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.
The hardest decision I’ve ever made in my life.
The hardest decision Mama’s ever had to make, too. It’s a courageous and loving decision, but that doesn’t make it any easier.
My girls, Tippear and Purrscilla “told” me when it was time. Tip, who was a throwaway and never turned down any kind of food, refused her dinner one night and breakfast the next day.She had lymphoma.
Purrscilla had inflammatory bowel disease. Good vet care and careful feeding kept her with us a year, but in the end, the constant vomiting and struggle to eat enough wore her down. In the last week or so, developed the habit of sitting on my desk and licking me, which she was not prone to doing. Then one night, she lay in the window all night, frequently patting me on the head. There was something in her eyes that told me, Mama, I’m so tired and sick.
These were terribly difficult decisions, and I cried for days, and I’m crying as I write this. It was worse to see my girls so sick, with so little quality of life. They both went peacefully in my arms, and I felt my own Mom gently sweep them away. I had them cremated and brought their ashes home. They had both been abandoned, and in Purrscilla’s case, abused. To me, bringing them home comforts me that I did not abandon them at the end.
Nicholette, I cannot express enough to be good to yourself. You’ve given Sage a long and loving life. She is not “just a cat”. It’s ok and right to grieve, hurt, cry, even be angry. I hope you have a support system in family and friends, but if not, your vet will probably know of groups in your area. There is also, an extensive online community of us who have been where you are and are willing to help.
Love, hugs, prayers and purrs. https://uploads.disquscdn.com/images/4d7612eba69b3254fc3478b0f79cc71df3de45f8d9fd1eb720ef7a47f5380458.jpg https://uploads.disquscdn.com/images/b1c9c95ac7a308f6fc23e549a69957be6620f993c006415aa9f731ff61d177cc.jpg
Having been through what you are experiencing with two cats myself I can only say I feel for you. I think having her checked by the vet is an excellent idea; it may help you with your decision. I assume she is being fed a special diet for cats with kidney problems? For what it’s worth, while she can still eat, and provided she is not in pain, then let her live. I knew it was time for my pusses to go when they refused food. Having to decide whether or not your beloved cat child should be euthanized is never an easy decision to make, and I hope it will not be necessary just yet.
Thank you for your response, Catherine. It is a terribly hard decision to make, and Mama’s had to make it several times in her life with cats. It’s never easy, and a lot of grief is involved.
Gentiel purrs to you, MaggieB. Mama still cries when she writes about Dahlia, and that was four years ago now. It’s really important for Nicholette to be good to herself, just as it is for anyone who’s going through this tough decision.
Please know that drooling can be from nausea!! Most cats with CRF have nausea. The best website with a TON of info you need to know about CRF can be found at the following URL. Please go there and “search” her site for nausea and read the info in general. http://www.felinecrf.org/
Thank you for recommending felinecrf.org–it’s a great website filled with great info about chronic kidney disease. Mama’s been using it as a resource while dealing with Thomas’s kidney disease, too. And you’re right; drooling can be a sign of nausea.
there is no easy answer….you have to go with your feelings on this. we did have a very wise friend tell mom that it is better to be a week early than 24 hours too late. which is true – when we lost Tim it was in the middle of the night at the emergency vet with no one there with mom….. (hugs)
We’re so sorry you had to go through that alone. Our own mama knows how hard that is because she had to have a vet help our Dahlia along to the other side, and it was late at night, at the emergency clinic, and she was totally alone too.
There is no easy way to decide what’s best for your fur-baby. Some will tell you, some you have to make that hard call. My first two kitties had told me it was their time, my last one I had to make the tough call. Its a lot based on your gut, if you feel their quality of life is still a good one, if they have more good days than bad, etc. It doesn’t help that kitties aren’t actually made to have generally long lifespans, 23 is ancient for a kitty, so when things turn sour they have a tendency to turn fast. Kidneys are also one of the most common killer of cats, as that tend to be the first thing to show age. I am very sorry for your kitty, and I hope you choose what is best for them.
Thank you so much for your comment. It is a terribly hard decision, and you’re right that cat have a tendency to do well…until they don’t. That’s what happened with Siouxsie.
• REGRET EUTHANASIA for my cat
I am one of those who regret having my cat’s life ended prematurely.
My treating vet and I were in agreement that I’m Here Max could have his usual quality of life with the administration of pain medication for a month due to an inoperable cancer which had spread to his jaw.
He was never a playful cat during his estimated thirteen years, nor much of a lap cat .He liked to warm himself by the heater and meowed only in the morning when he wanted his wet food. He used the cat litter without urging and his weight had stabilized when medication for hyperthyroidism was started. In short, other than being in the house most of the time rather than being mostly outside as before, and sleeping more due to the pain medication his life was much the same as before cancer of the jaw progressed.
I didn’t find it a problem to wipe the occasional drool but he started to bleed on the left side of his gum line. I was concerned about this but had planned to take I’m Here Max to consult with a vet who also practiced holistic medicine for pets so I went ahead with the appointment and asked if anything could be done about his bleeding from his jaw by removing the three teeth which had become loose. The vet told me that he would lose his teeth on his own but that she wouldn’t remove his teeth but had good results with jaw removal.
I had stated from the beginning that I didn’t want jaw removal, radiation or chemo so I’m not sure why the subject was brought up although IF I remember right she did state that this wasn’t an option at this point.
The reason for my visit was to have herbal medication added to his current treatment was pushed aside and replaced by what I thought the vet was getting at was that, even with hospice as an option, a more effective pain killer, later on, the correct thing for me to do was to have him euthanized.
To be honest, at the time I relied on what I perceived was the better judgment of the vet and a friend to euthanize him (ie: have him killed).
That much as I would miss him and he required no more care really than a well cat I bought into the guilt trip that I was being selfish to keep him alive when he had a terminal cancer.
That day I was initially relieved that I’m Here Max would be safe from any future suffering due to my “selfish desire” to keep him alive for an estimated 1 to 2 months more.
It was less than two hours later that I realized that I had made a decision that was neither good for my cat, I’m Here Max, or for me.
I had pain medication on hand and an 24 hour Emergency Clinic
within a half hour drive with an indoor cat who NEVER meows so I feel confident he would let me know, if I missed other signs that the time had come. In addition I had him under the care of a vet who supported hospice as a good option for I’m Here Max and me.
While others may not have the same support I had, I also had to contend with the ideas that “You’re being selfish to keep your cat alive in pain” and “You can’t tell when your cat is in pain”. In short the implication is that I are doing the wrong thing to let the cat live because the cat has a terminal illness and he was in pain which I didn’t realize.
Don’t let this guilt trip influence what is best for your pet.
While sick cats find hiding places healthy cats do too.
Cats aren’t silent in pain. They want YOU to do something,
Euthanasia can NEVER be undone.
Euthanasia is a god send in the right circumstances but this wasn’t one of them.