When to say goodbye :(

My 14 year old cat Shelby is not doing well. All tests have come back unremarkable but she continues to decline. Her back legs have become weak and after several opinions the doctors believe it is spinal lymphoma. Her vet decided against an MRI because she feels it will not give us information that could help her. We know she is terminal and have been keeping her comfortable with pain medication. I have even brought her to a holistic vet that did acupuncture. She is still eating, drinking, and using the litterbox but I can tell she has some discomfort. I know some people have euthanized their pets right away when they knew it was terminal and others that let them suffer until the end. I want to make sure I do what is best for her. Just wondering others thoughts/opinions etc. and maybe what helped others decide when they were faced with this difficult decision

I'm sorry you are going through this.  Of course we know with cats that this moment will come sooner or later, but it doesn't make it any easier.

I've been through two such experiences in the last several years.  With one we made a decision to euthanize.  Looking back, I am not sure it was time, and knowing more things since then, I wish we had done more care for her in the months leading up to that decision.  She may have lived comfortably for longer.  I know it's common to look back and second guess such decisions though.  With the other, I sometimes think it skewed the opposite direction.  We didn't get to the decision point as she died on her own before we were ready to reach that conclusion.

I don't know much about Shelby's suspected condition of spinal lymphoma.  I'm sure you've read up on the condition from various sources and I certainly couldn't tell you anything specific that would be more useful than those.

But regardless of condition, many factors are the same in figuring out quality of life with a terminal disease.  I see no need to euthanize right away if she can still be comfortable.  Things you might evaluate are eating/drinking on her own, using the litter box with no trouble, enjoying her favorite spaces and able to get to them on her own (walking, jumping), enjoying your company and attention, playing, etc.  There are probably more items, and it needn't be that if she loses one of them that is too much.  Each individual cat situation is different.  You will have to evaluate this yourself with Shelby, but just know that it's not necessarily a choice between euthanize now or suffering until the end. 

With Amber we went through periods where she wasn't eating on her own, but she could do everything else to some degree.  But thinking back about her last couple weeks or so, I don't think she was really too happy with it.  She responded to our presence, could get around on her own (even up and down stairs!), used her litter box without fail, etc.  She just didn't feel that great.  And we think her heart condition (she also had hyperthyroid and kidney disease, and was 17 years old) was responsible for her death at home.  I can only hope she didn't suffer too much; I can't really know for sure.  I thought we were working towards turning a corner with the kidney disease.  That is the premise I was using for keeping her going with the only issue being not eating.

What I would do when faced with a terminally ill cat is treat her like we would treat a human in palliative hospice care.  We know they're terminal, we are not doing any more aggressive treatment, but we are keeping them comfortable and free of pain.  As long as this can be done with a cat, I do not think one needs to rush to euthanize. But when this can no longer be done, because we are able to make this choice with our pets, I would absolutely choose to euthanize rather than having a cat suffer through final days when she could no longer be comfortable.

Determining whether a cat is still comfortable or not is not really an exact science.  And I don't know from what you've written so far where I would personally place Shelby on such a scale.  It's almost always going to be somewhat of a judgment call, not so much of a clear line.

Some will say that the cat will let you know when it is time.  I personally have not found that to be true so far but if that makes sense and works for you, that is another data point to use.

I hope some of that may be of use as you spend some more time with Shelby.  Take care.

This is a wonderful piece written by a TCS member that has given comfort to many of us:  http://www.thecatsite.com/t/237066/when-the-moment-comes

It's always a difficult decision.  I, too, have often wondered if we've made the decision 1)  too soon, and 2)  too late

Maybe this "quality of life" scale can help you out:  http://www.veterinarypracticenews.com/November-2009/Quality-Of-Life-Scale/

I'm so sorry you are going through this. I had to put my 17 year old down in August. Here is the experience I went through with Blaze.

I first noticed she was walking like she was drunk. I immediately called my vet and took her in. Turns out she was in late stage 4 kidney failure. What ever the vet said to do, I did. I reached out to people on this forum (and I cant thank the amazing people on here enough) to see what they did, and asked this same question. Unfortunately, Blaze deteriorated quickly. Three days later, she was put on an IV drip for the entire day. The next day, she yowled while using the litter box and immediately threw up. She wouldn't eat, she would barely drink, and she would not come that close to me. Again, read up on how to stimulate her appitite. Still nothing. The next day I had to go to work (I worked very early mornings), called the vet, left and took her in. The vet said she didnt bounce back at all from the IV. He was honest and said that she probably would not last the week and while she wasn't in that much pain, she just felt very sick all the time. He said he would do whatever I wanted, but said that her time was up. I decided that rather than come home and find that she had died alone, she should go peacefully in my arms. It broke my heart, and still does.

Do I wish I had more time with her? Absolutely. I miss the heck out of my kitty.

Do I regret putting her to sleep? Yes and no. Yes because I wish I could have done more. No because she was in such a decline and so quickly. There really wasn't anything they could do at that point. I didnt want her to suffer or be alone in the end.

Feel free to msg me anytime if you want to chat. I'm sending happy thoughts your way.

Check the cat out , thyroid , lungs and heart, my mothers cat sugar has been diagnosed with congestive heart failure, with fluid around the heart, the vet gave sugar a shot to help lessen the fluid , but I'm not sure how long she has till this CHF kills her. she is 13+ years old has a heart mummer and lethargic, when given meds, she moves yet when on the phone with my mother , I heard sugars screaming sound  over the phone. cats aren't meant to live forever, if your cat is showing signs that are not normal get another vet than the one you have ok, don't wait for this vet to diagnose him/her with CHF it is painful to watch your kitty go through this, and you to have to see this too. be brave, be strong get another opinion and check all vitals .

I really appreciate all of the responses from everyone. You are all so kind.

I had to go to fly to FL for 3 days for a wedding. I looked into changing our tickets but it was about 900 dollars to go a day later. My Mom took great care of her. She came over several times each day to make sure she was ok and sent us pictures. I said goodbye not knowing if I would see her again. When we came home she was almost walking normal and looked great. Today she is walking a lot worse. She is eating normal and still getting to the litterbox. When she lays down she stretches out and looks happy and comfortable. I brought her to the animal hospital before we left and mentioned her kidneys feel swollen and she has increased thirst and urination. The doctor said there is nothing else to do and keep her comfortable etc. She was kind and talked to me for a while but didn't do any tests other than a physical exam. She said since all of her tests (multiple blood tests, urinalysis, xrays, ultrasound, etc.) Were all unremarkable 3 weeks ago there is no point to test again. She said they still believe it's spinal lymphoma and there is no point to put her through more tests. I'm wondering if there is anyway they could have missed kidney disease Or maybe I'm in denial. She has more symptoms of kidney disease than cancer. It all started about a month and a half ago when she was vomiting foam, not eating or drinking, and had some mild trouble walking. We admitted her to the hospital. 4 vets cared for her and she got better after two days other than her trouble walking. The vet hopped it was an orthopedic injury that might heal with rest but that hasn't been the case. She said the only other options are spinal lymphoma or a degenerative disk disease. All tests that were done were unremarkable and they said to take her home and keep giving her pain meds. It's now been about a month in a half and her condition is about the same. I'm not sure if I should accept what they are saying and keep her comfortable or get another opinion. I just don't want to put her through unnecessary testing.

Your cat is old and as with most of us life is not always comfortable as we age so don't expect a kitten or anything. It is when they get to the point where they are obviously suffering and it is hard to do anything that you need to do something. If the cat is still getting around and is interested in things and is not showing signs of obvious pain or discomfort then I think it is fine to help them keep going. My guy got a host of issues when he was 17 and was doing better at 19 years old than he was at 17. He needed a lot of help but I always thought of it as the price for being old and I made it as fast as i could and as painless. In the last few months I was really watching him closely but I don't think it really got to the point where he should have been put down. He fought every step of the way and never gave up or avoided his treatments and looked like he wanted to continue on. The end came very fast and I knew it was time and did what had to be done. I gave him pain meds for the last two years to help with arthritis and made everything easily accessible for him and he was able to live out his retirement in relative comfort. I did a lot of research on this topic and there are a number of really good baselines you can use to measure your cats quality of life. The quality of life is what makes the biggest difference so as long as it is there for the most part then I would keep trying. I would also take x-rays or some type of scan for sure just to ensure you haven;t missed something. Best of luck and hopefully things work out for the best with both of you.

It sounds like you gave your guy a long and good quality life! I'm sorry for your loss. Thank you for the reply. I'm considering more testing but I'm not sure. She had lots of testing including xrays about a month and a half ago.

I'm happy you had so many good years with your kitty. No matter how long we have its never long enough. I feel the pain of what you're going through, I've been there too and know its the toughest decision to make.

The most special cat I could ever have in my life was with me for ten years. He started acting strange and I took him in to the vet. After X-rays and blood work the devastating diagnosis was given, my sweetheart had incurable cancer. The vet sent him home with pain meds and other meds to keep him comfortable. At times, he acted so much like his normal self, other times he was moody and could barely eat. He let me know when he was ready to cross the Bridge, I was looking for signs and he was very clear about it. He started hiding a lot, he stopped sleeping with me, he stopped playing fetch, his daily walks around the block on the leash were shorter until we didn't get past our driveway when he turned around to go back in. He stopped eating altogether, that's when I knew it was time. It hurt me to see him suffer and it hurt to let him go, even though I knew it was the kindest thing I could do for him. I felt he was too young to have that problem and I felt cheated of a few more years. I also felt blessed that we had another month to cherish because I knew time was limited and I wanted to show him all the love I could during that time. One of my treasures is a paw print imprint the vet made for me with his footprint.

I truly wish you and your kitty the very best. I know this is so heartbreaking for you. Sometimes our furry friends depend on us to make some tough choices but no matter what they know we love them. I hope you will have some more quality time to love each other. (((((Hugs)))))
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