Published by: Ingrid King. Last Updated on: November 1, 2022 by Crystal Uys

During these past couple of weeks, two friends had to make difficult decisions about medical care for their cats, and it got me thinking about what a challenging task this is for so many of us.

Advances in veterinary medicine make it possible to treat medical conditions in cats that would have been a death sentence a decade ago.  From chemotherapy to kidney transplants, cats can now receive almost the same level of medical care as humans.  But just because these treatments are available doesn’t necessarily mean they’re right for each cat.

To treat or not to treat: two stories

Pandora is an 18-year-old calico in chronic renal failure.  It’s unclear which stage her disease is currently in, because my friend has chosen not to pursue medical treatment beyond the basics:  Pandora is on medication to control her high blood pressure, and she gets a thorough check up every six months to monitor her lab values.  Pandora goes through phases were she doesn’t want to eat and becomes withdrawn, but so far, she has always bounced back after a few days.  My friend has chosen to keep Pandora comfortable at home, and when that’s no longer possible, she’ll be ready (or as ready as any of us will ever be) to let her go.

The decision for Bob, a 14-year-old orange tabby belonging to my friend Robin over at Covered in Cat Hair, was more difficult.  He’s FIV positive,  and a recent ultrasound showed a large mass that was wrapped around his liver.  Without a biopsy, there was no telling what was going on.  Surgery is always a risk, but especially for a senior FIV positive cat.  The surgeon told my friend that, in a worst case scenario, if it was cancer and it had spread, she needed to be prepared to authorize euthanasia while Bob was still on the table.  On the other hand, there was also a chance that the mass could be removed, and Bob could have many more months, if not years, of good quality of life.  My friend agonized over this decision, and eventually decided to have the surgery done.  The mass was removed, and as of this writing, Bob has recovered from his surgery and is undergoing chemotherapy for lymphoma.

Not every cat owner would have made these decisions for their cats.  In Pandora’s case, some would choose more aggressive treatment and more frequent visits to the vet, and possibly hospitalization for IV fluids.  In Bob’s case, some would have elected to forgo surgery and just let him live out however much time he may have left without intervention.  These situations are never black and white, and there is no one right decision.  The only wrong decision in these cases would be indecision when it translates into pain and suffering for the cat.

So what factors should a cat owner take into account when faced with making medical decisions?

Get the facts first

The most important thing is to get all the facts first.  Be sure you understand the medical condition your cat is dealing with.  It can be difficult to know what questions to ask your veterinarian when faced with a frightening diagnosis, so don’t be afraid to ask follow up questions once you’ve had a chance to process the initial information.  Make sure you understand all the treatment options, along with cost, side effects, and prognosis for each option.  Get a second opinion and/or go see a specialist if you’re not comfortable with what your veterinarian tells you.

By all means, research your cat’s condition on the internet, but use common sense and look for sites that present facts and not just anecdotes and opinions.  Dr. Nancy Kay, the author of Speaking for Spot:  Be the Advocate Your Dog Needs to Live a Healthy, Happy, Longer Life has written a series of fantastic articles about how to find accurate pet health information on the internet.

A personal decision

Once you understand the medical facts, the decision becomes more personal.  Factors that come into play are your cat’s temperament, your comfort level with providing any follow up care that may be required at home, and your finances.

In my years of managing a veterinary practice, a question many clients often asked was “what would you do if it was your cat?”  I wish I could have answered it, but I couldn’t.  I couldn’t because, first of all, I’m not a veterinarian.  I also couldn’t have answered it because what I would do for my cat could be completely wrong for the client’s cat.

But after having faced having to make difficult decisions for two of my cats in recent years, I now have an answer I would give these clients.  For me, it comes down to this:  Listen to your heart.  After weighing all the factors, try to set aside your fear and worry for your cat long enough to connect with your center.  Some call it gut instinct, or intuition.  And then make the best possible decision for your cat.  Because when it comes down to it, the one thing you know better than all the veterinarians in the world combined is your cat.

Photo of Bob by Robin A.F. Olson, used with permission.  Bob passed away peacefully, surrounded by those he loved, in September of 2011.

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28 Comments on Making Medical Decisions for Your Cat

  1. I have definitely been here and it is so hard. I count my lucky stars that so far I have not had to choose between a medical procedure and paying rent which I overheard a man go through at a clinic once and it was awful. What I struggle with at the moment is the conflict between the law which requires rabies shots for cats even when they are indoor only. I have a medical exemption for my FIV+ tortie girl but my 3 boys are coming up for renewal and I’m really on the fence. I have a vet who supports not doing vaccines if at all possible so I won’t be pushed to give them their annual shot but then I worry about if they do get out what the legal repercussions could be if their shots are expired. Growing up we lived in the country and no vaccines were given to any of the animals but now we live “in town” and it’s all difference. I”m grateful my vet is supportive either way.

    • That’s a very tough decision, Michelle. If you decide to renew their rabies vaccines, at least make sure they get the one year Purevax rather than the 3-year vaccine. Purevax is safer for cats.

  2. Zane was my first adult pet. I had pets growing up, but it was my parents who made the Last Decision in each case, although not without input from me.

    Zane was about 14, and aside from slowing down a bit he was OK; then, one night, I found him passed out on the bathroom floor. I called a friend and we rushed him to the emergency vet, who told me it was the feline equivalent of congestive heart failure, and he was drowning in his own body fluids. I told her to do what needed to be done. The regular vet, looking at the report the next day, said that there was no way this could have been either predicted or prevented—it wasn’t due to anything I had done or left undone.

    Zane had been my father’s cat before mine, so loosing him was like loosing father again, and that was like loosing mother again. I kept saying, “I want my mommy, I want my daddy, I want my kitty!” I cried and cried and cried.

    A few months later, a friend asked me to foster a kitten–Rupert! The fosterage turned into adoption. I love Rupert and am so glad he came into my life. But I miss Zane.

    • You’ll probably never stop missing Zane, Bruce, but I’m glad you have Rupert in your life now. I think Zane would approve. 🙂

  3. Bob lived another 9 months after the surgery and most of it was good. Near the end I know we could have put him down, but part of me didn’t want to do that to end my own suffering at watching him fade away. He was comfortable, getting nutrition, loved, so we opted to let him go when he was ready, on his terms. Though heartbreaking, it was also an honor to watch him pass away. He was never alone for a second and when he was gone we gently cleaned him and lit candles and just sat with him. I found it comforting.

    I agree, Ingrid, in the end you must follow your heart. Living includes suffering. Your cat MAY suffer from whatever is done to them, but if it also means recovery or improved life, then why deny that to your cat? It’s never easy, but I hope everyone will not let fear drive them to let their cat go when it could have survived.

    • It takes a great deal of courage to make these tough decision, and you have shown an inordinate amount of grace during your journey with Bob, and by sharing it with the world. Thank you for all you do for cats and their humans, Robin.

  4. What a great article and I totally agree that just because technology is available using it is not always the right options. I am a Hospice RN (for people) and am fortunate that my vet understands hospice and has helped me provide comfort care, including pain management, for several of my feline friends. One cat died on his own, the others we jointly decided to euthanize.

    I wish Hospice support were more available for animals and their guardians.

    • Thankfully, hospice is becoming more of an option for pets as well. It’s a subject close to my heart, and I’ll be writing about it more in the future.

  5. What an important subject — thank you for posting it. I think when we are in the middle of intense emotion, it can be difficult to think clearly. Getting the facts, though, is important…getting a second opinion may even be necessary. One of my cats had renal failure and we had to make the choice for euthanasia and it was an incredibly sad time for us. Our sweet animals lay their lives in our hands and we owe it to them to make well-educated decisions. Every situation is different, but we can examine each one closely before making choices for our beloved pets.

  6. Having just dealt with the decision to euthanase my feline friend of 17 and a half years it was a very personal decision and one I did not take lightly. the vet told me he had weeks to live when I took him in and that the downhill slide would have been quite fast. I elected not to undertake expensive treatments and to let his renal failire take its course. He died before it really took hold and he did not suffer/ If only we all could have such a death and such a choice. I still see him sitting in the driveway in the early morning and have discovered his sunning spots. There is sometimes a flash of him going past to his food bowl. I am comfortable with my decision and hope a similar one can be made for or by me when the time comes

    • I’m so sorry for your loss, Amanda. As you said, what more can any of us ask for: to die peacefully and without suffering.

  7. I agree w/getting as much info as you can when you are told what is wrong with you pet. I also suggest reading Cat Fancy and anything on pet health. It’s good to have a much info about feline dieases. Cause of Cat Fancy, I ended take to my cat to the vet who ended up agreeing and after testing my cat did have VAS, and had 2 other w/diabetes. If not being a head of the game, I would have been freaked out more. Can’t tell you, how many feline yahoo grps I’m in, and feel ppl let their pet go to soon, cause they didn’t know the facts, and I feel that Reg Vets, and ER Vets, don’t have all the answers. If U can cons w/a spc vet it’s even better. As for $$ just can’t fantom it. I’m lucky I guess to have 2 vets to let me make pmts, and as for the spc vet I use CareCredit. (good for ppl too) I right now have a cat that was sick, and we just don’t know what is wrong, could be cancer, but just didn’t op for the surgery, he was down to 6.5 pd, and felt like he wieghed nothing. He had a high fever, and WBC, along w/high Calcium. He was in the hosp for almost a week, half that time w/a feeding tube. I’m glad to say that was labor day week, and he is still w/me. He now weighs 8.2lbs and gets predislone twice a day. Wish he would wiegh a bit more, but i’m happy he has mantianed that. He has his next blood test on Fri, to check his Calcium. Should he have cancer the pedisolin may be buying me time w/Simba. Or he may have had several different things going on. If I had gone w/the surgery, and it was cancer, i was told that maybe would get another 8mo. Just didn’t know to go through all that and have still a short time w/him. Plus Simba I don’t think would handle chemo well. He isn’t to happy when we get their. He really hates the vet, but w/being sick he’s gotten a bit better. Sorry if to long, but wanted to share, went w/my gut and I still have him. don’t know what will happen if his meds are cut down, and if he has cancer, but at least these 4mo have been good, had he had chemo,don’t know if I could say that. I had a cat I did Chemo w/and he was a good boy ea time. but we last the fight. He had cancer due to a inj that he got ! VAS/ISS learn about it.
    Also my comment about the Vets and ER Vets not having all the answers. Simba was taken to the reg vet who had a stand in for him, and didn’t seem to find anything wrong w/simba, but gave fluides, few days later I took him to the ER, and yet again another numb nut! the next day took him to another ER, where he was found to have 105.8 temp. Can’t tell you how up set I was that I knew something was wrong, and he was getting wrose. Just goes to show, don’t give up, find someone else and study !!! There are a lot of great yahoo feline grps to help out.

    • I’m sorry to hear all that Simba is going through, Vickie. What you shared about your decision process about his treatment is a great example of how individual these decision are. When you were given Simba’s prognosis of 8 months, you felt that that was too short a time to consider putting him through surgery and chemo. Someone else might feel that that’s a long time, and go for the treatment. As I said in my article, there is no right or wrong decision, the only decision that is right is what’s right for your cat. I wish you and Simba all the best!

      • Thank you, beside what I want I have to think about how my cat will handle it as well. Like my other cat who had to cancer surgerys and chemo, loved the attn at the vet, Simba can’t stand the vet. poop guy has warning lable on his chart. but he isn’t as bad. So fingers crossed blood work this Fri is even better. I would say that he seems to be back to him old self. Vickie

  8. Thank you SO very much for this wonderful and so insightful post, Ingrid! This is such a delicate and important issue we (cat moms and dads) all have to face sooner or later. I really loved the beautiful way you wrote about such an important and difficult subject. You are so right, facing these difficult decisions means facing our own fears and being willing to listen to our beloved cat. And to our own heart. Thank you.

    • Thanks, Anna. Listening to, and with, our hearts can be so difficult in the middle of struggling with these decisions.

  9. Thank you for this too! It is comforting to me to read this as my cat Simba has a heart condition and is on medication for it; however he is still coughing and I am trying to decide what to do. Some friends of mine say and I find this too, is to let Simba decide and that he will somehow let me know what to do. It may not make much sense but this is what comes to me. I am also on a fixed income and that may also affect decisions. He sees a different vet in the same office today and I just might ask what would you do if this were your cat? Thanks again for this. I have never made a post before.

    • I’m sorry to hear about Simba, Jeanette. I always encourage people to listen to their animals – I think they do let us know what they want, as long as we are able to set aside our own fears and worries for them, and listen with our hearts.

  10. Outstanding post. For many people (me included), this is the hardest part of sharing your life with a furkid. I will keep and recommend it to others. You put it so well. Thank you.

  11. Excellent post. This one goes in the “Save” pile as well. It’s so difficult to make these decision when the emotions are running high. Thanks for your blog.

    pawhugs, Max

    • Thanks, Max! It’s almost impossible to take our emotions out of the equation when we’re faced with making these decisions.

  12. A grievous illness in an animal companion is also an opportunity for us to examine our feelings about death and dying. Many people are terrified of death, or they have issues around the death of another beloved person or animal that they need to resolve. Our animal companions are giving us a great blessing by allowing us an opportunity to work through that and come to a place of, if not peace, at least the beginning of resolving some of those crucial attitudes and feelings.

    I’ve experienced the death of five deeply beloved animal friends at this point in my life, and with each one I’ve come to understand the nature of grief and have gained insight into what happens to an animal’s soul and spirit as the time of transition approaches.

    I’m still working through some of the issues around my cat Sinéad’s death–which was particularly difficult because I never found her body and only have a dream message and the words of a fellow animal communicator to help me believe that she is, in fact, dead. The interesting thing is that Sinéad’s death is also helping me to understand and accept the fact that even though I don’t remember the full extent of traumas I experienced in my childhood, the way I’m experiencing my life is clear evidence that trauma did happen, and probably to a deeper extent than I remember.

    • Janea, thank you for this beautiful comment, and for sharing your insight.

      I think you’re absolutely right, the fear of death, dying, and losing our beloved animal companions play a large part in these decisions. If we’re willing to face these fears, we may be surprised at what we can learn from these amazing animals.

  13. That is such a great post Ingrid. One of your best. I especially liked the last paragraph. There isn’t anyone that knows what is happening with your pet better than you do. For myself, the cost would be a major factor and also the quality of life that the cat would have to go through treatment. Anyway, I like this post a lot. Thanks.

    • Thanks, Marg! I think quality of life is probably the most deciding factor for most people, but even that can mean different things for different cats. Only the cat’s person can ever really make that determination.

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