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.”
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:
- How’s her breathing?
- Is she dehydrated?
- Is she in pain?
- How much is she eating?
- Is the Insta-Purr™ still functioning?
- How much time is she spending in the closet?
- How much time is she spending looking out the window?
- Can she still jump, or at least climb, on furniture?
- How is she getting along with my other cat, Thunder?
- 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.