Tag Archives: lung cancer

Goodbye

Holly, May 18, 1996 – October 18, 2012

Holly had a couple really good days last weekend, but she had a serious coughing fit last Sunday night, and by Monday, her breathing had gotten pretty bad. On Tuesday, the vet drained some fluid from her chest, and her breathing got a little better — but it still wasn’t normal, and apparently her tumors had grown even more since the previous week. The vet increased her diuretic prescription (to help get rid of some of the fluid) but said that the remaining breathing problems were mostly caused by the solid masses, not by fluids.

I took most of the week off work. On Wednesday night, she seemed to rally. She’d been lying beside me on the couch, and then she did something that she’d done a thousand times before. She went into the bedroom, found Thunder lying on the bed, and meowed loudly. I came in and sat on the bed; Holly jumped up and walked over to Thunder, who proceeded to groom her thoroughly while she purred. It was the most normal moment we’d had since she’d gotten sick. Then she slept all night in her usual spot, curled up next to me.

On Thursday, she just seemed really exhausted. She did eat a couple times, but she spent most of the day either on my lap or right next to me, sleeping or just focusing on breathing. Thursday night, I had a vet come to the house and euthanize her.

Holly and Thunder in better days

I miss Holly’s purr, and I miss seeing her and Thunder play together. Thunder was pretty depressed that first night, but he seems to be doing okay and possibly even enjoying the extra attention I’m giving him. Every so often, though, he’ll go to a chair she spent a lot of her time on or to one of the cave-like cat beds I bought for her when she was sick and just sniff it thoroughly. They weren’t inseparable, but they were friends, and he’d lived with her since he was ten weeks old.

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Decisions

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-Purrâ„¢ 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.