal in most cats. Cats are very tolerant of corticosteroid therapy.

    They tolerate very few pain meds, and we are very limited in what we have available. Buprenorphine is great, but expensive. NSAIDs are not compatible with the prednisolone, and only two are really used in cats. Onsior is only approved for 3 days (six in Europe) Metacam is no longer approved for use in cats in the USA (it is in Europe), but is still used by cat specialists because we have so few options for long term pain medicine in cats.

  523. Heather says:

    My 12-year-old cat has IBD and FLUTD/FIC/whatever the term is these days. We’ve controlled the IBD since it was diagnosed ~3yrs ago (after many, many vet visits) with a hydrolyzed protein diet and prednisone every other day. Unfortunately, he’s had urinary issues as well, and ~2yrs ago the vet decided it was FLUTD/FIC for lack of a better diagnosis. I’ve tried various (vet-directed, things from that OSU website) things to help him deal with it but nothing seemed to help, and last April we settled on a daily dose of amitriptyline, which seemed to be working up until the end of Sept when he started going to the litter box excessively (12x in 30min multiple times a day excessive), crying when he got out only to turn back around and go in again. And he started to urinate outside the box with visible blood. I took him to the vet, who said the prednisone makes him more likely to get UTIs, gave him an antibiotic shot that did not help and ended up with a pill-form of enrofloxacin to give him, which did seem to do the trick.
    Except now, two months later, he’s started doing the exact same thing, complete with visibly bloody urine. Went to the vet. Got the same pill-form enrofloxacin. No improvement. I had to take him in again to get a sterile urine sample for them to culture, do not know the result yet, but they sent him home with a liquid antibiotic (Clamavox) to take as well, which he hates, and tramadol, which does not seem to help.
    So right now I am giving him various medications five or six times a day, and the poor thing has started high-tailing it away when he hears a pill bottle. He still eats well but has maybe been drinking more than usual. He is never interested in playing with anything for more than a couple minutes at a time, but will still snuggle and purr when he’s not on one of his litter box sojourns. I can barely sleep between listening to him dig in the litter box and straining to hear if he’s going on the couch. Giving him medications and cleaning up all his messes is entirely on me and I am so, so, so tired of nothing working, but his quality of life still seems okay, at least when he is not actively having unsolved urinary issues, but I do not have the money to go through a urine culture every time this happens. I love my cat very much, but I am at a loss. I have not discussed euthanization with my vet because I do not want them to think badly of me, but financially and mentally I am not in a good place.

  524. Doc says:

    Hello, Heather,

    Your veterinarian has been going through this with you for years, and I am certain that they understand what you are going through. Sharing your feelings with them is not likely to make them think badly of you.

    This is a very difficult situation. I would be concerned that there could even be a structural problem in the bladder that is contributing to the recurrent infections. You could have a bladder tumor, or such a damaged bladder lining that its irregular surface makes lots of “hidey holes” for the bacteria, making him more susceptible to urinary tract infections.

    If there comes a time when his quality of life is poor and you just don’t have the spiritual and financial resources to improve it (or it CANNOT be improved), then sometimes euthanasia is the best decision you can make (though not an easy one).

    You should share your concerns and frustration with your veterinarian. They need to know where your head and heart are in this.

  525. Heather says:

    Thank you very much for your response. I admit another reason I have avoided discussing it with my vet (besides feeling like a horrible person for even thinking about it) is that I will probably have trouble articulating myself without crying. Which I’m sure won’t be a first for the vet, but… I feel like I don’t have the right to cry.

    If there is nothing conclusive on his urine culture, my vet suggested he see an internist, which I am guessing is likely to be expensive. My husband is understandably angry about all the money I’ve already spent on this cat that pees on our stuff, so I’m just… I don’t know. I feel awful that maybe half of my distress over the entire situation is for the stress it’s placed on me and not my poor cat. No one in my family really understands since they have never had pets, and with my husband already angry I am out of options to talk about this.

    Right now the thing my cat most seems to enjoy is sitting on me, so I am making sure he has the opportunity to do so as much as possible. He’s always been pretty snuggly, but his desire seems to have increased lately.

    Again, thank you very much for your response.

  526. Doc says:

    Hello, Heather,

    While some doctors are uncomfortable with a distressed client, most are very understanding. I think that if you are overcome with emotion that you have a right to cry.

    The closest internist to us charges $135 for the initial exam and consultation. That’s not a ton, but it certainly is possible to spend a lot on diagnostics. The specialty group in Memphis, Tennessee charges $500 for an ultrasound workup.

    I hope that the culture will show an easily treated bacteria. Be sure to discuss duration of treatment with your veterinarian. With such a recurring infection, it might require several weeks to get it really cleared up.

    When I have a case this difficult, I usually get a consultation with a specialist. That doesn’t guarantee success, but at least it helps me feel like I’m doing the right things.

  527. Alice says:

    Thanks for your response! Balkie did improve after 1 week of b12 and Nausea meds along with his opiates. But when he found out we were hiding them in his food he stopped eating much. After struggling to pill him by force a few times, we stopped and focused on feeding him. We learned to give sub q fluids and he improved again, but by the end of the bag he seemed worn out. We decided to only treat his pain for a week, and helped him pass after thanksgiving. We feel the loss still, but I am relieved he never suffered too bad. He left a bag of young again dry cat food that I gave to my 2 16 month olds cats. They didn’t want their usual wet food lately, but they liked the dry as a temp replacement.
    It’s been about 5 days, and they have had watery diarrhea ever since. I took the food away, but one of them won’t eat anything else. Besides the diarrhea they both seem fine, maybe a little tired ocassionally. One threw up once the first day, but that’s all. They hate the vet. Do I need to take them in yet, or should I wait?

  528. Heather says:

    Thank you for the information. Now I at least have an idea of what to expect if I am able to go that route.

    Unfortunately, the culture did not show any bacteria, so I am supposed to discontinue the two antibiotics and increase his dose of prednisone for the next 4-5 days to help with inflammation. Not the news I was hoping to hear.

  529. Doc says:

    Hello, Alice,
    Thanks for the feedback.

    A sudden change of diet can often cause a temporary loose stool situation, but it usually resolves in a few days.

    If this continues and a change back to their regular food doesn’t handle it, then I would at least try to get a stool exam done. Unfortunately, with diarrhea, it is difficult to collect a specimen, and even when you do, it is dilute, making it difficult to find things.

    I understand that the cats hate to go to the doctor, but that may be what is needed.

  530. Doc says:

    Hello, Heather,

    I understand that the news is not what you wanted to hear.

    It is possible that calming the inflammation down will make a big difference. Let’s hope so.

  531. Heather says:

    Unfortunately the increased prednisone was the go-to response for FIC flare-ups before he started the amitriptyline and it never made much of an impact. I was looking back over my notes from last year and he spent most of the winter and a large portion of the spring in flare-up mode with only brief respites between. My vet is supposed to contact me in the next few days to check on how he’s doing; I think it might be time to raise the subject of euthanasia with her.

  532. ronald bulman says:

    Put our kitty to sleep three days ago. She fought a terrible aggressive cancer on her right rear quarters for close to a year. Three operations to remove tumors and the last operation was not successful because it had grown around her spine. I promised her no more trips to the vet or office visits, which each one she was like a wild cat. I guess calico females are tough little girls. Her quality of life slowly went downhill. She couldn’t only walk a few feet and lay down. No longer could go out onto the deck or down the hall into her other bed. I was keeping her bed, water, food, litter box within a few feet of her. Her right leg became swollen and tumors were visible on her rear quarters.
    She had been a diabetic for almost four years and receiving insulin twice a day. We were always there for her and never vacationed. I had no kids, so she was my kid and I loved her more than anything else in the world. I promised to her no rides anymore, so I found a vet that did house calls. She died peacefully with her head in my hand. She is now being cremated and going to be buried in her favorite flower garden. The vet said if he died and came back as a cat, he would want it to be in our home. She is fourteen years old and we adopted her thirteen years to the day.

  533. Kandy says:

    My beautiful calico Charity, and her lifelong mate suffered a blow to their relationship when Charity developed breast cancer, at 17. The pain for charity, and myself became to great. She couldnt even get up on the bed with me her last night home, although she tried. I had been away on training for my job and because she missed me her symptoms became more advanced. I gently picked her up and put her in my arms, under the covers, where she always slept. I had her at the vets the next day to say goodbye. She loved the car ride! Always has. She and Chase were born in Texas, but moved North, East, and back to Texas with us through the years.

    My delimma is that Chase, having survived his mate , is now 19. He hurts, walks slow, drinks a bowl of water in a few hours and I can tell it’s time for him to go. With new jobs, and a granddaughter we are raising, and we live in the country-access to a vet is a drive, and expensive . I was with charity but my heart cnt handle the cry the shot causes. My heart hurts.

  534. Doc says:

    Hello, Kandy,

    Thank you for sharing your story. This is always a difficult decision, no matter how old the pet is, and no matter how many problems are there.

    Certainly, the pet feels a needle stick, but I do not believe that it is any more painful than an antibiotic injection. The sting is an unpleasant surprise, but it doesn’t last long. Then soon they are feeling no pain at all.

  535. kylie says:

    Hi there,

    I know its years later, but I was just reading comments on here, as I’m researching senior animal treatments etc. I am very confused by the comments that ages like 15 and 16 are past usual life expectancy, I have rescued cats for years, and have never had one live less than 15yrs, in fact average age of expiry is 18-20, a few have lived longer. A 15 or 16yr old cat has a lot of life left in them!

  536. Doc says:

    Hello, Kylie,

    I am glad you are having such good experiences, but I can tell you that your experience is not typical.

    Sometimes it is the miles instead of the years, as well. I certainly have some older patients looking good at that age, but most are having a tough time.

    We don’t have good choices for older cats with arthritis problems, which is a real quality of life issue for older cats.

    People frequently neglect their teeth, and this causes additional health problems.

    Outdoor cats have too much wear and tear, and a lot of indoor cats succumb to chronic kidney failure.

    Cancer doesn’t respect any age limits.

  537. Jessica says:

    My cats are both about to turn 19. They both have stage 2 renal disease at last blood work. My one cat, Homer, however also has high blood pressure, is completely blind and has feline dementia along with the kidney disease. He is having a lot of peeing outside the litter box and almost always poops outside the litter box. He howls and meows all day and gets confused a lot. I give him blood pressure medication twice a day and anipryl for the dementia. I also have to give them both miralax for their constipation due to the kidney disease. I am exhausted from not sleeping and am constantly cleaning accidents. I don’t think the anipryl is helping much with dementia. Anyway, he is otherwise eating and still showing me affection so I am completely conflicted about what to do but this is so overwhelming and exhausting. Just not the same cat I always had. What sign should I look for???

  538. Doc says:

    Hello, Jessica,

    I doubt that the dementia will get better.

    There is no easy answer here. Is the cat living, or just existing?
    Does he do things he enjoys?
    Does he have any good days?

    You have certainly gone the extra mile. I do not think that anyone could accuse you of doing a “convenience euthanasia” when you decide that you’ve come to the end of the trail.

    I cannot tell you when you will arrive at that end, but nobody has the right to second-guess you after the effort and love you have given the cats.

  539. Rachelle says:

    I have a 15 yr old male Himalayan who I rescued and has been such a blessing in my life. 3 mos ago I noticed a tumor on his chest. It was dx as a Mast cell and has grown to about a quarter in size. Tried to have it removed but his RBC’s came back at 16 so the Vet refused. He eats, drinks and litter habits remain intact. He has given up on grooming himself. Tx includes Benadryl and Tramadol. Would appreciate any advice. Is it time to say goodbye?

  540. Doc says:

    Hello, Rachelle,

    Sorry I’ve taken so long to see this.

    Mast cells produce a lot of histamine so Benadryl (diphenhydramine) and famotidine (Pepsid) sometimes help the patient to feel better.

    Tramadol is a mild narcotic pain medicine. I don’t have a lot of experience with its use in cats. The dose for cancer pain is listed as about a milligram per pound twice daily. The pills taste awful, so it can be difficult to get cut pieces down without a problem.

    An article on the very reliable website Veterinary Partner.com gives a good review of mast cell tumors.
    Here’s a link:
    http://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=1600

    Many elderly cats without major illnesses give up on grooming. If you feel he is still enjoying life in other ways, then I would spend some quality time grooming him.

    As other parts of “normal life” drop out, it will be time to consider euthanasia.

  541. Roxanne Smith says:

    I have a cat named Jasmine American short hair when she was ten she had to go to hospital and found out she had pancreatitis and we paid $2000 to save her she is turning 15years old may 31st and ppl say I’m heartless to have saved her cause she would be suffering but she don’t act like it I been upset a lot thinking I did wrong thing I just can’t stand the sight of her looking at me falling asleep and never wakes up and thinking mom why u picking to put me down that’s what I think her face would be tellin me

  542. Doc says:

    Hello, Roxanne,

    If she has had five years since that episode of pancreatitis, you didn’t do the wrong thing.

    If she is doing poorly now, that doesn’t mean those five years were worthless.

    If she still eats and plays a little, and sleeps well, then I wouldn’t say she is suffering.

    If there are more specific questions you would like to ask, or more information to add, please write again.

  543. Summer says:

    I have an 18 year old that was diagnosed with diabetes in January and a lump in his lower abdomen the lump was removed in March but has grown rapidly with in two months the vet told me there was nothing more I could do and that he only had 2-3 months left to live. His tumor has gotten so big it has now abscessed and has a foul odor he was shaved from his surgery so he still has not much hair that has grown so I have been able to bandage his open wound. He’s still eating drinking but just yesterday he’s been having trouble walking and not making it to the liter box he moans when he lays down but he’s done that before in his life so I’m not sure if he’s in pain he still goes outside he’s just slower I don’t want to put him down but I also don’t know want him to be in pain. My husband believes it is time. Has anyone else had this type of problem with there cat and cancer or am I just selfishly keeping him alive way past the time I should have. If so what did you do?

  544. Doc says:

    Hello, Summer,

    Sorry to be late in replying. It sounds to be like your cat is in pain, and probably getting worse every day.

    I do not believe you are selfish, but I do believe you are having trouble confronting the loss of your friend.

    It sounds like slow death instead of longer life.

    No one else can make the decision for you or tell you what to do, but it sounds to me like it is time to let him go.

  545. Debbie Riggs says:

    Hello! Could really use some input. My cat is 19 years old and is having some kidney failure but responded to the k/d diet well. While is is only 8 lbs he still zipped around the house at times and loved to eat some white meat chicken here and there. He recently fell and sliced his tongue underneath and his tongue is crooked and he can no longer lap up water nor eat his hard k/d food. I gave him soft pate food which he lapped up but then got a cold (no temp) and now is not eating nor drinking. I have been giving him water through a dropper but it is not enough and trying to get him to eat but he seems to not want any. My vet says he can put in some stitches but concerned about putting him under due his age. And the vet said he is not sure the tongue can be corrected as it might be nerve damage. I do not know what to do at this point as concerned about his age and surgery, nerve damage and if can be corrected and cost to do so. Any help/advise you can give would be appreciated. Thank you!

  546. Doc says:

    Hello, Debbie,

    I wish I had a good answer for you. Your doctor is in a better position to advise you than I am.

    If there is nerve damage, we really don’t have any way to deal with that.

    You could in a feeding tube (esophagostomy tube) surgically and feed and water him through that. That would require anesthesia, but it’s a pretty short procedure.

    If the tongue were able to heal, that would let you keep the cat nourished and hydrated.

    At his age I would be worried both about the anesthesia, and his ability to heal, both the tongue and the incision around the feeding tube.

    It’s a tough situation.

  547. Mary S says:

    I have a 16 yr old Main Coon who was diagnosed with Low Grade GI Lymphoma 3.5 yrs ago. With steady dosing of prednisone and leukeran, we extended her life well beyond the initial prognosis from the vet. Her blood was analyzed every 3 months and her levels always came back normal. Her weight flunctuated over the 3 yrs, but nothing alarming. In March, my vet requested an ultrasound be performed to determine if the cancer had spread (I honestly think he was baffled that she was still alive). The ultrasound was performed last Friday, the cancer hadn’t spread and I asked them to test her blood for any and everything. The vet called yesterday and everything was normal except for .3 lbs weight loss. Last night, my cat took a very sharp turn for the worse (dilated pupils, shivering, loud purring, loss of appetite, no litter box usage, hiding, lethargic, defecation on my bed, a lot of sleeping and an overall sense of something wrong with her). As I’ve seen stated in many of your posts, I don’t want to trap her spirit in a sick body nor do I want to prolong the inevitable. I can feel everybody vertebrae on her back and her hip bones now. Have you ever seen a cat take this type of turn after passing ultrasound and blood work tests? I’m keeping a close eye on her and giving her TLC, but have come to grips with what I may have to eventually do.

  548. Doc says:

    Hello, Mary,

    The tests just show what they show. They don’t show us microscopic changes, and even a C-T scan or MRI might miss a tiny brain tumor. They can’t predict blood clots, strokes.

    They just tell you how things are at that moment.

    It sounds to me like you are in tune with your cat, and will know what to do when the time comes.

  549. Kate T. says:

    I am so glad I found this site today. Our 15-year old cat Cutie was diagnosed in January 2017 with small cell GI lymphoma. Our vet prescribed chemo and prednisone and her condition was stable until this past January when she started losing weight again. We tried two other chemo drugs, to no avail, and we stopped her treatments in early April to let nature take its course. A few weeks ago her breathing became much more labored, and she has started peeing and pooping outside the litter box. I have been struggling, as have we all, with the question of when, if at all, to euthanize this beloved creature and reading your stories, and the good doctor’s responses, have helped me immensely. Thanks to you all!

  550. Doc says:

    Hello, Kate,

    Thank you for sharing your story. There comes a time when you’re not living longer, you’re just dying slowly. That’s not a good time.

    It sounds like you have made the right decision.

  551. Yvonne Wright says:

    It is so difficult to know when to have a pet put to sleep. We lost our 16 year old cat, Minty, this morning. He was diagnosed with tongue cancer only three weeks ago and the vet has kept him going with Metacam and we have fed him soup-like foods. Over the last couple of days I have been blotting blood from his mouth every half hour or so but during last night it worsened. He passed very peacefully and I feel it was the right thing to do for him only now I have to cope with the loss. He followed us around and slept on our bed.

  552. Doc says:

    Hello, Yvonne,

    Thank you for sharing your story. I am glad your friend went peacefully. I wish it could always be that way.

  553. Adi says:

    Hello,
    Our cat is 17+, and was diagnosed with ckd 2 years ago. She’s on daily sub-q for 15 months now, and medical food of course. She was doing ok until a 2 months ago, when she had some tooth problems which prevented her from eating (dry or canned). She had to go to surgery to remove the bad teeth. After recovering, she ate but only wet food.
    A month ago she had an ear infection that was treated, but within days we noticed she can’t blink with her left eye. We tried different antibiotics but nothing helped. She then started loosing balance and she falls quite often and walk weird. The paralysis is spreading and now she can’t really eat properly. It’s like she doesn’t know what to do with her mouth and tounge. And she is starving (she was give steroids injection 10 days ago). So right now- she can only lick some wet food, and not even that- it’s like she is soaking her mouth in the bowl, and “eat” only the liquids- we mix food with water. She is boney- you can see her spine and pelvis, she lost weight in a short time. She can’t groom, and she is getting dirty from food and defecations. I really don’t know what to do – she comes to us and sits on our lap and purrs. But it looks as if she is starving to death, which is suffering even if not painful. I’m lost 🙁 the vet says it’s time now, but the fact she is still hungry and wants attention confuses me.
    I would appreciate any advice. Thank you for this thread.

  554. Doc says:

    Hello, Adi,

    I can understand your concern, as it sounds like your friend still wants to live. Unfortunately, it also sounds like her body will no longer support her spirit.

    It sounds like she is experiencing slow death instead of longer life.

    I’m not there, I haven’t seen her, I don’t know her. What you’re telling me sounds like it is time to let her go.

  555. Christie Garrett says:

    Adi I understand exactly how you are feeling. I just put my 17 year old Friday down yesterday. I did not find these post until I got home from the vets office. Thank you all for these post because I do know that I made the right decision yesterday. I do however think that maybe I should have done it sooner but I am at peace that my precious girl is now having all good days instead of so few of them.
    Friday has survived a severe reaction to the drug methemazole for hyperthyroidism. It suppressed her bone marrow from making red blood cells so she had two blood transfusion and then radio active iodine treatment. Then she was diagnosed with with ckd and diabetes. Everyday was filled with pills and shots but she bounced back and lived for almost two years without more bad than good days until about 3 months ago when she suddenly went blind. Then she started with anxiety. Circling around yowling,trying to hide,sitting in corners etc. Vet treated her with some antibiotics but said her feared that her problems were neurological. She seemed to get better for a few weeks then back to the same thing. This time it was worse and she did not seem to know me, would not answer to me saying her name. I probably should have let her go a little sooner but yesterday I was able to understand that she was saying I have had enough. I came back to you one time but not this time. We had one more peaceful time together yesterday while I held her in my arms she lay her head on my shoulder so comfortably then the vet administered the sedative and I held her for awhile as she slept. He administered the drug that stopped her heart. My Fridays heart stopped and mine broke. But I know that I will see her again at rainbow bridge where all her days are good ones.

    Thanks again to all the posters here. It helps ease the pain.

  556. Adi says:

    Hi Christie and Doc,
    Sorry fir my late reply… i only saw your message now. I’m so sorry for your loss.
    Doc- i read your reply back then, and didn’t write yet. Probably because Mitzi (that’s her name) is still with us, but not without awful doubts on our side. We already had an appointment to put her down, but when i woke up that morning i just couldn’t. So right now we’re giving her peliative care. She get her medicine and pain killers and tons of comfort and love. Is it enough? Not sure. She manages to eat more now. Gets dirty from food and has to be cleaned by us 5 times a day. I can’t really tell why is it so hard to me- the fact she is still with us mentally, or fear i will not forgive myself. Very difficult for me. We keep consulting the vet to do the best for her. I guess if she will have it harder – i will let her go, but i’m not so confident with myself anymore. The least i try is to make her feel loved and calm. Thank you all for you help. It’s really comforting.

  557. Doc says:

    Hello, Adi,

    This is a tough deal. We invest a lot of ourselves in this relationship with a pet. Sometimes it feels like we are losing a part of our self. That doesn’t make it any easier, like cutting off your hand.

    Best wishes at this difficult time.

  558. Christie Garrett says:

    Adi it has been a little over two weeks now since I made the decision to let my 17 year old cat Friday go. I just wanted you to know that the pain of my decision has eased and I am at peace.

    Now that she is not here I can reflect on the times she was a happy cat compared to the last few months of her life. She really had no quality of life. She could not see,was confused, anxious and restless most of the time. I know that I would not want to simply be here struggling to live a life like that. That is no life at all. I wanted for her what I would want for myself.

    She was trying to tell me but I refused to listen. Once I listened I understood what I needed to do. I gave her a peaceful death. I prolonged her suffering no more.

    I wish you peace with your decisions for your kitty. Listen to her she will let you know when it’s time to let go.

    I wish you comfort.

  559. Nancy says:

    I struggled with what to do for my 14-year old cat, Bob, after learning he had a brain tumor in October 2018. The length of one’s life is not only measured in days and years but in quality of life and that is hard to measure. So, I thought if Bob were to visit me and I had his brain tumor, what would he do for me? There is a dearth of information about our pets. I believe pets ‘love’ and ‘enjoy’ which are complex thoughts but basic. I wanted my once jolly boy to be able to enjoy his tummy rub and not to be in total agony.
    Yesterday I took a slow drive with Bob on my lap and in my arms to the vet clinic where they discovered the tumor. These were the vets who said euthanasia was not a crazy option when they found the tumor. Bob even was engaged as he looked out the window in the car, very cat-like in the car on the way to the vet. No one at the clinic condescended about my decision to refill the meds I was giving Bob and, more than one vet offered to refer Bob to an oncology specialist. (I am a nurse and I have seen humans in all manner of illness and disease and I have seen patients recover just the same: it doesn’t make the decision any easier.)
    Yesterday, I drove home alone. I had held Bob and rubbed his tummy. If I had a brain tumor filling up a third of my head behind my right eye, I think that I would want medication to sleep most of the. I held Bob against my chest so he could hear my heart beat and I could feel his muffled purrs. I know he craved being close to me and to hear the sound of my heart more than food, laser light, or Yahtzee dice the last few weeks. I said goodbye to a gentle, kind soul. I told him ”I love you” again and again.
    Note: I wanted Bob with me last night, lying on my chest and in my arms. I wanted him to push his furry face into mine (crusty eye and all), brush against my chin, and push his head under my chin. I wanted to feel his warmth and soft fur on my chest and abdomen; his tail slowly wagging because I think he was comforted by the sound of my heart beat. I think what I did was right for Bob because I did not want Bob to blow blood out of his nose, scratch at the right side of his head, or be in pain anymore.
    I did not do the wrong thing or an unethical thing: I believe I did the right thing because I knew Bob. I am crying today and I will cry for Bob for some time to come. I am torn by what I know and what I don’t know and, I am comforted to see so many other humans agonize over the same decision. Thank you everyone who has posted.

  560. james poma says:

    Hello everyone, My cat Spazy was diagnosed with oral cancer about a month ago, and its been extremely aggressive, i had noticed a small lump earlier on her jaw line as she has had many issues with tooth loss and was also diagnosed FIV years ago, i took her in to schedule another oral cleaning, and by the time the appointment it had grown very quickly, the vets took xrays and showed me that in the small span of time the cancer had destroyed her jaw on the left side, i looked at my options as shes my little lovely girl and weighed the fact that with how aggressive it was and the successful treatment treatment rate ( kemo, jaw reconstruction feeding tubes and sadly alot of pain) that and the fact she hated going to the vets as it was best if i could just comfort her until it was time for her. Today in a few hours i’ll be putting her down, as shes very lethargic, lost alot of weight ( her front legs are so skinny ) she struggles to eat even though she does still eat but has to use her paws to adjust the food in her mouth, she also cycles through food and i spoil her and leave her a few choices to see what she will eat so i can administer her medication, she mostly lays in her little bed with her toys, but i noticed blood yesterday in her drool, and she has been drooling, she is distant and mainly wants to lay in her bed, she still shows signs of affection and she stayed with me while i slept last night on my chest hugging me.
    I’ve read alot of the posts here and just wanted to share this with everyone, Its so incredibly difficult to decide when its the right time, the factors can be difficult to weigh against trying to give her as much time as possible, between dec 26th and today february 15th her jaw is huge, with no signs of the tumor stopping, she lays in mostly one spot, i clean her mouth every time shes done eating and wipe drool, she in no way can eat hard food and i give her meds daily, but her quality of life seems as shes just hanging on to make it through the day, while she wastes away. I saved her as a stray roughly 12 years ago, shes been my beloved companion and family member, and as much as it tears my heart in too, i had to sit and think about her and not my self, and about will i know right befor it becomes to much for her, cause you wont know intill its possibly already past that point, its by far one of the most difficult things ive ever had to do today, and i type this as she’s resting in her little bed with her toys and her little blanket, im even tearing up typing this, but its important to her that she doesn’t have prolonged pain, and i agree with the is she having more good days then bad, well shes mostly been laying around struggling to drink and eat and is lethargic, and the mouth bleeding also in no way shows the tumor is slowing down. Sadly i cannot spend every day with her to keep track of her well being which hurts as i rush home after work to check on her and wake up in the middle of the night if i hear a meow. All i can say is from this experience is that the signs i’ve seen that lead me to make the decision are her overall quality of life shes shown me, she was named spaz for a reason, very spunky and always a fun little joy, but her being so distant and the effects of the tumor have wiped her out, as much as i want to tell myself shes still eating watching her eat shows the struggle shes having, i just dont want her to be surviving of of the medication just to live another day, its slow and painful watching her waste away with so little sign of joy and life like she used to have every waking moment, I love my baby girl spazy, but i have to do right by her. I hope the very best for anyone that has to go through this, its heart breaking and emotionally draining, but i know im making the right choice for her, to be there for her and not be away at work when her time comes or shes in alot of pain.

  561. Doc says:

    Hello, James,

    Thank you for sharing your story. This is always a difficult decision, even when the choice seems to be “clear”.

    Best wishes

  562. Kat says:

    My 21 year old male cat has been crying a lot and being vocal. He has a tumor on his lower jaw bone..waiting for the histo to come back. He also has stage 2 ckd and megacolon which has been managed for past 2 years and been doing fine. Aalso has a heart murmur since birth.

    Sometimes I can get him to eat turkey lunchmeat but I syringe feed him daily with appropriate diet.

    Everyday is different…he has good days then bad days…I just love him so much…waiting for vet to call with news on tumor then decide when to have him put to sleep.

  563. Doc says:

    Hello, Kat,

    My hat is off to you. You have been giving this cat a very high level of nursing care, far beyond what most people could cope with.

    While it is possible to remove half the jaw, in a cat his age, I would be very worried about complications from such a surgery.

    When the time comes to let him leave his broken body, you can rest easy in knowing that you have done everything possible to give him a long and loving life.

  564. Janette Butterworth says:

    Dear Doc

    Three weeks ago, whilst stroking my 13 year old Persian cross Sonny Jim, I was alarmed to find a large, solid mass on the left side of his face. He is very fluffy and it was only by chance that I found it by stoking his thick fluff. I took him to the vets the next day, and he was examined by a junior vet who diagnosed an abscess. She asked me to bring him back after the weekend and gave him an antibiotic shot plus prescribed Metacam.
    After the weekend, I took Sonny back to the vet’s as planned. I left him there for the day and went to work. At 11am I had a call from a more senior vet saying that it wasn’t an abscess but a suspected tumour and that they needed to do a biopsy for analysis.
    To cut a long story short, a biopsy was done a few days later and sent to the lab. I was told that results showed that it is likely to be a tumour of the salivary gland. The mass is huge and adhered to his underlying tissue, and surgery would be extreme and very risky, and would need to be followed up by radiation. I don’t want to put Sonny through this, as he became super depressed even when having to wear an Elizabethan collar just for a few days after the surgery.
    Other than the huge tumour, Sonny is behaving perfectly normally, grooming, eating and drinking and playing like a kitten, with no signs of pain. The vet said that the signs of deterioration would start with difficulty in swallowing. Sonny has made gulping noises intermittently for some time whilst eating, but doesn’t struggle with food. The vet also noticed that the lymph node on that side was very enlarged and hard, but the other side of the neck is normal. I feel that it might be the enlarged lymph node pressing on Sonny’s oesophagus, which is making him gulp. I am praying that the diagnosis is wrong and that it could be benign (just living in hope) as they could not categorically say what kind of tumour it is, just likely ‘soft tissue’.
    What kind of prognosis is likely if it is malignant and has spread to the local lymph nodes? Would it be days/ weeks or weeks/months? My vet isn’t very approachable and I have struggled to get much additional information from him. I cannot afford to take Sonny elsewhere for another opinion, as I have already spent over £500 and that has just been for diagnosis alone.
    Thank you so much
    Janette

  565. Doc says:

    Hello, Janette,

    Wow, that is a tough situation. As I have only a general idea of what is going on, I can only give you general comments. Without seeing the patient and test results, my opinion can be off the mark.

    From your description this sounds like a soft tissue sarcoma. These tumors are poorly differentiated, meaning that they don’t look like a specific cell type. That’s one reason they may not be able to give you a more specific diagnosis. Instead, you see the characteristics of malignant cancers – lots of rapidly dividing cells and frequently the cell sizes are not uniform.

    It sounds like the tumor is invasive, penetrating the tissues around it. This is why radiation would be recommended as a follow-up: to kill the abnormal cells that would unavoidably be left behind.

    In other parts of the body, one might just do a more radical surgery, taking a broader swath of tissue. Unfortunately, in this location, that would be tantamount to cutting the patient’s head off. It’s just not an option.

    I agree with your doctor in thinking that at some point your friend will be unable to swallow, and that is the beginning of the end.

    With one of my own dogs, I knew he had a malignant cancer that was widely spread throughout his body. I had removed a large tumor along with his spleen, but could see hundreds of small tumors throughout his abdomen. He seemed to feel okay until one day when he dropped his treat. He wouldn’t allow examination of his mouth. I anesthetized him and found a large mass in his throat.

    At that point I had the options of letting him starve to death on pain-killers, putting in a feeding tube until the cancer manifested somewhere else fatally, or going ahead with euthanasia (which is what I did, which was difficult for me, even though the situation seemed clear-cut).

    I fear the prognosis for your cat is poor, with weeks being the likely time-frame until he has difficulty swallowing.

    As long as he seems to feel good, or can feel good with pain medicine, I would enjoy his last days as much as possible.

    Best wishes.

  566. Janette Butterworth says:

    Dear Doc

    Thank you for your prompt reply, it is not good news but it is sort of what I expected:( Can you please answer one more thing for me? I feel so guilty that I didn’t spot this tumour earlier, maybe it could have been treatable. Do these tumours grow quickly, as I’m sure I would have noticed it earlier if he has had it for some time? Also, I have seen conflicting information on salivary gland tumors, being that they are very painful or painless. I don’t know whether to ask for Metacam, but he isn’t displaying signs of pain at the moment.
    Thank you so much for what you do here, myself and I am sure all the other posters here too are eternally grateful.

    Kind regards
    Janette and Sonny
    Kind regards

  567. Jay says:

    My lovely cat is 21 years old. He has been living with arthritis for many years. While he cannot jump, he gets on the bed with stairs. He mostly sleeps, and gets up sometimes to eat, drink, or go the litter box. His dental is not good and gets sores on his lips or under. I’ve not done anything for this because I won’t put him under anaesthetic because of his age, and he has a heart murmur. I know he has pain from his athritis, and it is painful for me to watch him limp. I am having to make a move overseas this year, and have been thinking about trying to take him in the cabin with me. I am worried about doing this and wondering if it would be cruel to him to do so. Also if I am keeping him longer than I should when he struggles with getting around. It is kllling me trying to figure out the right thing to do.

  568. Doc says:

    Hello, Jay,

    I wish that we had better options for pain control in our cats. Buprenorphine is a narcotic that is really good, but too expensive for long-term use. Onsior is the only non-steroidal anti-inflammatory approved for cats in the USA, but only for 3 days. In Europe it is approved for 6 days.

    Metacam (Meloxicam) is approved in Europe, but not in USA. However, many cat specialists use it on a long-term basis, providing clients are willing to sign a waiver saying that they understand it is not approved, and may cause kidney or other problems. The reason that they do this is that many cats do very well with it, and the alternative is misery with their arthritis.

    There does come a time when the body won’t support the spirit, and you’re dying slowly instead of living longer. I wish that I could make this decision easier for you, but you know your cat better than I do.

    A trans-Atlantic flight is a pretty long time to be confined to a crate, but if he mostly sleeps anyway, it might not be so bad. Hard to say what the changes in cabin pressure would do, as far as making him more uncomfortable.

    That’s a hard thing to test.

  569. Keanu Young says:

    Thank you for providing a place where we can go for answers and to grieve.

    I had my best friend put down on Wednesday. I am still devastated. Jojo was a sweet girl, just a lovable cat who helped me cope when my son and girlfriend moved to NY last summer. She was our cat but when my family decided to move to NY to be closer to family, Jojo became my responsibility. I loved that she would greet me when I came home from work. She kept me company when no one else was around and kept me from being lonely.

    She had liver issues, so she was on a special GI diet. I also mixed Miralax into wet food to help keep her from getting constipated. In February, I noticed that she was vomiting so I took her to an emergency vet who gave her fluids and an enema. They wanted to do a complete workup on her, including imaging and blood work but it was going to be expensive, so I decided to take her to see her regular Vet. However, she stopped vomiting and otherwise seemed okay, so I waited a couple of weeks. I started noticing that she wasn’t eating as much and started feeling lighter, so I finally took her in (in March). Her Vet did blood work and a urinalysis. She called me the next morning (I had them keep her overnight) to tell me that she was a very sick girl and that her kidneys were failing. She sent me home with fluids that I would have to give subcutaneously and Mirtazapine. She advised that Jojo’s short term prognosis would be dependent on getting her to eat. Unfortunately, her appetite continued to be subdued. She would only eat treats so that is what I gave her. In a matter of weeks her appetite disappeared altogether. I continued to give her subcutaneous fluids but even that wasn’t enough. I also noticed that she stopped drinking too. Over the last week of her life, I tried to force feed and force hydrate her, but she didn’t seem to tolerate that well. She also stopped cleaning herself, would drool, and her back legs were very week- she struggled to get to where she wanted to be. I called my Vet the day before putting her down to see if there was anything we could do to help with her nausea. I gave her the medicine our Vet prescribed on Tuesday but not sure how much it helped. At the time, I was adamant that even in her deteriorated condition that I just couldn’t euthanize her. I talked it over with my vet who told me to consider quality of life issues but to make no decision until I was ready to. That night Jojo slept in her litter box. She looked so frail and uncomfortable. They next day, I took her in to see our Vet. I asked her if there is anything we could do. She advised that we could try to prolong her life but that her condition was irreversible and that she would only continue to deteriorate. She saw me struggling with the decision and talked to me. She said if it would make the decision any easier- she would euthanize her cat if it was in Jojo’s condition. She knew how much I loved Jojo and I believe as her Vet, she loved her too. So, it wasn’t an easy decision for either of us. I prayed for strength and ask that I go with the decision that would be best for Jojo. I ended up choosing to euthanize her. It was an extremely emotional and difficult decision, but I felt like that was the best option for her. I am still struggling with the decision and trying to play every second of that visit back to see what could have been different but what helps is knowing how peaceful she looked right before she was put down. I hope she realizes that my decision was out of love for her.

  570. Doc says:

    Hello, Keanu,

    Thanks for sharing your story. It sounds like you did the right thing. When someone we love is dying slowly, with no quality of life, it is no kindness to watch it play out naturally. It is never easy to make the decision, but this was the right decision.

  571. Julie Siegel says:

    Our beloved 13 year old female indoor only cat developed a nasty looking skin abscess one month ago of undetermined origin. We thought perhaps her pesty brother scratched her, or our German Shepherd, who lovingly likes to herd her flock of 5 cats, may have accidentally nipped her. It truly was odd! When in a week it wasn’t closing up, our vet surgically closed it, (3 weeks ago.) Then a week ago, thereabouts, approximately, give or take her stitches came out. To make a long story short, my wonderful kitty, suddenly had her healing wound rupture! We went from thinking she had Actenomyces, the rare bacteria, because her skin was morphing in this horrible way, to seeing 10 lumps grow all over her body in one weeks’s tome. A needle biopsy confirmed she has Cutaneous Lymphoma, which I gather is an extremely rare form of Lymphoma in cats. She is on Bupromorhine, and began Steroids, last night when we learned. However, our vet is speaking to the oncologist about chemotherapy, because of such poor outcome. Is it worth it to put her through such a complex modality, as it appears for such a short average survival time? What do you think? She is eating, but confined to a bathroom, so as not to further injure the gaping lesion, which can’t be bandaged. I visit her constantly in the bathroom, at which times she usually purrs. Although, at times she is quiet, which I interpret as her being painful. This is why I don’t know if I should put her through the treatment only for more of this existence, or will she feel better? Thank you for trying to help me understand this very complex situation. Sincerely, Julie

  572. Doc says:

    Hello, Julie,

    At this point, I would want to hear what the oncologist has to say. I’m certainly no cancer specialist.

    When my own cats had lymphoma (similar cancer, but in the lymph nodes and other areas, rather than skin), they didn’t respond well to the chemo. I certainly wanted to try, but our results were very disappointing.

    I haven’t treated many cats with chemo, and have more experience with dogs. My dog patients haven’t felt ill with their chemo, and some have had really good responses. Even those who failed to respond didn’t have a lot of problems with the drugs.

    My own cats seemed to feel pretty bad with their treatments, but that is a very small sampling.

    When you hear from the oncologist, you will want to know how the treatment is to be given, how many treatments, what they expect in the way of side-effects, and how much extension of good quality of life could be expected (though obviously not guaranteed – they can simply tell you the range of responses that they have had).

  573. Isilay says:

    Hi, I have a 14 year old kitty who was diagnosed with the cancer of spleen and liver last week. I first took him to vet at the beginning of this month because he had lost his appetite and started vomiting frequently. This week they finally diagnosed the cancer and vet taking care of him told me that the cancer has spread everywhere, and he also cannot survive long with his severe anemia. He alluded that my furbaby had days to live and I should take him home to spend some time with him. He told me that he would have operated a surgery even if there had been one percent chance of survival. Furthermore, my baby has severe anemia that still continues. His blood test results were three times lower than the minimum limit. After this sad conversation, I took him to another vet who told me the same thing, but offered some palliative care involving paste to keep his appetite strong, cotisone pills and a stomach medicine to prevent him from vomiting. He undergoes this routine medicine therapy every other day. In addition, I give my boy fish oil and a food supplement for recuperation and force feed him with stringe with a chicken wet food mix. On the days he takes cortisone, he eats some food and drinks, though in small amounts than usual. On the days when there is no cortisone he never touches his food and does not even go near it. He usually stays on the same spot- under the dining table and he very rarely comes out. Today I realized that he has become extremely defensive when I try to give him his food with a syringe. Today also the vet had an extremely hard time giving him his pill, his lip got hurt and bled in the process. I know it is evident what I should do now after reading all these comments. But now I am still facing a dilemma- should I keep giving him cortisone to make him eat and have a better quality of life until the last moment, or should I have him put down immediately? I would like to have my furbaby with me for as long as possible, but at the same time I do not want to see him suffer. He is the sweetest and gentlest cat that I have ever seen in my life. Please help me how to look at it. The second vet said he does not seem to have pain because of the tumors but he has discomfort because of lack of blood cells which also shuts down his appetite. Thank you very much for your help!

  574. Doc says:

    Hello, Isilay,

    This is always so tough. If your cat feels good on the cortisone days and the alternative is euthanasia, I would consider doing the cortisone every day. What have you got to lose?

    If the only difference is that he eats a little on those days, but is still basically miserable, that is not so good.

    It’s more like you are prolonging the dying, rather than the living.

    You know your cat better than anyone else, and I don’t think that anyone else is in a position to do other than respect your decision. Your knowledge and your caring will lead you to the right choice.

  575. Isilay says:

    Dear Doctor, thank you so much for your answers, and setting up a site like this! The expected thing happened and my baby has stopped eating altogether despite a daily dose of cortisone. He has not eaten even a morsel of food since Saturday night and is entirely seclusive – he lives under the bed now and even refuses to lie on the puffy blanket I put there for him. His body temperature has dropped, his ears and paws feel cold to touch and his body is no longer warm. He only sits, last night I constantly checked him out, and he never slept at all. Just stayed under the bed sitting, not lying, not putting his face down like he used to do when sleeping. I now know my baby is dying. For tomorrow evening I made an appointment with his doctor to put him down. I can’t bear to look at his face now, he looks so so sad and desperate. I know I should have put him down yesterday and feel so guilty. Do you think he is pain? My boyfriend insists on not putting him to sleep and does not support my decision to let my baby peacefully go because families do not do the same thing to people when they get sick. He is against euthanasia and because he did not let his own dog go, he told me his dog died crying. He prefers to leave the cat alone. His lack of support devastates me and makes the decision even harder for me. Please tell me if there is any logic in leaving a cat alone rather than putting him to sleep in such a situation where he has incurable cancer and refuses to eat even his favorite wet food. Please help, I lose my mind every time my furbaby looks at me in the eye looking so helpless.

  576. Doc says:

    Hello, Isilay,

    I can understand people who have difficulty with this decision, as your boyfriend does. However, you have to make the decision that is right for you. It is yours to make, not his.

    In the situation that you describe, it is no kindness to watch the animal die slowly.

  577. Robyn Anscombe says:

    Hello,
    Please let me tell you Rusties story. He is a Ragdoll. I adopted him when he was fourteen weeks. At three years he was readopted by another lady, due to us decreasing our breeding program as a registered breeder. I thought he had a really good home. But he didn’t. I went and visited him yesterday as she was complaining that he was weeing everywhere. When l saw Rusti l was devastated. It was clear he had sustained a spinal injury, being unable to walk very well, stumbling everywhere. I picked him up and left her property. My question is, what shall l do about Rusties life. He doesn’t wee in a kitty litter box because obviously it’s too painful for him. He is completely macerated because he is unable to enjoy his food. He is laying around because he is in pain and doesn’t or cannot participate in play. He loves a cuddle, purrs and is very affectionate. Is it worthy to continue his life because he responds well to affection?

  578. Doc says:

    Hello, Robyn,

    This is a certainly a difficult case. With an injury that makes Rustie unable to walk, we know that he will require life-long nursing care. This raises two questions.

    The first, and most important, is whether he can enjoy any quality of life, even with intensive nursing care. Will he eat? Can he gain back his weight? Can he be pain-free?

    We are very limited in our options for pain relief in cats. Buprenorphine is a narcotic that works great, but very pricey. The only NSAID (aspirin type anti-inflammatory) that is approved in the USA is Onsior, and that only for 3 days. Metacam has been used extensively for cats as a last resort when they have such severe arthritis that they cannot get around without medication. It is approved in Europe, but not in USA. However, many cat specialists still use it, simply asking their clients to sign a waiver indicating they understand the situation.

    If Rustie’s pain cannot be controlled, then your ability to provide nursing care (keeping him clean, hand-feeding him, etc.) is irrelevant.

    If it is possible to give him a good quality of life with nursing care, then the next question is whether or not you have the resources to provide it, both monetary and time-wise, as well as emotionally. Constant care-giving can be rewarding, but also draining.

    I can appreciate the difficulty in considering euthanasia with a pet who responds positively to your handling and affection. However, if his life is limited to purring at you until he dies, that is not much of a life.

  579. judy Barbera says:

    Hi,
    My 12 yr old female cat was diagnosed with large cell transmural large intestional Lymphoma on 5/3/2019. The vet was able to cut out the tumor (7.5 cm x 4.0 cm) from her illieum junction and the margins were clean. However, the tumor had already gone through the muscular wall. The vet says 6-9 months with or without treatment. Infusion with CHOPS therapy is out of the questions due to travelling (2.5 hrs one-way)to the specialist) and the expense. She is on predisone now and she is doing very well, and gaining almost 6-9 ozs per week. She was 9.4 pre-illness and was down to 7.1 prior to surgery and now is gaining about 1/2 lb per week. We are debating putting her on lomustine. Your thoughts? Also, why does the vet say her life expectancy is 6-9 months “with or without treatment”. That part doesn’t make sense to us. Thanks, Judy

  580. Doc says:

    Hello, Judy,

    Like myself, your veterinarian is not an oncologist (cancer specialist). I suspect that the life-expectancy prognosis is what the oncologist told her/him. I certainly don’t have the experience in this area to give an estimate.

    There are some individuals that have great response to chemotherapy and go into long-term remission, but many do not. Sometimes we just achieve a palliative effect, meaning that life is better on the treatment, even if it doesn’t last longer.

    If I were seeing this cat, I would have to consult with an oncologist and rely upon their recommendations.

    It’s great that you are seeing improvements so far.

  581. Marilyn S. says:

    We are struggling too. Our 11 year old, one eyed kitty has lymphoma – tumors near his intestines. He has lost all muscle mass, down from 19 pounds to around 11. He has severe diarreah, outside the boxes we have for him and intermittent vomiting. The poops have gotten more frequent and he cannot make it to the litter boxes at times. He has lower energy and has had a couple of rough days mixed in with good days. We are so worried about him. We stay close to home daily and not sure if it is time. He is on Prednisone, and will start Fortiflora later tonight – Cerenia for nausea. Advice please –

  582. Doc says:

    Hello, Marilyn,

    I think that with the intermittent vomiting that Cerenia is a good choice. It not only suppresses nausea, but has anti-inflammatory effects, as well.

    It sounds like your veterinarian is giving you good advice and care.

    It also sounds like your kitty is moving toward more bad days than good.

    I wish I could give you some mathematical formula to tell you when to let him go, but it is never that easy.

    Talk with your veterinarian about your questions. Best wishes.

  583. Laura S. says:

    Hi – I just wanted to say thank you for this post and for the comments. I read through a lot of them. My cat Phineas has oral squamous cell carcinoma in his lower jaw. He’s my little buddy that I’ve raised since he was a kitten (he turns 11 this month). He was diagnosed in mid-April and, of course, this disease is incurable. He’s still in the “more good days than bad” category, I’d say, but after reading all this I knew it was time. I just now made the appointment for Wednesday for a vet to come to our house and put him down. He’s still eating, but losing weight, and still doing the things he loves, but has slowed down a lot. Sometimes he hides. He naps a lot more. I can’t, in good conscience, watch him get worse because “he’s still okay.” I had always promised him I’d take care of him forever, and this will be my last fulfillment of that promise – letting him go now, at home, on a beautiful day with the birds chirping outside, with me and my husband at his side. <3 Though I'm a total wreck right now, I will never doubt my decision. So, thank you <3

  584. Aisha says:

    Hi, I’m hoping this is still active. My 14 year old kitty was diagnosed with a tumor in her lung yesterday. She was also diagnosed with hyperthyroidism and it appears the cancer has affected her front paw. It’s all happened very fast as she only started limping a couple of weeks ago and had a mild cough that was treated with antibiotics. The news is devastating and due to her age and the fact that she is a very nervous cat, I’m not inclined to put her through invasive treatment if it’s either not going to work or only extend her life shortly. We lost our wee boy only 6 months ago so this has been a huge shock. Like others I’m unsure when will be the right time to say goodbye. She’s having trouble walking and has stopped eating but still comes for a cuddle. The fact that she’s become so ill in such a short period of time makes me think it’s progressing fast. I think I left it too late with our boy and now I’m massively conflicted. I feel like palliative care is best for her now. I’m waiting on my vet to get back to me to see what the animal hospital thinks of her blood and x-ray results but I know that her time is short.

  585. Doc says:

    Hello, Aisha,

    If you have lung tumors, then that is unlikely to be treatable. The leg tumor could certainly be a source of pain.

    Palliative therapy is more difficult in cats, as they don’t tolerate a lot of the pain meds that we can use in dogs and people.

    They do well with the narcotic buprenorphine, but it can get pricey. Onsior is a Non-steroidal Anti-inflammatory (NSAID) that is the only one of those approved for use in cats in the USA. It is approved for 3 days only (though approved for 6 days in Europe).

    Meloxicam is an NSAID that is approved for cats in other countries, but not in the USA. Feline specialists still use it, as we have so few alternatives in cats. They just tell people it’s not approved, and monitor kidney function while using it. Metacam is the trade name.

    I hope that the lab results will be helpful in making your decision. It is always hard to decide when – more bad days, or more good days.

    The doctor seeing your cat is the doctor best equipped to advise you. Share your concerns with him/her.

    Best wishes.

  586. Laurie says:

    Wow, you are an amazing person to respond to all these messages, and so compassionately. I hope you can help guide me to the correct decision.
    My almost-14-yo long-haired red tabby was diagnosed with diabetes about 15 months ago. It was agonizing getting him used to the necessary indignities – ear-pricking, insulin injections, and oftentimes he needed Cerenia for vomiting and mirtazipine to help with appetite.
    Let me say that he HATES, and has always hated, having his body manipulated. I’ve never been able to get anywhere near his paws to trim his nails, and he is almost impossible to pill, and believe me, I’ve tried EVERYTHING. He did eventually get used to the ear sticks and insulin to the point where he was hardly bothered by him, but prying his mouth open was another thing altogether.
    After several extremely difficult months of changing food to wet food, dealing with extreme digestive issues, nausea, inappetance, vomiting, etc., I finally got him on a good track. Neuropathy has not resolved to this day, though, despite giving him the supplement that is supposed to help (another pill!!! but I was able to crush it and get most of it into him via his food).
    Earlier this year he went into remission and was a pretty happy, normal cat for about 6 months.
    In November I noticed he seemed to be getting thinner (he had already lost weight before his initial diagnosis). Over just three or four days, he lost his appetite completely, became very lethargic and ‘meat loaf’y when he sat, and would just sit or crouch in front of the water dish staring into space.
    Verified that he was out of remission, took him into vet, where he was diagnosed with likely UTI (high white count in both blood and urine; no other worrisome numbers). He was given sub-q fluids, kept overnight, given a 2-week antibiotic injection and more Cerenia. Back on the Vetsulin and constant glucose monitoring. He seemed to bounce back somewhat for a couple of weeks, but then began vomiting more and drinking less, so back we went about a month later. He had lost a whole pound, he was still at just over 12 lbs. though so not emaciated, and more blood and urine work revealed nothing. More sub-Q, more Cerenia (an injection this time), more antibiotics (oral – great). This time his bounceback lasted only a couple of days, and I wonder if even that was more due to the adrenaline and stress of the vet and the relief at being home. He also hates being in the carrier and riding in the car.
    So now I am faced with the prospect of another vet visit (or more than one), with more elaborate testing, more fluids under the skin, more Cerenia, and who knows what else. In the meantime, he just seems like he’s tired of it all. He sleeps or lies in his bed or on the sofa about 22 hours a day or more. He’s barely eating. He still purrs if I pet him but even that seems half-hearted. He spends a lot of the little time he’s awake and up just sitting and staring into space.
    I think I know what I should do, but I am wondering whether another trip to the vet should be in order or not. All I can think is that whatever they find is not going to be good, and will involve a gradual, or sudden, decline despite their and my intervention. Can you guide me toward the best decision for him? Thank you for any advice at all. It’s heartbreaking reading all the stories of pet owners trying to do right by their pets, but also it’s reassuring.

  587. Doc says:

    Hello, Laurie,

    The 2-week antibiotic injection (Convenia) is really convenient, but doesn’t have the best track record for UTI. However, it can cause a false-negative culture result.

    I have certainly used it myself when the owner was just exhausted and felt unable to medicate the cat orally. I just haven’t always been happy with my results.

    It is very difficult to get the diabetes regulated if there is source of inflammation in the body (like a UTI).

    It is likely that other organs are now being affected. The disruption of the cat’s metabolism is likely taking its toll all over.

    Being dehydrated certainly makes you feel bad, even if there were no other problems. With any type of kidney problem, it makes it worse in a hurry. Thus, support with the subcutaneous fluids may have to be done on a frequent basis.

    The mirtazapine is available in a trans-dermal formulation (Mirataz), which makes it easer to use. If the cat won’t eat, it certainly won’t get better.

    Which brings us to the elephant in the room. “Can the cat get better?” I don’t think he’s going to get well. Can he get okay? It’s not looking good, from your description.

    I can’t tell you it’s time to let him go, but it sounds like it.

  588. Laurie says:

    Wow, you are still here. I can’t thank you enough for your response, and for this site. I’m sitting here crying because I just made an appointment for Rufus to be euthanized tomorrow. He had a pretty good day yesterday, but honestly a pretty good day for him isn’t really great anymore. I spoke with a friend who said my situation was very similar to that of one of her cats – there were no obvious overarching diagnoses that would have made euthanasia an easy (less difficult) decision, but there was just a gradual decline. I feel like Rufus’s decline has been exacerbated by the diabetes (which, why would he even get? What causes it? He was never overweight in his life) and the concomitant issues.
    Yesterday he ate small amounts of food throughout the day. He used the litter box. He stepped outside to enjoy the weather for a bit. He slept in my son’s bed with him for most of the night. Today he’s back to being indifferent, for the most part, toward his food. This morning his eyes were dilated like he’s hurting, and his breathing seemed a little rapid and shallow. He’s still purring and the eyes aren’t dilated constantly. He just ate a little bit. I have decided that I don’t want to wait until his eyes look like he is hurting all the time, until his appetite is completely gone, until he isn’t even interested in going outside, before I let him go. Best to do it while he’s not lost all of his quality of life.
    He was my buddy and my alarm cat. He alerted me to an intruder in my house in the middle of the night, many years ago.
    Thank you again for this page and for your compassionate replies to every single query that has been put to you. My gratitude knows no bounds.

  589. Laurie says:

    Posting for the benefit of folks in the position of having to make the awful decision. We let our big ginger guy Rufus go yesterday. It was almost as though he knew and was like, ‘what took you so long?’ He’s usually pretty reserved around strangers, but came right up to the vet who came to our home. We took him into the room where he’d been spending most of his time and sat on the bed with him in between us while she administered the sedative, and he purred the whole time until it took effect and he drifted away. Again, it was almost as though he was just waiting for someone to help him let go; at least that’s how I decided to rationalize it. And he went very peacefully while we sobbed on the bed.
    Having been through this more times than I’d like to admit, I know that there will always be moments of second-guessing my decision; feeling guilty for playing God with my pet’s life; wondering if I chose the right time, if there even is such a thing. But I am as content as is possible that he left us before he was miserable all the time, and that his last day here on earth was filled with love and purrs and treats and even a little trip outdoors to breathe the fresh air and listen to the birds. Peace to all of you, and Doc, I am forever in your debt. Your words have been priceless.

  590. Katie says:

    Hi,

    I am not quite sure if i am here for some advice or more for some reassurance. I have had my beautiful british shorthair boy, named Chocolate, since he was a kitten, he is now almost 13. He is the most beautiful, friendly, loyal cat you could ask for.

    He was fit and healthy until may of this year when he deteriorated, his weight dropped down to 4.6kg it had previously been around 5-5. He also had become quite grumpy towards the other cats and was spending a lot of time alone. I took him to the vets who found he had an infection in his mouth, he had several teeth removed. After this he completly bounced back, and almost returned to his kitten like personality, he gained some of his weight back and was eating well.

    However in August he started to lose weight again and completly lost his appetite, he felt dehydrated. He looked very sad and lost. I took him to the vet who gave him an appetite stimulant, some antibiotic and took some blood work, telling me she would phone back with the results.

    I got him home and he was ravenous, eating anything i put in front of him. Sadly i then got the call that his liver enzymes were off the scale and she suggested he needed to come in overnight to have fluids and medication. When i got him to the out of hours vet and told him chocolate had eaten, he suggested i water down his food and monitor him at home until the morning. He improved and over the next month he had weekly blood tests, was given liver health tablets and antibiotics. There was little improvement in his bloods.

    I was told he needed an ultrasound and then possibly a liver biopsy. The vets view was that it was likely either a mass in his ghoulbladder, liver failure or a tumour in his liver.

    I have punished myself ever since but at the time i decided with my vets support, that he is not strong enough for surgeries, he doesnt need to be prodded and pulled around as he is too frail so my vet recommended that we give him the liver health tablets and bring him home to see his last days,weeks, months whatever it may be. It took some time for me to make peace with it, but i think i made the right decision.

    We seperated him from my other cats as they dont understand he isnt always in the mood to play. He was so much happier, always on my lap purring, greeting me at the door and just seemed generally happier with life.

    I have been keeping a diary of his mood, toilet, eating habits and grading each as good ok or bad. He genreally had 5+ good days a week with the occasional ok or bad. Ive also been weighing him he has genrally been 4kg or 3.9, my vet said anything under 4 is a concern.

    However the last week i felt he deteriorated. He went off his food, not eating for a whole 24 hours and he had a very upset tummy for 3 days this week, also drinking high amounts of water. His weight at his lowest was 3.5 but has been around 3.6-3.8 for the rest of the week
    He seemed a bit distant too and didnt look at content as before. I phoned the vets yesterday morning to book him in to go to sleep tonight.

    I am now grappling with my decision, which i was so sure of at the time, because he has been constantly on my lap, purring and has eaten really well since yesterday morning.

    Part of me thinks this is the right time, because i dont want him to have to go to sleep when he is feeling really rotten with an upset tummy and an empty stomach. But the fact he seems happy, is so cuddly and purring makes me think i have jumped the gun a bit.

    I am trying to rationalise it that he had had an extra 3.5 months with us that we didnt think he would (i had taken him to be put to sleep in September but the vet said she didnt think i was ready). I have spoilt him rotten , he has had lots of cuddles and i also get the whole day with him today before we go tonight. But i just need to know the decision I have made seems like the right one. I am posting this very last minute so am very aware it may not be possible for people to respond. I think i made the right decision, i hope i have, i hope everyone else who has to make this difficult decision can be at peace as it is the most heartbreaking thing a pet owner can do

  591. Penny says:

    Hello everyone. I’m writing with what I feel is the hardest decision of my life. My dearest kitty Sammy is struggling with an aggressive form of laryngeal cancer, together with intestinal small cell lymphoma. She’s on Prednisone, Mirtazapine, Tramadol, and when it’s
    possible to give her, Cerenia. The doctors say that her lymphoma might not be very progressive, but her laryngeal cancer, which is a non-lymphoma growth is slowly growing into her throat and will undoubtedly eventually begin to suffocate her. They’ve said that there’s no point in operating because the laryngeal cancer has most likely spread. Currently, Sammy is fairly alert, moving around, using her litter box ok, eating very little, not playing at all, wheezing sometimes a lot and sometimes a little (depending on whether she’s been moving around or not), but still loves to snuggle. Her eyes are clear, and she just moves a bit slower than before, but she is very responsive to her family. My biggest fear is that she will begin to suffocate and suffer horribly, but I’m not sure how much wheezing is too much, to the point that she needs to be released. The vets suggested that she will be ready any time soon…but what does that mean? I am so conflicted to the point where I’m not even sleeping well. I love her so much and I don’t want to see her suffer, but I also don’t want to take her light away while she’s still responsive. I can’t even judge what is a good day versus a bad day because she changes from moment to moment depending on her wheezing. Doc, I don’t know if you have any answers, but anything you can offer would be greatly appreciated here.

  592. Doc says:

    Hello, Katie,

    It is obvious that you have worked very hard to give Chocolate the best quality of life possible as he declined.

    It is also obvious that you have given a great deal of thought and caring in making this decision.

    Don’t second-guess yourself at this point. Just know that you have done your best.

  593. Doc says:

    Hello, Penny,

    If you see any open-mouth breathing, that would be a sign of respiratory distress. If she has trouble eating or drinking (as she needs all her room back there to breathe), that would be another sign that we are near the end. If the noise becomes more high-pitched then the airway is getting smaller.

    I understand your concern about not wanting to wait too long and having her suffer, but this is a hard call.

    Be alert for those warning signs, and just your own feelings about how your cat is feeling. You know her better than anyone else.

  594. Jessica Laws says:

    Our 12 year old black female cat, we call her Kittens, was diagnosed with nasal lymphoma about 10 days ago. She’s displaying signs that it is affecting her brain. Started out pacing aimlessly and attacking the other cats and one of our dogs. Never did this before. The last 2 days she is declining rapidly. The version of her we’ve had for the last 12 years is pretty much gone. It’s really hard to figure out if it’s time or not. I put her on the couch and she sort of walked off of it and fell on her side. When she paces, she almost walks into walls, seems confused. She will stop and crouch down, stare at nothing and wobble back and forth some. She follows our dog around like she doesn’t know who she is. She walks over things in her path instead of going around, including the dogs. But she does enjoy being pet and is still eating and drinking, using litter box. I don’t want to wait till she’s completely gone or starrts having seizures. Please help!

  595. Doc says:

    Hello, Jessica,

    I wish I had an easy answer for your question. I think you would be able to see her deterioration before she is “completely gone” as you say. The seizures on the other hand would be really unpredictable.

    If you think she is still enjoying life, than I would let her do so.

    With all the abnormal things you have described, I suspect you will see more bad things happening pretty soon.

    It’s all about whether she is having any pleasure in life, or just struggling to make it through the day.

  596. Mine Ozdemir says:

    Hello Dr,
    My cat is diagnosed with intestinal lymphoma beginning of December. She has been throwing up and sometimes she has diarrhea. My doc told me to euthanize her when he saw the ultrasound. He said his intestines became very large. I was shocked I said I need time to say goodbye so he gave her famotidine. She seemed really good for a week. When she started throwing up I took her again and we decided to do steroids . She responded so well and good for a month. I took her again he gave her another steroid shot along with B12. She responded ok not as good as the first time though. She throws up couple of days a week she has diarrhea once a week now. I am taking her tomorrow for the third time but I am undecided at this point. I will never able to make a appointment for euthanasia. I have been going mental thinking about it. She still wants food 3 times a day eats little by little and slowly. She always weights around 8-9 pounds but now down to 5 pounds. Her stomach/ intestines always making loud noises. What should I do??

  597. Doc says:

    Hello, Mine,

    There are more aggressive chemotherapies than the corticosteroids, but they can also have more side-effects, and are more expensive. The longer the lymphoma has been present, the poorer the prognosis.

    Sometimes the disease is segmental, and you have to remove a section of the most badly affected intestine, as medication will only shrink things so much.

    Ideally you would see a specialist for evaluation. I am certainly not an internal medicine specialist, nor a radiologist. It is possible that your cat is beyond our capacity to help, but a specialist would be your best course if you have not seen one (and if that is possible).

    Otherwise, you are looking at more of the same, and probably progressively less effectiveness with the treatment as time goes by.

    I wish I could tell you how to make your decision. Work with your doctor.

  598. Lisa says:

    Such a hard time we are in he same boat with our 18 and a half year old cat, we had to make the decision last year to put our other 17 year old cat down, it’s never an easy decision ? you will know when the time is right though

  599. Danielle says:

    I found this site on a lark, doing searching for “cat with lymphoma of the spleen not responding to steroid treatment”. Hamlet was diagnosed last Wednesday with lymphoma, and a second opinion at a closer vet to us than the emergency hospital confirmed it was probably in his spleen. There are no tumors, but she said his spleen “looks a little inflamed and the wrong color”.

    Hamlet was a 15lb chonky boy about 3 years ago, but now he’s about 5 pounds. He went from 8 to 5 in about two weeks. We tried everything. Steroid pills, steroid shot, anti nausea, appetite stimulant, IV fluids everyday. Still he has diarrhea. Still he refuses to eat a great deal, just a few large uncoordinated bites before he lists off, his hind legs stumbling, as he makes his way to the couch or the bed.

    He still meows for butter. He still wants to sit with me while I write, cuddle in our hair at night while we sleep, and spend all of his waking moments next to his mommies. I can tell myself that is his “quality of life”, but the truth is he is not responding to treatment. He has cancer. He is deteriorating every day just a little bit more, and his purrs and non-glassy stares are just glimpses into the kitten he once was.

    The doctor on this site gave others great advice. We can’t make them young again, and there’s a time where we can’t give them more good days than bad. It’s only been a week, and like others I sit here and read the pain in other’s postings who say “my pet still gets around, so is it the right time?”

    And I think, there will be a time where he can’t get around. It might not be soon, or it might. He tries to jump up on the desk and makes it only 10% of the time anymore. Do I really want to wait until he’s too sickly to come to bed?

    It is unfair he didn’t respond to treatment, even his kind vet is surprised. But like so many of you with your old elder pets, I have been honored to know him all 15 years of his life, and mine. There never seems to be a “right time” to say goodbye when we promised to love them always. Sometimes it feels like “always” comes so soon.

    We’re going to give Hamlet another day of constant snuggles, kisses and love, then make the hard decision to euthanize at home before he is even more of a shadow of his former self. I feel like lymphoma of the spleen was harder to decide over than the lung cancer my cat had before this. My heart goes out to everyone. But the pain we feel is equal to the love we gave.

  600. Lisa says:

    My 14 year old adorable cat Biff had surgery to have a tumor in his upper jaw area removed as well as some teeth in August. After the biopsy came back, he was diagnosed with OSCC and the tumor was malignant. I decided not to do chemo or radiation. He actually started gaining weight after the surgery, but this week seems to be having trouble eating again. He also sneezes and shakes his head, especially in the mornings. He sleeps most of the day but still wants to be near me. I can definitely see the tumor growing back; the left side of his face is swelling. Do you know why he is shaking his head? I’m guessing he’s in a lot of pain. I’m thinking I’ll have to make that terrible decision of putting him to sleep within a few weeks but I’m also thinking of whether to start giving him pain medication. Thank you for any advice you can give.

    • Doc says:

      Hello, Lisa, I am sorry to be so late in replying, but our website was re-vamped and the blog comments went into limbo. I am sure that you have already had some resolution here. I will say that that type of tumor has a terrible prognosis. You can’t really do a wider surgical removal. Bone involvement is usually quite painful. I would definitely have given pain medication in a situation like this. Again, I apologize for the delayed reply.

  601. Jennie says:

    I am trying to make a the difficult decision right now about my amazing 24-year-old cat. She is a small tortoise hair cat that only a year ago could still come to our house by climbing a tree and jumping from the tree to the upstairs balcony. She was diagnosed with kidney disease 4 years ago. She has has various treatments over the years and takes blood pressure medicine. Over the last week her back leg has become weak and she sometimes falls when she walks, a couple of days ago her interest in food and water decreased significantly. All she is interested in is sitting on my lap and sleeping or having me rub her head. I keep thinking that she will lose interest in my company and thats when I will know but now I think that might not ever happen. I keep wanting to think that her desire for closeness means its not time, but the not drinking water or eating is probably the more telling sign. I have an appointment for someone to come tomorrow to let her go. Even after all these years i got with her, I’m still not ready.

    • Doc says:

      Hello, Jennie, I’m sorry to be so late replying, but we had a revamp of our website and the comments were hidden until today. Thank you for sharing your story. It’s always hard to say goodbye to a friend. Twenty-four years is an amazing life for a cat. I am sorry for your loss.

  602. Ashley says:

    Hello,
    I know the inevitable is coming soon for my 9yr old feline best friend Patches. Earlier this year she was diagnosed with a giant cell soft tissue sarcoma tumor on her front left leg.
    We had it removed the day of diagnosis but knew the likelihood of recurrence was high. Within 5 weeks it came back very aggressively so we opted for amputation at the end of July. She loves her humans that live with her but is quite feisty and not a fan of strangers, car rides, or unfamiliar places on top of having asthma so I knew cancer treatment would not be optimal for her.
    Within the last few weeks we’ve noticed the tumor has come back and keeps getting larger. She gets around just fine, healthy appetite, normal use of litter box, playful, and still seeks out affection. She has lost a very small amount of weight but still looks and feels healthy. This kind of tumor grows very rapidly which is making this decision very difficult in terms of when. I would like to avoid any suffering for her as she’s been through enough this year having been through two surgeries (she handled it all like a champ) but fearful of making the decision too soon when she still has a good quality of life.
    I love her to pieces and know her time is coming soon. I’d like to remember her while she is still well but can’t help feeling guilty that it may be too soon.

    • Doc says:

      Hello, Ashley, I am sorry to be so late in replying, but our website was re-vamped and the blog comments went into limbo. These soft tissue sarcomas in cats are horrible. You remove them, it looks great, and back they come, and in a hurry. I have gone back three and four times before the tumor was doing so much damage that we couldn’t consider removal another time. It’s tough. I wish I could give you some kind of chart or something, but I can’t. You have a better knowledge of how your cat feels than anyone else does. You will just need to work with your veterinarian to decide when the time is right.

  603. Jay says:

    I just found this blog and find it sad, but comforting. We have a wonderful 18-year-old cat named Sweetcat. He’s a Russian Blue that we picked up from a shelter in 2005.

    Sweetcat head issues with vomiting for several years. The vet checked blood levels but didn’t recommend anything until recommending an ultrasound when things got worse earlier this year. Sweetcat was vomiting daily by this time.

    The blood work and ultrasound showed some kidney disease and, worse for the cat, a mottled spleen, swollen lymph nodes, and inflamed intestines. We were told that although it could be a very bad case of IBD, it was likely advanced lymphoma.

    Since then, Sweetcat has gone blind in one eye with a detached retina. He has begun walking with his hind legs apart and weak. He is on prednisolone and blood pressure meds.

    He still uses his litter box for the most part, eats a lot, can jump somewhat (he jumps on our laps and then on to the bed), and sits in our laps often. He purrs, if not as much as previously. He talks to us a lot and not in a pained way.

    But he also sleeps about 20 hours a day and no longer goes outside or plays. He just wants to be around us and sleeping in our laps, except for when he is using the litter box or eating.

    His time is coming very soon, and it makes us all very sad, but I appreciate all the information and empathy here. He doesn’t seem to be in pain, but he also isn’t doing very much and is losing weight and strength.

    It has been an honor to know Sweetcat. We will miss him terribly.

    • Doc says:

      Hello, Jay, Thanks for sharing your story. It sounds like your veterinarian is doing a good job to help maintain Sweetcat’s quality of life as he nears the end. When you have such a long relationship with a cat, you really get to know them. You will know when he is no longer able to enjoy life.

  604. Meagan says:

    Hello Doctor,

    I have spent the entire week reading and going through all the comments in hopes I would find the answer we are looking for but I am still at a loss.
    I have had my 14 year old Persian Sadie for the better part of my life. She has been with me since I was 20 and has never failed to be there for me through all the hard times as well as life’s major milestones such as my wedding and first pregnancy. She is literally my comfort blanket.
    This past Saturday we got home from crib shopping to find that Sadie had not left the same spot all day. This was out of character for her and when I attempted to feed her her wet food (which she normally comes running for) she was uninterested. She was even snapping at us when we attempted to pet her. We decided to take her to the vet right then and there which resulted in myself and the vet being bitten (she does not do well at vet appointments) and them putting her under anesthesia just to do the exam. During the exam the Doctor found a mass. We did an x-ray which confirmed said mass and a blood panel but neither seemed to give us the answers we were looking for. The doctor sent us home with an antibiotic and Buprenorphine and told us to wait it out. I spent the entire night until 6am Sunday morning with Sadie while she recovered from anesthesia. It was absolutely heartbreaking seeing my baby look and feel so helpless. Here I was 8 months pregnant laying in a mattress soaked in cat pee because she couldn’t get up to relieve herself. I refused to leave her side as if I left her for a minute she would try to jump down from the bed which resulted in her hurting herself and when I placed her on the floor she would stumble around falling over.
    On Sunday night we took Sadie for a second opinion. They confirmed that there was definitely a mass it was just a matter of what this mass was. They said we can take Sadie to a specialist out of town who would do an ultrasound and test the mass to establish a treatment plan. Long story short, if the mass is benign we could *possibly* do surgery to have it removed. If the mass is malignant we could, again, *possibly* do surgery or treat with medicine/chemo but results are never guaranteed.
    This is where it gets tough. Sadie is an older cat and does not do well at vet visits. Its a whole production even getting her in her crate and it usually results in someone being bitten. Most vets will no longer touch her without wanting to use anesthesia which would require 24 hour monitoring from us after each visit. We have already spent $800 on testing, the ultrasound would be another $800 then the cost of surgery or chemo thereafter which can start at $1200+. My lovely husband has offered to pay for treatment but with the baby on the way I don’t know if this is feasible. More than anything, I don’t want to put her through all the stress of multiple vet visits and medications just to have an unhappy outcome. Like I said, we are expecting our first child in 6 weeks and I am concerned about nursing a sick cat on the days leading up to the child’s birth or with a new born. Also, do I want to be exposing myself and my newborn to Covid-19 if we end up having to do multiple vet or specialist visits down the road? I feel guilty even considering euthanasia and feel as though I am making excuses or I am giving up on her. Is this “convenience euthanasia”? . All I’ve done since Saturday is cry and the idea of life without my precious baby. I have read message boards and communicated back and forth with our vet desperately looking for a sign. I feel angry that this is happening to us right now but friends tell me maybe this timing is a blessing?
    Its now Wednesday and Sadie has been having good days and bad days. There are days where she wont leave the same spot in the hallway or eat special treats like salmon or ice cream. Other days shell still hop up on the bed in the middle of the night purring and come running for her food. She has not gone #2 since at least last Friday and her painkillers are down to the last drop. I cannot get her to take her antibiotics as if I crush them in her food she wont eat, and putting it in a syringe results in one very wet cat and no medicine making it in her mouth.
    I think I know in my heart what we need to do but its just a matter of when. I feel like its a lose/lose. I selfishly want to keep her here but I also selfishly don’t want to drag it on any longer than we have to as this has been the longest, toughest week of my families life.

    • Doc says:

      Hello, Meagan, Wow. With Sadie’s being so unhappy about taking medicine, it doesn’t sound like you would be able to give her any sedation before her visit. And if she’s that upset, I doubt that Feliway (the comfort pheromone spray) will be enough to make a big difference.

      If I were in this situation, and wanted to do as much as I could, I’d skip the ultrasound and just go to an exploratory surgery. If they open her up and the mass cannot be successfully removed, you know that her situation can only get worse, and (as hard as it is to confront), euthanasia could be performed intra-operatively while she is already anesthetized. Even with I.V. fluids and full surgical support, I think it would cost less than the travel and ultrasound exam, and you would either have your answer (not operable), or could remove the mass and perhaps extend her life and quality of life.

      If this were not feasible (I obviously haven’t seen your cat or her condition), then I would hardly consider this a “convenience” euthanasia. Your cat is having a lot of bad days and she has a mass in her abdomen, and that is most likely something that isn’t going to get well. You know your cat and you know your situation and you are the person best qualified to make the decision that is right for you and your cat. No one else has grounds to judge.

      • Meagan says:

        Hi Doctor,

        Thank you for your quick response. The fact that you continue to respond to each and every one of us is beyond kind.

        I have just sent out Vet an email suggesting explorative surgery. We’ll see what she comes back with.

        All the best and thanks again.
        Meagan

  605. Jen says:

    I have a 14 year old, male cat who was just diagnosed with diabetes. He was a big cat, and had lost a ton of weight and was drinking water like crazy in a span of 2 weeks, so I took him in. I know the only treatment is insulin, but this cat will not let anyone do anything to him. It takes 2 of us to put advantage on him every month. If anyone reaches down to pet him and he cant see that both hands are empty, he jumps away. If anyone tries to hold him, he freaks out. He freaks out and hides if someone come to the door. There is no way that we could give him insulin shots twice a day, and I know this. Even if we managed to hold him down, he would be terrified and traumatized constantly. If it was my other cat or my dog, I would try it optimistically, but this cat will not do well with it, even if we could manage to make it happen. So I’m still really struggling with this, but after talking to my vet and another vet, I have decided to just make his life as great as possible until it seems like he’s suffering, and then have the senior care people come to the house to euthanize him. I am so worried I’m not doing the right thing, or I won’t know when it’s time. Right now, he’s eating way more than he ever has, and he’s a little anxious and vocal, and he’s drinking a lot, but he doesn’t seem to be in pain. do you have any advice on how I will know?

    • Doc says:

      Hello, Jen,

      These cases are so difficult. I have had more than one patient who was so uncooperative that the owners just gave up. They were more than willing to monitor and treat, but their situation was similar to yours, and they just couldn’t do it. Don’t beat yourself up. Eventually, he will probably go into keto-acidosis. This occurs when he metabolizes his fat stores excessively rapidly (since he can’t really benefit from his food in a normal way). They get very sick, vomiting, requiring intensive care. He might also develop kidney or liver problems. I would guess that you will see a point where he no longer feels like eating, despite his weight loss, and that will be the end of the line.

  606. tracy grammer says:

    I’m here on behalf of my beloved Miss Kitty, who is 18.5 and has both stage 3 kidney failure and rectal strictures from ulcerations (the FNA was inconclusive for cancer). The stricture has complicated her stool issues (we treat with Miralax to soften, and lidocaine so that pushing doesn’t hurt) but since she no longer grooms, it falls to me to clean her up. Like anybody here, I gladly do it. Her kidneys have apparently nosedived since April. She gets sub-cu fluids every other day now, a phosphate binder when she eats/if she eats, Renakare gel; she also gets amlodipine for her blood pressure.
    She isn’t eating. A few licks of wet food and then she smacks her chops and zones out. She struggles to eat dry treats; it’s like she can’t control her tongue and it ends up flicking the treat away from her. I’ve tried syringe feeding; also fed her from the end of a chopstick. But she doesn’t get more than 3ml of food at a time. I’m concerned because she’s probably dropped half a pound in 2 weeks.
    My kitty stumbles and seems weak; she zones out near the water bowl; yesterday I found her lying beside it. She used to come downstairs and “ask” to go outside around 1pm each day but she hasn’t done that in about 4 days now. I don’t know if it’s time, or if this is a bump in the road. I am keeping a quality of life calendar and I think we’re getting close to the end, but I wonder if there’s something we haven’t tried that could help her at this point. As so many others here have said, she is my everything, the love of my life, and I’d do anything for her —
    Thank you so much for your service. Blessings on us all.

    • Doc says:

      Hello, Tracy, I applaud your dedication to your friend. It is hard to imagine how much time and effort you have put into caring for her as her body continues to deteriorate. It sounds to me like you and your veterinarian are doing everything possible to maintain some quality of life for Miss Kitty, but there comes a time when there just isn’t enough body left to sustain the spirit. If this is a “bump in the road” it’s a pretty big one. Four days is a lot. This is always a difficult time, but I think that you can at least be confident that you have left no stone unturned.

  607. Michael says:

    I have a 19-year-old male tabby cat named Nigel. He’s been with me and my family since he was just a kitten, and he’s brought us so much love and joy throughout the years. But whereas he was once the “mighty hunter” of our backyard, he now spends the majority of his days asleep on the bed or couch. Recently, I’ve noticed that his hind legs are giving him trouble. He’ll occasionally stumble as he walks, and his stance has changed to where it appears as though he’s trying to put less weight on his back paws. We have little makeshift stepping stools for him to get up and down from the couch/bed; he’ll lead with his front paws, and then slowly lift his hind legs one at a time. He still eats, drinks, uses his litter box, and enjoys a gentle petting. When he picks one of his kitty beds, he’ll give me this look as he sits down, as if to say, “stay with me. please don’t go anywhere.” His most peaceful moments appear to be when he’s asleep. He’s had a long, wonderful life, but his age is catching up with him, and I worry that his hampered mobility is only to get worse. For these reasons, we’re contemplating whether it would be more merciful and humane to put him to sleep this month. I certainly don’t want to wait until he’s suffering to release him from this world.

    • Doc says:

      Hello, Michael,
      This is a tough time. We don’t have a lot of options for pain medication in cats with arthritis. Metacam is approved in Europe, but has a “black box” warning in the USA saying do not use in cats. However there are cat specialists who do use it, as we have so few alternatives. Some cats seem to benefit from gabapentin, but it can also be pretty sedative. Cosequin for cats can be mixed with the food, and helps some, but it’s no miracle.

      When it come down to such a poor quality of life that you are considering euthanasia, you might consider using prednisolone. This form of cortisone is a really good anti-inflammatory. While it does have some potential for adverse effects with long-term use, you might be buying some time with improved quality of life.

      If you haven’t discussed with your veterinarian looking at alternatives for dealing with his arthritis, I would certainly recommend that.

      In the final analysis, you are probably the person best equipped to know when Nigel is approaching the end, and it will be time to free him from the prison of a decaying body.

  608. Laura says:

    Hello, first of all thank you to all the brave pet parents for sharing their stories. And second, thank you to doc for responding with such care and kindness.

    My Dorian is a 14 year old tuxedo. She was a dumpster kitty and I’ve had her since she could fit inside my two hands. When i first got her i didn’t have a carrier, so i would put her in my hoodie to keep her contained. She quickly became attached and I’ve just always felt we had a connection.

    I noticed a lump on her back just below her shoulder blades on Dec 3. It was probably the size of a flat grape and felt weird and gritty when i squeezed it. It didn’t cause her pain, so i made an appointment with the vet to see her the following Thursday. By the time the appointment came around, her lump had grown to the size of a plum. I could movie it around, and feel around it, and still wasn’t causing her pain. But it was crazy it grew that fast. I thought it was maybe an infected cyst. The vet tried to do a needle aspiration, but couldn’t tell from that what the lump was. She said to come back the following Tuesday for a biopsy. Honestly, at this point i was worried and didn’t want to wait over the weekend. She was able to make an available time the next day (friday the 11) to do the biopsy.

    Dorian did very well for her procedure, and continued to act normally. Eating and drinking, while she was sleeping a bit more, i chalked it up to surgery and the pain meds. The vet put her biopsy in as a rush, so we were to expect results either Tuesday or Wednesday.

    Fast forward to Wednesday morning, and i still haven’t heard anything. I’m freaking out and still so worried, so i called to see if they had the results back. The vet called me back shortly after to tell me that she received the results and that Dorian had a myxosarcoma. It is a very rare type of soft tissue sarcoma, and is malignant. At this point i wasn’t sure of the prognosis or options. She said she had spoken with a surgeon at Medvet, who had performed surgeries on her pets, and that they could see Dorian that day at 1:30 pm.

    I was kind of in shock at this point, and it was all happening so fast. I made some arrangements on my work schedule and got her to the surgery consult. The surgeon seemed very confident that he could remove the mass and it would heal well. However, due to the size, and to get sufficient margins, he would have to take some muscle from her back/ribs and legs. We talked through all the options, including minimal surgery and radiation, and doing nothing. After the call with the surgeon, i felt confident that surgery was the right option, even though it would be very expensive.

    Then on the drive home (this was just yesterday! It feels like weeks ago) i started second guessing myself. Was i doing this for me? So i didn’t have to say good bye? What if this aggressive surgery was too hard for her to recover and then the tumor came back? If they don’t get all the cancer cells, these types of STS come back with greater growth rates. And with how fast this is growing, i can’t imagine.

    I have had so many emotions over the past 24 hours. I’m typing this as Dorian lays next to me snoring. She’s been having more trouble with her back legs. I fear that taking those muscles from her front legs will just cause her more mobility issues, and is sensitive when i try and pick her up. And she is already favoring her leg on the tumor side. I also worry that this surgery will be too much for her, and she will struggle with recovery, and daily activities like eating and using the litter box. I don’t want to have her go through the stress of this extensive surgery only to watch her decline after.

    So i was comparing pictures i took after her biopsy on Friday the 11 with what the site looks like today. The tumor is now the size of an orange and protrudes from her body. That is from a flat grape to an orange in 2 weeks. It is so fast.

    I only learned all of this cancer stuff yesterday, but i feel like with the rate it’s growing i have to decide immediately.

    The hardest part is she is still alert and bright eyed. She hasn’t been as active, like getting up to follow me around, or come when i open canned food. But she’s still eating and drinking.

    I just worry that no matter what decision i make it’s the wrong one. What if she could do super well after surgery? What if I’m choosing euthanasia when she could recover? I don’t know what is right. It feels like my heart is breaking. I am distraught and have cried for two days. It’s just happening so fast. I feel like there isn’t a chance to breathe.

    I don’t want to hurt my best friend. I also don’t want to see her struggle or suffer. I don’t know what is right. But in this moment seeing how aggressively it’s growing. It makes me think there isn’t a better option.

    Why did this happen to her? And why do i have to make this choice? It’s so hard.

    • Doc says:

      Hello, Laura,

      We don’t understand why these tumors develop. I don’t think anyone can answer that one for you.

      I am no surgical specialist. In the past, I have done some pretty radical surgeries to remove these, and they have grown back, but we bought the cat several months of good quality of life.

      I have a patient who had the removal done by a surgical specialist and we made it about one and a half years, but the tumor has come back. The owner took her back to the specialist for a consult. He felt the tumor could be removed, but the surgery proposed was radical enough that the owner decided to just let nature take its course. This tumor is not nearly so fast-growing as the one you describe.

      Let the surgeon know your concerns ( as well as the rapid growth that has taken place).

  609. Sarah says:

    Hello;

    I need some advise, my cat is 12 years old and was diagnosed with diabetes this past summer, and seems to be doing ok with the insulin and the vet has confirmed that there has been improvement, but needs some work. But he also has a large lump on his back right leg, I had took him to his vet to see what it was, they took the fluid but forgot to send it to the lab to get it tested. But they made another appointment to drain more fluid to do test.

    But before the vet appointment it opened and started to bleed, and took him to the vet that day, to try and drain it more and to collect more fluid to do the test. The people who did the test said it came back negative for cancer but the vet still thinks it is. But wants to do surgery at another place due to it being so close to Christmas and are at limited hours, and the estimated cost to do the surgery is between 2,000 to 4,000 dollars. Which I can not afford to do, plus I am concerned with doing it because he has diabetes and he is 12 years old.

    I don’t know if I should put him down but I am not ready for that yet as he still seems like his self, and is still eating and drinking. Just the lump on his leg that is large and he has diabetes. What should I do?

    • Doc says:

      Hello, Sarah,

      That is a really tough situation. The diabetes can slow healing, but I wouldn’t let that alone keep me from doing surgery.

      It is certainly possible to miss the diagnosis with just the fluid analysis. Sometimes you just can’t tell without a piece of tissue to see the way the cells relate to one another.

      It is unfortunate that the surgery is so expensive, and so lose to Christmas, as well.

      If surgery is not an option, then you just have to see how long your friend can maintain a good quality of life with the tumor.

  610. Katie says:

    I’ve read so many of the comments and can relate. I have a 10 year old bengal cat that possibly had a brain tumor. We’ve been to 3 vets, X-rays and test. Nothings confirmed just an idea due to not being able to financially afford what the vet wants. Long story short, he’s lost a lot of weight, and he continues. He’s on prednisone for heavy breathing, Mirataz to stimulate appetite, an anticonvulsant medication for seizures (which has helped) but as of recent he’s been having small episodes. Sometimes he’s unstable when he walks, but it’s not everyday. I too feel guilty if I make the decision to put him down.. did he have a lot left in him. The vet wants us to see a neurologist, but I can’t even afford her X-rays and blood work. It’s actually been a while since he’s had a real bad day, but two days in a row he’s had small seizures and now he’s back to not doing the greatest. You can just tell he doesn’t feel good. It’s just not consistent enough to say it’s his time. He eats, uses his litter box regularly, but he sleeps a lot more than anything else. He also just wants to be on my lap or close to me. He’s still very vocal at times but not near as much as he used to be. Someone described their cat as a smaller, muted version and that’s exactly what he is. I just don’t know what to do. I have mild anxiety and I tend to overthink and I’ll definitely beat myself up over making a “wrong” decision. Please help.

    • Doc says:

      Hello, Katie,

      I can understand why your doctor has recommended that you see a neurologist. Without advanced imaging like a C-T scan or MRI, mores specialized tests like analyzing the fluid around the brain, we can’t really know what’s going on inside the skull. We can only speculate about brain tumors in an older patient who starts having seizures — it’s pretty high on the list.

      I also understand that not everyone has the resources to spend a couple of thousand dollars on their pet. Most pet-owners don’t, actually. And if you found out for certain that there was a brain tumor, having surgery to remove it cannot be guaranteed to be successful (not to mention the additional expense).

      So don’t beat yourself up because this isn’t feasible for you.

      You just have to weight the good days against the bad. Also, if the seizures cannot be controlled by the medication, that really means it’s time to let him go. An occasional mild seizure may be tolerated okay, but if they become severe and long-lasting, or won’t stop without emergency treatment, that’s a bad sign.

      You know your friend, and I think you’ll know when he has lost the ability to enjoy life.

  611. Stephen says:

    I have a male cat that is 16 years old been the best cat ever. He has not been eating for last 3-4 months . The vet says he has fluid in his body probably due to a cancer. My vet says there is not much more she can do. Says we need to go to a specialists . The vet says if it was her cat she would put him down. He cries when you pick him up. My wife can not even fathom the thought of putting him down. I love this cat but can see putting him through more stuff to try and extend his life. Any advice would be appreciated to explain to my wife and 7 year old daughter. I feel like there is not much more they can do for him. With covid hitting my business hard I do not even have the extra $$. Thanks Stephen

    • Doc says:

      Hello, Stephen,
      I cannot think of anything “good” (i.e. treatable with a good expectation of full recovery) that would be causing your cat’s condition. Everything I can think of is “bad disease” (no good treatment). Seeing a specialist might give you some options I’m not thinking of. On the other hand, sometimes all of our diagnostic testing just tells us which incurable disease we’re dealing with.

      We don’t have a lot of options for pain medication in the cat. Opioids are good, but expensive. Onsior is a non-steroidal anti-inflammatory, but is only approved for 3 days use (6 days in Europe). We used to use Metacam (also an NSAID), but this is more complicated now. It is still approved for cats in other countries, but not in the US. Many cat specialists still use it, but warn the owners that it is off label. If our only other choice is constant pain, then some risk from the medication doesn’t sound so bad.

      Sometimes controlling the pain improves the appetite. We also sometimes use an appetite stimulant called mirtazapine. This is available in trans-dermal formulation called Mirataz. You must rub a little of the cream on the hairless inside of the ear.

      In speaking with the rest of the family about considering euthanasia, you might ask them what they think about pain causing loss of appetite. You know the cat hurts, as he cries when picked up. Cats are really good at concealing their pain. Even though he is not crying at other times, the fact that he isn’t eating much suggests that he feels pretty bad, and may be in pain all the time.

  612. Meera says:

    Hello,
    My cat Lucy is 18 years old and was diagnosed with kidney failure a few months ago after I noticed her urinating outside the box. I have seen a decline – her appetite was normal and asking for food to now I feed her breakfast, lunch and dinner in bed and she licks at it. She sleeps all day, her eyes are sunken, she seems uncomfortable lying in her bed all day trying to get comfortable, She is weak and I see her wobbling, she does not interact with the other two cats, she is not cleaning herself anymore, I found feces in her bed this morning. She was 7 pounds and now is 4 pounds 10 ounces. She tries to sit in my lap once a day but seems uncomfortable. I have cried everyday and I have never seen an animal live this long… unfortunately most of our animals were hit by cars or had a heart attack. I struggle with the decision. Any words would be helpful.

    • Doc says:

      Hello, Meera,

      Everything you are telling me makes me think how miserable your cat is, and how miserable you are. I just don’t hear anything that makes it sound like you should feel bad about ending this. Francis Bacon once wrote, “A healthy body is a guest-chamber for the soul, and a sick one is a prison.”

      You don’t need to feel bad about letting your friend escape the prison of her dying body.

      • Meera says:

        Thank you for having this space, after reading many of the posts that you wrote and to this- I decided it was time. She passed yesterday. I am very sad but know it was the right decision. thank you again,
        Meera

  613. Angela says:

    Thank you for providing this space. Reading through these stories is giving me a little bit of comfort. I lost my best friend, Reba, a few days ago. She would have been 17 this coming April. Last April, she was diagnosed with hyperthyroidism. In August, she spent two nights in the emergency hospital after severe diarrhea, vomiting, dehydration, and bloody mucous in her stool. At that time, it became evident that the hyperthyroidism had been masking her kidney disease. However, her levels indicated that she was not in an immediately dire situation (BUN 44 and creatinine 2.8) and she was started on a kidney diet. For the next few months, she seemed to be doing better. She happily ate her food each day and was especially fond of the Fortiflora probiotic sprinkled on top. The diarrhea and vomiting stopped. She felt less bony when snuggling up with me ( around 8 lbs) and I began to think that we may even have a couple of more years together. Fast forward to a couple of weeks ago and she became less and less interested in her food. She would eat some but it had certainly decreased. I began noticing urine directly outside of her box. I chalked the declining interest in her food to simply being a little finicky or bored of the same flavor and the urine outside of the box to her arthritis. Last weekend, she would only lick the top of her wet food briefly before walking away. She would accept it in small amounts from my hand but that was it. She would only eat on her own if I gave her plain cooked chicken or a little bit of tuna. I knew she was due in late February to be checked again and decided I would call to have it scheduled for the coming week instead. She then began urinating far from her box which was so unlike her. She was drinking a lot more water. On Monday evening, her back legs began to buckle underneath her and she was stumbling intermittently. I noticed that she smelled differently as odd as that may sound. I put her in her bed next to me that evening and called her vet immediately when they opened. That morning she continued to stumble intermittently and urinated all over me as I tried to help her to her litter box. Her usual vet was not available but I took her in and she saw another vet from the same practice. After running some tests, the vet called and told me that her kidney levels were extremely high and that she didn’t want to sound pessimistic but the prognosis wasn’t good. She explained that we could try a hail mary, hospitalize her, flush her kidneys and then try subcutaneous fluids at home but that she didn’t foresee this extending Reba’s life beyond 4-8 weeks max. I made the choice to have Reba pass peacefully in my lap rather than put her through extensive treatment. Reba would tolerate the vet but it was not an enjoyable experience and any kind of overnight stay would turn her into an anxiety ridden cat who would hide in the back of her cage hissing. She was extremely shy and she only liked me. I am now devastated and questioning whether I acted too soon or in a panic. I keep reading quality of life scales and so many of them talk about cats secluding themselves or failing to greet their owners. Reba never failed to greet me. She never secluded herself. She would insist on laying as close to me as possible. I am reading about cats with levels worse than her’s surviving comfortably for many months. I am in agony thinking that I didn’t do enough and feeling as though this all escalated far faster than I ever anticipated and that I acted too quickly. I didn’t want her to reach a point of suffering but I’m struggling to know when that point would have come, if it possibly already had even though she didn’t fit all of the criteria, and if I misjudged the situation. The grief is immense.

    • Doc says:

      Hello, Angela,
      Some patients whose kidneys are failing have a very slow and gradual deterioration. Others percolate along for a while, then go down-hill in a hurry. Chronic kidney disease is one of the more common causes of death in elderly cats. Seventeen is a pretty phenomenal age for a cat to achieve, so I don’t think you need to berate yourself about not doing enough. You start with four times as much kidney function as you need, so continuing low levels of loss can go unnoticed for a long time. I am sorry for your loss.

      • Angela says:

        Thank you, Doc for the space you have provided here and the compassionate, informed responses. It really has provided me a great deal of comfort reading so many of the stories here. I can only hope that I provided my beloved Reba a peaceful transition and spared her the discomfort that seems like it would have been inevitable. Thank you.

  614. cassie says:

    Hello Doc,

    I want to thank you for the space you have provided for so many people, like myself, who are struggling with this difficult decision. Reading everyone’s stories, and your compassionate advice has helped me validate that I’m making the right decision.

    My cat Bucky is around 15 years old. Last March, he developed lesions on his head and neck that he would scratch at constantly. Our vet has tried numerous rounds of antibiotics, steroids, gabapentin, antvirals. We also initially went grain free before doing a skin biopsy. Our vet felt that Bucky may have developed a protein allergy, so he was switched to a rabbit based diet. While on the grain free diet he developed gastritis and began vomiting. He tolerated the rabbit based food for about 3 weeks before he couldn’t keep it down. We actually put him back on the grain free food as he wouldn’t eat anything else. He has lost a lot of weight and is most skin and bones.. He did well for about two weeks. Yesterday he began vomiting blood.

    He’s so itchy. Most of his waking time is spent scratching. He constantly has open sores on his body from where he has scratched or chewed himself raw. He’s been in a cone since November to keep himself from tearing at his face, as he caught his eye and developed an infection in October.

    At the same time, he sustained a superficial paw injury in June that became infected. He required long term antibiotics and casting/debridements for 3 months, and now even though he is “healed” it has become another spot that he chews at.

    Yesterday, after he vomited blood, he had a very large episode of bowel incontinence, which required a bath to clean him. This happened again today. My husband and I made the decision to have him euthanized this weekend, but I was really struggling with the thought that this could be viewed as a “convenience” euthanasia as when he is tolerating food he seems content, he still wants human attention (he’s asleep in my lap while I’m typing this). I just can’t imagine that he’s not miserable. He’s been declining over the last year, and we’ve tried so hard to right the ship, but we only seem to add new problems.

    Rereading what I’ve typed, I know he’s had more bad days than good lately, and that my husband, myself, and most importantly Bucky, are tired. It’s just hard to let go.

    • Doc says:

      Hello, Cassie,
      After reading your story, I don’t see how anyone could classify this as a “convenience euthanasia”. I think that would have happened a long time ago.
      It is obvious that you have worked very hard to care for your buddy, and that you have also worked hard to come to the best decision that you can. I know you will miss Bucky, but it sounds like he’s ready to be released from the prison of a failing body. Best wishes.

  615. Kristen says:

    Hi Doc,

    Thank you for this wonderful site and all that you do. My 9 year old cat was diagnosed with Cutaneous Lymphoma – originally presented very similar to eosinophilic granuloma. I’ve been told it has likely spread to her nasal cavity and gastrointestinal tract. She has a voracious appetite, always crying to eat, but has not lost any weight, in fact her stomach looks distended. She is on prednisone, but that does not do much for her. She had a nose bleed last week. She still plays – runs around with my other cat, mostly only in the morning, then the rest of the day just sleeps. Her behaviour changes throughout the day, one second she is in my lap wanted to be pet and cuddled, the next she is growling at me, I assume if I touch an area that may be painful. I am so stuck on how to proceed since she is my first baby, and still seems so active. I can’t imagine putting her to sleep, but I also don’t want to let her suffer if that is what is happening. We have a vet appointment tomorrow to have her stomach looked at.

    • Doc says:

      Hello, Kristen,

      There are more aggressive forms of chemotherapy for lymphoma, but they are much more difficult to administer, more toxic, require more monitoring, and have more adverse effects (vomiting, hair loss, etc.). Be sure it is prednisolone, not prednisone. Cat’s cannot easily convert prednisone to the more active prednisolone the way dogs do.

      I hope your doctor will be able to give you some new insight after the next visit.

  616. Marcy Massura says:

    First of all. Doc, you are doing amazing work with this site and responding to so many. I am really grateful for people (but like you.
    My Mozy, age 12, lymphoma, did ultrasound and it has spread. A lot. Chose to bring home, giving steroids and other things to soothe her tummy and try to get her to eat. She sleeps (but away from us), nibbles a little at her food, drinks a little water, and goes potty (we put litter boxes in nearly all the rooms because she has horrible diarrhea and this helps her so much. The ‘end’ probably isn’t today. But it could be tomorrow, or a week from now, or? It’s soon. I know. I am struggling with watching her for any sign of distress- because I want to be sure she isn’t suffering badly. This is hard. Her love has been so awesome. But this part is so so hard.

  617. Sarah says:

    Doc –
    Thanks for your insights. I’ve read all the stories here, and would like to add my story. My 7 year bengal, Quorra, got her wings 5/4/21. We lost a difficult battle with her GI lymphoma. For most of Q’s life she was on Royal Canin bengal dry food, Purina Friskies savory shreds wet food, and clumping clay litter.
    In June 2020, her anorexia/lethargic behavior prompted exploratory surgery- they found a “twisted” intestine and a small intestinal mass. (My research has shown that the twisted intestine was probably caused by the cancer)
    Quorra didn’t seem to fully recover from the 1st surgery as she had vomiting issues and looked bloated months later. Ultrasound found a complication from this surgery – a “stricture” / scar tissue caused blockage, and another intestinal mass was also shown. In September 2020, I went to a specialty hospital, and a board certified surgeon removed the stricture/mass. The biopsy for this procedure showed conflicting results – intermediate to high grade lymphoma, and possible emerging low grade lymphoma (along w/ a pathology note stating all changes appeared inflammatory without the concern of neoplasia). It is due to this biopsy report that Quorra didn’t have a definitive cancer diagnosis for months. I suspected maybe it was IBD. Quorra didn’t have any symptoms at this point and her surgeon advised to monitor for recurrence (vomiting, diarrhea, etc).
    However, Quorra did GREAT for 6 months after the 2nd surgery. She gained weight, was happy, playful, acted like her normal/fun self. During these months I upgraded her food/litter to higher quality options (cut out dry food). She did well on Raws Cat Pate wet food (new proteins rabbit/duck), and Pioneerpet SmartCat grass seed litter.
    Then in Feb/March 2021 Quorra began to look bloated with a distended belly. Xray/ultrasound found she had fluid in her belly. The ultrasound showed she had “multiple” masses on her small intestine. The ultrasound findings prompted our general vet to begin treatment with lomustine/CCNU. 1 week after the CCNU dose, the fluid in Quorra’s belly miraculously disappeared.
    Quorra’s appetite had slowly been waning for weeks, but I was using transdermal Mirataz as needed. She was then prescribed transdermal prednisolone due to symptom of itching around her face. However, about 3 weeks after that lomustine dose, Q became anorexic, had a fever, and was lethargic. I rushed her to ER/specialists, and the ultrasound/aspirate showed she was septic. She needed emergency surgery for septic peritonitis – an intestinal tumor perforated. I was told by one of the doctors that if Quorra were her cat, then she would euthanize without doing the surgery (mortality rate is high for her diagnosed septic bile peritonitis). I was not ready to give up on Quorra, so we proceeded with the highly expensive surgery. The oncologist advised that it was hard to tell if the tumor perforated as a response to chemo, or due to cancer progression.
    Quorra recovered from the 3rd surgery, but remained hospitalized for 4 days. During this time she had blood transfusion and was on feeding tube, IV meds (opioids, pro-motility agents, steroid). She also got a chemo drug Elspar. The next board certified surgeon called Quorra “one tough cat!” She impressed everyone by surviving such a grave diagnosis. He advised that the perforated tumor was removed, but Quorra still had about 15 small masses throughout her intestine that couldn’t be removed. Biopsy from the 3rd surgery confirmed intermediate to large cell lymphoma.
    The goal after this surgery was to treat with chemo after she was healed enough. Quorra recovered great, was eating well, and stayed on prednisolone. 2 weeks after surgery, we met with the oncologist and Quorra got another dose of the CCNU/lomustine. However, another 2 weeks after CCNU, Quorra began looking bloated again and became anorexic/lethargic. Bloodwork showed her WBC/neutrophil count was extremely high – the general vet and oncologist both suspected a tumor had perforated again. My final convo with the oncologist raised the same question – did a tumor perforate as a response to chemo, or due to cancer progression? The general vet suspected it was the chemo. It was at this point that everyone suggested it was time.
    I truly fought for Quorra and never wanted to give up on her as she was only 7 years old. Unfortunately we could not win this battle. The CHOP chemo protocol was not in the cards for us, so we had to try the lomustine.
    It’s worth noting that lymphoma is caused by “chronic inflammation,” so moving forward I will be extremely cautious about food/environment for pets.
    In the end I arranged for an in-home euthanasia. It was interesting that the 1st injection seemed to sting as she meowed for the first time in days when administered. However, Quorra was loved until her very last moments on Earth. She transitioned the way I wanted her to – at home with family. Rest easy, Quorra. I’ll see you on the other side.
    1/27/14 – 5/4/21

    Doc – this quote you referenced really helped me, so thank you:
    “A healthy body is a guest- chamber for the soul; a sick body is a prison.”

    <333

  618. Jane says:

    Hey Doc,
    Seeing all these comments and responses over the years is really helping me come to make a hard decision. It has also brought me to make my own post in hopes for another opinion.
    My cat just turned 10 in March, so she is getting older. As of maybe a month and a half ago, she’s started throwing up clear liquid with white foam, which also resulted in a loss of appetite; at the beginning just eating less and as of a couple days ago, nothing really, unless it’s licking the flavouring off some treats. I think this means it’s time right?
    So backtracking, a bit of backstory I guess. We brought her to the vet, reluctantly because the price kinda scared us away, but finally did, and they said she seemed fine (just off a physical exam) and gave her a pill medication (can’t remember what it was at the moment) but it was to reduce the vomiting. It had worked, but after the few days, she went back to vomiting and the loss of appetite. A bit after this we brought her to a different vet and they said her temperature was low and seemed dehydrated. (I think because she was eating even less than the first vet visit). They did a blood test and the next day gave us the results that her kidneys were failing and only had a low percent of functioning left (it was either 15 or 25.) They told us to put her on a diet and could inject some fluid in her to help the dehydration, but we opted out of that as she seems to still drink water. About just over a week later from the second vet visit and she doesn’t eat anything really, just the flavouring of the treats like I mentioned.
    When it’s dinner time for her brother (we always feed them at the same time but obviously haven’t really been as of late) she always seems to want to eat; will sit waiting where the food is prepared, come downstairs when the food is about to be made… etc. Throughout this whole process we’ve been trying to give her new foods but she would eat them for a couple days and then get sick of it, and like I said, now won’t eat anything. She seems to be having “good days” laying in bed with me, loving being pet and such, but from reading these posts, it’s seems as though she is suffering and having “bad days” since she’s basically starving herself right?
    As I’m writing this post I feel like the answer is more clear but I think like everyone else, I wanted reassurance that I don’t seem to be doing this out of convenience as she still seems to be in good spirits, purring (which I’ve now learned isn’t always a good sign) and cuddling with me.

    • Doc says:

      Hello, Jane,
      If her kidneys are failing, then the waste building up in her blood makes her feel lousy, and even nauseated at times.
      I can’t really make a pronouncement with the data I have, but kidney failure is certainly a common cause of death in older cats.

      It certainly doesn’t sound to me like you are making your decision out of convenience.

      These times are rarely easy ones. I wish you the best.

  619. Rob says:

    I just wanted to write this in case it helps anyone. Reading through these comments has helped me.

    Today I had to make one of the hardest decisions in my life, to say goodbye to our little dude Milo. Before he came to us he had a hard life. When we got him from the local shelter he’d been there for 7 months, it was his second time there and he’d had 6 pervious owners. We were told he’d had a tough time with some of them.

    The first 2 years we had with him were hard. We discovered quickly that he would have regular vomiting fits and not eat, to the point where he would get really thin and weak. We worked though a number of vets and spent thousands of dollars trying to help him until we finally found vet who could. They examined everything, did blood work, ultrasound, a whole bunch of things and eventually told us we should treat him with anti vomiting shots when he had an episode, but other than that to leave him.

    We did exactly that and the following 3 years were great. He settled in with us and throughout the last 18 months of lockdown he became my best buddy. Sitting on my desk while I worked, always wanted to be stroked, nuzzling his little head on my arm, shouting at me when his food bowl was empty and snuggling with me and my girlfriend at night. He really was the coolest little dude.

    Then last weekend something happened. He came to me in the night confused, really unsettled, and looked at me like he didn’t know who I was. The next day he went really downhill, he wasn’t his happy little self. He didn’t come to me for food, or sit on my desk, he just paced round in circles looking totally lost. The first emergency vet couldn’t do anything, we couldn’t get him out of his box. I’ve never seen him aggressive like that. The second emergency vet told me he seemed ok but they would do blood-work, when it came back they said it “could” be a tumour. The third vets, the one’s who’d helped us those three years ago knew exactly what was wrong. It was something neurological and he’d lost his sight and his hearing, they said the only way to be sure exactly what had caused it was an MRI, however with his age at 15 if it was a tumour there was nothing we could do.

    We took him home, prayed he would show a sign of improvement, and hoped we wouldn’t have to make a difficult decision. 7 days had passed since he lost his sight and hearing, and while there were moments where he recognised us and miaowed, most of the time he spent either pacing around confused, or hiding.

    So I made one of the hardest decisions of my life. I didn’t want him to suffer more tests and vet visits and medication, and I couldn’t bear to see him so lost, a shadow of himself.

    Today we said goodbye to Milo. I know he’s in a better place and he’s not suffering. We’ll miss him dearly. He really was the coolest little dude.

  620. Looby says:

    We have made the gut wrenching decision to have our beloved cat put down tomorrow.

    He has an aggressive oral tumour which has been growing fiercely. We tried antibiotics to see if it could be a bad bone infection but it is not and it has spread down his neck.

    The decision has been a painful one. On the one hand I do feel it is too “”early” to put him to sleep. He still enjoys attention and food but I have seen signs of him being in pain. He still has better days than bad and the times which are bad appear to last short periods of time. However, he is 10 years old and I believe we have given him a wonderful life. I feel my last act of kindness is to let him go before he experiences severe pain that makes me see, beyond doubt, that he is definitely in pain. He is not going to get better and I hope this is a kind, selfless act I can give him. It’s been a horrible week leading up to tomorrow, I just hope my decision is the right one.

    • Doc says:

      Hello, Looby,

      Aggressive oral tumors are very difficult to manage. You can’t amputate a patient’s head to control the tumors. I feel that you are making the right decision here, as hard as that is.

  621. JD says:

    Thank you for this space. My part Russian Blue cat is 21 1/2 years old and I have had him since he was 4 months old. He is hyperthyroid but will not respond to or take medication. He was diagnosed years ago, and he has had regular vet check-ups his entire life.

    The good: he still eats (although not nearly as much as he used to), and he drinks (a TON) of water. He can still hop up on the couch, but only does so occasionally. He recognizes me and purrs when I pet him. He still uses the litter box, though sometimes he misses. Puppy pads fix this. He will do the stairs once a day–if that.

    The not-so-good: he has arthritis in his hind legs which causes him to wobble and walk with an unsteady gait. He has stopped grooming himself and will not allow me to brush him–I assume it hurts him due to arthritis, so his once shiny and perfect coat is unkempt. He was once quite robust weight-wise and now he weighs around 8lbs.

    He has had sneezing, stuffy nose, and coughing issues since he was a kitten (FIV negative), and a few times a year I take him to get a shot to ease these symptoms. Usually it helps within about two-three days, but this time it has seemed to not have an effect at all. I suspect it is due to his weakening immune system. Additionally, he will step in his litter and get it stuck to his back paws, and I am unable to remove it due to him not letting me touch his feet (likely it is painful). I try my best but often the effort is futile. He has had an abcess that won’t heal on his stomach that has been there for a few years. It doesn’t seem to bother him and the vet knows about it, and there is nothing they can do since surgery is not an option at his age.

    My dilemma is knowing what a “good day” and a “bad day” even look like at this point. I struggle to know whether he is living or slowly dying, and how to delineate between the two. I wonder: if I have to even ask that question, do I perhaps know the answer? What I do know is that I don’t want this cat to suffer one day, and if that means I have to make the choice to put him down earlier than I might want to, I have to find a way to live with that.

    I travel a lot for work and have several trips upcoming, but I do have 24/7 cat care. My question becomes, do I want to leave him with others for long-ish periods of time in this condition? He does not appear to be suffering, but he also doesn’t appear to be overly happy. He sleeps about 20 horus a day.

    This is so hard, and I am comforted by reading other stories. I just hope I will make the right choice.

    • Doc says:

      Hello, JD,
      Thanks for your story. These are never easy decisions. I hear that his good things are basically he will still eat and drink, and he purrs when you pet him. Other than that, it sounds like his life is not much fun. I think perhaps you do know the answer.
      Best wishes.

  622. Tam says:

    All of the posts I’ve read are comforting. A 16 yr old male cat that I had was senile. For the last year of his life he’d yowl during the night cuz he was lost in the house so I’d call to him then he’d come running, jump on the bed and go to sleep. He started to go outside his litter box which is really disgusting to me but I dealt with it. Out of convienence I wish I did put him down but I couldn’t. After spending $400 the vet couldn’t really say what was wrong. Finally in the last few days of his life he stopped eating and drinking and stayed under the coffee table…then I knew it was time. Now I have a different cat that I inherited she is 17 and not doing so great. Her brain is good but has lost a lot of weight and can’t eat much. She walks hunched at times. With this cat I feel it is time and I don’t want to dump a bunch of money into such an old cat like I did the last one. I swear I will never have another pet again.

    • Doc says:

      Hello, Tam,
      When you are dealing with miserable end of life issues, sometimes it’s hard to remember the joyous part of owning a pet. Sometimes with these ancient cats it is hard to find a way to improve their quality of life. It’s not always a matter of money, just that sometimes there aren’t a lot of good options. The only way to know if you can help is to do a full diagnostic workup. Unfortunately, sometimes that just tells you which incurable disease it is, rather than giving you an avenue to improve things.
      These are just tough.

  623. Mabel says:

    I have a 16 year old cat and I have had since she was a kitten. She stopped grooming herself most days a couple months ago, has been very lethargic, usually hides 99% of the time, and lately has begun scratching all of the hair off of her back and head. She has a bump under her chin and her appetite had decreased until I took her to the vet last week and they gave her a steroid shot. She has been to the vet three times in the past two months, nothing they have done has helped her. No one really knows what’s wrong with her and I can’t afford blood work. She is not herself and I think all days are bad days. She will occasionally roam about the house, but then goes to hide again. I have been giving her topical meds and oral antihistamines, but no improvement. If I were to put her down, I can’t decide if it would be Mercy or convenience. It makes me so sad to see her like this and I feel so horrible for her. She hasn’t played in a very long time and I feel like she’s very sad and in some kind of pain or mental confusion or anxiety.

    • Doc says:

      Hello, Mabel,
      This doesn’t sound like your cat is getting much relief. If she can’t get better or get any relief, I don’t think that you would be wrong to let her suffering end.

      • Paul says:

        We have just had our beautiful 16 year old Pink put to sleep and it’s breaking our hearts . She was diabetic but the insulin was failing to get her glucose down . She had gone from 6k to 4K in two weeks and for the last 3 days had stopped eating . The vet scanned her and told us she had tumours in her intestine and lungs and lymph nodes and she had days to live . She was still under when she called us and advised we let her go . Because we only took her for a scan we had no time to say goodbye and decided not to go as we feared this may cause her distress as she more recently liked our presence but from a distance . Now we are experiencing abandonment issues despite the vets reassurance. We feel awful

        • Doc says:

          Hello, Paul,
          I can understand how you feel. I have heard grief counselors say that it’s best to say goodbye and not feel like you’ve left something sort of “hanging out there”. On the other hand, waking her up long enough just to say goodbye before euthanasia could feel selfish, so you’re sort of “damned if you do, damned if you don’t”. I am sorry for your loss, but it sounds like you did everything possible to maintain and extend her quality of life.

  624. Kelly says:

    Thank you for this post and for everyone who has commented over the years – I read through many of them and they have helped me tremendously.

    My sweet girl Gracie was diagnosed with oral squamous cell carcinoma 4 days ago. She has a large tumor toward the back of her lower jaw, which has invaded the bone. Tomorrow morning, our vet is coming to put her to rest. This cancer is terrible, and moved so quickly. I’ve been having a very difficult time trying to figure out when the “right” time would be, and had to make the difficult call this morning when Gracie would no longer take food or water. All the comments on this thread have helped me understand that while this is a difficult and gut wrenching decision to make, this is the kindest thing we can possibly do for her and it is time. I will always remember her for the chubby, playful, snuggly, and sweet girl she has always been, and will cherish all of our good memories with her.

    But still, I wish we didn’t have to make this decision. It’s such a painful call to make and my heart is broken.

  625. Stefanie says:

    My sweet kitty Baxter (14.5 years) was diagnosed with oral tumor (cancer), almost 2 weeks ago when I noticed the slightest bit of drool on his mouth and that he had a bump on his lower right jaw. I took him to the vet thinking he had a tooth issue, but they said likely cancer, although I did not biopsy it as they said it is likely too large to remove, so to just keep him comfortable. Since then he stopped eating wet food and will mostly only eat treats and some chow (weird as I thought wet food would be easier). I have 2 cats, so it is hard for me to tell exactly how much he is eating. While eating, he will seem to gag and then paws at his face to help the gagging. He manages so far not to actually choke. He also has lots of drool that bothers him and hangs down in long strands. If I feed him treats 1 by 1, then he doesn’t gag. He drinks water, but oddly only if I pour it on the floor (not from his bowl). He is still very mobile (gets on the table, goes up and down stairs). I don’t think he has lost weight. He still likes cuddles and isn’t hiding. I guess I’m struggling to know when the right time to euthanize will be. Part of me thinks it is in a day or so, as the near choking scares me, but then he does seem to manage to eat some and seems happy enough, so maybe I should keep waiting. My vet said anytime is okay, but I feel terrible giving up on him too soon, but don’t want him to suffer either. Thoughts on whether now is best or wait? He is not on pain medicine and I guess I prefer not to have him on the medication as I know it will just prolong the inevitable.

    • Doc says:

      Hello, Stefanie,
      Sorry that I’ve gotten behind. I broke my foot and it has made things complicated. If your cat still seems happy, and you have the time and the will to nurse him, there’s nothing wrong with that. I know it’s hard to give up a friend. I think when he can no longer eat, it’s probably time to let go. Starving to death on pain-killers or a feeding tube is no life.

  626. Lex says:

    My parents 14 yr old farm cat was just diagnosed with diabetes. Gus is currently doing ok, but they have decided to spend Christmas with him and say goodbye. My sister doesn’t understand why they selected not to give him shots. The problem is he is an indoor/outdoor cat on a farm. When he’s needed meds in the past, he would just not come home to avoid something. I’ve talked to my dad, and I understand his fear that a preditor will get Gus due to his weakened state. He’s lost about half his weight, and his coat is very shabby. I feel selfish to rather say goodbye than him just disappearing one day.

    • Doc says:

      Hello, Lex,
      These are always tough ones. I have had house-pets who just became so uncooperative about taking the insulin injections that people gave up. From a medical standpoint, they could have gone a long time, but from a practical standpoint it just became impossible. Without treatment, Gus will get thinner and thinner and very weak. I don’t know when is the best time to draw the line, but it sounds like you are close.

  627. Joanne says:

    Our soon-to-be 15-year-old cat has hyperthyroidism and was diagnosed in October with intermediate intestinal lymphoma. She’s always been a smaller cat, but had gotten her weight up to 10 pounds or so before dropping to barely 7 pounds. She’s now all fur, skin and bones. She had surgery to remove the mass in her intestine and they removed slightly more than 50% of her intestine and lymph nodes which the vet described as “hamburger” (ew). We were told steroids could help extend her life but we were only looking at 3 months tops. The surgery wasn’t done with our normal vet, so I reached out to our vet after to get clarification because I was being told the side effects of steroids could look like end of life (diarrhea, vomiting, lethargy, etc.) so how would I know the difference? Our regular vet said we should do chemo pills in addition to the steroids and could get up to 6-9 more months with her. I have the chemo pills, but I’m honestly unsure if I want to give them to our cat. Giving her just the steroids has been TOUGH. Even her topical hyperthyroid meds are a battle so she isn’t getting those consistently. But the biggest reason for my hesitation is that she is already sleeping ALL the time. She’s very needy, clingy and vocal (not like her old self – prior to the start of her downfall last summer, she had only meowed a handful of occasions in her life — and those were when she was in a kennel for transport or secured in a room while we were moving furniture and she only wanted to ever be petted on her terms). Her appetite is voracious and she drinks normally. She will no longer go in her litterboxes at all. She pees and poos (occasionally, it’s VERY loose) all over the house. And pooping scares her. Like as soon as she does it, she bolts around the house petrified and hides for awhile. Peeing doesn’t have the same effect. She is very anxious and I just can’t imagine putting her on chemo with the potential for more wild side effects. Like so many who have posted here over the years, I’m struggling with whether o not I’m missing all the signs she’s giving that her life is no fun any more. She still jumps on furniture and stares out the windows, she’ll even play with toys for a couple of minutes at a time on occasion (typical for her). She loves rubbing against anything and everything, but her anxiety and her bathroom habits, particularly her fear of pooping, concern me greatly. Should it?

    • Doc says:

      Hello, Joanne,
      I understand your dilemma. There sometimes comes a point when we are extending life, but with no quality. It is always a difficult decision to make. You must think about what she can still enjoy, and when that is gone, it’s time.

  628. Joslyn says:

    Just want to thank contributors here and those that made them possible.

    Our Balou was diagnosed with an oral tumor-the vet suspected SCC, turned out it is a different kind. At first this gave me hope, but I have realized the outcome will be the same as the tumor is growing exponentially and the vet said debulking or surgery would probably not be successful.

    Knowing that soon I will have to make the decision is unbearable. But I love him so much and do not want him to live in pain or waste away. Balou has always been our tough curmudgeon so it is hard for me to know when the time is right. I suppose as long as he still eats as he is now, I will wait. My heart goes out to those who have also dealt with this.

  629. Ben says:

    My wife and I are dealing with chronic illness in our first cat, who is only 4, but had been malnourished before we adopted her, and has had repeated health issues.
    She started vomiting last June, we took her to the vet, they started running down the checklist, all the while her vomiting increasing in frequency. It wasn’t worms. It wasn’t dietary intolerance. We took her in for blood work, nothing noteworthy. Ultrasound, maybe some thickened intestinal walls? Endoscopy, found swelling in the stomach, biopsied it, not cancer. Gave her some steroids and anti-emetics. Nothing changed. Time for exploratory surgery, found a giant mass on her stomach. We made the call to remove it (along with a lot of her stomach), she got stitched up and brought home. Biopsy results from the growth? Still not cancerous!? Their best guess is a super-rare disease called Menetriere’s?
    But we bring her home, and her recovery is great, she’s eating, taking anti-emetics. But then about a week ago we were instructed to stop the anti-emetics, and she started regurgitating (not vomiting) her food shortly after eating it. Now she is regurgitating probably 3/4ths of her meals. This is probably tied to the now tiny stomach she’s left with after the surgery, and our vet thinks it might be some sort of disorder of the esophagus, possibly tied to the gastrectomy.
    But she was already a tiny cat, and she’s actually digesting maybe a quarter of the food she needs. We desperately want to feed her more, and she eats ravenously, but she can’t keep it down. The anti-emetics don’t help, possibly because most of the food doesn’t actually make it into the stomach. She’s frequently swallowing saliva, which I’m told is a sign of nausea.
    We’re not ready to say goodbye, she’s so young, but if our vet can’t help us get this fixed we may just be torturing her by being always hungry but unable to consume enough food. If she could just digest her food, all her other behavior is great. But I suppose it doesn’t matter if she’s running and jumping and playing if we’re slowly starving her to death.

    P.S. Invest in pet insurance. My cat could live to be 70 before her premiums caught up to what I’ve been reimbursed since 2021.

    • Doc says:

      Hello, Ben,
      Thanks for sharing your story. This is certainly an unusual and difficult case. It sounds like your veterinarian has done some amazing work. I don’t know whether you have discussed referral to a teaching institution or not. They can do swallowing studies with a fluoroscope (X-ray motion picture) that might help sort things out.

  630. Sara says:

    i read this article and thread 12 hours ago and it helped me make the decision to let my 12 year old kitty go today. she only started showing symptoms about 3 weeks ago and then about two weeks ago it went sharply downhill. the first time i took her to the vet he said it seemed bad and i might want to try and be ready, whic of course was devastating. he kept her overnight and the next day thought she may be just fine with steroids and medicated food (she stopped eating and lost almost half her bodyweight VERY quickly but was still trying to eat, drinking water, using the litterbox, never hid so we thought she might be okay). she rallied from the steroids and i got 2 more happy, pretty normal weeks with her. she acted like herself and wanted more food between prescribed meals and it seemed like she really would be just fine. then yesterday she suddenly stopped eating the medicated food. i couldn’t take her to the vet yesterday because of class but i got her some fancy feast bc i thought maybe she associated the taste of the food with being sick. she purred and ate and perked right up, then turned on a dime this morning and was not reactive to food or me touching her, and for the first time moaned when i picked her up to help her off the bed. I googled some of the new symptoms (there were a few small things) and literally NONE of the results said anything even a little hopeful.

    so i started looking around and I found this article. I ended up rushing her into the vet and we were only there for 2 hours. she had lost more weight and couldnt eat and I knew it was time. the vet said the only options left were exploratory surgery for thousands of dollars (im a student and she was 12 so that was pretty much out) a feeding tube, or “considering quality of life”. i made the decision to let her go after remembering seeing the “more bad than good days” thing here and realizing she wasn’t coming back from this one. I somehow pulled it together and smiled and used the silly little voice I used with her all the way through (took about 10 minutes). Absolutely lost it after. vet called me later and said they found she had very severe colon cancer and lymphoma and there was never anything anyone couldve done. I feel like I got two bonus weeks with her and I had plenty of time to tell her everything I wanted to say as she went. she never broke eye contact even for a second. i hope she knew how much i loved her. I am 26 and she has gotten me through my entire adult life and since I moved out ive only ever lived on my own with just her and I in a one bedroom. the loss is HEAVY and my apartment feels cold and empty.

    im sorry this is so long. thank you for writing this. i am crushed. to the point where i feel silly and overdramatic. but you helped me make the kindest decision I could and do just one last thing for my best friend who changed my life and was the only thing that got me through a LOT of really hard times. the vet told me she wouldve gone within a few days anyway. at least i got to hold her and say everything I wanted and make sure she was relaxed and comfortable in her last few minutes.

    thank you. and thanks for having such a loving comment section where i feel okay posting this while I try to act far more okay than I am to my friends. i keep thinking i see her in my peripherals and my heart breaks a little every time. But I KNOW I did the right thing now and don’t ever have to question that. that is invaluable.

  631. Stephanie says:

    Thank you so much for this! I have been grieving the loss of my 15 yr old kitty for a few days. Around 12 yrs old I came back from my sisters wedding and noticed she was urinating blood. The first vet gave medicine for a UTI without any tests but after two days she was getting no better and actually stopped urinating. I took her to a different vet and spent so much on blood work, ultrasound, X-rays etc.. she had a handful of stones blocking so I agreed to surgery and it was a lot worse than they thought. Her bladder tore but I took her home that same night and nursed her back to health. Since than I’ve had to take her back to the vet a few times because I was scared she had stones and they would always do an X-ray and cultures say it’s a UTI also saying she started having kidney disease but not that bad…… we got another cat during COVID and she Hated this cat. The cat actually gave her some life.. she wanted to sit with us all even though she didn’t want to be near him. She spend more time with the family but her jumping got worse. She couldn’t jump high . She started urinating sometimes when she would jump. She would urinate herself if the other cat came too close. I tried to keep them apart .. he never hurt her but she would fall onto her back and hiss and growl if he came close. She was still eating and drinking but would sleep most of the day. Granted I work from home and would be with her all day so she really didn’t hve a need to leave the sofa. The other night she tried to get on my bed and couldn’t get up so I picked her up and pet her until we fell asleep. The next morning she had woke me up when she climbed back in the bed but when I went to get her food I noticed her back legs were so unsteady and she kept trying to jump and do things she would normally do. She couldn’t get on the sofa but also didn’t want me to put her anywhere (she’s always been that way though she only wants to be touched when she wants to be touched and she will let you know , usually in bed). I noticed she seemed to be uncomfortable and obviously something majorly wrong . She could use the legs and than at times be unable to use them and dragged them or fell over. So as soon as the vet opened I brought her in. They wanted to do all these tests but we had X-rays from September and I remembered them talking about an area of her spine they wanted to keep an eye on. So I asked this vet to look at the X-rays and she saw whatever this was (I can’t think of it because at that point I was so upset) she said we could do light therapy and acupuncture and of course do all the diagnostic tests to see what’s wrong… but that she did believe it had to do with the arthritis in the back. Her tempature was also 98 degrees … but she also peed in the carrier because she was afraid (she’s been afraid to go in the car her entire life). They also said she lost weight. I made the hardest decision to put her down and now I can’t help but think I failed her. Maybe it was a uti? Maybe she would of been better when I took her home… I was always told you put down an elderly pet when they stop eating … she still ate. She was very alert. She was trying to get out of my arms before they gave her the sedative . Clearly there is nothing I can do now, she’s gone … but how do I know it was the right choice ? And I also wonder how come the vet didn’t bring up euthanasia, I had to suggest it. Yet after I suggested it, I asked her what she would do. She said if it was her cat (and she is a rehabilitation vet) she would euthanize . Why didn’t she suggest that from the start? Is there an ethical reason or maybe her boss wants you to pay for all these tests ? Idk but it just added to my stress. Any insight would be great. I think she was talking about bone spurs on the spine and when she touched her spine she was in pain…. But when she pinched the webbing in her feet she noticed it but did not appear to be in pain. So she had feeling in the legs. This is the first pet I’ve had to put down she’s been with me my entire adult life and I have other pets I will need to put down one day, I want to be able to trust my myself with that decision when the time comes and right now I am so confused , I don’t.

    • Doc says:

      Hello, Stephanie,
      These are always difficult times. It is possible that the doctor did not offer euthanasia outright because it seemed you wanted to do everything possible. Also, we are not anxious to end a pet’s life, but rather to improve it, if we can. If we cannot, and the quality of life is poor, then I try to put things in perspective. I tell people what we can do to try to improve the situation, but I also try to be frank about how much improvement we can (or can’t) expect. I want them to have enough information that they can feel like they made the best decision that they could, so they aren’t second-guessing themselves later. This is hard enough without that. When they ask me, “What would you do if this were your pet?” I don’t always have a great answer. It has been hard for me when the time came, even when the decision was very clear cut “on paper”. We just try to work through it together.

  632. Erin says:

    I’m struggling after putting my 18 year old cat down last week. She was diagnosed with Stage 2 Kidney Disease and arthritis at the beginning of March. I changed her diet to all wet food and kidney care. I started her on a course of Adequan. Earlier in the week I noticed her gait changed and it was difficult for her to move her back paws forward. I made an appointment for a couple days later thinking maybe her kidneys were hurting and it was time to introduce fluids. Her mobility got progressively worse over the next day and she wet her bed which was very unlike her. The doctor checked her and did x-rays. She said she was constipated and gave me laxatives and taught me how to give her fluids. She told me to put a litter box by her bed but I felt like I wasn’t getting across the changes I was noticing. She still walked and ate and drank when we got home. I gave her the Adequan and laxatives and started her fluids the next day. She walked that morning but it was very labored. I set her on the couch with litter pads the rest of the day and night thinking the fluids tired her out. I brought her food and comforted her. She remained there through the night having accidents. I bathed her and tried to test her walking but her little paws splayed out from under her. Even her front paws started to turn in when I tried to get her to prop up. I called the vet and they thought it could be saddle thrombus and had me go to the ER. The ER doctor ruled out saddle thrombus and thought it was either slipped discs or a spinal tumor. I would have to get an MRI to be sure that would cost $3000. The Xrays also showed she only had one kidney, asthma, extensive arthritis and bone deterioration. If it was a spinal tumor, it would be inoperable and she’d spend her last days in a hospital since it was the weekend and they wouldn’t do the MRI until Monday. The partial paralysis looked so bad and had only progressed, I wasn’t sure she’d get her mobility back in the weeks it takes to treat slipped discs if that’s what she had. She looked like she was ready and it seemed like we didn’t have good options in front of us. I said goodbye and it’s been very hard. I wondered if I had started the fluids earlier, could that have prevented the slipped discs, if that’s what is was. Or if I should have tried the extensive treatment plan of 6-8 weeks of crate life, meds and physical therapy. I now know guilt is normal with grief but the thoughts linger and this is still very new.

    • Doc says:

      Hello, Erin,
      The fluids would help with the constipation. The fluids help keep the kidneys functioning better by putting more flow through them, thus helping to filter more waste. I cannot imagine that the fluids would make any difference in regard to her spinal problems. Bodies just don’t last as long as spirits, and sometimes it is best to just leave them behind and start a new adventure.

  633. Robin says:

    I really could use some sort of advice on what to do about my 15 year old cat with lymphoma. She was just diagnosed a little over a week ago with high grade lymphoma that presented as wheezing like a cold. She was started on prednisolone, which seemed to help at first, but her lymph nodes that swelled super fast on her neck not only have gotten worse but the swelling has spread to many of her other lymph nodes. I can feel every node around her neck has swollen severely, as well as some on her legs and ribs though not nearly as large. Additionally, she has beginning stage 3 kidney disease for which my vet is having me give a phosphate binder, but with the cancer I wonder if it’s connected.

    She is struggling to breathe and wheezing a lot as she has to breathe out through her mouth, but she is still very aware, hungry, and happy to cuddle with me. At the same time though she doesn’t vocalize nearly as much as she used to, doesn’t sleep with or on me anymore (one of her favorite things to do that breaks my heart), doesn’t play or zoom the way she used to, and only occasionally grooms her paws. Today she was given a bigger steroid dose and she played a little bit with a new toy but she spends most of her time unable to sleep because she can’t breathe when laying her head down. She spends almost all her time changing places she’s laying down and staring into space with her eyes half closed unless it’s feeding time where she gets excited for food and treats, hopping up to eat them. However solid foods seem to be giving her trouble and she’s choking on trying to swallow despite being able to move around, use her boxes, drink lots of water, and eat softer foods.

    I’m just so torn up about it because I still feel traumatized by our previous cat we just lost in 2020 who I felt was put down too soon for a different disease making him struggle to breathe, though it’s hard to say if he was. I’ve had her so long and she’s been there for everything, imagining giving up on her too soon is breaking my heart- but so is hearing her wheeze and seeing her struggle to sleep. She already cried at me taking her to an emergency vet today so I know her mind is very present, but I hate the idea she’s suffocating. Sadly, we decided not to go through with surgery or chemo at this time because due to her age it might just make her worse and my goal is quality over longevity- but am I making the right choice?

    Would chemo help her breathe again, or is it better to let go even if she’s still so aware because her throat is so swollen? I know her struggling to breathe is not comfortable but I haven’t seen any mention of euthanizing a cat early for that. I know for a fact she’s uncomfortable and perhaps in a bit of pain, but only in her throat- she’d be fine for a little longer if she could just breathe. Can you help me understand if it’s better to let go sooner if she can’t breathe well even when the rest of her body (aside the kidneys) is still working?

    • Doc says:

      Hello, Robin,
      So sorry that I’ve gotten behind on these. The chemo isn’t likely to reduce swelling very fast, and cats have a somewhat lower tolerance for the drugs than dogs and people do. If the steroids aren’t helping, and she is having difficulty breathing, it is probably time to let her go.

      • Robin says:

        Sadly I came to the same conclusion with my vet; he said her case was the fastest worst case he’d seen in a while. While I miss my baby every day, I know she lived her full life expectancy at the very least and she was clearly ready. I still feel guilty having wished she could pass peacefully but this article and the comments helped me feel better. Thank you

  634. Will says:

    I’ve just been told by my vet that there’s nothing they can do for my 15 year old cat, her kidneys are failing and her blood tests were so bad they just wanted to know if I wanted to put her down straight away. This would be all 3 of my cats, siblings from the same litter, dead in the space of 6 months all from kidney disease. Losing a cat is hard but losing 3 one after another in the space of 6 months is unbearable.

    • Doc says:

      Hello, Will,
      This is truly a difficult time. Each new loss restimulates the pain of previous losses, bringing them to the forefront, even when you feel like you had fully come to terms with them. The old traumas link to the new one, making it even more difficult. Sometimes realizing this helps to deal with the new loss, understanding why it seems harder than ever. Having to go through the grieving process so soon and so often is still very tough. Try to remember the good times.

  635. Daphne says:

    Hi there,

    These posts have been very helpful as my wife and I think about what is best for our almost 14 year-old cat, Toby. We adopted him 4 years ago when his previous owners gave him up for urinating outside of the litter box and needing too much attention. We solved the litter box issue by getting him UTI treatment and changing his litter (he was declawed as a kitten and is very picky).

    He has been very healthy and happy so far, except two months ago when he suddenly vomited a large pile of blood. We took him to the vet and he was immediately diagnosed with pancreatitis. He took a course of syringe-fed medication and a month of prescription biome dry food. He seemed to be doing well.

    Then, a month ago he started peeing outside the box and was extremely lethargic. We took him back to the vet and he was diagnosed with diabetes – the vet thinks it was caused by the pancreatitis because his free glucose number was normal at the time of pancreatitis diagnosis, but 500 when diagnosed with diabetes. We have him on glargine 2x day, and he has improved a bit. When we have tested his fasting blood sugars at home, they are in a normal range. However, we are concerned that he is suffering because he is acting so unlike himself.

    Toby is an extremely gentle and loving boy. He has always been a lap cat and a snuggle bug, with a giant purr. He has loud conversations with us and spoons in our bed. In the last month, he has stopped sleeping with us completely. We have to close the door because he wakes us up at 2am and yowls until he is fed at 7:30. Instead of sitting with us on the couch or snuggling, trying to sit on laptops or participating in yoga, he sits in a doorway for hours. He frequently looks confused about where he is. He still has not stopped peeing outside of the box and has poor control of his tail. He pees on himself a lot. Grooming hasn’t stopped, but is becoming an issue. Sometimes, he spends hours looking at a single spot on the floor. He strains in the litter box despite being on an entirely wet food diet.

    Toby loves food and still eats his Friskies (low carb, high protein) pate with great gusto. But, he never seems to be full. He has lost about a pound since diabetes diagnosis. He also doesn’t seem to be purring the way he used to.

    We are very conflicted for a variety of reasons. Toby still has many good days, but on his bad days he can’t poop and hides under our bed or the coffee table (he loves people normally). He appears healthy but we are worried about a slow, painful decline in his health. We do not want to get to the point where he needs to go to the hospital as we cannot afford this and he would hate it. He is fine with the insulin injections, but trying to take blood glucose readings is miserable for all of us. We do not know what his life was like before he came to us, but he seems to be convinced we are giving him away every time we take him to the vet. We are hesitant to do in-vet glucose curves because of this, but we do think his insulin dosage seems good based on his fasting levels taken at home.

    Thank you for any advice or words of wisdom that you can share about when to know that it is time to say goodbye.

    • Doc says:

      Hello, Daphne,
      Sorry to be so late in replying. The blog got hacked and we had to do some house-cleaning.
      Pancreatitis is much more difficult to diagnose and treat in the cat than in the dog. The clinical signs are not consistent and can be confused with other disease processes. In a situation like this, I would be very concerned that there is some additional disease process going on.
      Doing an in-clinic glucose curve with a cat is often unproductive. The cat is stressed, so doesn’t eat normally, and stress artificially elevates the blood glucose, but not in a consistent manner. If I can’t do it at home, then we sometimes get a fructosamine level. This blood tests reflects an average of how well blood sugar has been regulated over the past two weeks.

      If I were proceeding with looking for additional disease that could be treated, I would be getting a radiologist to perform a good abdominal ultrasound.

  636. Abby's Catmom says:

    My 14yo tabby has OA. I take her monthly for Solensia injections, and I think they help a little. She also has inflammatory bowel issues, and I administer B12 every other week but that appears to be losing efficacy. She cries when I insert the needle. She cries when I pick her up, and she hates riding in the car to go to the vet clinic. Her one joy seems to be napping on my lap, but I must pick her up for that (and she cries). She sleeps in one (maybe two) rooms of the house, and rarely ventures any farther. She no longer seeks out sunny spots to lounge, the effort to get on my bed no longer seems worth it (I have several items she can use for a gradual progression up/down). She doesn’t seem to have “good” days, just “days.” I feel like there is more treatment I could pursue for her symptoms, but I am just buying months at this point, prolonging the inevitable.

    • Doc says:

      Hello, Abby’s Catmom,
      We never want to have to make this decision. We always hope that there will be a peaceful transition that doesn’t require us to “play god”.
      And yet… when it looks like a loved one is enjoying nothing and just waiting to die, that’s hard, too.
      I wish it were a thing where you could just add up the numbers and know what is best to do, but it isn’t. You see the decision coming soon. Don’t feel guilty about whatever decision you make.

Leave a Reply

Your email address will not be published. Required fields are marked *