End of life decision-making

Hello, and thank you in advance to all who take time to read and possibly offer thoughts about my situation. I joined today specifically to post this sad question and hear from others who I know love their cats as much as I love mine, and possibly have faced something similar.

My kitty is 13 years old and was diagnosed with lymphoma in November. At that time she was having respiratory difficulty, had lost weight and clearly felt unwell. At the time of diagnosis she had a thoracentesis and that fluid removal provided good relief. We opted not to do further treatment, to bring her home and love her and give her the best days possible for the time she had left.

We expected only a couple of good weeks, and to my amazement she has made it all this time in good spirits and appearing to feel reasonably well. We're so grateful for each good moment. 

But she is declining again and I am faced with making the dreaded decision about quality of life and giving her a peaceful ending. The last few days her respiratory effort is increased. She can only lie on her belly, often making herself fairly "flat." She occasionally (only a couple of times a day) appears to be taking a few rapid breaths with an open mouth. Also, alarmingly, I have not seen evidence that she has used her litter box in about 2 days.

All of that said, she continues to be up and around. She has certainly lost weight, but she still eats small amounts of food. She doesn't want to be touched but she likes to be near where "her people" are (though she alternates being "out" with time in a closet). I know she is uncomfortable...but she is not (yet) in acute distress.

I've only had to make a decision about euthanasia for a cat before when it was an emergency, clearly no other alternatives. I am finding it very difficult to think clearly about making a decision for my sweet girl. I don't want to wait until she is in the throes of true respiratory distress. I know that her observable symptoms may not show the true picture of how bad she feels right now. And I do feel that in the last couple of days I haven't seen signs of real "pleasure." 

If I re-read all of this, my gut says it is time. And of course I know I am the only one who can make this decision. I plan to speak the to the vet in the morning. But if anyone has thoughts to share, I would appreciate hearing them. Thanks again.

There is something to be said for being able to make the decision to give your baby the final act of kindness, rather than being forced to do it. All my life it was always an emergency situation as well. With Lucky, I made the choice the day before I took him in. I enjoyed that last day with him as much as possible. He was not comfortable and no longer eating (end stage renal failure). But he still slept in bed with me. It was hard for him to get up there, but goodness he found a way up there. Ironically, the "easier way" was there the whole time, he only discovered it his last night though.

Lucky had been telling me for a couple of days it was time. But I needed the blood work to justify it. I needed to at least give it a chance. And when his numbers came back so much worse, I knew it was time. He pretty much crashed that same day.

I guess the question is, how much is your baby suffering, and is there any hope to lessen the suffering to the point she has a good quality of life. That is definitely a discussion to have with your vet. Eating is such a big deal to me, so hard to say from my point of view. You know better than we do of course.

My heart goes out to you. I've never had to make that decision (yet).  You sound like a wonderful cat mom... your kitty has been so lucky having you as her mom.

In a case like this there is no real "rule" ,(besides some of the guidelines already mentioned) it is just that knowing that comes from your heart what would be the best way to proceed.  The best for your kitty.
 

Have you asked her what she wants you to do?   If you can find a quiet peaceful space inside, ask her and then wait for her response. You may be surprised how clearly you will perceive the answer...

Best of luck and big hugs..... Don't envy what you are going through...

More hugs....

I am so sorry you have to make this awful decision. 

I'm so sorry that you are having to make the decision of euthanasia for your cat.

It is never an easy decision to make, but especially difficult when your cat is still eating, and moving around.

I agree with 'Donutte' in that the question would be how much suffering your cat is in, and if there were anything you could give such as painkillers, or other meds, to relieve her suffering to gain quality of life back. Or if another 'fluid removal from her chest' would help her to get back to a better quality than she is right now.

It is very worrisome when a cat is open mouth breathing, and no longer using her litter box. Not being able to eat enough, to sustain herself, is another factor to consider. 

I would always choose quality of life, and base my decision on the amount of suffering my cat was in. Your vet will be able to guide you, and give their honest opinion of what they see and hear.

Again, I am so sorry, and wish you peace and strength in the decision you have to make.  It is so good that you had this extra time with her, and enjoyed the moments, because even when the time comes, your heart will be broken, but you will know that you shared amazing times together, and will focus on those days, and not on the ending, or the dreaded lymphoma disease.

Gosh, I'm so sorry you are having to make this decision!  I really do understand what you are going through.  It was 6 months ago yesterday that I had my Gracie girl PTS.  She'd been sick about 4 months with a URI.  She continued getting worse despite one treatment after another.  When I was out of money, they gave me an ultimatum.  They said in order to properly diagnose her, she would need to do a $1000 x-ray under anesthesia.   And that was the least expensive option.  But I was told even then, there was no guarantee her illness could be treated even if she was rightly diagnosed.  I felt like I had been backed up against the wall and the decision kind of forced upon me.  There was no option, and I was out of money.  Well, I had $67 on my Care Credit, which is nothing.  So I called the vet of my choice, a very kind man, soft-spoken and gentle with animals.  He came to the house.  If you can do that, I would recommend it.  Make sure you ask the vet to give an anesthetic (the first shot) that does not burn.  I'm so sorry for you and your kitty.  Hugs.

Hello SadCatMom.

There is no easy way to say this, but for your sweet cat's sake, you must not wait until she is in further distress, and she is already in distress. I speak from experience, sorry to say. I had a 7 year old cat with mammary cancer and she was losing balance but still loving, when one night she went into full respiratory distress, just like that. In those days there were no 24/7 vet hospitals near me, so she was in agony for about 5 hours of full on wheezing. She did not deserve that.

Cats do not live forever, as we do not. You can't save her life or give her any more quality time, from what you have said. You need to ask yourself if you are preserving a hard life, or extending a slow death. I am most sorry. You have given her a wonderful life. We all come to a point where we cannot do any more for our furkids, and you are at that point. You have permission to do what is right, ok? It's hard, we have all been there.

(((hugs)))

(((((Sadcatmom)))) My heart goes out to you, having to make this.   A very good friend told me that I would have to make the choice because my Tiger was so bonded to me that she would hang on longer than she should have( I lost her to pancreatic cancer) The same friend also said that when you have left no stone unturned as far as treatment and are honest enough to see the truth for what it is, then you can be clear about doing the right thing and not letting your baby suffer. I hated hearing it, but those words hung in my mind when the time came.  It is never something we feel good about, but we do it with love and respect for our precious babies.   If you have any doubt in your mind, please, go to the Crossing the Bridge Forum and read the post by Gareth called When The Moment Comes, it helped me so much, it was the truth.

Just by reading your post, I can tell you've done all this and more. Your sweet baby will tell you when it's her time. It just hurts like hell to comprehend and follow through with it. If you are in need of support, we're here for you as most of us have been in  your shoes. Hugs and strength vibes being sent for both of you.

I am so sorry you are going through this. I lost my little girl to that horrible lymphoma. She died in my home. 3 weeks ago. Sweetheart spend as much as you can. Give her a lot of love. Whisper in her ear how much you love her. I know the pain you feel. My heart is with you. I pray for you. Big hugs.

And this is just why I came here and posted -- I knew I would have the wisdom and support of people who have been through this and understand. Thank you all so much for your thoughtful replies. 

Misterwhiskers, I hear you and appreciate what you have to say. I fear letting things go so long that we are suddenly in the spot you describe. Obviously none of us want our animals to go through that, and I am taking your story to heart.

Ginny, thank you for sharing, and I definitely plan to find out about having someone come to us at home if possible.

CatNap, Furmummy and Donutte, you all say wise and helpful things and just having your thoughts and kindness make me feel less alone as I move forward.

Littlecutie and RuthM, I'm so sorry for your losses! There just is no other love like that we get when these precious souls choose us!

And Zed, thank you!

I feel so sorry for you. Letting a beloved friend go is the most difficult decision you have to make. My son had to make that decision about a year ago for Holly, his 16-year- old cat. She had been showing signs of dementia for some time, then went into a decline that got worse and worse. She eventually could not get up to go to the litter pan and became incontinent. My son filled her up every other day with sub q liquids. He said she gave him the evil eye every time he rolled over the IV pole. The vet said they couldn't keep her alive more than a few months, so my son finally decided to let her go. He grieved, even though it was his decision.


Rest in peace, sweet Holly.

The amount of distress, discomfort and even pain we allow our cats go through is measured by the hope of a recovery, remission or knowing there is no hope just further deterioration and quality of life. The moment your gut tells you you're delaying the end for yourself rather than monitoring your pets quality of life is as close to the right time as you can get. You should discuss any palliative care options with your vet , how long they might be effective or if it's even advisable. I don't mean to sound cold. Sadly taking the emotion out is the best way to step back and really look at the situation. It is generally better to let go a bit early that later when the stress of losing them is compounded by the feeling of being forced.

For us letting Kitten go a bit early meant the last hours we spent with her were more positive for us and her rather than having the last vision of her being in mortal distress or pain and not able to connect with us at all. She knew we were here people and was content to sit in my husbands arms.

I truly hope you get a bit more time. But that's between you, your family and the vet.

Sometimes it helps to actual sit down and write things out.  My hubby and I actually sat down and made a list of all the things our senior cat loved to do.  We called this our quality of life list.  It really put things in perspective when we were able to physically see all the things he could not longer do anymore.  My cat had a stroke and we took the list with us to the vet and actually asked if he would be ever able to do any of those things again.  The vet told us it was very unlikely.  It hurt like hell to let him go but we knew we could not continue to let him suffer.  Maybe something like this would help you and you could always discuss things with your vet.  

I am sorry you are in a place where you are having to think about this painful choice that is the last act of love we can give our babies.

SadCatMom said:

 
And this is just why I came here and posted -- I knew I would have the wisdom and support of people who have been through this and understand. Thank you all so much for your thoughtful replies. 

Misterwhiskers, I hear you and appreciate what you have to say. I fear letting things go so long that we are suddenly in the spot you describe. Obviously none of us want our animals to go through that, and I am taking your story to heart.

Ginny, thank you for sharing, and I definitely plan to find out about having someone come to us at home if possible.

CatNap, Furmummy and Donutte, you all say wise and helpful things and just having your thoughts and kindness make me feel less alone as I move forward.

Littlecutie and RuthM, I'm so sorry for your losses! There just is no other love like that we get when these precious souls choose us!

And Zed, thank you!

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@SadCatMom   Can I ask what your sweet cat's name is?

She sounds like quite a strong cat, to have already beaten the odds of the time she was given. If you ever feel like talking about her, or posting any photos, we'll all be here to lend an ear.

Just know your cat loves you, no matter what decision, or timing you have to do. She knows that you have her best interests at heart.

I'm new as well, but my heart aches for you.

My husband and I have always had dogs, and we have been put in those decision making situations as well.  We never really had an interest to invite a cat into our lives until we had a stray show up at our door in the fall of 2010.  We thought "he" was a "she" when we went to get "her" fixed.  Only to find out what we were going to call "Gypsy" was a "Gyps-him".  So, we called him Louie instead.

In March of 2011, I noticed him getting more lethargic, and "picking" at his food.  Our vet was wonderful through it all, but also gave a "heads up" that FIP was showing up more than in the past, and it was always a chance. 

In April 2011, after top-notch veterinary care, trying to hand feed him at the hospital, and wishing we could keep him forever, we had to make that decision.  It was the most difficult decision we have ever made.  All our "kids" are near and dear to us, but that little guy made us "cat people".  He opened our eyes to a world we never knew existed, and since then we rescued two cats (one in the later part of 2011 after we worked diligently to make our home FIP free which is never a guarantee), and another in 2012 to get him a pal.  As of last week, we just rescued a neighbor's stray as well.  Along with having our three dogs (and yes, they all get along).

I guess where I'm going with this, is 13 years is amazing!  And you have given your kiddo the best love one could ever ask for.  For some strange reason, just like with humans, some lives are cut shorter than others.  Louie was only estimated at just under two years old when we had to let him go.  But, what he did in that short time for us, was magnificent (we only had him for about 1/2 year).  And we just hope that the life we gave him was better than what some of us have in 80 years of life.  He taught us a lot, and made me more interested in the feline behavior than ever. 

Be strong, and think of all the joy your cat has brought you.  I cry for you, but I also know your heart will heal, as ours did.  And in doing so, we have now rescued three more kitties.

Hi my lovey,

 If its any consolation i had to have my kitty put down in( 2014 dec) although the hardest part was taking her to the vet knowing she was not coming home, i cradled her while she went to sleep and when the vet was listening to her heartbeat to stop, she looked at me and said "would you believe she is purring" then she looked at me me and said she is gone, although EXTREMELY upset i knew she was in a better place there was no more pain or being stuck with needles we had her cremated and she was back home with us the next day, i was keeping her alive for me not for her she had had enough, i know say to myself it was the best thing for her, but do find myself in the same situation again now with her mum, but i hope this gives you some kind of peace sweet good luck xx

In the past two years we lost our two elderly family cats.

First to go was Sara, who we lost at 15 to arthritis. She was very over weight, which didn't help. There were a lot of signs that she wasn't doing well, but we missed them or maybe tried not to believe them until she started living in a bathroom and wouldn't get up to go to the litterbox or to eat.
We took her to the vet and they gave us a pain medicine to squirt in her mouth. I wish we hadn't tried bringing her home again.
That night was terrible. She would seize up and scream in pain. We gave her more pain meds than she was supposed to get, just to make it to the morning so we could end that pain for her.

Last summer we lost Sally, at 18. Sally had always been my cat and was my cat soul mate. She had a lot of health issues at the end (hyperthyroidism, hypertension that caused blindness, one working kidney). We saw the vet with her pretty regularly, had her on lots of meds, and were doing everything we could for her. We regularly asked the vet how to know when its time. We wanted to make sure that she wasn't being forced to stick around for our sake, that it was still what was best for her.
The vet always went back to quality of life, and said that she still had some kick left in her. She didn't always make it to the litterbox anymore, but she was still getting around, still social with us, still eating.
Her last day we took her to the vet because she had stopped eating. The vet said she was in kidney failure. My family had animals go through that in the past and had seen first hand how bad it was for an animal to go through, and warned me, but she was my cat so it was up to me.
I decided to make the last appointment of the day for her and take her home in the mean time to spend time with her and say my goodbyes.

That was the hardest thing I ever had to do, but it was the right thing. I went through two very different last days with my cats. I hope I never have to put another animal through what Sara went through.

I wasn't sure I'd know when the time came or be able to say goodbye, but I did. You'll know. The vet will give you the facts and then you'll have to really look and see for yourself, even if you didn't want to see it before. And you'll know. Don't let your kitty get to the hard part. Let her show you when she's ready and can't keep it up anymore and then let her go. I know my Sally held out for me, and I love her even more for that. But in the end, the best thing I could do to show her how much I love her was save her from the pain I knew would come if I didn't say goodbye.

Its hard, it is the worst thing about pet ownership. You bring a wonderful little animal into your life and fall in love, and then too soon you have to say goodbye. No matter how long lived they are, its always too soon. I'm so sorry you have to go through this.

(Also - the anesthisia is optional and often more intial pain than its worth. We used it for Sara and she was gone before she passed, completely out of it. Sally just got the important shot and didn't show any signs of pain. I would skip the anesthesia if she doesn't need it, that way she's still present when you say your very last goodbyes.)