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The Decision to Euthanise
When is it the end? How do you know it is time to euthanise your cat?
Help making that awful decision.  This is a decision we are faced with daily in our lives as veterinarians. Still our answer is "I don't know either." It never gets easier, no matter how many times you have to go through this. Small comfort, to you facing this awful prospect with possibly your closest friend. This is the hardest time in our guardianship of these small lives.
We are making a decision to end a life. The terror remains that we end it too soon, taking the easy way out and preventing suffering or inconvenience to ourselves; or too late, allowing too much suffering and pain. Each cat is different, each person is different and each relationship is different. I cannot impose my own personal beliefs on you. This is the time you will draw a lot of differing opinions on what should be done - some prefer not to see any suffering, or have not the resources to deal with the caring and nursing the cat needs; others will suffer through to the terminal point, doing everything medically possible up to that point. What you do depends on your beliefs and your relationship with this cat.
The cat is helpless in all of this. They have no voice. They trust us to care. They cannot tell us where the pain is, what the suffering is or wether they would rather live through this. In my experience, the entire cat, every single living cell, is fighting to be alive right up to the point of death. I have seen cats that decide to die, that give up the fight and let go. The light goes out of their eyes. I have seen cats in so much misery that they just lie down and appear to give up. They have an "inward look". Some of these cats recover, with help. I have seen old cats just teeter along happily, frail old folk still experiencing simple joy in being alive, until one day they stop eating and we know then perhaps it is time. Age cannot ever be the exscuse "well, she is old, doc, is it worth it?" - the question should lie not in age, but in quality of life.What is quality of life? For cats; food, warmth and love. A spot of sunshine. A good chin rub. A soft place to lie, safe but able to keep an eye out for the rest of the world passing by. Routine.That special human. When isn't it quality of life? Uncontrollable pain, nausea or seizures causing anorexia that cannot be fixed by any medical or surgical means. When "bad days" exceed "good days". When the only recourse is to seek a dark place and sleep.
We have to leave a lot of this burden to you - the other half of this cat-human relationship, the guardian and true caregiver. You know your cat and its daily nuances better than we do, who only see it once a year, or have only met the sick cat. We can guide on curable, manageable, try-able. We can offer comfort, pain relief, drugs and solutions to improve quality of life. Some cats cannot accept much intervention, others are relieved by that same intervention. Where we can be really of assistance is prognosis in cancers, and some other diseases. Despite poor prognosis, again, there may be a lot we can do to improve that quality of life whilst you and your cat come to terms with what you are facing.
Making this decision is an inevitable part of sharing your life with an animal. We are in our society removed from our own mortality, and may never have the opportunity to develop compassion through caring for the aged except through our pets. This gift they give us too.
Humans facing death relay to us what their suffering is. Their pain is not just physical, but intensely emotional. Physical suffering at the end is seen as part of the process of living and dying, the two never separated. The worst is the emotional - the need to be touched, to be loved, at just the point when the world withdraws from you, unable to face your need for comfort. The best gift we can give to any life is to let it die loved, knowing and feeling it is loved.
You are not alone. Try these websites:
www.avma.org "Care for Animals"
www.veterinarypartner.com
There are a number of books, many dealing with pets, but I have found some of the more helpful deal with loss of our human friends and relatives. Try Banyan Books (W 4th Ave, Vancouver). Titles to look for include Charlotte's Web, The Tenth Good Thing About Barney, What the Dying Want.
At Vancouver Feline Hospital, we will not euthanise a cat we have not examined. The veterinarian retains the right to decline to perform euthanasia on any animal that is not terminally ill or in undue suffering. An examination by the veterinarian, at the usual consultation fee, is necessary to determine this. The owner of the cat must be present. If euthanasia is an option, then the owner will be required to sign the release form and pay any relevant fees. Having said this, no veterinarian will unnecessarily prolong suffering, and we do follow the BCSPCA critical distress protocol on dropped-off/abandoned cats. The veterinarian may waver the charge for euthanasia for an existing patient, but the owner is expected to pay the costs involved in private cremation or any special services requested.
We make a big thing of the time of death - it is the closure of a case, the loss of a friend, a heartbreaking experience for all of us. Owners, friends and staff can be present. We prefer to do this in Hospital, rather than invading the cat's home, in one of our private exam rooms, with a pre-placed iv catheter, and the cat on the owner's lap or in a comfortable position. The owner generally indicates the timimg of the injection. We leave the owner as much room and time with their cat as possible. We offer fur clippings, clay pawprints, private cremation (and some owners may elect to take their pet's body for a crematory service themselves, by arrangement). We can arrange a memorial donation to the Winn Foundation Pet Memorial Program or other charity of the owner's choice.
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