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