Is it time to euthanize my cat?
January 24, 2021 10:28 AM   Subscribe

My cat is old (not totally sure how old). She doesn't have any painful maladies but howls a lot and seems uncomfortable. I could use some insights from other cat people who have made end-of-life calls for their pets. Details within...

Here are some relevant data points. Apologies for rambling a bit:

She's being treated for some thyroid issues and has lost weight. She yowls a lot, particularly in the middle of the night. I think she's mostly deaf and also has vision loss so gets disoriented when she can't find us. When I put myself in her field of vision she immediately quiets down.

Not sure exactly how old she is. We inherited her from my mother 11 years ago, mom had had her 2-3 years and had gotten her out of an emergency fostering situation. And she wasn't a kitten at that point. So safe bet is that she's at least 15.

Two significant environmental changes in recent years:
1) We got a dog 2.5 years ago and she was VERY happy being a bachelor cat so she didn't like the change. The dog doesn't bother her, she mostly tolerates it. But she was stressed out for a few weeks when he first arrived and wasn't cleaning herself as regularly, and that hasn't fully recovered. Her fur was getting knotted, though that's gotten better, and I now regularly have to clean out her ears myself.
2) We moved from a condo to a house a year ago and that has revealed mobility issues. She moves very slowly up and down the stairs, going one step at a time. The yowls started after we moved, which is why I suspect it has more to do with disorientation than discomfort.

She spent most of her time in our condo on our bed, sleeping under covers during the day and on my pillow or on a blanket next to the bed at night. Now she sleeps elsewhere and only visits me in bed occasionally. If I pick her up and bring her to bed she'll stay for a few minutes and then wander away.

She still has a good appetite and goes in the litter box (I've had cats my whole life and have had them going on the floor of my bedroom or in my bed at the end).

Despite the mobility issues the vet doesn't seem to think her legs or hips are in bad shape for a cat her age. She'll let herself be examined and doesn't cry when her hips are manipulated. She can jump to chair height still, if not quite table height anymore.

She's had regular visits to the vet over the last year to watch her thyroid, and I've asked the vet if she's in pain or if quality of life is a concern and the vet didn't think so. She's apparently not in pain but she doesn't exactly seem comfortable. The yowling, declining hygiene, and mobility reduction are flags for me.

I'm not one to prolong a pet's life or spend lots of money on procedures to drag things out (not that that's on the table here). But to be honest I don't fully trust vets as I think their incentives aren't always aligned with the animal's health. I don't think I've ever had a vet say to me "it's time".

So I'd like some feedback on whether it's time from you, MeFites. I'm pretty attached to this cat as she's a link to my deceased mother, but I recognize that euthanizing a pet is an act of love and care. I've done it several times. I'll be sad but I'll deal. The hardest part would be taking her in and staying with her while she went to sleep. Of course because of covid that likely wouldn't happen, which also feels harsh. Speaking honestly, I'd be fine at this stage if she slipped away peacefully in her sleep. Her comfort is my main priority.

Your thoughts and experiences with end of life pet calls are appreciated.
posted by dry white toast to Pets & Animals (21 answers total) 8 users marked this as a favorite
Response by poster: Another detail I forgot to add: I've been seeing some skin irritation around her face, like little scabs, and the other day she was bleeding under mouth (we checked and didn't see any bleeding from her mouth and gums though).
posted by dry white toast at 10:34 AM on January 24, 2021

I had an elderkitty who didn't get quite so disoriented but definitely declined over her last two years, and the thing I think helped the most was having her on gabapentin. It made her calmer and improved her appetite, and also probably helped with the pain she was having from some (unfixable, because we couldn't safely anaesthetize her) dental issues. I'd bring that up with your vet and maybe give it a shot before talking euthanasia. It also might be worth it to bring her to a different vet and just get a fresh set of eyeballs on her bloodwork, etc, if you have that option.
posted by restless_nomad at 10:34 AM on January 24, 2021 [7 favorites]

(Also re: the vet thing, I have a social relationship with our current vet, and when we had to put two of our animals down within six months due to old-age related decline, she said that she was very relieved we were willing to bring it up and make that call, because the reaction of most of her customers to the idea is WHITE-HOT OUTRAGE and she's become extremely cagey about suggesting it.)
posted by restless_nomad at 10:49 AM on January 24, 2021 [8 favorites]

We're carefully watching an ill cat, so I'll share with you what I'm looking for on a daily basis:
-- Is she eating and drinking?
-- Is she able to use the litter box (less for my convenience but as a marker of how her reasoning & mobility are doing)
-- Is she enjoying some petting and connection from us?
-- Are her resting spots "normal" (even if they're not her usual spots) or are they attempts at hiding away? In my experience, a very sick cat will pick not just a non-usual spot but will really try to hide away as best they can and rarely emerge.
-- Will she take a treat from me? Right now my cat is accepting treats hand-fed to her in a gentle way.

For me this all means that my cat isn't ready to go yet. YMMV.

Friends just went through this and FYI they found a mobile vet who would come inside their house (masked) to do the euthanasia at home.
posted by BlahLaLa at 11:03 AM on January 24, 2021 [9 favorites]

This all seems very normal for an elderly cat. If she's eating and able to use the litter, and responds positively to the sort of attention from you that she normally likes, then she's probably fine. Just old and cranky. I would personally not euthanize my own cat in these circumstances, although I'd consider changing some things about how her life in the household is arranged. (ie making sure her food and her litter are on the same floor of the house as where people usually are, giving her comfortable places to sleep close to where you tend to spend your days, that sort of thing)

My own very elderly cat lived until he was nearly 24. Toward the end, I spent a lot of time carrying him around and holding him in my lap while I worked. My personal tipping point was when his hind legs became partially paralyzed and he stopped wanting to eat -- not being able to use the litter and not being interested in food, in addition to all of his other problems, were a signal to us that he was in his final decline, and we decided not to drag things out any further.
posted by Narrative Priorities at 11:07 AM on January 24, 2021 [3 favorites]

But to be honest I don't fully trust vets as I think their incentives aren't always aligned with the animal's health.

It's much more likely that your vet is used to dealing with pet owners whose emotional needs aren't aligned with the animal's health and comfort.
posted by mhoye at 11:18 AM on January 24, 2021 [24 favorites]

The scabs on her face may be feline chin acne. One of mine just went through a bout of it.

Chin acne is often caused by bacteria lingering in food and water containers. In my case, it was a reminder that I needed to be better about washing out their food and water bowls rather than just rinsing or wiping them down. Once I started doing that, it cleared right up.

Here's a wikipedia article. Be warned that there's a big photo of a cat's gross bloody chin.
posted by Pallas Athena at 11:35 AM on January 24, 2021 [4 favorites]

Desorientation and yowling at night sounds like dementia to me. When one of our cats started showing those same symptoms, I tried out a supplement called Cholodin. And what do you know, it helped a whole lot.
The tablets look and smell like yeast treats, so he took them willingly and he was much happier. Your cat may vary, but it helped in our case.
posted by Too-Ticky at 11:41 AM on January 24, 2021 [4 favorites]

From what you've offered, it sounds like your cat is in fairly good health but older and behaving normal for her age. We two geriatric cats in ours house -- and the one with thyroid issues specifically did start to yowl as her thyroid issues became more apparent. The yowling isn't related to pain and is more of a "hello I'm here", "I've caught a mouse", "I'm bored", or "I'm hungry".

Geriatric cat #2 has some mobility issues as well. He's just not able to jump anymore and his back legs aren't as strong. We medicate him with gabipentin for his general aches & pains, aging teeth, and CBD which in combination seem to manage any pain he might have, increase his appetite, and manage a little bit of his elderly restlessness.

Which is to say - the behavior you are seeing sounds normal. Some medication may help ease elder aches, pains, and restlessness. Talk to your vet and try to be specific about the behaviors you would like to address or the concerns you might have. We researched and added in CBD but just ran this by our vet & didn't wait for the suggestion.

It can be very stressful to care for an elderly or ill cat. For me there's been some stress at the realization we are at a new stage -- a new level of age or progression of an illness -- but then I'm all to accept that stage as a new normal. There are small losses as pets age and don't act the same as they once did but that doesn't necessarily mean their quality of life has degraded to the point of concern.
posted by countrymod at 11:50 AM on January 24, 2021 [2 favorites]

We had to put our sweet 18 year old cat down the day after Christmas. Her health had been declining for a couple of years, so we knew it was only a matter of time, and had been sort of evaluating the situation as we went along.

In the last year of her life she had many vet visits to treat a recurring UTI. She'd get an antibiotic shot, get better for a few weeks and then we would notice the symptoms returning. However, we had hopes for a while that each round of treatment might be the one that worked. She had a bout of constipation that required an enema to relieve, so we got her a special food that promised "perfect poops" and it did seem to help. One of her biggest symptoms was loss of appetite whenever she didn't feel good, and she developed an aversion to whatever food she'd been eating with each new round of sickness, so I spent a fair amount of time and money seeking out new foods and treats to entice her to eat, and tricking her into drinking by various means (putting "human" water glasses in odd places for her to find, and getting a cat drinking fountain which interested her for a couple of weeks.) She also yowled a lot but she was always a yowler even when she was healthy so it was just an increase, not a new behavior.

When thinking about when to euthanize, we considered the following:

Were there treatments for her ailments, could we afford them, and were they non-traumatic? (The occasional vet visit for an antibiotic shot and fluids was fine; in between bouts of illness, she seemed to feel reasonably well)

Were we able to manage her issues enough to keep her reasonably comfortable and happy?
(The effort I put in to keep her eating and drinking worked for a while; towels and waterproof pads on the furniture kept us from freaking out over the minor incontinence issues; assistance to get to favorite sleeping and hanging out places helped her once her mobility became more limited)

Did she still seem to enjoy things?
(She slept a lot, but came out regularly for cuddles and pets; she still seemed to enjoy eating whenever we found a food she wasn't averse to)

Eventually, the eating and drinking issues became more pronounced. The yowling became near-constant whenever she was awake. She was restless and couldn't settle down to sleep. The vet wanted to try an oral antibiotic which meant giving her oral medication twice a day, which she absolutely hated. The vet also said her kidney values were going up, which was concerning. Still, we hoped the oral antibiotic would do the trick.

It didn't. She declined very quickly over Christmas, stopped eating and drinking entirely, was restless, unable to sleep, wandered around yowling, just seemed so much more dramatically ill than before.

The vet didn't come right out and say "it's time" but when she outlined a possible treatment plan, she stressed that it would be hard on the cat. She'd need to stay at the vet's office for a few days, get intravenous medication and fluids, and there was a good chance she might die anyway while she was there. Her tone indicated that she was dubious about the outcome, and when we asked if it was time her answer was "it might be." And when she determined that I was open to the possibility, she stated it with more conviction. She said we could make an appointment for that afternoon, or for the next day if I needed more time. She gave her a shot of fluids and an antibiotic shot to hopefully make her more comfortable while we decided what to do.

When I got her home it was clear that this poor sweet cat was just done. She seemed to have trouble with her back legs. She was disoriented and walked into a wall, then just gave up and laid down on the floor where she was. We put her in her favorite spot on the couch where she slept the rest of the morning while we petted her and loved on her. We wound up keeping the appointment that afternoon as it seemed clear that she was ready.

Even though the vet's office had gone to curbside drop-off due to Covid, they did let people in to be with their pet during euthanasia. While she was sleeping so peacefully at home, I wished I'd have thought to ask about a house call. But we wanted to get it over with, so we took her in to the office and were able to be with her when she passed. It was very peaceful.

I feel like we made the right decision. We kept her going as long as we could manage and put her down when we were sure she was suffering, so there haven't been any "what ifs" regarding whether we jumped the gun, and also no guilt over having waited too long. From what you describe of your cat, I personally would probably give it a bit more time if I could manage her issues and she seemed to have some quality of life without needing a traumatic amount of medical intervention. But I would also err on the side of euthanizing a bit too early, rather than too late. I've waited too long in a couple of cases and still remember and feel terrible about the suffering that resulted. I had to keep in mind that euthanasia is not difficult for the cat. They don't know what is happening, they just go to sleep peacefully and don't suffer any longer.
posted by Serene Empress Dork at 12:22 PM on January 24, 2021 [10 favorites]

I had a very old cat who, at the end of his life, hid in the closet all day and mostly only came out to yowl at the top of his lungs.

I thought about euthanasia but was conflicted because he was driving me nuts and that made me not trust my own judgement -- I didn't want to unfairly kill him because, for example, he was waking my baby up during its naps.

Unfortunately, I think I waited too long. He did die of natural causes but there was pain and stress in his death, in addition to which, in retrospect, I think the last several months to a year of his life were unhappy enough that an earlier death would have been a mercy.

If I had another old cat I would probably create some kind of logical metrics ahead of time to help me make this kind of decision, because it's really hard and fraught to make in real time. Like, how much purring/cuddling, how much eating, how much yowling, how many painful medical problems, etc.

I wish you good discernment, and also compassion for yourself -- this stuff is hard!
posted by hungrytiger at 12:39 PM on January 24, 2021 [2 favorites]

Juuust checking -- is it possible she's yowling at night because of the mobility issues? Is she maybe wanting to come upstairs to be with you, but can't make it?

Or... wanting to go downstairs for food? Or somewhere warmer? Just considering possibilities.

If you're reluctant to carry her upstairs because she can't make it to the litter box -- maybe a second litter box upstairs (if you don't already have one; you sound pretty savvy and might have thought of this already).
posted by amtho at 1:02 PM on January 24, 2021

Response by poster: is it possible she's yowling at night because of the mobility issues? Is she maybe wanting to come upstairs to be with you, but can't make it?

Or... wanting to go downstairs for food? Or somewhere warmer? Just considering possibilities.

If you're reluctant to carry her upstairs because she can't make it to the litter box -- maybe a second litter box upstairs (if you don't already have one; you sound pretty savvy and might have thought of this already).

We have most of her stuff, food, water, litter, on the second floor so it's nearby when we're asleep because the disorientation seemed very intense when we first moved in. She doesn't hesitate to go up and down stairs, she's just slow with it.

I've done some carrying her to the floor we're on, but I'll try this more often. Finding a place for her to settle on the first floor or basement has been the biggest challenge. Over christmas she immediately moved into the very large bag that holds our fake tree once we pulled it out of storage that had been left by the dining table, and was very content in it. The overnight yowling mostly stopped and it didn't seem to be a problem that we were on a different floor. Since we packed it up the yowling has returned, and we haven't found a replacement that she's taken to yet.

I've wondered about dementia. She has a vet appointment tomorrow, so I'll ask about the Cholodin.

And also re the vet, I hear what people are saying about owners taking poorly to suggestions about end-of-life. I've certainly watched lots of friends go through ridiculous hoops to prolong life and have had to stop myself from saying "enough already!" I've tried to make it cleat to the vet that that isn't me.

I appreciate the feedback, all! Exactly what I was looking for.
posted by dry white toast at 1:27 PM on January 24, 2021 [2 favorites]

We used a veterinary service called Lap of Love to euthanize a beloved elder cat a year ago - they came to us so it was much less traumatic than having to take a cat in. On my mind with my almost 18 year old kitty as well. I think as long as your guy is eating, purring some in situations where it's clear it's contentment and not trauma-purring, cuddling you're just dealing with normal old cat stuff. It's hard!
posted by leslies at 2:37 PM on January 24, 2021

The most useful heuristic I've heard for thinking about these issues is that you should start thinking about euthanasia when your pet no longer has two of the three As: Appetite, Activity and Affection.

Appetite: Is your pet eating, drinking, and otherwise taking care of their bodily needs?

Activity: Is your pet able to enjoy the things that they enjoyed when they were healthy? (Whether that's play or just staring out the window).

Affection: Is your pet still able and willing to engage with you and receive affection? Are they seeking you out in the ways that they used to? (This is often a proxy for pain, one of the big signs that we waited too long to put down the dog that I grew up with was when he started snapping at anyone who touched his back half, because his hips were in so much pain.)

As I said, the rule of thumb is that a majority wins. If your pet is doing poorly in one of the areas, it's probably worth continuing to try to work on that, confident that as long as the other two areas are ok, your pet's quality of life is not too bad. If they've gone badly downhill in two of the three areas, (and they haven't responded to treatment) it's time to start thinking seriously about letting them go. If all three are bad, then you've probably waited too long already.
posted by firechicago at 2:47 PM on January 24, 2021 [11 favorites]

I have absolutely had a vet tell me "It's time."

A good vet will do this, especially if you ask him/her questions like "What would you do in this situation?"

I worry a bit that you're being a little rash. I'm not saying you definitely are, but be careful you don't go too far in the direction of unnecessary heroic measures and wind up shortening the life of a creature that depends on you.
posted by yellowcandy at 4:18 PM on January 24, 2021 [1 favorite]

Best answer: Wow no it's not time. You just need to provide extra support for your senior cat, just like you would for an elderly person.

Here's some things that can help:

- Antianxiety and arthritis meds given in pill pocket treats or via an ear cream

- Pet stairs to help her get up and down from the bed, windowsill, etc.

- Cleansing wipes to help her with her hygiene

- Heated cat bed to sleep on to help with her joints

- Feliway calming pheromones dispenser

- Calorie boosting gel to help her put weight back on

- Subcutaneous fluids if she's getting dehydrated or starting to have kidney problems

Senior cats can continue to live happy, fulfilling lives for many more years if you give them the extra care and accommodations they need.
posted by Jacqueline at 6:09 PM on January 24, 2021 [5 favorites]

Since we packed it up the yowling has returned, and we haven't found a replacement that she's taken to yet.

What about finding a replacement bag for the Christmas tree, and letting her have the old one? I imagine it's not the most stylish thing to have around the house, but if it makes her a little hapeir and she howls less, might be worth it. :-)
posted by oneirodynia at 9:28 PM on January 24, 2021 [2 favorites]

Here's an enclosing cat bed that might be comforting. I think there are probably less expensive versions out there now (I found this several years ago).

Also - If she's having a little trouble going up/down stairs, it might be nice to have a litter box in both places.

I know older cats do get cold; maybe think about -- NOT a heating pad -- a high-quality electric bed OR something designed to reflect heat to her.
posted by amtho at 1:22 AM on January 25, 2021 [1 favorite]

Over christmas she immediately moved into the very large bag that holds our fake tree once we pulled it out of storage that had been left by the dining table, and was very content in it. The overnight yowling mostly stopped and it didn't seem to be a problem that we were on a different floor. Since we packed it up the yowling has returned, and we haven't found a replacement that she's taken to yet.

You might find it easier to find a replacement that the in-storage fake tree takes to, and give the one the cat likes to the cat.
posted by flabdablet at 6:57 PM on January 25, 2021 [1 favorite]

A specific arthritis medication that's done one of our arthritic elderly cats good is an injectable called Adequan. It's very convenient because after a ramp up period, you'll probably only need to give her the shots once a month or so.
posted by foxfirefey at 8:32 PM on February 8, 2021

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