I’ve been spending a lot of time trying to decide how to decide when the end should come for Holly. It seems like the only way to find the right time is to wait too long and then look back and say to yourself “I wish I’d done this three days ago.”

Holly in the cave-like cat bed I bought to encourage her to stay out of the closet.

I turned to the Internet for help, because that’s what I do when I obsess over things. Many sites link to this Quality of Life Scale, which asks you to rate seven aspects of your pet’s life (pain, happiness, etc.) on a scale of 1-10. The highest possible score is 70, and anything above 35 is considered “acceptable”. I think this scale is deeply flawed: the categories overlap, the judging is subjective, and equal weight is given to things that aren’t equally important. One category (“more good days than bad”, which is separate from “happiness”) seems more relevant to humans than to cats; I don’t know what cats think about, but I don’t believe they really have a concept of “good days” or “bad days” or spend a lot of time comparing the present to the past. The scale also leaves out one important issue: reactions to medications, vet visits, and other medical procedures. Still, it asks some good questions and is worth looking at, if you ignore the scoring and just think about each question individually.

That seems to be the approach taken by the research study described in this journal paper. People who brought their cats and dogs for cancer treatment were given a questionnaire with questions similar to those on the Quality of Life Scale linked to above, but more specific, plus a few questions about their pets’ overall health and quality of life. Then they and their veterinarians were given a second questionnaire asking them to rate and comment on the usefulness of the first one. Finally, the researchers calculated how the answers to each question correlated with the owners’ perceptions of overall quality of life and looked at all the suggestions for improvement. This looks like it could be developed into a useful tool for tracking how the quality of a cat’s (or dog’s) life is changing over time.

I started out looking for a magic formula that would tell me when it was time to euthanize Holly. I didn’t find one. The next best thing would have been to find a study that asked people who’d had a cat euthanized (or who’d decided to let their cat die naturally) about the decisions they’d made and what they wished they’d done differently. I didn’t find that either. I did get some insight into my own attitude, though — I decided it would be better to err on the side of shortening her life by a few days than to have her suffer. And I came up with my own private, Holly-centric set of questions:

  1. How’s her breathing?
  2. Is she dehydrated?
  3. Is she in pain?
  4. How much is she eating?
  5. Is the Insta-Purr™ still functioning?
  6. How much time is she spending in the closet?
  7. How much time is she spending looking out the window?
  8. Can she still jump, or at least climb, on furniture?
  9. How is she getting along with my other cat, Thunder?
  10. Are her twice-daily medications just annoying or traumatic? How about her visits to the vet?

In the end, though, it came down to this: I was watching her breathe, and I thought: this looks so tiring; if she stops now, that’s okay.


13 thoughts on “Decisions

  1. Anonymous

    Ive just had my cat put down due to cancer,he was nearly ten and my best friend.Im not coping that well.

  2. sue

    Thank you for writing such a thoughtful article. Our cat is 14, I think what you did was the best you could have done. Asking the vet to come to your home was very thoughtful. I’m sure you’ll always miss Holly.

  3. Gen's human

    Yes, exactly this. My can has lung cancer that has metastasized to her legs, and she’s been in slow decline for nine months. How can I decide when she’s done? She still rumbles when I pet her, loves watching the birds out the window, and goes outside to lie in the sun whenever the weather is good. But her breathing keeps getting worse, she can walk less and less without pausing to catch her breath, and although her appetite is good, she can only eat a bit at a time. I keep hoping for some magic knowledge to tell me she’s ready to go, but I don’t see it coming, and the internet has been less than helpful. Thank you for posting your experience, as it is the most useful non-answer I have found. My condolences on your loss.

  4. Jennifer smith

    I am dealing with this right now with our Lucy. She’s 14 and was diagnosed with lunch cancer in January. She’s been on prednisone ever since. Her breathing is difficult at times and her putting is on “SPEAKERPHONE!” Last week I called her vet and scheduled for her to be euthanized next Tuesday. But I just can’t do it…. I can’t plan a week ahead of her final days. I’ve decided to take each day one at a time. This is so difficult. I rescinded Lucy my senior year in high school when I was living with my parents and dating my (now) husband. Lucy is our very first fur baby (we have two skin babies! Lol) this is such a hard decision. She slept on our bed lastnight for the first time in months. I am so thankful that I came across this blog tonight while googling. Thank you!

  5. A northern cat lady

    Thank you for your posts. If you ever wonder about whether you should keep them up or not, let this be a vote for keeping them up. Your thoughts helped us make a very difficult decision at the best time for our cat who was diagnosed with advanced lung cancer. Rather than leaving in fear and pain, he left in peace. We decided it was better to let him go now, before worse days arrived.

  6. Lola

    I’m trying to come to terms with my 15 yr old cat dying of lung cancer. We have spent months giving him chemo, anti-nausea and appetite pills. It’s been heart breaking. We are now struggling with the next step. It just sucks.

  7. Barbara

    Thank you for this post. I recently had to euthanize my 11 year old who had been sick with an undetermined illness (despite our best attempts to find a diagnosis). It was the most difficult decision I’ve had to make. His autopsy showed he had very advanced lung cancer and there was nothing that could have been done. I know I did what needed to be done but I wonder sometimes if I shouldn’t have known earlier. Your blog has helped me realize that there is no real way of knowing except to watch them carefully and love them. The hardest part is to forgive myself if I didn’t get it right and he suffered more than he needed to. Somehow it helps me to know that others have the same difficulty in making that most difficult of decisions. Thanks for your honesty and compassion.

  8. baci88

    I am sat here with tears streaming down my eyes searching for comfort to the multitude of things spinning around in my head. The guilt, the regrets, the questions: did I do my best, could I have done more?
    I lost the love of my life 10 days ago to lung cancer. My little boy Treasure. I rescued him 9 years ago or rather he chose me to rescue him when he walked into the kitchen and made himself at home. (I think it was more he rescued me.) He had this beautiful fearless energy that made everyone who met him fall in love with him.
    His behavior started to alter early this year. He was diagnosed with cat flue in February and though he recovered little this were slightly off. The vet said He seemed fine, but ran some blood test and nothing came up in his results. In October for his six months check up I asked for more blood test and everything was still showing a healthy cat. In November I noticed his breathing was double his normal so back to the vets. A flare up from upper respiratory disease. Sent him home on meds, breathing not improved back to vets more tests nothing. 5 days later breathing 100 Breaths a minute rush to the vets. He was kept overnight and had X-rays on the following morning which showed one lung lobe full of fluid. Then the results from the biopsy Lung cancer! Okay can we fight this, we had options so Tuesday night I had a plan… 1am Wednesday he wants some biscuits great he needs to keep his strength up. A couple minutes later I hear a horrible cry then he brings up the little he ate… Everything came together, the change to the sound of his voice, his purr his meow, why he wanted to eat but couldn’t. It wasn’t an upset tummy, it was pain. I called the vets first thing and that afternoon, he was gone, no more suffering for my boy.
    I keep hearing the voices…. How could I have missed this, how long was he suffering, should I have let him go without a fight? Then I read this blog and the post and for tonight I have some peace between my head and my heart. Thank you all.

  9. Cyn

    Thank you so much for sharing this. It really helped me. I euthanized my 16-year-old kitty Lanoiry, who had lung cancer, just last night and I have such mixed feelings. I appreciated hearing your thoughts as I share many of them.

  10. S.

    Thank you for leaving the blog up. I have a 9 yr old cat with metastatic lung cancer. She’s now on palliative care after the best chemo option (in the vets opinion) failed to stop tumor growth. Your posts and also the comments have been helpful in getting some perspective.


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