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February 06, 2007


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Cara deBeer

Hi Dr. Mobley. I love the blog. Thank you for posting it, it's very insightful.

I didn't really know where to put this question so I went with the communications tag. Really, though, it's about euthanasia.

My husband and I have a cat, Zoe, who is 15. She is diabetic, which is fine (we have another diabetic senior cat too, diabetes is not in itself a big problem.) But even when her diabetes is stabilized, she's so skinny! She has gone from a big 12 pound Maine Coon to a weeny 5 pound Maine Coon. She looks and feel bony. We know she has some arthritis (she gets chondroitin); the vet thinks she may have a tumor of some sort, possibly even/as well as a brain tumor. She definitely has dental problems.

My husband and I have made the decision that at her advanced age, we aren't interested in aggressively treating the tumor or even the dental problems (we have four other cats - most with chronic health problems - in addition to this one, which is a bit of a financial strain. Zoe's insulin and prescription food alone run about $150/month.) Zoe's quality of life seems to me to be poor - she will accept petting but is not the affectionate lapcat she used to be; she has always lived in a multicat household but now HATES the other cats; and she's occasionally incontinent. Mealtimes get her excited but that's it; the rest of the time she spends asleep.

How do we know when it's time? We keep taking her back to the vet every 3 months for an assessment to see if she's in much pain and they never seem to think she is. I don't want to euthanize her just because she is no longer a charming little kitten or because she has health problems - she has definitely earned her retirement, but I also don't want her to suffer through a terrible existence because we haven't got the guts to make a decision.

Do you have any advice? And by the way, if you think the dental issues are worth treating, we would reconsider, if it would improve her quality of life.

Thanks again.


Hello, Cara,

Well... no pressure, huh?

The decision to provide euthanasia is often a difficult one. In fact, it is almost always a difficult decision, even when the situation is pretty clear-cut (as in the dog caught in a combine harvester header who had all four of his legs cut off: the owner wanted me to "fix him". Holy cow!)

"Quality of life" and "quality of life issues" are the buzz-words. They are more than just buzz-words, though. If one is sure that a patient is in constant pain which is NOT going to get better, then the decision is pretty clear. But what about the patient who just never feels GOOD?

You don't really see obvious signs of pain (screaming, moaning, writhing, restlessness, etc.), but you never see what you consider the normal activities. No playing, no exploring, no interaction with other pets or people. She still eats and is interested in food, but just sleeps the rest of the time.

With this pet, we know she won't have any energy -- she's wasting away, burning up her body fat and muscle tissue just to stay alive. This means that she isn't getting much good out of her food. Just breathing is taking all she's got.

Is she in pain? This is a very hard question to answer, particularly with cats, as they are very stoic and famous for concealing signs of illness. Even when you know your pet better than anyone else, this can be a hard call. One of the few ways that I know to assess this is to give a trial therapy of pain medication, such as buprenorphine, and see if there is improvement.

Another criterion that I use is to think to myself, "If this were me, would I be in pain?" This is less useful here, as I've never been 100 years old and wasting away (at least not this lifetime). My great-aunt Clara lived to be 101. She retained her mental faculties to the end. She was rather feeble physically in the last ten years. You could tell pretty quickly how interesting your conversation was. If you were boring her, she'd just go to sleep. If not the conversation would be lively for as long as you could stay with it.

Aunt Clara didn't feel bad, but she had trouble getting up and walking, even around the house. She slept a lot. When asked how it felt to be 100, she would reply, "I'm just surprised every day when I wake up."

Contrast this with an experience I had with a relative dying with cancer in a hospice environment. She begged me to smother her with a pillow.

Which brings me back to my opening statement: No pressure, huh?

Whenever a client uses the "S" word ("Do you think he's suffering?"), I know it's over. In 31 years, nobody has ever used this word unless they were looking for the way out.

In your case, you are concerned about whether you are condemning the cat to slow death. Ironically, you are afraid someone might think you were considering a "convenience euthanasia". Since most cats don't live to be 15 in the first place, and many owners will not go to the trouble to treat diabetics (and it IS some trouble, I know), you could hardly be thought to have cut any corners in the cat's care.

Here's what the numbers say:
Your cat has lived to an above average lifespan of 15 years.
Your cat has lost sixty percent of its body weight.
Your cat never plays, explores, or interacts with others.
Your cat never "feels good".

Your question: is the cat in pain? Answer: I don't know.
Your question: is it "time"? Answer: Only you can decide.

I wish I could make it easy for you, but it never is.

Best wishes.


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