by Barbara George
Tellington Ttouch Behaviourist
This article is for information only; discuss the options with your vet before making any decision.
Probably the hardest decision to take in the life of your cat is when to let her go peacefully without undue suffering. There are times when there is no alternative, such as serious injury in an accident, or when her system shuts down.
Cats are experts at hiding illness and injury – this is a survival trait. This means that we don’t always know how they really feel and must rely on our interpretation of their behaviour to make a judgement. We don’t want our cats to suffer, at the same time we do want to spend as much quality time with them as possible.
There is also the debate about continuing to medicate a reluctant cat when there is little chance of improvement. Are a few days extra really worth the trauma of medicating a cat that runs away at the sight of you, or would you rather spend the last days in a gentle, safe and loving relationship? Some vets do see the compassionate side of this debate while others consider this ‘Medical Neglect’.
Cats do not consider blindness, deafness or loss of limbs as disabilities, and can lead happy and healthy lives with some modification to their environment. In the same way cats suffering with Feline Leukaemia and Feline Aids can have a good life quality for years.
Quality of life is measured in many ways and the answer and right time will depend on the cat, the situation, finances, and the owner.
There are a number of quality of life scales; here is a quick overview of a few. All scores are subjective so it is easy to fool ourselves that she has a reasonable quality so that we don’t have to make the decision today. Always consider the input of your vet. I find it interesting that none of these scales take into consideration the age, breed or size of the cats or the financial burden of medication and care.
Once an issue has been determined it would be useful to complete one of these scales on a regular basis. This will help to define the general health and improvement or deterioration experienced by her. It will also help your vet in applying the best medication and care as you can give an accurate assessment at every visit.
The ‘HHHHHMM’ scale created by Dr Alice Villalobos looks at seven criteria, each one having a rating of 10. A total of 70 is perfect while 35 indicates a reasonable quality overall, be aware of any low scores that may indicate areas of concern. The criteria covered are: Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility and More good days than bad days.
Transitions Vet has 10 criteria in their scale, being Appetite, Hydration, Weight Loss, Appearance, Toileting, Mobility, Activity, Comfort, Sleep, Quality of Life. There is a questionnaire form to complete and submit for a result which is returned on the site within minutes.
All Pets Veterinary Clinic consider the owner’s feelings in their ratings, Quality of Life. They rate cats negatively, as opposed to the others that use a positive rating. Their criteria include Pain, Appetite, Hydration, Hygiene, Activity, Happiness, General Behaviour and Owner Perceptions.
The Journeys Quality of Life scale looks at 8 criteria, including the owner. Their criteria are Jumping (Mobility), Ouch (pain), Uncertainty and Understanding, Respiration, Neatness (Hygiene), Eating and drinking, You and Social Ability. Each criterion is scored out of 10, with 80 being perfect. This scale includes a section for your understanding of the medical issues affecting her as well as your stress levels when dealing with her issues.
Ohio State University has a chart of 25 criteria and some thoughts and questions to consider.
Nature’s Corner Magazine has an interesting article on different types of assessment and the humane approach to euthanasia.
Another article on making the decision and the guilt gives some good advice to cat owners.