One of the most difficult parts of being a cat parent is saying goodbye to our beloved companion when they reach the end of their life. At that point, you’ve hopefully lived with your furry friend for at least 15 years. It can be really difficult to notice a decline in your cat’s quality of life (QoL) because changes are often gradual. On the other hand, when there is an incident, such as an accident at any age or a sudden change such as a dramatic change in kidney function, the question stares you in the face: how do you know when enough is enough?
Many conditions in older cats are chronic and cats can do well and live comfortably with minimal support (such as daily medications, subcutaneous fluids or a feeding tube). It is natural for us to not want to admit to deterioration. We don’t want to lose them! But at some point, we need to recognize that Fluffy just isn’t enjoying her/his life anymore.
Palliative care is both desirable and available. It helps us keep our beloved companions free from pain, well hydrated and nourished, and able to perform their normal cat routines. Your veterinary team can help you meet these needs in the clinic, but also teach you how to continue this care at home, where Fluffy is happiest. This is a good time to set up an end of life plan with your veterinarian on palliative procedures as well as discussing euthanasia (literally meaning “a good death” or assisted dying).
Unlike us, where we can rationalize that feeling dreadful for a day or two from chemotherapy or surgery or treatments three times a day are tolerable because they will make us feel better in the future, cats live only in the moment. Discomfort, pain, and fear are their only reality. We, their people, have to ask ourselves: “Who am I doing this for?” Are we wanting to proceed with treatment that will reduce QoL for 3 days every week? What about 3 days every 3 weeks? Which is best from your kitty’s perspective?
How do we assess QoL? One way is to write down (preferably while kitty is still well) what he/she really enjoys doing (e.g., sleeping on the windowsill, running up and down the stairs, snuggling in bed, batting around the belt on your bathrobe). Check back on that list whenever you are wondering about QoL.
Another way is to use a calendar and give a daily (or twice daily) score out of 10 to perceived QoL. Are there a lot of 3/10s? Is the trend of scores declining?
If you want a more objective approach, you can use the H5M2 evaluation. This assesses:
Each component is scored out of 10 (1 poor, 10 best) with a total score of more than 35 indicating an acceptable QoL.
Once you have come to the heartbreaking realization that it is time to release your furry friend from their physically and emotionally uncomfortable state, what’s next?
Your veterinarian will discuss, if you haven’t already had the conversation with them, giving your cat a sedative to reduce any distress before giving the euthanasia solution. Euthanasia is painless and should also be stress-free. Each clinic will have its own protocol, but be prepared to bring your sweet friend in with a blanket or toy they love. Make sure you have informed all family members who might want to say goodbye either before or at this visit. Remember that the timing is based on how your kitty is feeling.
After euthanasia, you may take their body home with you (depends on jurisdiction), or have it buried, or cremated. It is good to think about this before the decision is necessary. The clinic may offer to send you home with a lock of fur, make a paw print, or give you the ashes. Regardless, you can hold the special memories in your heart and mind forever. And photos really help!
At this time of sadness, there may also be a sense of relief to not need to give treatments and have the freedom to travel. This is not bad and you shouldn’t feel guilty about it. It is also really normal to feel numb or overwhelmed. You may find yourself breaking into tears in the most unexpected situations. Respect your grieving process and be kind to yourself. Your friend is no longer stressed or suffering – you cared for them as well as you could. Cherish the memories you have. It was a gift to have them in your life and they were lucky to have you in their life. They have become part of who you are so they will truly never leave you.
• Thayer V, Monroe P, Smith R: AAFP Position Statement: Veterinary hospice care for cats. J Feline Med Surg September 2010; 12 (9): 728-730
• The Ohio State University Veterinary Medical Center. How Do I Know When It’s Time? Assessing Quality of Life for Your Companion Animal and Making End-of-Life Decisions. • www.catvets.com/end-of-life-toolkit
This article was written by Cat Healthy Feline Specialist Dr. Margie Scherk DVM, DABVP.