Dear Most Esteemed and Knowledgeable Kitties:
My sweet cat Sage of 23 years … yes, that is correct–23 years old and never sick a day in her life–has the early stages of kidney failure. I am giving her fluids every day and a wet food diet, lots of love and whatever she wants, but she has developed a lot of drooling. She has a good appetite but has a hard time eating lately. Food falls from her mouth and she seems to have a hard time grabbing hard treats. I know she has bad teeth, but I cannot give her anesthesia at this stage of her life. Should I put her down? How will I know when she is in pain and suffering a lot? I gave her some drugs for nausea. but she still seems to drool.
Thomas: Oh, Nicholette, we really feel for you! After 23 years together, facing the end of your beloved cat friend’s life is really hard. We know that because we watched Mama go through it with our sweet Siouxsie …
Bella: That’s her, in the picture at the top of the post! Siouxsie loved to go to work with Mama, and in this photo, one of Mama’s colleagues is giving her a skritch under the chin.
Tara: Mama had to make the euthanasia decision for Siouxsie, and it was really hard for her, too.
Thomas: Euthanasia is the veterinarian-ese term for putting a cat down. When translated, it means “good death.” It’s called euthanasia because it’s quick, painless and helps your cat to go over the rainbow bridge without suffering.
Tara: The first thing we’d recommend is that you bring Sage to the vet and have a heart-to-heart with him or her. Let your vet know about your concerns about her quality of life and see if there’s something they can do to help her feel better if her life is otherwise good.
Bella: There may be some things your vet can do to help with Sage’s pain. When Siouxsie got close to the end, Mama was giving her buprenorphine, an opioid drug, to help relieve her severe arthritis pain. Siouxsie’s quality of life was good otherwise, so Mama felt comfortable giving her the drug so she could enjoy life more.
Thomas: The drooling you’re seeing is probably due to her dental disease, because that’s one of the main signs of a sore mouth.
Bella: So continue to give her soft food and only give her soft treats, too, because she’s obviously finding them easier to eat.
Tara: And keep her as comfortable as you can.
Thomas: There’s another tool you can use to determine Sage’s quality of life, too. It’s called the Quality of Life Scale, also known as the HHHHMM Scale, and it’s used in the feline hospice movement.
Bella: Using the Quality of Life scale can help you see beyond your emotions and to the logic of Sage’s situation. You can also bring your HHHHMM assessment to your vet as a tool for discussing whether it’s time for euthanasia.
Tara: In the meantime, just love her and enjoy her company. Twenty-three years together is something to be celebrated, and you both deserve your remaining time together to be as full of love and joy–and as free from pain–as possible.
Thomas: Whatever choice you make, it’s going to be a difficult one. It sure was for Mama!
Bella: Mama was fortunate to be surrounded by compassionate people who understood the depth of her love for Siouxsie and the profound grief that comes with making that final decision.
Tara: We hope you too are fortunate enough to be surrounded by people who love you, care about you, and understand how strong your relationship with Sage has become over the 23 years you’ve enjoyed her company.
Thomas: We can’t tell you what to do, so we hope you’ll take our advice to heart. Have a serious talk with your vet, see if pain control will help, and when it’s time to make that final decision, know that we’re here for you and you can always talk to or email us.
Bella: What about you other readers? What advice would you give Nicholette as she goes through this process with her beloved Sage?
Tara: Please share your thoughts in the comments.