A Question of Quality

If you’ve been following my articles about Junebug the ailing cat – and why wouldn’t you? It’s riveting stuff – then you’ll know that she’s in her last days of life. The veterinarian has concluded that she has lymphoma, and at her age, in her condition, I’ve elected not to pursue treatment for it. There is simply no way that she would survive it. The vet also felt that Junebug had only a short while left to live – days, probably; weeks, not so much. So how does one spend those final days with a beloved pet? And how do you know when it’s time to euthanize?

My usual criteria is suffering. Is the animal suffering? Is it in pain? Is there any semblance of quality of life? In Junebug’s case, the answers appear to be no, no, and not really. Mind you, she is eating, and, when I pick her up and carry her, she’s weeing in the litter box, as well. She drinks a lot of water whenever I put the bowl in front of her. And that’s about all there is to her life. Mainly, she sleeps. I’ve taken to leaving a window open in the bedroom, so that she might enjoy the breeze, maybe listen to some birds chirping, but I can’t say whether she’s done either.

If you’ve read my third book, Sorry Honey, But The Critters Come First (available on Amazon), then you’ll know about the terminally ill cat I cared for, twenty years ago. It was my first experience caring for an animal that was dying, and towards the end, I struggled daily with whether it was time to euthanize or not. I needed to be sure, you see, and I didn’t want to rush things. If that cat thought he could go on for another day, then I was willing to do the same.

I did ask the veterinary staff, more than once, to tell me how I would know that the cat was ready to die. They kept saying, “You’ll know,” as if at some point, the answer would magically appear out of thin air. But “You’ll know” didn’t seem like enough information to go on. Finally, when I pressed hard enough, they said that the cat would go off his food. This he eventually did, and I had him euthanized later that same day. But Junebug hasn’t gone off her food.

Our days follow the same routine: first thing when I get up, I carry her to the litter box. She has a wee, and then I carry her back to bed. She’s very weak, so I don’t know that she would make the entire trip on her own. Indeed, one day last week, I found that she’d wee-ed on the bed. That was the day I started carrying her to and from the box.

Next, I give her a steroid pill. It’s the only thing keeping her going, in my opinion, because steroids will encourage an appetite. A few hours after the steroid, her interest in food perks up and I feed her. After she eats (and it’s very little, but she’ll eat extra helpings if I offer them), I bring a bowl of water and hold it in front of her. She always drinks a lot. Then I leave her to sleep.

I’ll come back many times, during the day, and offer her food and water again. She almost always accepts, which makes it hard to know whether she’s ready to die or not. That is to say, going off her food might not be Junebug’s criteria for dying. Heaven knows her lifelong hobby was eating kibble. Maybe she’s still eating because she still wants to, no matter how diminished you or I think her life has become.

Some time in mid to late afternoon, I’ll take her to the box again. She’s smart enough to know that this is her designated weeing time, and she takes care of business quickly. Once back in bed, she opts to sleep some more. Throughout the evening, I’ll continue to offer more food and water, and take her to the box one last time before I climb into bed next to her. Before you start thinking that her situation is dire, let me add that she does climb out of bed of her own volition to eat, drink, and eliminate. I choose to help her simply because the help helps.

For Junebug’s entire life, she’s chosen to sleep next to my pillow. She’s done it of her own accord, since she was a kitten. While she’s too weak and tired to be as affectionate these days as she used to be, she’ll still end up beside my pillow every night, where I’ll spend any amount of time whispering how much I love her, and singing her The Junebug Song, which goes like this:

There’s a tiny Junebug, short and stout.

She’s got a tail and a pretty little snout.

When the sun is shining, all come out

just to see the kitty with the pretty little snout.

I’ve been singing it for years. I’ll sing it during the euthanasia process, as well, and then the song will be retired, never to be sung again.

In terms of the affection I just mentioned before, I can report that, over the last few months of her illness, Junebug has come up with several interesting displays of that affection, things she’s never done before in all her 13 years, and, it seems, some of which were one-offs, never to be repeated. The most expressive was the week or so that she spent climbing onto my chest in the middle of the night. She would curl up there and purr for a time, and I, of course, accommodated every single one of those snuggles. Then she stopped doing it and hasn’t done it since.

One night, I felt a small nip on my neck. I knew it was her, and I knew that the nip meant she wanted something, but I played opossum, waiting to see if she would nibble me again. Indeed she did. A minute or two after the first, she gave me a small nip to my chin. A minute or two later, she nipped my lip. I thoroughly enjoyed all three nips, but stopped keeping her waiting after the third one. Turns out she was hungry and wanted some kibble. She hasn’t nipped me again since.

A couple of nights ago, as I lay on my side half-asleep, she put her two front paws on my ribs and stood there for a moment – long enough to tell me, again, that she wanted some kibble. I imagine it would be hard for anyone – not just me – to give up such antics voluntarily, but it I worry that I might have to.

I’ve told Junebug, explicitly, several times, that it’s o.k. to go if she needs to, that she shouldn’t keep living just for me. I don’t know if that’s what she’s doing, but I wanted her to have my blessing to stop, to let go, to be done, if that’s what she wanted to do. So far, she hasn’t been so inclined, which makes it that much harder to decide whether to interfere, whether to make the decision for her.

I know what you’re thinking. You’re thinking that I’m holding off doing the right thing because I can’t bear to part with her. But it’s not quite that cut and dried. I’m a big believer in letting the animal decide whether it’s time (assuming that they are conscious and able to make the decision), but I also know that there are times when the human must do it for the pet. In this instance, the Junebug I knew isn’t really there anymore, which makes the decision somewhat easier.

The Junebug I knew was an opinionated kitty, very definite in her belief that I should always drop what I’m doing in favor of giving her more kibble, or more attention. And she thrived on that attention: for years, most nights she would join me in the loo as I performed my nightly brush-and-wash ritual. She would lie on the floor and meow from time to time if I was taking too long to notice her. Then she’d purr happily when I got down on the floor with her and gave her lots of pets.

Later, she’d join me in bed, next to my pillow. It was the same routine for over a decade. But not anymore. That assertive part of her personality has left her, and her meows sound much different. For a start, they sound as frail as she looks. For another, she’s too weak to want to walk to the loo anymore. Not being the same Junebug does make having to decide whether to euthanize easier, but even so, it’s still my beloved Junebug we’re talking about. And I can’t discount the very real possibility that she simply doesn’t want to go yet.

So we’re taking things day by day, hour by hour. I watch her closely all day long, waiting to see whether she’s giving me a sign that she wants to be done, and I keep not seeing one. She continues to eat, drink, wee and poo, seek out attention, and cuddle next to me. And she seems content with those things. It occurs to me that it’s entirely possible that my idea of quality of life, and her idea of quality of life, are very different, in which case, I must defer to her. 

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