Making the decision to euthanize a beloved pet is the hardest thing an owner ever has to do. In my role as an in-home euthanasia provider, I see people struggling with this almost every day.
The most common question I hear from owners as they are reaching the end of their pet’s life is, "How will I know when it’s time?" My answer: "There is no 'right' time."
Quality of life is a roller coaster. You may make an appointment for euthanasia, only to have your cat rally and have a good morning. In response, you cancel the appointment and your cat’s condition declines overnight making you wish you hadn’t second guessed yourself.
Waiting until the suffering is nearly constant would make the decision to euthanize "easier," but this is certainly not best for the animal in question. All we can do is monitor quality of life, and when we see signs of significant decline with no reasonable expectation for meaningful improvement, euthanasia is warranted from that point on.
To help with this, I recommend that you write down a few concrete milestones. These are red flags. As quality of life deteriorates we get used to a new normal, and it can be hard to remember what a pet’s life used to be like. I tell people to monitor five categories: eating, drinking, peeing, pooping, and joy in life. Dr. Alice Villalobos has developed a more in depth quality of life scale that is worth taking a look at as well.
Without adequate nutrition, hydration, and elimination, suffering inevitably follows. Medications and/or medical procedures are available that can assist cats with their bodily functions and provide pain relief, but eventually they become inadequate to the job at hand.
Evaluating "joy in life" is more difficult. This is where the red flags are most useful. Has your cat always greeted you when you arrive home? If she no longer has the energy to walk to the front door, it is time to assess her situation. Has your cat always wanted to sit on your lap but is now seeking solitude behind the couch? While behavioral changes like these are more subtle than, for instance, an unwillingness to eat, they are just as important.
My clients frequently tell me how worried they are that they might step in too early. To this I reply, "Better a week too early than an hour too late." I have seen what the "hour too late" looks like and would do anything to spare pets and their owners this level of suffering. In my 12 years of veterinary practice, I have never had a single owner tell me that they wished they had waited longer to euthanize, but countless people have said that they wished they would have stepped in sooner.
If your pet is suffering and you cannot euthanize, you must provide hospice care. I often hear people claiming that they want their pet to die "naturally," but there is nothing natural about an animal enduring days, weeks, or even months of misery before death mercifully arrives. We bring this about by providing shelter from predators and the environment, and with nutritional support and medical care. We do this all out of love. But with the ability to prolong life comes the responsibility of saying "enough is enough" when we are no longer doing right by our beloved companions by keeping them alive.
Dr. Jennifer Coates