So your cat is very sick, their quality of life is drastically decreased, and either because of your financial situation or because there is nothing more that can be done, you are out of options for treatments to improve your cat's quality of life or longevity of life.
When do you call it quits? That is a very hard decision to make, and there is no good answer for it. Everyone has a different point at which they are ready to stop and end their cat's suffering. Only you can make that decision as to when. But, here are a few things to think about to help you make that decision. One of our criteria for recommending euthanasia for a cat at All Feline Hospital is no hope of getting better and no quality of life. What does that mean? Keep reading.
No hope of getting better. This is not a cut-and-dried process. Some diseases have a good chance of getting better, but the financial and emotional costs involved in this process may be more than you can handle. A financial example: if your cat eats a lily, and develops acute kidney failure that destroys both kidneys. Yes, for about $5,000 - $20,000 you can get your cat a kidney transplant that may give them a normal life. But, most of us just don't have that kind of money to spend.
An emotional example: if your cat is hit by a car and can't walk or control their eliminations. This might be something that with several months of drugs, physical therapy, and intensive care, your cat will be able to walk again and control their eliminations. But in the meantime, you work a full-time job, you don't have any help at home, and your cat is dripping urine and stool all over your house. You find yourself getting angry at your cat, even though you know it is not their fault, and you start resenting them for taking all of your time when you are not working. You don't want to, you love your cat, but the healing process is so prolonged and so time-consuming, that it is eating away at you. If you don't have help - physical and emotional, then it may not be worth it in the long run.
But, there may just not be any hope of getting better. An example of this would include chronic wasting diseases like end-stage inflammatory bowel disease. You may be willing and able to do anything and everything for your cat, but there may be absolutely nothing that anyone in the world can do, regardless of how much money or time you can devote to your cat. Some illnesses just can't be fixed. At this point, you have to look at your cat's quality of life.
Quality of life
This is a measurement that you, as your cat's owner and lifelong friend, are going to be able to make the best assessment of. We can give you the medical facts, but you are the one who sees how your cat is at home. Quality of life is going to be a little different for every cat depending on their age and pain level. Probably the two primary things to look for are does your cat still seeks you out for attention and responds well when you give it to them, and if your cat still eating and drinking.
If your cat is hiding all of the time, either under the bed or in a closet, then they don't feel good.
They may very well be following a deep-seated instinct that when they feel they are close to death, they need to go off alone to die. Now that doesn't mean because your cat hides once, that they are ready to give up. You have to look at the overall picture. If they are hiding some of the time, but yet other times they are sleeping or hanging out in their usual spots, then you have to assess, what are they doing more? If they are in their usual spots more than they are hiding, then they are probably having more good days than bad days. But, if they are hiding more often, then maybe it is time to call it quits.
How does your cat respond to you when you give your cat attention?
If they still nuzzle back at you, if they purr when you pet them, if they seek you out for your lap or just for attention, then they are still enjoying life to some extent. But, if when you pet your cat they shrink away, if they will no longer purr even though they used to when you petted them, or if they show no interest in spending time with you, even though they did previously, then they are suffering, and it may be time to stop. If they go back and forth between wanting attention and not wanting attention, then again, you will need to assess which is occurring more often.
Is your cat able to move around, and use the litter box?
If they are not able to move around at all and just lay in one place 24/7 other than when you move them - is that really a quality of life? Are they eliminating in a litter box, or at least somewhere other than where they are sleeping? If they can't move around enough to even get out of their own waste, that is not really a quality of life. Would you want to lay in your own urine and excrement all day? If they are able to eliminate other than where they sleep, but they are urinating and defecating all over your home, that may not be a quality of life for you, and you need to take your own stress level into account also. You don't want to be perpetually angry with them when they have no control over their eliminations, that will just eat away at you.
Is your cat eating and drinking?
This is kind of a big one. Your cat has to eat and drink to survive, and starving to death is a miserable way to die. Now, there are some disease processes, especially with kidney disease, that can result in such intense nausea in your cat that they don't want to eat or drink. There are medications that you can give to your cat to try and counteract this nausea, but at some point, they won't work anymore. But, just because your cat continues to eat and drink, that doesn't necessarily mean that they still have a quality of life. We have seen cats that are wasting away that can no longer move around, that eliminate where they lay, but they still eat and drink. That is not a quality of life either.
You are going to have to take into account a lot of factors when you evaluate your cat's quality of life, but regardless of what your friends or family may tell you, you are the one who knows your cat best, so only you are the one who can make that final decision. But, you are also in the middle of things, and your strong attachments and feelings for your cat may cloud your judgment to some extent. Friends and family may be able to see the bigger picture, but again, this is your decision. Listen to what your friends and family say, but make the decision that you can live with.
There will be times when your cat may have no quality of life, but there is a reasonable chance that they will get better. If you have the financial and emotional resources to nurse them through it, then maybe you should keep going. Or when there is no hope of getting better, but your cat still has a decent quality of life. There may be no reason to prematurely end your cat's life just because they have an incurable illness or injury, but you and they still have a good quality of life. In the end, the decision will be yours, and you will have to be able to live with yourself with it. It will never be an easy decision as long as you love your cat, but don't be afraid to ask for help from your vet, from your friends and your family, or even from a professional such as a therapist. We will do the best we can to help you through the process.