Not sure how to know when its time to say goodbye

[bringbackthesun1]

Hi there, I'm hoping someone could help and offer some advice. We have a wonderful, and very much adored by 2 small children, 15 year old cat with advanced heart disease. Despite being told almost a year ago that he would only have a few months he's proved us wrong and until quite recently you wouldn't have known anything was wrong.
He now has a very swollen tummy and is very weak in his back legs. Noticed yesterday that his front legs are swollen too. We spoke to the vet about this a few weeks ago and she said that this was quite normal and increased some of his medication. Basically they've just advised to watch out for decreasing quality of life. I feel now that he is uncomfortable. He can't move more than a few steps without needing to rest. BUT is eating well, toileting ok, purring and enjoying being with us. I'm really struggling with it as although we are all prepared for it its going to be devastating when he's no longer here. My husband feels that while he is still eating, drinking and showing signs of happiness we shouldn't make any decisions but I feel really anxious and guilty that he may be suffering quite considerably. Im watching him now, asleep in the sun but can see his heart hammering away through his fur and can see he's not having a comfortable rest.
I keep hoping that he'll just curl up comfortably and take his last breath but think that we will have to make the choice.
Its just an awful decision :-(

I had this dilemma recently with my cat - significant changes on liver on ultrasound, aged 13, very skinny, but because appetite remained good and vet said not in pain I kept going. He hardly left the house the last six months of his life but one day looked at me, miaowed, and asked to be let out. He never came back and body found a few days later by dog under a bush so obviously had taken matters into own hands and gone away to die. I now think I went on far too long with him because I could not seem to make the decision until he was visibly at death’s door. Think I was waiting for vet to broach it but he never did.

Big hugs. It is such a difficult call isn’t it?

In the same boat with my beautiful 18 year old boy. He has dementia and advancing bowel disease, is wobbly on his feet, we have bad hours when I think it's time, we have to do it now - and then he perks up again, and I feel the same that while he's purring and wanting to be with me and eating well, why would I do this to him? The vet has said at this point that this is end of life care and he fully supports my decision when I feel it's time. But I've never before had to make the decision without a pet in direct crisis where it was the obvious necessary and most loving thing to do.

I don't have the answers, just a lot of sympathy

can see his heart hammering away through his fur and can see he's not having a comfortable rest.

That would persuade me now is the time, when you know he can't get better and can't be comfortable most the time. Act now.

I’ve got to be honest I don’t think it’s right to wait for the animal to go and die alone - far better to give them a painless passing having a cuddle with his family.

if he’s snoozing in the sun but he looks uncomfortable, he can’t walk and he’s having more bad than good moments. Purring can be a self soothing behaviour so it’s not necessarily a sign he’s content. I would say it’s probably time. I’m sorry op it’s so tough

The kindest thing you can do for your beloved pet is to make that decision. Who are you keeping him alive for? Better a day too early than a day too late

If he's comfortable enough to sleep, despite the racing heartbeats, leave him enjoy his last weeks/months. If he's doing as you say he's happy.

Can the vet give you some painkillers for him if you think it's painful? Heart failure is not painful like cancer, but you can get tires and uncomfortable with the swelling. Maybe chat to your vet about how you pet is likely experiencing this?

A vet once told me that a cat has the ability to mask their suffering to a good deal.

As a poster said “better a day too early, than a day too late, I’ve also heard “better a WEEK too early, than a day too late.

If I can, I’ve always called the vet for a home visit, so my cats last day doesn’t involve the stress of a cat carrier and a drive to the vet.

It is the hardest and most important decision

I still wonder if I left it too late with my last old boy, but mostly I think it was about right, and there is no perfect moment.

Cats purr to self soothe so it's sadly not a good indicator of happiness. I think the time when you start thinking 'is it time?' is probably the right time. Once I'd decided, I booked him in for a few days away, and fed him his very favourite things that he hadn't been having due to stomach issues.

Ascites and limb oedema usually means endgame. I would euth now before his chest cavity fills up with fluid. Severe ascites is also not comfortable- it's extra weight to carry and it pushes forward on the diaphragm making it harder for the patient to breathe. My mum had hers drained once or twice in her palliative care ward, then got opiates as and when, then eventually a syringe driver to make things as easy for her as possible. Her legs got so heavy with oedema that she couldn't lift them at all. Cardiac deaths in cats can be peaceful, but they can also be very not peaceful at all and hard on both cat and family witnessing it. Respiratory distress is probably not far away in this case.

By the way, if all 4 legs are swollen it may be difficult/impossible for the vet to find a vein and intraperitoneal injection would be very very slow if the stuff is diluted in a bellyful of ascites. If this were my case and no vein was apparent I would give strong sedatives+methadone into the muscle, then ketamine to induce anaesthesia, have another look for a vein including jugular if necessary, then if not possible I would give the euthanasia injection directly into the heart (once the cat is anaethetised) having explained to the owner my reasoning and offered them the chance to leave the room at any point +/- coming back in afterwards if they like.

Ask yourself who is benefitting from keeping your cat alive? Is the cat getting better? Or is keeping the cat alive and not making that final decision because you are reluctant to make it . You have cared for your cat for years, and in return it has given you unconditional love, ask yourself why you are repaying that love by making their last weeks or days of life uncomfortable and possibly painful.

Have a look back through photos of your cat from a year or two back, now look at them as they are today, you might be shocked. I know I was when I eventually made the call for one of my cats then afterwards compared his last photos with earlier ones and realised how very poor his condition was, his deterioration had been gradual and I hadn’t really appreciated it. It still breaks my heart that I made his last few weeks more difficult for him because of my own selfishness and reluctance to face the truth. I did not make that mistake with subsequent cats. Cats don’t have a realisation of time, a “ few more weeks of life” means nothing to them, their reality is based on their present situation, present pain, present discomfort.

This ^^. I made a big mistake with my cat (posted about above) for selfish reasons and the outcome ended up being worse for both of us. Have learnt an important lesson for future pets.

I only have experience of end stage heart failure in humans, but it's not pleasant. If he's already swelling then he is struggling and there will come a point were this will cause his lungs to fill with blood stained fluid. You can't tell when this exact point will be. You want to avoid this. Its not a nice way to go. Essentially drowning in frothy pink secretions. Better to choose a time before that point. Give him lots of love and his favourite treats and rest easy knowing that he was loved and you prevented a distressing end

Thank you all. We’ve made the decision we will take him this week. Appreciate your comments and advice. I will stop reading these now though as the thought of what may happen before we act is tormenting me.
sorry to those who’ve experienced the same and thank you for the kindness x

My cat had heart disease but did well on medication, until her kidneys failed. I just looked at one day and just knew she'd had enough.