Knowing when it's time...
Ok, it's time to have a talk. One that no one wants to talk about but is part of having pets. It is a harsh and sad reality that our feline friends can't be with us forever. While modern veterinary medicine has come such a long way in how we can care for our pets, not all diseases can be cured.
No one wants to talk about this ugly side of pet ownership... it's painful, emotional and devastating to think about losing one of our fur kids. But having an open discussion about end of life decisions ahead of time can help make this part of the journey a little less painful. It is something we have control over at a time where making decisions can be difficult.
I'm a firm believer in the saying "just because we can, doesn't mean we should." This means that yes, in some instances, we can keep going, keep doing tests, keep doing procedures. But is it going to change the outcome? If so, then let's do it. But at some point we have to remember what is best for our patient and pet. Are we doing it for them or for us?
It can be hard to get caught up in the emotions of fear and grief when discussing a gravely ill pet that is not going to get better. It is my job to educate you on treatment options, even if that means living out their days in peace or making the decision to humanely euthanize them. Some owners feel the obligation to do absolutely everything they can for the pet so they don't feel like they've given up on them. And that is ok. But it's also ok to say we've done our best, and now it's time to prepare for the end of our journey.
I hate the phrase "we gave up on him/her" or "he/she gave up."
No one has given up. Our pets fight the good fight with our support and guidance, your love and care, and their own internal spirit. But at some point, they get tired. Their bodies start to shut down, and it is harder for them to stay engaged. It's ok to let them rest. They've been our companions and done their job over and above what we deserve. Thank them for their unconditional devotion to us. Tell them it's ok to rest. Know that no matter the circumstances, you have done what you can for your cat. There is no room for guilt in making a decision to end their pain. Whether that is by humane euthanasia, or hospice care at home.
I know we all wish that our sick pets would go to sleep and not wake up. It relieves us of making that decision to let them go. Unfortunately, this rarely happens. I want to make sure our pet caretakers have information ahead of time to have a plan.
How do you see your cat's final moments happening?
When they are comfortable and having a good day, knowing their time is limited?
When they are showing signs of distress/pain that can't be managed?
At home in your lap with an at home euthanasia veterinarian?
At home with hospice/palliative care until nature takes its course?
In our veterinary hospital by their side?
Do you want to be present for the sedation and final euthanasia injection?
Do you want to be present for the sedation part only?
Should the entire family be present?
The option that I don't like is the emergency euthanasia. Some conditions (lung disease, heart disease, certain cancers) can lead to an emergency situation where you are rushing to the ER to make that final decision to let your cat go. It's stressful and traumatic on everyone.
Having a plan ahead of time is helpful. As you can see there are so many decisions to be made. Making them in the midst of a traumatic event when your head is spinning and your heart is breaking is almost impossible.
There is no guilt in letting a terminally ill cat go on a "good day" of snacks, a visit outside, spoiling them rotten and having that memory. Letting a sick kitty go is harder, they are having more bad days than good days, they may be withdrawn, not eating, or in pain.
Helping identify your cat's Quality of Life can be a great resource. It can help take some of the emotion out of making these decisions, allowing us to use objective measurements of what makes up a good life. Dr. Spencer has reached out to Lap of Love (https://www.lapoflove.com/), a mobile veterinary service that provides in-home euthanasia. They have been gracious enough to allow us to share their Quality of Life scale and resources for our clients.
The grief that surrounds losing a beloved pet can take many forms. Of course we have the post-loss grief that it has actually happened, but one form that many people don't think about is called anticipatory grief. When you receive the news that your pet is terminally ill, it is not uncommon to start the grief process, even though your cat is still with you. I experienced this with two of my pets, my heart cat Julep (she had refractory asthma and pulmonary fibrosis and got to the point that she had trouble breathing despite medications, inhalers, stem cell therapy, oxygen at home) and my heart dog Karma (a bloodhound that kept me going in a tough spot of life, she developed cancer of her liver and spleen and it spread to her lungs). I would spend time hugging them, crying, not being able to imagine losing them. They were my life. I don't have human kids, these were my four legged kids.
The grief after losing a cat with a chronic illness can be particularly painful. You have spent many hours on a daily basis medicating, feeding, nurturing and caretaking. And then they're gone, and you feel more than alone. I have experienced many forms of grief losing my pets and found this form very challenging. I felt like I had lost my purpose, and I didn't know what to do. My brain was numb. What was I going to do with all these medications? Food? Supplies? My kitty Cuervo had heart disease, high blood pressure, kidney failure. He was such a trooper, a gentle soul that never complained. Then he developed a multi-drug resistant form of kidney infection that no known antibiotics would treat. Making the decision of when and how to let him go was so hard, but I knew the morning I made the choice that it was the right thing to do.
We are lucky in that pet grief is now more "socially acceptable." Hearing from people "it's just a cat" is hurtful and damaging. There are now grief counselors that specialize in pet loss. I have included links below.
What happens after? More decisions that need to be made...
Do you want to bury your pet at home?
Do you want a private cremation with the ashes returned to you?
Do you want a mass cremation without the ashes returned?
Do you want a paw print or lock of fur?
Do you to want to memorialize your pet in a special way (jewelry, glass, special urn, garden stone) ?
Whatever path you choose is ok. We are here to be with you on that journey.
You don't have to do it alone. Dr. (Bowyer) Spencer has been trained in veterinary hospice and palliative care for this reason. It is our duty to provide our patients a dignified, pain free, stress free life for as long as we can.
Ok, enough of sad. Go hug your cat, give him/her some catnip, get a laser toy out, and enjoy every day you have together!
Lap of Love
AAHA/IAAHPC End-of-Life Care Guidelines for Dogs and Cats:
Pet Loss Support Groups
Cremation and Burial Services
Julep Mel Cuervo