Euthanasia Decisions and Your Cat

Our culture has evolved to embrace the human-animal bond with love and respect. Our cats are members of the family, and many of us describe ourselves as “pet parents.” Because of advances in veterinary medicine and preventive care, as well as the migration of cats from the barnyard catching mice to the bedroom sharing a pillow with us, cats are living longer and in closer relationships with humans than ever before. The longer the relationship, the stronger the bond. The stronger the bond, the more challenging it is to consider the end of a cat’s life, including the difficult decisions around euthanasia. Although it is heart-breaking to think about the fact that our cats’ lives are generally shorter than our own, thinking about a cat’s eventual need for euthanasia and making a plan ahead of time will relieve much of the stress associated with decisions made when the end of life is near.

“Making a plan ahead of time will relieve much of the stress associated with decisions made when the end of life is near.”

How will I know when euthanasia is the most appropriate and humane option for my cat?

Open and honest communication with your veterinarian and veterinary healthcare team throughout a cat’s life lays the foundation for effective communication when that cat’s life begins to draw to a close. At some point, most cats will develop a life-limiting disease (such as chronic kidney disease or cancer). As soon as such a diagnosis is made, it is time to begin measuring the cat’s quality of life.

Quality of life is a fairly subjective concept, which is why Dr. Alice Villalobos, a veterinary oncologist, has created a qualityof-life scale to help cat owners assign some objective scores to everyday aspects of their cat’s life (see the handout “Quality of Life at the End of Life for Your Cat”). This quality-of-life scale helps us identify trends over time—specifically, declining quality over days and weeks. Your veterinarian will be better equipped to help you identify the right time for euthanasia if you keep him or her informed about the day-to-day details of your cat’s life at home. Discussion with your veterinarian will clarify any specific medical implications of your cat’s disease that can serve as benchmarks to suggest that euthanasia should be considered.

Quality-of-life-related questions that should be asked and answered as the time for euthanasia approaches include:

  • What disease signs and symptoms will I see that will let me know it is time for euthanasia?
  • What day-to-day activities will disappear from my pet’s routine?
  • How will I measure day-to-day quality of life?
  • How often will I measure quality of life?
  • How often will I discuss quality-of-life trends with my veterinary healthcare team?
  • Which categories on the quality-of-life scale will be the most important for my cat?

My spiritual beliefs prevent me from actively or willingly ending an animal’s life. Because I will not consent to euthanasia, how can a discussion of euthanasia benefit my cat and me?

“It is certainly possible to honor spiritual beliefs that prevent euthanasia while still providing and delivering appropriate pain management and comfort care.”

In this scenario, speaking with your veterinarian about your cat’s approaching end of life is even more important. It is certainly possible to honor spiritual beliefs that prevent euthanasia while still providing and delivering appropriate pain management and comfort care. In this case, your veterinary healthcare team may need to be a bit more involved in measuring quality-of-life trends to prevent your cat from suffering unnecessarily.

Where will euthanasia happen?

Most often, euthanasia is provided at the veterinary practice or in your home. In general, the location can be left to the discretion of the family. If you choose euthanasia at home, your primary care veterinarian may be able to provide that service. If not, there are house-call veterinarians as well as veterinarians who dedicate their entire practice to providing inhome euthanasia services. Veterinary professionals can help you, your family, and your cat to be quite comfortable at this challenging time.

What should I consider or plan for regarding what will happen after my cat’s passing?

There are a number of questions that should be asked and answered in preparation for the approaching death of your beloved cat. Some examples include:

  • How will my cat’s body be handled after death?
  • Do I want my cat to be cremated or buried?
  • Do I want to keep a memorial, such as a lock of hair or my cat’s footprint in clay?
  • How will my cat’s body be transported after death?
  • What should I do if my cat dies on his or her own?

By having a detailed plan in place ahead of time, you may feel a sense of quiet or peace that will allow you to f ocus on the remaining time you and your cat will share.

“The veterinary healthcare team will be an important partner as you negotiate the difficult days and decisions leading up to your cat’s death.”

The veterinary healthcare team will be an important partner as you negotiate the difficult days and decisions leading up to your cat’s death. It is important to communicate your wishes clearly so that they can be honored appropriately. A bit of planning can make this challenging event a little less painful.

This client information sheet is based on material written by: Robin Downing, DVM, CVPP, CCRP, DAAPM © Copyright 2012 LifeLearn Inc. Used and/or modified with permission under license.

Euthanasia Decisions and Your Dog

Our culture has evolved to embrace the human-animal bond with love and respect. Our dogs are members of the family, and many of us describe ourselves as “pet parents.” Because of advances in veterinary medicine and preventive care, as well as the migration of dogs from the backyard to the house and even into our bedrooms, dogs are living longer and in closer relationships with humans than ever before. The longer the relationship, the stronger the bond. The stronger the bond, the more challenging it is to consider the end of a dog’s life, including the difficult decisions around euthanasia. Although it is heart-breaking to think about the fact that our dogs’ lives are generally shorter than our own, thinking about your dog’s eventual need for euthanasia and making a plan ahead of time will relieve much of the stress associated with decisions made when the end of life is near.

“Making a plan ahead of time will relieve much of the stress associated with decisions made when the end of life is near.”

How will I know when euthanasia is the most appropriate and humane option for my dog?

Open and honest communication with your veterinarian and veterinary healthcare team throughout a dog’s life lays the foundation for effective communication when that dog’s life begins to draw to a close. At some point, most dogs will develop a life-limiting disease (such as organ failure or cancer). As soon as such a diagnosis is made, it is time to begin measuring the dog’s quality of life.

Quality of life is a fairly subjective concept, which is why Dr. Alice Villalobos, a veterinary oncologist, has created a qualityof-life scale to help dog owners assign some objective scores to everyday aspects of their dog’s life (see the handout “Quality of Life at the End of Life for Your Dog”). This quality-of-life scale helps us identify trends over time—specifically, declining quality over days and weeks. Your veterinarian will be better equipped to help you identify the right time for euthanasia if you keep him or her informed about the day-to-day details of your dog’s life at home. Discussion with your veterinarian will clarify any specific medical implications of your dog’s disease that can serve as benchmarks to suggest that euthanasia should be considered.

Quality-of-life-related questions that should be asked and answered as the time for euthanasia approaches include:

  • What disease signs and symptoms will I see that will let me know it is time for euthanasia?
  • What day-to-day activities will disappear from my pet’s routine?
  • How will I measure day-to-day quality of life?
  • How often will I measure quality of life?
  • How often will I discuss quality-of-life trends with my veterinary healthcare team?
  • Which categories on the quality-of-life scale will be the most important for my dog?

My spiritual beliefs prevent me from actively or willingly ending an animal’s life. Because I will not consent to euthanasia, how can a discussion of euthanasia benefit my dog and me?

“It is certainly possible to honor spiritual beliefs that prevent euthanasia while still providing and delivering appropriate pain management and comfort care.”

In this scenario, speaking with your veterinarian about your dog’s approaching end of life is even more important. It is certainly possible to honor spiritual beliefs that prevent euthanasia while still providing and delivering appropriate pain management and comfort care. In this case, your veterinary healthcare team may need to be a bit more involved in measuring quality-of-life trends to prevent your dog from suffering unnecessarily.

Where will euthanasia happen?

Most often, euthanasia is provided at the veterinary practice or in your home. In general, the location can be left to the discretion of the family. If you choose euthanasia at home, your primary care veterinarian may be able to provide that service. If not, there are house-call veterinarians as well as veterinarians who dedicate their entire practice to providing in-home euthanasia services. Veterinary professionals can help you, your family, and your dog to be quite comfortable at this challenging time.

What should I consider or plan for regarding what will happen after my dog’s passing?

There are a number of questions that should be asked and answered in preparation for the approaching death of your beloved dog. Some examples include:

  • How will my dog’s body be handled after death?
  • Do I want my dog to be cremated or buried?
  • Do I want to keep a memorial, such as a lock of hair or my dog’s footprint in clay?
  • How will my dog’s body be transported after death?
  • What should I do if my dog dies on his or her own?

By having a detailed plan in place ahead of time, you may feel a sense of quiet or peace that will allow you to focus on the remaining time you and your dog will share.

“The veterinary healthcare team will be an important partner as you negotiate the difficult days and decisions leading up to your dog’s death.”

The veterinary healthcare team will be an important partner as you negotiate the difficult days and decisions leading up to your dog’s death. It is important to communicate your wishes clearly so that they can be honored appropriately. A bit of planning can make this challenging event a little less painful.

This client information sheet is based on material written by: Robin Downing, DVM, CVPP, CCRP, DAAPM © Copyright 2012 LifeLearn Inc. Used and/or modified with permission under license

Quality of Life at the End of Life for Your Cat

Each and every pet has certain needs that should be recognized and respected. Quality of life is a way to refer to and discuss the day-to-day life and lifestyle of a cat reaching the end of its life. If we can successfully meet an ailing or chronically ill cat’s basic needs, then we can feel confident that our efforts in preserving life are justified.

If we can successfully meet an ailing cat’s basic needs, then we can feel confident that preserving life is justified.

What are some of the conditions that might cause a cat’s quality of life to deteriorate?

Most senior pets develop one or more medical conditions that tend to worsen over time. Examples of chronic medical conditions common in the older cat include:

  • Blindness—Generally occurs gradually from fibrous changes in the lens of the eye.
  • Cancer—The risk of cancers of all types increases with age.
  • Chronic renal disease—This degenerative kidney disease leads to the decreased ability of the kidneys to filter biological waste from the blood.
  • Deafness—Generally occurs gradually over time as the eardrum becomes less flexible.
  • Osteoarthritis—Painful inflammation and deterioration of the joints.

Cats can provide special challenges as they age because they are already very adept at disguising illnesses. The signs and symptoms associated with chronic degenerative conditions can be quite subtle, even for owners who are “tuned in” to their cats’ needs and routine behaviors

Cats can provide special challenges as they age because they are already very adept at disguising illnesses.

Is there a way to objectively measure my cat’s quality of life?

Dr. Alice Villalobos, a veterinary oncologist, has developed a quality-of-life scale for cats so that owners can act on behalf of their beloved animal family members as a pet’s end of life approaches. The quality-of-life scale provides guidelines that help owners and veterinarians work together to maintain a healthy human–animal bond. The scale provides a tool with which to measure the success of a palliative care or hospice plan for a cat with life-limiting disease and to fine-tune that care/plan. Kingsbrook Animal Hospital 5322 New Design Road, Frederick, MD, 21703 Phone: (301) 631-6900 Website: KingsbrookVet.com Dr. Villalobos’ quality-of-life scale looks at seven different parameters and scores each parameter from 1 to 10, with 10 being the best. A score above 5 in each category, or an overall score greater than 35, suggests that the cat’s quality of life is acceptable and that it is reasonable to continue end-of-life care and support.

The categories to be measured can be remembered as “HHHHHMM.” This list of letters stands for Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More good days than bad.

The quality-of-life scale helps owners act on behalf of their beloved animal family members as a cat’s end of life approaches.

What does each category mean for a cat approaching the end of its life?

The HHHHHMM scale:

Hurt: 1–10

Adequate pain control, including the ability to breathe properly, is an absolute necessity. Most pet owners do not know that being able to breathe is ranked as an important pain management strategy. Cats hide their pain extremely well. They will become very still if breathing is a problem. Pain control may include oral or injectable medication.

Hunger: 1–10

If a cat cannot eat properly or willingly, first try hand-feeding. If this is not successful, it may be appropriate to consider a feeding tube for blended or liquid diets, particularly if oral medication must be given.

Hydration: 1–10

Fluid under the skin is generally an easy and well-tolerated way to supplement what an ailing cat is drinking. This is not a “heroic” measure and can really help an older cat feel better.

Hygiene: 1–10

Can the cat be brushed, combed, and kept clean? Is the coat matted? Cats are very sensitive about keeping themselves clean. If they have an oral tumor or back pain, they may not be able to groom and may need help. Waterless shampoo works well to keep the coat clean, and a regular “lion cut” can keep the coat short and easy to manage.

Happiness: 1–10

Is the cat experiencing joy or mental stimulation? Cats communicate with their eyes as well as by purring. Is the ailing cat still interacting with family members and with the environment? Placing comfortable beds near family activities helps a cat remain engaged in life.

Mobility: 1–10

If the cat can no longer move around on its own, it may be time to consider a mobility device. Cats are surprisingly accepting of two- and four-wheel carts as long as any pain is well managed. Mobility and hygiene go together when a cat is bedridden. The veterinarian is an important resource when working through mobility issues.

More good days than bad: 1–10

When there are too many bad days in a row, or if the cat seems to be “turned off” to life, quality of life is compromised. Bad days may mean nausea, vomiting, diarrhea, seizures, frustration, unrelenting pain/discomfort, or inability to breathe.

How will I know it’s the right time to consider euthanasia?

A healthy human–animal bond requires a two-way exchange, and when that exchange is gone, the time for humane euthanasia has arrived. It is important to plan for the end of life before that time arrives, and the quality-of-life scale can be an integral part of that planning. You can help your cat maintain a good day-to-day life experience by using this scale to regularly measuring the parameters that evaluate how well your cat’s basic needs are being met. The scale can also help you clarify the decision for euthanasia, hopefully relieving anxiety and regret about your beloved cat’s end of life

Can my veterinarian help me decide when to let go?

Veterinarians are often asked to help cat owners with the heart-breaking decisions around euthanasia. Your veterinarian is there to help with these very difficult decisions.

This client information sheet is based on material written by: Robin Downing, DVM, CVPP, CCRP, DAAPM © Copyright 2012 LifeLearn Inc. Used and/or modified with permission under license.