How do I know when it's time?

[TeaMakesItBetter]

My lovely cat is nearly 9 and has a couple of serious problems.

He has kidney failure because of a congenital defect which when undiagnosed nearly took him off me two years ago. Thankfully we got him through that and with regular blood tests and an altered diet we got him back up to weight and healthy as can be. Secondly he has mobility issues which the vet initially thought was a joint/arthiritic problem. It was getting worse so I had his entire skeleton x-rayed in the summer so they could get to the bottom of it. It was a big deal as GA on top of the kidney problem was potentially problematic but they found nothing however and have concluded it is a neurological, muscle wasting problem though they don't know what exactly and can't work it out from repeat visits/bloods etc. The vet couldn't offer him anything as steroid injections to help his muscles would undoubtedly kill him quickly as his kidneys couldn't process it and they felt painkillers did nothing to help and were again detrimental to the kidneys. At this point I opted not to put him through any more tests as he's clearly unwell and repeated vets visits were causing him stress. The decision was, we'd continue to give him as good a life as possible for as long as he was happy.

At this point, he has no muscle left on him and has very decreased mobility - he hasn't been able to jump onto a bed for some time and now doesn't attempt the sofa, I caught him struggling on the stairs last night. My husband was desperately worried about him whilst I was away last week and he completed a large DIY project but he's been much cheerier since I've been back. However otherwise, he is happy, does not appear depressed, asks for food, frequently - even though the act of eating temporaily further reduces his mobility and he finds it difficult to get back to his bed, once he's had a rest, he's "fine", he's playful, loving, interested but has had a couple of accidents rather than using his litter tray though this may be coincidental/due to recent house upheaval.

I don't think the time is now, but I don't think it seems like it can be very far away - I don't ever want to get to a point where he is distressed. But how do I know? And when the time comes, what happens? How do I go about it? What happens to him afterwards? He's always been my baby substitute and even though I have an actual baby now he's no less important to me than he ever was.

I'm very sad.

[MyLittleFluffball]

I'm very, very sorry. This is one of the few situations where I can feel comfortable saying, "I know how you feel". I utterly adore/ adored my 14-year-old cat who I had had since she was around 8 weeks old. We had a beautiful emotional connection and she trusted me implicitly. I just completely loved and adored her and would have done anything for her. And then she was abruptly diagnosed with Stage IVB cancer and had no good options. Even with aggressive chemotherapy, which she would have to have one full day roughly every week for the rest of her life, she had, at best, only 9 more months to live - and without the treatment she had only 1-2 months (she ended up lasting only 4 weeks - I chose not to put her through chemotherapy just so that I could have her for longer). I couldn't imagine parting with her and obsessed over when I would know it was time... (even though she was euthanised on November 11th and I thought I had moved past the crying stage of grief, I am crying just writing about this again...)

Anyway. I was told, "You will KNOW, you just will", when I was obsessing over when would be the right time - because I wanted to euthanise her before she began to suffer, but only once her quality of life was clearly going downhill and nothing more could be done. And I did just know. The final two days of her life she barely moved from a spot on the lawn, which was on a slope which I think relieved some of the pressure of her tumour. She couldn't walk properly, only a few steps at a time before stopping and looking at me, wanting me to carry her to where she needed to go. She had developed lymphoedema which was progressively getting worse and couldn't be treated - bloating in her tummy, chest and legs which meant they were swollen and she didn't like to be touched on her legs anymore. Her interest in food had reduced, despite a huge daily dose of steroids (10mg), an appetite stimulant. On the second-last day of her life, she looked unhappy and uncomfortable and I began administering painkillers (a squirt in the mouth every 8 hours - they helped a lot). She couldn't reach to clean her bottom because of the tumour/ lymphoedema. She was still affectionate, purring, interested in food... but her quality of life was going and couldn't be brought back, I would have done anything to give her more "happy time" but knew that I could only prolong her existence and would need to rely on painkillers to hope that she was comfortable. And at that point the vet who did a home visit estimated that my cat had probably 1-3 days left to live. The nature of the cancer meant that my cat's natural death would likely not have been pleasant for us to witness or for her to go through - likely drowning through fluid on the lungs, or her tumour in her spleen rupturing, or organ failure.

Sorry for that - I needed to write that down I think. The point I am making is, you love your cat. You would do anything to keep your cat here for longer, living happily. But because you are a loving owner, you presumably also would not like to see your cat suffer, just existing thanks to medical intervention, not enjoying life but not able to escape it either. You will KNOW when your cat has reached that point. If you are a loving owner you would likely begin to feel very guilty and worried about what your cat is going through, or upset about his deteriorating quality of life and the fact that nothing can be done to improve it. You will know that keeping your cat going for longer would just be for you and not for your cat. You will know that a humane, peaceful, loving death would be better for your cat than waiting for a potentially painful one.

Someone wrote on my original thread something that stuck with me: "Better a day too soon than a moment too late". It's true. You will question yourself a lot in the rawness of your grief after deciding to euthanise your cat, but in the long run you will know that it is better to regret missing a few extra days with your cat (with your cat no longer enjoying life during those days), versus regretting being selfish and holding on to your cat when your cat is suffering, and then watching your cat die in agony (if that is what ends up happening - it may not but it is a risk, and it is a high-stakes risk).

[MyLittleFluffball]

Sorry I forgot to address the last part of your post.

Vets often use benchmarks like not eating, difficulty breathing, hiding away and not wanting anyone near, as indicators that "it's time". I think this is leaving it too late, personally (at least when you know your cat is terminally ill) - I think it would take a lot of suffering for an animal (or human) to reach that stage. But you could use these benchmarks if you wanted to be sure.

I had my cat euthanised during a home visit from a lovely vet who had been managing my cat's palliative care. She was very gentle and respectful and absolutely wonderful, I and my cat were so lucky. I held my cat, talked to her and stroked her during the process. The vet shaved a small part of my cat's fur on her front leg to find a site for the needle. The vet then first injected a sedative, and my cat kind of fell down in my lap and quickly seemed to go to sleep - it was supposed to take 10-15 minutes to work but for my cat it took only 1-2 minutes, suggesting that she was quite debilitated. The vet then injected a general anaesthetic, which put my cat into a deep coma-like state. Then the vet injected the euthanising agent, and almost immediately my cat's heart stopped beating and she was gone. I sensed the change. She was now lifeless. Her face was now the face of a dead cat, no longer her beautiful lively face. It is a shock, it is very sad.

The vet then allowed me to take as much time as I wanted to say goodbye, but I had already said goodbye while my cat was living and didn't see much point now that my cat was gone. But everyone is different. The vet then took my cat with her back to the veterinary practice, and arranged for the cremation process, which I had previously agreed to (these people contacted me via email within 2 hours of my cat's death to find out what I wanted). My cat was euthanised on Friday afternoon and her ashes had been returned to me by Wednesday morning.

If you're really wanting to know what would happen, there are YouTube videos that are not gruesome. There is one of a cat called Callie that is very educational, which was the intention of the owner - very sad though. These videos also help you to see what a cat can look like/ how they may behave when "it's time".

I hope that this helps. I'm not trying to be gruesome, I'm just trying to help, it is an awful, awful thing to have to go through, but ultimately I believe it is one of the most loving things you can do for your lifelong companion - a way of loving and looking after them right until the end. I would strongly recommend arranging a home visit if you can, and ensuring in advance that you know a vet who is willing to do that. My cat hated car rides and the vet. At least her final weeks were peaceful.

[kreechergotstuckupthechimney]

Lovely post mylittlefluffball.

[Gay40]

Ack....this has made me cry. My old cat is kind of on a downhill slope, and while she's still got a great life and is on permanent medication, we can see the gradual changes in her.
DP will be heartbroken when the time comes. I'm dreading that moment of her face changing, perfectly described above.

[TeaMakesItBetter]

fluffball

Thank you so much for your kind posts and for taking the time to respond. I was so upset to read them but it sounds as if you had a very kind vet and your cat passed under the best possible circumstances. I'm sorry it took a while for me to come back to the thread. I read your posts then went away and couldn't find the post when I came back. I don't want DH to know I'm posting about this so didn't want to take the chance whilst he was around.

My puss seems ok but he is I think struggling to go to the toilet, hes weeing in his tray fine but asking to go outside for pooing though this is fairly normal, he does seem to be having trouble holding himself up to go. I'm keeping a very close eye on this. He's been pretty happy this weekend though, very loving, coming for cuddles, mewing for food, being generally interested and playful.

I don't know what to do. I haven't made an appointment to take him to the vet I think because partly I think there's nothing they can do, partly i'm worried what they will say. I think I will have to do this for one day this week.

[MyLittleFluffball]

Yes it is a very hypervigilant time, when you are very worried about your cat but they're not quite on death's door. It depends on what your own feelings/ values/ ideas are, but advice I would give you, which I was given myself, was just take each day at a time and don't get too caught up in knowing that your cat has a limited time remaining - there is no need to "jump the gun" on euthanasia decisions if your cat still seems generally happy, though with restricted mobility. You really will know when your cat is no longer very happy, you will feel sorry for your cat and will genuinely worry that your cat won't last long enough for the vet appointment. Now that you know your cat is basically dying, you're probably looking at your cat through that lens, questioning every unusual thing and worrying constantly. I learnt that there is no need to interpret everything in light of your cat's illness/ prognosis, your cat will let you know when he is uncomfortable/ unhappy.

Just keep telling yourself: "I will continue to give him as good a life as possible for as long as he is happy". Maybe put together some markers of when you will know "it's time" - does your cat have to show disinterest in food for an entire day, stay in the same spot the entire day, begin showing distress/ pain when trying to poo, begin showing less affection towards you and instead seem to only tolerate you, will it get more difficult to "get" him to purr, etc. Like I said, I think trouble breathing/ not eating for days/ hiding away in dark places and lashing out at everyone when they approach is leaving it too late, but vets would usually use such signs as "definite indicators", from what I have learnt/ heard/ read.

Once you know what you need to look out for, try to relax a bit and just enjoy each day with your cat and spoil him rotten until you start getting to that questionable point. It is very sad when they are gone - I will miss my beautiful and beloved little companion forever and always just want her back - so you need to feel as sure as you can be that you've picked the right time or you will forever regret it/ be upset with yourself about your decision. If you're anything like me, you won't want to let him go prematurely for "convenience" reasons (i.e., ending the high-level care required and the worry and stress) but you also don't want to keep holding on and fearing the decision until you have undoubtedly allowed your cat to suffer.

Often/ usually people don't get the chance to let their pets go in the best possible way, like I think I did. In that sense I feel lucky. So there is a lot to weigh up.

[MyLittleFluffball]

Oh and I also get upset every time I read my two previous posts. :(

[TeaMakesItBetter]

I took him the vets today. It went as I expected, the vet was not happy with him at all and would have been happy to euthenise him today. I declined. I took the option of high dose steroids which should improve his mobility short term, making him more comfortable but will accelerate the kidney dysfuntion. At this point there's nothing to lose and if it makes his last days more comfortable then it is worth it. There's a 50/50 chance this will work and this weekend is crucial. If it doesn't work, I think we'll need to have him put to sleep as soon as next week as his mobility really is severely compromised, though he remains friendly and happy so its a really difficult decision.

Thanks for listening.

[MyLittleFluffball]

From my own experience I know how nice it is to be able to vent somewhere and have people respond/ give advice/ support. :) Thank you for coming back to this thread and updating us. :)

I'm very sorry to hear about your cat. I'm surprised the vet would have been happy to euthanise your cat on the spot, but given that your cat is not unhappy, I think you made the right decision in allowing him a few more days. It is heartbreaking to look at your cat and know how limited their remaining time is, but by giving your cat steroids, he may have a few more happy days - or even longer - and it can also give you a bit more time to say your goodbyes and adjust to the idea that he is going. It would be great if you could take some photos and videos of your cat, unless he looks so sick that you don't want to document this final stage and would prefer to be left with happy memories of his healthier self.

With my cat, I also took the option of giving her steroids to prolong her life/ quality of life - 5mg, then upped to 10mg. It gave her 4 more happy weeks, when initially she seemed almost on death's door. Up to almost the very end they meant that my cat was not in pain. They can have a miraculous effect and I do hope they help your cat. When my cat started refusing to take the steroids under any circumstances it was heartbreaking and yet another indicator that she was nearing the end.

Wishing you and your cat all the best this weekend - I hope you see some positive changes. :)

[suzi2]

My elderly, failing cat was PTS in Sept. He had gone downhill for a while but still had plenty 'joy' in life. Then that week he just started to fail completely. He stopped eating and showed increased mobility troubles. I took him to the vet and she gave him some medication for his back. 36 hours later I made an appointment, on a Saturday, to get him seen again. I was sure it was time to let him go and the vet agreed. He hadn't improved in 36 hours and I felt that any further treatment was just prolonging the inevitable. I think with all the treatment in the world he would have had a matter of a week or two before going 'naturally' and painfully. For me the decision was clear and the vet was 100% in support of it. But I couldn't have done it on that first visit 36 hours earlier without at least exploring the possibility he could improve again. He really wasn't himself when I let him go and I can see that much more clearly now. If he had been a friends cat I could have told them it was time. But it's sometimes harder to be sure when it's your own.

I hope you have a good weekend with her and she shows some signs of hope. One thing I wish had done differently, was getting the vet to the house to put him down. I never thought at the time.

[Onemorning]

Hello Tea, how's kitty doing?

MLF and suzi2, I'm so sorry about your losses.

I have an elderly boy (17) who is on meds for heart disease and epilepsy. I can see gradual changes in him, and I know that one day it'll be his turn.

[MyLittleFluffball]

suzi2, I'm very sorry about your loss, and Onemorning, thank you for your kind words here and on my original thread. I'm sorry your own cat is nearing this time. :(

TeaMakesItBetter, I hope your cat showed improvement over the weekend, and I'm very sorry if he didn't. :(

[TheOriginalFAB]

Oh, this is a tough thread and I am sorry for all of you who have lost a loving cat .

I have a long thread about FABCat as she isn't well and I feel no one knows that to do for the best. I have seen 2 vets with her and feel I am getting mixed messages.

Cats get to you, don't they, even though they are in charge of us.

[chocolateyclur]

I'm sorry you're going through this.

I have always tried, as much as possible, to do it from the animal's point of view. Animals live in the moment, therefore don't look back sadly as we might and think "I wish I were more mobile" etc.

If there are indicators such as terrible, unmanageable pain etc, then I decide it's time.

Other than that, I try to think of my animal's 3 favourite things in life. With my childhood dog, these were eating, spending time in the garden lounging in the sun and snuggling with me. In his last week, he stopped wanting to cuddle, and would spend time behind the settee. He would barely eat, and we would have to put him outside for the toilet - and he'd want to be back in straight away. People say about the "light leaving your eyes" - and I can remember looking at him and knowing. Hardest thing I'd ever had to admit to myself. For years afterwards I would dream about him lying on the table at the vet, and the vet telling me he had fought the euthanasia and I could take him home. It was such a realistic dream that I would wake up smiling, expecting to see him.

You know your kitty best. And this is the final, unselfish act of love. I am so sorry you're having to go through this.

[chocolateyclur]

Missed a bit out there - I meant to say that when one of my pets shows that two of their 3 favourite things arent being enjoyed, or are now even causing them more suffering, it helps as an indicator that it's time.

[suzi2]

People say about the "light leaving your eyes" - and I can remember looking at him and knowing.

This was very much the case with my last cat. He wasn't himself. He still knew me, he still liked the fuss and things, but he just wasn't 'there' and seemed to be sad and struggling at each moment. I also knew that there was no 'cure' and no amount of drugs would have kept him going another month or two longer. So that made the decision easier - that if anything, i was cutting his life short by a matter of days or weeks. Still tough though.