End-of-life care for cats encompasses managing chronic disease progression, quality of life assessment, and making compassionate euthanasia decisions. A welfare-centred approach prioritises the cat's experience throughout this process.
Regular quality of life (QoL) assessment using validated tools (HHHHHMM scale adapted for cats; Feline Quality of Life Scale) enables systematic tracking of good versus difficult days. Key domains include: pain and discomfort management; appetite and interest in food; hydration status; hygiene and grooming ability; happiness and engagement; mobility; and the ratio of good to bad days. Declining QoL scores over time indicate progression toward the point where euthanasia becomes the most compassionate choice.
Palliative care prioritises comfort and quality of life over curative interventions. Effective pain management—multimodal analgesia appropriate to the conditions present—is the cornerstone of palliative care. Anti-nausea medications reduce chronic nausea from renal or hepatic disease. Appetite stimulants maintain food intake and associated pleasure. Environmental adaptations—accessible litter trays, warm bedding, reduced activity requirements—accommodate reduced mobility. Regular veterinary monitoring adjusts palliative care as disease progresses.
Signs suggesting QoL decline requiring serious assessment: prolonged periods of hiding or withdrawal; loss of interest in previously enjoyed activities; consistent refusal of food; inability to maintain hygiene; persistent pain signs despite medication; dyspnoea; repeated falls or inability to rise; and owner sense that the cat is "no longer themselves." Any single severe sign warrants veterinary reassessment; multiple concurrent signs indicate urgent QoL review.
Veterinary euthanasia is the kindest final gift when quality of life cannot be maintained. The decision should be made before prolonged suffering occurs—waiting for "natural death" often means allowing preventable suffering. Home euthanasia services enable cats to pass peacefully in familiar surroundings rather than experiencing the stress of a final clinic visit. Owner grief support, including acknowledgment that euthanasia is an act of love rather than failure, is an important component of compassionate end-of-life care.