Each 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.
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 older cats include:
- Blindness. Generally occurs gradually from changes in the lens of the eye.
- Cancer. The risk of cancers of all types increases with age.
- Dental disease: Painful inflammation and infection in the gingiva and oral cavity.
- Chronic renal disease. This degenerative kidney disease decreases the kidneys’ ability 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.
- Overweight/obesity. More than half of senior cats are overweight or obese, which reduces their quality of life.
Cats can provide special challenges as they age because they are already very adept at disguising illnesses. The signs associated with chronic degenerative conditions can be quite subtle, even for owners who are tuned in to their cat's needs and routine behaviors.
Is there a way to objectively measure my cat’s quality of life?
Dr. Alice Villalobos, a veterinary oncologist, developed a quality-of-life scale for cats that provides guidelines to help owners and veterinarians work together to maintain a healthy human-animal bond. The scale allows you 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.
Dr. Villalobos' quality-of-life scale looks at seven different categories 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.
What does each category mean for a cat approaching the end of its life?
The categories can be remembered as "HHHHHMM": Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More good days than bad.
Hurt. 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. 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. 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 but can help an older cat feel better.
Hygiene. 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 (dry) shampoo works well to keep the coat clean and a regular “lion cut” can keep the coat short and easy to manage.
Happiness. 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. 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-wheeled carts, if pain is well managed. Mobility and hygiene go together when a cat is bedridden. Your veterinarian is an important resource when working through mobility issues.
More good days than bad. When there are too many bad days in a row, or if the cat seems "turned off" to life, quality of life is compromised. Bad days may mean nausea, vomiting, diarrhea, seizures, frustration, pain/discomfort, or inability to breathe.
How will I know it’s time to consider euthanasia?
Euthanasia is one of the most difficult choices to make for beloved feline friend. It is important to plan for the end of life before it arrives, and the quality-of-life scale can help with that planning. You can help your cat maintain a good day-to-day life experience by using this scale to regularly measure 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 difficult decisions around euthanasia. Your veterinarian is there to help. There are many medical problems that you may assume cannot be managed, but with the aid of your veterinarian, with supportive care, and with minimal expense, options may be available. Involve your veterinarian and their support staff early, so they can help guide you during this difficult time.
