End of life considerations for cat with skin cancer
June 16, 2024 6:43 AM Subscribe
One of our cats has suffered from skin cancer for years, and it's looking pretty bad. Unsure how to gauge "quality of life" at this point. What would you do? (cw: gross details inside)
Molly, the cat who came with our house, is about 12 years old and has spent nearly every day of it outside. Because of her white fur and pink skin, she has developed squamous cell carcinomas on her ears. This resulted in the tips of her ears turning black and skin periodically shedding, but until recently it seemed to be able to heal itself. The vet encouraged us (and her previous owners) to try to keep her inside or to keep her out of the sun, but she's been an outside cat her whole life and is miserable when inside for too long.
Recently, the cancers have advanced to the point where the ears are no longer able to heal themselves and she is losing pieces of skin that are not re-growing. We took her in to the vet to explore the possibility of surgery, but her blood work disclosed that she is FIV positive. Given her age, we decided to shift to comfort care.
We've nursed many old cats through their last days, but never with this set of conditions. I imagine her ears are quite painful, but she's still eating well and is eager to go outside in the morning (she sleeps inside at night). On the other hand, her ears are literally falling off, her eyes are goopy, and all the white fur on her head is tinged pink with blood. It's awful to watch her deteriorate like this, but because her behavior seems normal I'm really unsure what to do. In some moments I feel that it's cruel to keep her alive in this condition, but she hasn't "told" us she's ready to go yet.
I'm not sure exactly what my question is here. Maybe it's simply what would you do in this situation, or what would be the tipping point for you in making the decision of when it's time to say goodbye?
Molly, the cat who came with our house, is about 12 years old and has spent nearly every day of it outside. Because of her white fur and pink skin, she has developed squamous cell carcinomas on her ears. This resulted in the tips of her ears turning black and skin periodically shedding, but until recently it seemed to be able to heal itself. The vet encouraged us (and her previous owners) to try to keep her inside or to keep her out of the sun, but she's been an outside cat her whole life and is miserable when inside for too long.
Recently, the cancers have advanced to the point where the ears are no longer able to heal themselves and she is losing pieces of skin that are not re-growing. We took her in to the vet to explore the possibility of surgery, but her blood work disclosed that she is FIV positive. Given her age, we decided to shift to comfort care.
We've nursed many old cats through their last days, but never with this set of conditions. I imagine her ears are quite painful, but she's still eating well and is eager to go outside in the morning (she sleeps inside at night). On the other hand, her ears are literally falling off, her eyes are goopy, and all the white fur on her head is tinged pink with blood. It's awful to watch her deteriorate like this, but because her behavior seems normal I'm really unsure what to do. In some moments I feel that it's cruel to keep her alive in this condition, but she hasn't "told" us she's ready to go yet.
I'm not sure exactly what my question is here. Maybe it's simply what would you do in this situation, or what would be the tipping point for you in making the decision of when it's time to say goodbye?
I'm sorry you are going through this. It's always difficult and painful.
The advice I was given is that our pets aren't anticipating an abstract future. They get excited about and act in the moment. They aren't going to sleep and thinking, "Yay! Tomorrow I get to go outside!" They aren't even thinking "I'm tired, I think I'll rest." They just rest when they find a comfortable spot and they are tired.
By letting your pet go in a humane fashion, you are not depriving your pet. You are saving them a day of pain. In my opinion, sooner is better than later.
posted by donpardo at 7:35 AM on June 16, 2024 [11 favorites]
The advice I was given is that our pets aren't anticipating an abstract future. They get excited about and act in the moment. They aren't going to sleep and thinking, "Yay! Tomorrow I get to go outside!" They aren't even thinking "I'm tired, I think I'll rest." They just rest when they find a comfortable spot and they are tired.
By letting your pet go in a humane fashion, you are not depriving your pet. You are saving them a day of pain. In my opinion, sooner is better than later.
posted by donpardo at 7:35 AM on June 16, 2024 [11 favorites]
What does the vet say? You might ask the vet, "If this was your cat, when would you say goodbye?" Is there any medication for pain/inflammation you could give her? Could you keep her inside in the heat of the day, and limit her outdoor time to morning/evening when the sun is less intense?
But, my sympathies - my one cat has had lung cancer for about a year and I'm in a somewhat similar spot of being unsure - he's slowed down and gotten quite thin, but still technically checks all the boxes for enjoying life (eating, going outside, cuddles, grooms, etc.) so it doesn't feel right to put him down yet. I guess my tipping point is when any of those things definitely stop.
posted by coffeecat at 8:20 AM on June 16, 2024 [5 favorites]
But, my sympathies - my one cat has had lung cancer for about a year and I'm in a somewhat similar spot of being unsure - he's slowed down and gotten quite thin, but still technically checks all the boxes for enjoying life (eating, going outside, cuddles, grooms, etc.) so it doesn't feel right to put him down yet. I guess my tipping point is when any of those things definitely stop.
posted by coffeecat at 8:20 AM on June 16, 2024 [5 favorites]
Best answer: I'm so sorry you're facing something so difficult.
Long ago, someone who worked with a lot of rescue cats told me about the "three A's" theory for judging an animal's health - those three A's stand or Activity, Appetite, and Affection. When she was trying to evaluate a cat's health, that's what she looked at.
A healthy cat has some degree of all three A's (how much of each depends on the cat - your cat may have a huge appetite, but be stand-offish; if that's just the way your cat is, that's just that). Whatever level each of your cat's A's is, she said, if it loses one, that's time to take it to the vet for a checkup. If it loses 2 A's, you get more concerned. But if it's lost all three A's, it may indeed be time to start talking about The End.
From what you've said, it sounds like right now, your cat still has at least two A's - she's still eating and she's still trying to get outside every day. You haven't mentioned whether she's the same level of affection with you that she usually is - but if that hasn't changed either, then that's all three A's she's got. That state may not last too much longer, from the sound of things, but if she were really uncomfortable, she would likely not be eating much and wouldn't be as active, and may not be as affectionate towards you.
But right now, she's got some definite health issues, but it sounds like as far as she's concerned, she's still hanging in there. So palliative care (treating the symptoms so she's comfortable for however long she wants to hang in there) might indeed be the way to go. It's probably tough for you to see, but if she's not acting like anything's wrong, then in her head she's probably thinking everything's just fine.
Good luck.
posted by EmpressCallipygos at 11:43 AM on June 16, 2024 [9 favorites]
Long ago, someone who worked with a lot of rescue cats told me about the "three A's" theory for judging an animal's health - those three A's stand or Activity, Appetite, and Affection. When she was trying to evaluate a cat's health, that's what she looked at.
A healthy cat has some degree of all three A's (how much of each depends on the cat - your cat may have a huge appetite, but be stand-offish; if that's just the way your cat is, that's just that). Whatever level each of your cat's A's is, she said, if it loses one, that's time to take it to the vet for a checkup. If it loses 2 A's, you get more concerned. But if it's lost all three A's, it may indeed be time to start talking about The End.
From what you've said, it sounds like right now, your cat still has at least two A's - she's still eating and she's still trying to get outside every day. You haven't mentioned whether she's the same level of affection with you that she usually is - but if that hasn't changed either, then that's all three A's she's got. That state may not last too much longer, from the sound of things, but if she were really uncomfortable, she would likely not be eating much and wouldn't be as active, and may not be as affectionate towards you.
But right now, she's got some definite health issues, but it sounds like as far as she's concerned, she's still hanging in there. So palliative care (treating the symptoms so she's comfortable for however long she wants to hang in there) might indeed be the way to go. It's probably tough for you to see, but if she's not acting like anything's wrong, then in her head she's probably thinking everything's just fine.
Good luck.
posted by EmpressCallipygos at 11:43 AM on June 16, 2024 [9 favorites]
This circumstance might not apply to your cat, but when I had a cat with a bloody, cancerous lesion on her leg, the concern was that it would start bleeding profusely and I'd have to take her to an emergency vet. She really really hated being in the car and being in any strange place, especially a vet's office, so I decided to have her put down because I did not want to risk her having to end her life with that kind of emotional trauma. As I said, this might not be an issue with you cat, but I wanted to put it out there as something to think about.
Best wishes whatever you decide.
posted by FencingGal at 4:27 PM on June 16, 2024 [1 favorite]
Best wishes whatever you decide.
posted by FencingGal at 4:27 PM on June 16, 2024 [1 favorite]
We had to make this decision a couple of years ago when our ageing cat started to lose her personality and was clearly suffering. Our approach was along the lines of the 'three As' EmpressCallipygos mentioned. This was a cat that had previously ruled the neighbourhood, roaming from house to house to exert her dominance and, when home, scaring away any dog that dared to come close to the gate.
Over a period of a couple of years, Soxie started to lose her confidence, then her ability to jump and climb, then, despite eating ravenously and aggressively seeking food all the time, lost more and more weight. Despite this, she seemed content to spend less time ruling her domain and more time lying in the sun so we let her be. But then she started losing her fur and, seemingly, her mind as well. She would no longer groom herself and we often had to cut off large clumps of tangled fur (at great cost of injury to all concerned) and she took to spending all the time she wasn't scrounging for food hiding under our bed up against the wall. Then she started constantly crying and struggled to get around.
In the end, we decided she could no longer be a cat and it was clear she was miserable and in pain at least most of the time, so we let her go. It's a hard decision, particularly for my wife, who raised Soxie from a kitten and had her for something like 14 years. But letting someone you love continue to suffer with no hope of improvement would be even harder. She will tell you when it's time and, given she is still acting normally, she's telling you it's not time yet. It must be sad for you to see her condition but, for as long as she isn't bothered, be reassured she doesn't care.
All the best.
posted by dg at 5:19 PM on June 16, 2024 [1 favorite]
Over a period of a couple of years, Soxie started to lose her confidence, then her ability to jump and climb, then, despite eating ravenously and aggressively seeking food all the time, lost more and more weight. Despite this, she seemed content to spend less time ruling her domain and more time lying in the sun so we let her be. But then she started losing her fur and, seemingly, her mind as well. She would no longer groom herself and we often had to cut off large clumps of tangled fur (at great cost of injury to all concerned) and she took to spending all the time she wasn't scrounging for food hiding under our bed up against the wall. Then she started constantly crying and struggled to get around.
In the end, we decided she could no longer be a cat and it was clear she was miserable and in pain at least most of the time, so we let her go. It's a hard decision, particularly for my wife, who raised Soxie from a kitten and had her for something like 14 years. But letting someone you love continue to suffer with no hope of improvement would be even harder. She will tell you when it's time and, given she is still acting normally, she's telling you it's not time yet. It must be sad for you to see her condition but, for as long as she isn't bothered, be reassured she doesn't care.
All the best.
posted by dg at 5:19 PM on June 16, 2024 [1 favorite]
Cats are experts in masking how they feel - particularly outside cats who have always nreded to present tough. Only you can decide, but I would be preparing myself for a soft and gentle farewell to this brave kitty. I'm sorry this is happening.
posted by tiny frying pan at 5:53 AM on June 17, 2024 [1 favorite]
posted by tiny frying pan at 5:53 AM on June 17, 2024 [1 favorite]
You are not logged in, either login or create an account to post comments
Her condition is a quality-of-life situation that she can't help you evaluate. When will she have to be kept indoors? When will she begin to experience pain? When will the lesions become infected? I suppose her final day will find her at the vet's office, lying peacefully in your lap, wrapped in a warm towel, waiting for the vet to administer that final injection. How do you want her to experience her last weeks, months, or days with you?
Please accept my sympathy and understanding. Our animal friends give us much--indeed, they give us their lives. With their passing, they give us the true message of our own mortality and the sweetness of life. This is no small thing to know.
posted by mule98J at 7:35 AM on June 16, 2024 [2 favorites]