euthanasia

Euthanasia: Knowing When to Say Goodbye

euthanasia-when-to-say-goodbye

Making a decision about whether or when the time is right for euthanasia is one of the hardest things a cat guardian will ever go through. Unlike human medicine, veterinary medicine is fortunate to be able to legally offer the option of gently ending suffering when there seems to be no hope for recovery. However, making this decision for a beloved cat can be agonizing.

A number of guidelines can help with the decision process.

Quality of life

There are several markers that can be used to determine whether your cat still has good quality of life. Pain is usually the first one cat guardians consider. No cat guardian wants to see a beloved cat suffer. Cats are masters at masking pain, so this can be difficult to detect. Adequate pain control is one of the most important concerns in a terminally ill cat. Another marker is appetite. Is the cat still eating enough? Can she eat on her own, or does she need assistance, such as a feeding tube? Another important marker is dignity. Is the pet still able to relieve herself on her own, or does she need assistance with urination and defecation?

A terminally ill cat will have good days and bad days. Do the good days still outweigh the bad? Does the cat still express joy and interest in her surroundings? Does she respond to family members?

Work closely with your cat’s veterinarian

Your cat’s veterinarian will be one of your most valuable resources when it comes to making this difficult decision. He or she can advise you on what your medical options are for your terminally ill cat, and how to provide hospice and palliative care. Few veterinarians will come right out and tell you when it’s time to euthanize, but they will be able to help you assess quality of life and guide you through the decision process.

Emotional aspects of the euthanasia decision

Fear of losing a beloved cat, and not being able to imagine life without her, can influence the decision. A cat guardian’s prior experience with illness and death, be it of a pet or a human, will be a factor. Difficult as it may be, the euthanasia decision should not be based on our own discomfort with the dying process. Religious beliefs may also impact the decision.

Denial can play a significant role in the decision process. Denial is a defense mechanism that initially saves the person from anxiety or pain, but it can become paralyzing. When it comes to dealing with a terminally ill pet, love and denial can be intricately linked, and it can sometimes be difficult to separate one from the other.

“You will just know”

Cat guardians are often told that “they will just know” when the time is right. When cat guardian and human are closely bonded, this may be true. However, it requires setting aside fear and worry and really tune in to the cat’s essence, and this can be very difficult when faced with imminent loss.

Making the euthanasia decision is a very personal and individual process, and the sad reality is that there is probably no way for cat guardians to ever be completely at peace with it.

This article was previously published on Answers.com and is republished with permission.

Hospice Care: An Alternative to Premature Euthanasia

hospice-care-cat

With cat guardians understanding the importance of regular preventive care, and with veterinary medicine becoming more and more advanced, cats live longer lives than ever before. However, despite all the advanced treatment options, some illnesses are considered terminal. In the past, euthanasia was often the only option pet owners would consider at that stage. An alternative to premature euthanasia that is garnering more attention in the world of pet care is hospice care.

What is hospice care?

The definition of a terminal illness is an illness for which there is no cure. It is an active, progressive, irreversible illness with a fatal prognosis. Hospice care provides an alternative to prolonged suffering and is designed to give supportive care to cats in the final phase of a terminal illness. The goal is to keep the cat comfortable and free of pain, with a focus on quality of life.

Hospice care is not about giving up, or even about dying. It may actually involve providing more care for a terminally ill cat than pursuing aggressive medical treatment, not less. The decision to provide hospice care should be made in conjunction with your veterinarian, who will become an integral partner in the process.

What does hospice care involve?

Hospice care focuses on keeping the patient comfortable. This may mean providing additional soft bedding with easy access to food, litter boxes, and favorite sleeping spots. Depending on the cat’s condition, gentle handling may be required because many terminal medical conditions create discomfort and pain.

Pain management, also known as palliative care, is one of the cornerstones of hospice care. Cats are masters at hiding pain, so it is up to the cat’s guardian to watch for even subtle signs of pain, such as hiding or avoiding contact with family members or changes in sleeping position. Work with your cat’s veterinarian to develop an appropriate pain control program for your cat.

Provide easy access to food and water at all times. You may need to experiment with special foods to get an ill cat to eat.

Sick cats may not be able to groom themselves normally. You may have to assist your cat with grooming by gently brushing, and keeping eyes, ears, the area around the mouth and around the rectum and genitalia clean.

There are many non-invasive, gentle holistic therapies that can provide relief to terminally ill cats. Energy therapies such as Reiki, Healing Touch, Tellington Touch and others are particularly effective.

A time of peace

Hospice care can present logistic and emotional challenges for cats and their guardians, but this can also be a time of peace and increased bonding with your beloved feline companion. Additionally, hospice care allows cat guardians to gently prepare themselves for the impending loss.
Diagnosis of a terminal illness does not have to be the end. Hospice care can provide a compassionate and loving final phase of life for both cat and human.

This article was previously published on Answers.com and is republished with permission.

Euthanasia: To Be With Your Cat, or Not?

Buckley in front of the maple tree

Making a decision about whether or when the time is right for euthanasia is one of the hardest things cat guardians will ever go through. I’ve previously written about what can help a cat guardian make this difficult decision. But once you have made the decision, there are still more things to consider.

One is location. I am a firm advocate of in home euthanasia. I’m always surprised when I hear from my readers that, until they read Buckley’s Story, they had no idea that having a pet euthanized at home was even an option. There are few veterinarians who offer home euthanasia. Those that do generally don’t advertise the fact, but some will come to your home when asked. Housecall veterinarians can be a good option for in home euthanasias. The In Home Pet Euthanasia Directory can help you locate a veterinarian who performs in home euthanasia in your area.

Another decision you will need to make is whether you want to be with your cat during the euthanasia, Continue Reading

A Team Approach to Caring for Cats with Cancer

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While cancer in cats is not as common as it in dogs, it is still one of the leading causes of death in older cats. According to the Animal Cancer Foundation, 6 million cats will be diagnosed with cancer in the United States along. And because cats are masters at masking illness, it is often harder to detect.

Cancer used to be a death sentence for cats, but recent advances in feline cancer research have made treatment possible in many cases. Just like with human cancers, early detection is key to successful treatment. Depending on the type of cancer, treatment options may include sugery, radiation, and chemotherapy.

Whether you choose aggressive treatment for your cat’s cancer, or whether you elect to provide palliative care, which focuses on providing quality of life for the ill cat as well as the cat’s caregiver, caring for the feline cancer patient is a team effort that involves the cat’s guardian, her veterinarian and staff, and, if needed, a social worker or bereavement counselor.

I recently had a chance to speak with Conor J. McNeill, DVM, Dipl. ACVIM (Oncology), an oncolgist at the Hope Center for Advanced Veterinary MedicineContinue Reading

Coping With the Pain of Pet Loss

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Even if our cats live into their late teens and sometimes early twenties, it’s just not long enough. The price we pay for sharing our lives with these wonderful companions is that all of us who considers our cats family members or best friends will sooner or later experience the pain of loss, and it can be as devastating as the loss of any loved one. Joelle Nielsen, a veterinary social worker at the Ohio State University College of Veterinary Medicine, says she often compares the loss of a pet to the loss of a child or a close family member. Nielsen says the big difference between losing a pet, compared to losing a human, is that “much of society is not aware of the strength of the human-animal bond, so pet loss is often seen as ‘disenfranchised loss,’ meaning it is not socially recognized.”

Another significant difference is the matter of euthanasia. Deciding to end a pet’s pain and suffering is one of the most difficult choices pet owners ever have to make, and it can engender massive feelings of guilt and regret after the fact.

While there are some commonalities, grieving the loss of a pet is a unique experience for each individual.  Factors that play into how the loss is handled Continue Reading

Euthanasia: The Loneliest Decision

Making a decision about whether or when the time is right for euthanasia is one of the hardest things someone loving a pet will ever go through. Unlike human medicine, veterinary medicine is fortunate to be able to legally offer the option of gently ending suffering when there seems to be no hope for recovery. Making this decision for a beloved pet can be agonizing to the point of being nearly impossible for some pet guardians.

And even though there are some guidelines that can help with the decision process, ultimately, nobody else can make this decision for you. It’s between you, and your pet.

My personal experience with having to make the euthanasia decision

I’ve had to make this decision three times. In April of 2000, Feebee lost his battle with lymphoma. After tolerating chemotherapy well for almost seven months, he declined rapidly, and instead of choosing more aggressive chemotherapy and blood transfusions, which might have given him some more time, I choose to let him go. And Feebee, in one final act of unconditional love, took the decision out of my hands: he died in my arms while my vet was on her way to my house.

Those of you who read Buckley’s Story already know how difficult my decision was to let Buckley go in November of 2008, when her severe heart disease was compounded by multiple other problems. I probably held on a little too long with her, but I’m now at peace with my decision. She, too, died in my arms, with my vet’s gentle assistance.

My most difficult decision was the one I had to make last May, when Amber came down with a sudden, severe illness. She was in intensive care for four days, and her prognosis was so poor that I decided against pursuing more aggressive treatment and took her home. I spent the afternoon with her before my vet came to the house. Amber laid on my chest, and looked right into my eyes as she took her final, peaceful breath with my vet’s help. I’m still not entirely at peace with this decision, a part of me will always wonder whether I gave up too soon.

How do you decide when it’s time?

There are some markers that can be used as guides. Pain is one of them. No pet parent wants to see a beloved pet suffer. Animals, especially cats, are masters at masking pain, so this can be difficult to detect. Another marker is appetite. For most pet guardians, the first indication that something is wrong is usually when a pet stops eating. A third important marker is dignity. Is the pet still able to relieve herself on her own, or does she need assistance with urination and defecation?

Dr. Alice Villalobos, founder of Pawspice, a hospice program for pets, has developed a Feline Quality of Life Scale that can help care givers determine quality of life based on criteria such as pain, appetite, hygiene, and whether the number of good days outweighs the bad.

Each relationship is unique

But decision points aren’t the only part of the equation. Each pet and each relationship between human and animal is unique.  There is no one right answer. And that’s why making this decision can make you feel like you’re all alone with this awful responsibility.

The emotional aspects of making the euthanasia decision can be incredibly complex. In addition to the love for the pet, and the fear of losing him and not being able to imagine life without him, a care giver’s prior experience with illness and death, be it of a pet or a human, will influence the decision. Religious beliefs may also impact the decision.

Denial can play a significant role in the process. When faced with difficult situations, denial is a natural defense mechanism that initially saves the person from anxiety or pain. However, getting stuck in denial can become paralyzing. When it comes to dealing with a terminally ill pet, love and denial can be intricately linked, and it can sometimes be difficult to separate one from the other.

A lonely decision

Making the euthanasia decision is a lonely decision. While others may provide support and advice, ultimately, nobody other than the pet’s caregiver can make this decision. And that’s where things get challenging. I’m currently dealing with a situation where a client’s cat has been ill for a long time, but the client is not ready to make a decision. She’s gone far past the stage where I would have made the decision, if the cat was mine. But at the same time, I can’t fault this client for not being able to make a decision: her cat, while medically in very bad shape, still responds to her, still purrs for her, and still eats well.

Sometimes, it can be hard for a caregiver to really see how far an animal may have declined. Watching a pet deteriorate a little more every day is hard, but seeing the decline happen a little bit at a time can feed the natural amount of denial most people have that the pet just isn’t that sick. Sometimes, it takes a visit from someone who hasn’t seen the pet in a while to make the pet’s guardian realize just how much the pet has declined.

One aspect to making the decision that is not often talked about was recently addressed in a beautiful post by Robin Olson of Covered in Cat Hair. Robin’s 14-year-old cat Bob has lymphoma, and has recently stopped responding to chemotherapy. He’s also dealing with multiple other problems. Robin writes:  “Try to watch out for the urge to just get it over with because YOU are suffering watching this natural process occur. This is very very difficult, but we owe it to our animals to give them every option and every day we can.” I couldn’t agree more. We don’t want our animals to suffer, that’s a given. But the euthanasia decision should never be based on our own discomfort with the dying process. I encourage you to read Robin’s entire post about Bob’s battle with cancer, and her struggle to do the right thing for him.

Will you “just know?”

It is often said that we will “just know” when the time is right. And I believe that when we do connect with the essence of our animals and manage to set aside worry and fear for even just a few moments at a time, we will know.  It takes courage to set aside our fears, and to tune in to the animal and really “hear”  them.

Ultimately, the only way any of us can make this decision is by listening to our animal friends with our hearts, not with our heads. It becomes a decision of love, not something to be reasoned out on an analytical and intellectual level.

The sad reality of making the euthanasia decision is that there is probably no way to ever be completely at peace with it. And that, too, makes it the loneliest decision.

Have you had to make the euthanasia decision for a beloved cat? What helped you during the decision process?

 

Quality of Life: What Does It Mean for You and Your Cat?

Buckley's Story

Last updated June 2019

Making a decision about whether or when the time is right for euthanasia is one of the hardest things someone loving a pet will ever go through. Unlike human medicine, veterinary medicine is fortunate to be able to legally offer the option of gently ending suffering when there seems to be no hope for recovery. It is a difficult decision to make at best, and it can be nearly impossible for some pet owners. There are so many factors that play into it.

What is quality of life?

The term that is used the most in this context is “quality of life.” But what does that really mean? Are there hard and fast rules as to what constitutes good quality of life? Of course not. Quality of life means something different for every person, and for every animal.

There are some fairly obvious markers. Pain is one of them. No pet owner wants to see a beloved pet suffer. Animals, especially cats, are masters at masking pain, so this can be difficult to detect. Another marker is appetite. For most pet owners, the first indication that something is wrong is usually when a pet stops eating. A third important marker is dignity: Is the pet still able to relieve herself on her own, or does she need assistance with urination and defecation?

But even these three markers are not always helpful when trying to make a decision. Pain can be managed with medication. Some pets stop eating or eat very little but are still happy and are enjoying life. And who is to say that the dog that needs assistance with being carried outside to urinate or the cat who needs help to get into the litter box and needs to be cleaned off afterwards does not appreciate this level of care from his loving human and is otherwise happy and content?

A final gift of love

It is often said that making the decision to euthanize a pet is the final gift of love we can give our animals. I wholeheartedly believe that, but it still does not make the decision process any easier. Love and denial can be intricately linked, and it can sometimes be difficult to separate one from the other.

I’ve had to make this decision with three of my cats: with Feebee in April of 2000, when he was losing his seven-month battle with lymphoma, with Buckley in November of 2008, when her heart disease was complicated by multiple other issues, and much too soon again with Amber in May of 2010 , after she came down to a sudden, unexpected illness, which was, most likely, virulent systemic calici virus.

All three of the decisions were agonizing for me, but I also know that each time, I made the right decision – for my cat, and for me. That’s not to say that it would have been the right decision for someone else, or for someone else’s cat.

Ultimately, the only way any of us can make this decision is by listening to our animal friends with our hearts, not with our heads.

Ultimately, the only way any of us can make this decision is by listening to our animal friends with our hearts, not with our heads. It becomes a decision of love, not something to be reasoned out on an analytical and intellectual level.

No easy answer

I think it’s impossible to ever be completely comfortable with the decision to end the life of someone we love so much. We do not want our pets to suffer, and when we are really in tune with our animals, we know when they are ready to make their transition. Any remaining doubt is usually caused by our sadness and grief at the thought of having to go on without their physical presence in our lives. I also believe that sometimes, our animals also love us so much that they often stick around longer than they might want to because they know how much we will miss them when they’re gone.

There is no easy answer for the question of what quality of life means. It’s going to mean something different for each person, and for each cat. And as your cat’s guardian, you’re the only one who can answer it.

Have you had to make this decision for your cat? What does quality of life mean for you and your cat?

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Portions of this post are adapted from Buckley’s Story: Lessons from a Feline Master Teacher.

Related reading:

How to cope with losing a pet

The final farewell: options after your pet dies

Euthanasia: How to Know When It’s Time

Making a decision about whether or when the time is right for euthanasia is one of the hardest things someone loving a pet will ever go through. Unlike human medicine, veterinary medicine is fortunate to be able to legally offer the option of gently ending suffering when there seems to be no hope for recovery. It is a difficult decision to make at best, and it can be nearly impossible for some pet owners. There are so many factors that play into it. The term that is used the most in this context is “quality of life.” But what does that really mean? Are there hard and fast rules as to what constitutes good quality of life? Of course not. Quality of life means something different for every person, and for every animal.

There are some fairly obvious markers. Pain is one of them. No pet owner wants to see a beloved pet suffer. Animals, especially cats, are masters at masking pain, so this can be difficult to detect. Another marker is appetite. For most pet owners, the first indication that something is wrong is usually when a pet stops eating. A third important marker is dignity. Is the pet still able to relieve herself on her own, or does she need assistance with urination and defecation?

But even these three markers are not always helpful when trying to make a decision. Pain can be managed with medication. Some pets stop eating or eat very little but are still happy and are enjoying life. And who is to say that the dog that needs assistance with being carried outside to urinate or the cat who needs help to get into the litter box and needs to be cleaned off afterwards does not appreciate this level of care from his loving human and is otherwise happy and content?  Each pet is different, and each relationship between human and animal is unique.  There is no one right answer.

It is often said that making the decision to euthanize a pet is the final gift of love we can give our animals. I wholeheartedly believe that, but it still does not make the decision process any easier. Love and denial can be intricately linked, and it can sometimes be difficult to separate one from the other.

It is often said that we will just “know” when the time is right.  And I believe that when we do connect with the essence of our animals and manage to set aside worry and fear for even just a few moments at a time, we will know.  It takes courage to set aside our fears, and to tune in to the animal and really “hear”  them.  Ultimately, the only way any of us can make this decision is by listening to our animal friends with our hearts, not with our heads. It becomes a decision of love, not something to be reasoned out on an analytical and intellectual level.

The Final Farewell – Options After Your Pet Dies

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One of the reasons why I wrote Buckley’s Story was because I wanted to help others  who are faced with losing a beloved animal companion.   After losing  Amber, and being faced with the devastating grief losing an animal companion brings yet again, it’s become even more important to me to share information that may help other grieving pet parents.

An article by John Grogan, the author of Marley and Me, titled Bringing Marley Home, really brought home to me how far reaching the decision of what to do with your pet’s remains can be.  If you’ve read the book or watched the movie, you may recall that Marley was buried in the Grogan family’s backyard.  Well, the Grogans moved to a new home recently, and the fact that Marley was buried at the old house nagged at them.  One moning, Grogan’s wife finally said what they’d all been thinking – Marley’s body needed to come to the new house with them.  At first, Grogan resisted.  The thought of exhuming Marley’s body sounded to him like something “those nutty dog people” would do.   But they decided to bring Marley “home.”  You can read the full article here.  The article convinced me that there’s a need to talk about this topic here in the Pet Loss Category.

A very personal decision

There are so many components to coping with losing a pet.  One that isn’t often talked about until a pet parent is faced with the decision is what to do with the pet’s body after death.  Most pet parents don’t want to think about this issue, but the time when it becomes an issue and when you’re in the throes of shock and grief is not the best time to think about it calmly and rationally.  It can often lead to a hasty decision that may result in regret later on.  It’s best to think about this difficult issue ahead of time.  Some people may think that’s morbid, but it really is part of being a responsible pet parent.  The decision what to do with a pet’s body is an individual one, and is guided by each person’s feelings about loss, death, and remembrance.  The ultimate goal of this decision is to find a way to preserve your pet’s memory in a way that feels right.

Burial

Home burial is an option chosen by many people as a way of keeping the pet’s body close.   People often choose a pet’s favorite location in the yard, and place a permanent marker as a memorial.  This could be a stone, a statue, or even a tree planted in the pet’s memory.  However, this may not be an option in some municipalities, so be sure to check your local ordinances.  You will also need to make sure that you dig a deep enough grave to ensure that the remains will not be disturbed.

As evidenced by Marley’s story above, this is probably only a good option if you know you’re not going to move, or if you’re sure that when you do move, you’ll either be able to leave your pet’s body behind, or go through what the Grogan family went through and exhume and move the body.

Another  burial option may be burial at a pet cemetery.  Most states have these, and some states have multiple locations.  The advantage of burial at a pet cemetary is that you won’t have to worry about your pet’s body being disturbed, or about what happens when you move.  Check your local listings for locations.

Cremation

Cremation is the most commonly chosen option for a pet’s body.  Some veterinarians offer this service, but most will contract it out to a crematorium that specializes in pets.  Usually, there are two options.  In a   group cremation, the pet’s ashes are cremated along with other pets, and the ashes are not returned to the owner.  In an individual cremation, the pet’s body is cremated by itself and ashes are returned to the owner.  Check with your veterinarian and/or local crematorium, there are sometimes various options even for individual cremations.  As those of you who read Buckley’s Story know, I was able to choose a witnessed cremation for Buckley, which meant I was able to be present for the actual cremation.  I needed that peace of mind to know that it was really her ashes that were being returned to me.  I choose the same option for Amber as well.

If you choose to have your pet’s ashes returned, what you do with them becomes  once again a very individual decision.  You may want to keep them in an urn in a special place in your home.  For some people, this is a way to bring the pet home one last time.   There are beautiful urns available, or you may already have a special container that is meaningful to you for this purpose.  Others may choose to scatter the ashes in a place where the pet loved to spend time, such as the backyard or a favorite park.  I keep my departed cats’ ashes on the dresser in my bedroom, and it brings me great comfort to see them there every day.  I also have a clause in my will that when my time comes, my ashes and those of any pets that have gone before me will be mingled together.

Memorial Service

Regardless of whether you choose burial or cremation, I think it’s important to have some sort of ritual or memorial service to mark a pet’s passing.  This can be something as simple as lighting a candle in the pet’s memory, or as elaborate as holding a full-fledged memorial service for family and friends.  Either way, a conscious marking of the occasion will go a long way towards helping you cope with the grieving process.

It is not easy to talk, or even think about, a pet’s death, but these are necessary decisions that are better made while you’re not in the throes of the initial devastating grief after losing a pet.

Amber’s Last Two Weeks

This past week of tributes to Amber, and all the love, support, kind words and cyber hugs you’ve offered through your comments and notes, have provided great comfort for me during this difficult time.  Thank you, all of you, from the bottom of my heart.

Throughout this past week, I’ve been getting a lot of questions about exactly what happened to Amber.  Even though it’s difficult to write about it, I’m hoping that by sharing the sequence of events of her disease process, I may help other cats who may present with the same, or similar symptoms.  I am not a vet, and I’m writing this from my vantage point of being Amber’s mom – a mom who is still grieving.  Dr. Fern Crist has promised me an article on the calici virus which we think caused Amber’s illness.  It will run here on The Conscious Cat in the next few days, again, in hopes that it may raise awareness about this virus.

I’ve also gotten a lot of questions about whether I need to worry about Allegra getting sick, too.  While there are, of course, no guarantees, the answer is almost definitely no.  The most likely scenario is that Allegra might actually have been the carrier of the virus – chances are that she had a mild form of the disease when she was younger (her medical history is a bit sketchy, and she was also over-vaccinated, so who knows), got over it, and is now immune, but was or is still shedding the virus.

On Sunday, May 2, Amber was stilll fine.  She was starting to get to know her new little sister, who, at that point, had been with us for almost a month.  She had a full breakfast, and spent the day doing all her normal, happy Amber things – napping in the sunny spots, looking out the window, cuddling with me while I was reading.  When I offered her dinner that evening, she didn’t seem very hungry, but ate about half of her meal.  Later that evening, I noticed her making some gagging noises – as if something was stuck in her throat perhaps.  She was breathing fine, and she even purred for me, so I thought maybe some hair had gotten lodged in her trachea, and that she was eventually going to be able to clear it herself.  We went to bed that night, with Amber curled up in my arms, as she had been almost every night since she came to live with me on July 29, 2000.

Unfortunately, the gagging didn’t stop overnight.  She ate a few bites of her breakfast Monday morning, and then went to one of her favorite napping spots for her morning nap.  I called Fern to run these odd symptoms by her, and we both agreed that I would just continue to keep an eye on Amber.  If things got worse, Fern would come and take a look at her.  Things didn’t change much throughout the day, but the gagging got progressively worse throughout the night (why is it that anytime a pet gets sick, things always get worse overnight?).  I didn’t want to take her to the emergency vet.  I knew that her situation wasn’t life threatening, but I also knew that she was very uncomfortable.  To compound things, she also vomited a couple of times overnight.  By Tuesday morning, it became clear that she needed to be seen by a vet.  After examining her, running bloodwork and taking a series of x-rays, we still weren’t any closer to diagnosis.  Fern was hearing high-pitched sounds in the back of her throat, like her airway was constricted or partially blocked.  She also thought she saw some redness and swelling at the back of her throat, but without getting a closer look, there was no telling what was going on.  And in order to take a closer look, Amber needed to be sedated.  There’s always a risk with sedation, but the bigger risk seemed to be to not know what was going on, so I agreed.  The good news was that the exam revealed no tumors or foreign bodies, but her larynx was severely swollen, making it tough for her to breathe.  The treatment would require steroids and supportive fluids.  Normally, I’m not a fan of using steroids because of their longterm side effects, but in this case, something was needed to knock the inflammation down and make Amber more comfortable quickly, so again, I agreed.  Thankfully, I’m able to give injections and fluids myself, so she could come home with me.

She seemed to be feeling better on Wednesday, and I started breathing a bit easier.  Meanwhile, Fern had done some research on this odd presentation of symptoms, and thought this might be a variant of a particularly nasty strain of calici virus making its way through the cat community.  This calici virus was appearing in other cats that had similar symptoms:  laryngitis, followed by inflammation and swelling in other parts of the body, including pancreatitis.  The way to treat a virus like this is with supportive care.  We thought we were on the right track, and the virus just needed to run its course and work its way out of Amber’s system.

By Friday, she wasn’t any better.  Fern stopped by my house to take another look at her, and still didn’t see anything that would lead her to think that it was anything other than a virus.  We decided to see how Amber would do through the weekend with continued supportive care.

She had a quiet weekend, but she was clearly uncomfortable.  Every afternoon, she’d rally and have a brief period of renewed energy, which gave me hope that things were starting to turn around.  She’d walk around a bit, jump up on the back of the loveseat and look out the window, and then go back to resting comfortably on her favorite sunny spot on the sofa.

However, by Monday morning, it was clear that not only was she not getting better, she was getting worse.  That’s when we took her to the internal medicine department at the Hope Center for Advanced Veterinary Medicine.  Ultrasound and other examinations revealed that she had fluid in her chest and abdomen.  An echocardiogram showed that she was in congestive heart failure – an underlying heart condition we were not aware of complicated matters, and the steroids and fluids she had been given had pushed her heart too far.  She spent the next three and a half days in intensive care.  She was given intravenous fluids, concentrated nutrition through a nasogastric feeding tube, and antibiotics for a complicating bacterial infection.  Thankfully, I was able to visit her twice a day.  It was hard to see her so sick, but she responded to me each and every time I came to visit, and she even purred for me at times.   I tried to cling to the hope that she was going to get better.

Ultimately, the challenge of needing to treat her with aggressive fluid therapy without pushing her heart too far proved to be too much.  On Thursday morning, after she seemingly had a good night, she took a turn for the worse, and while there was more that could have been done, her prognosis was so poor that I decided to stop treatment and take her home.   Her wonderful doctor at the Hope Center agreed that this was the right decision.

Amber and I spent the next few hours together, just soaking up every last little bit of togetherness that we could.  For most of that time, she was curled up in my arms, in our favorite spot.  Fern would come later in the afternoon to help her make the final transition.

I was still having a hard time with my decision.  I knew the decision to stop treatment was the right one, given the circumstances.  I wasn’t so sure about my decision to euthanize that afternoon.  Perhaps there was still a chance she would get better on her own?  Miracles have been known to happen.  Maybe I could have one more night with her?  Fern told me that if I waited too long, fluid would continue to accummulate in her chest, and she’d die miserably, would, in effect, be drowning in her own fluids.  Of course I could not let that happen.  But Amber seemed so happy to be home, and she seemed comfortable.  She just didn’t seem that sick!  She walked around the house, as if reclaiming her space again, then settled on her favorite spot on the loveseat.  She seemed content.  She even purred for me!  When I went into the kitchen a little while after she came  home to open a can of food for Allegra, Amber jumped off the loveseat and walked into the kitchen, tail held high in the air.  I coudn’t believe my eyes.  I offered her some food, and she even sniffed at it, but then turned away from the dish.  Still, the fact that she was interested enough to come into the kitchen….  it seemed like a glimmer of hope.  A little bit later, a friend came over to say good bye.  She brought flowers for me.  I laid the flowers on the coffee table while my friend talked to Amber.  Amber jumped off the loveseat, then up on the coffee table, to inspect the flowers.  My friend and I were speechless.  How could she show this burst of energy when she was supposedly so sick?  Seeing her so interested in what was going on around her made it really difficult to believe that her body was being ravaged from the inside and that I needed to let her go.

However, as the afternoon progressed, her breathing became a little more labored.  She was still comfortable, though.  She climbed into my lap, and curled up for another nap.  She purred some more.  And yet, her breathing continued to worsen.  At around three o’ clock, I called Fern and asked her to come in a couple of hours.  Only two more hours left together.  My heart was breaking, and yet, at that point, I knew I had no choice.

I will always treasure those last two hours.  Gradually, I began to feel more at peace.  I got a sense from Amber that she, too, was at peace.  When Fern arrived, Amber was lying on my chest, sleeping lightly, and occasionally lifting her head to look into my eyes.  Since she still had her catheter from the hospital, we didn’t even need to disturb her.  Fern gave her the final injection, and Amber passed peacefully, looking into my eyes until the last moment.