There is no topic more difficult than this. But it is also one of the most important for those living with a cat. Cats hide their suffering until the last moment. Recognizing the signs of end of life allows us to accompany them with love and dignity, without delaying interventions that can change everything.
Why talk about it
Three reasons:
- Early diagnosis can prolong and improve life
- Informed decisions about quality of life
- Conscious goodbyes when the time comes
Ignoring the signals leads to unnecessary suffering for the cat, and guilt for the owner.
The 10 signs (in order of importance)
1. Drastic decrease in appetite
The cat may:
- Refuse its favorite food
- Eat only half of its portions
- Drink much more
- Vomiting regularly
Alarm: total refusal of food for more than 24-36 hours.
2. Visible weight loss
Especially in senior cats, weight decreases progressively:
- Visible spine
- Protruding pelvis
- “Thin” shoulders
- Clumps of fur falling out
3. Deep lethargy
A healthy cat sleeps 14-16 hours. One at end of life:
- Sleeps 22-23 hours
- Does not respond to usual stimuli
- Does not play
- Shows no interest in food
- “Dull” gaze
4. Breathing difficulties
- Labored breathing at rest
- Open mouth (always an emergency)
- Abdomen moving with breath (abdominal breathing)
- Foam in the mouth
5. Dehydration
Skin tent test: lift the skin between the shoulder blades. If it does not return immediately to place → dehydrated.
Other signs:
- Dry gums
- Sunken eyes
- Apathy
6. Change in toilet habits
- Urinating a lot (kidney)
- Urinating little or not at all (blockage)
- Very rare or absent defecation
- Getting “lost” before the litter box
- Blood in urine
7. Isolation
The cat hides in unusual places:
- Under the bed for hours
- In closets
- In dark and cold areas
Instinctive behavior: they seek “a place to go away”.
8. Change in coat
- Dull, dry fur
- Failure to groom (grooming requires energy)
- Dandruff
- Areas soiled with urine or feces
9. Change in body temperature
- Cold extremities (ears, paws, tail)
- Low body temperature (below 37.5°C)
- Tremors without apparent cause
10. Lack of response to interactions
- Does not come when called
- Does not recognize family members
- Blank stare
- Difficulty standing
- Falls
The most common end-of-life diseases
Chronic kidney failure
The number 1 cause in senior cats. See dedicated article.
Tumors (lymphomas, mammary carcinomas)
Often rapid progression in seniors.
Hypertrophic cardiomyopathy
Typical in large breeds. Evolves into heart failure.
Diabetes
If uncontrolled, can quickly decompensate.
Untreated hyperthyroidism
Causes progressive wasting.
What to do when you see the signs
1. Urgent veterinary visit
Even if “accompanying” to end of life, the vet:
- Diagnoses accurately
- Establishes therapy for quality of life
- Helps with the final decision
2. Palliative care
Depending on the disease:
- Subcutaneous fluid therapy
- Anti-nausea (maropitant)
- Appetite stimulants (mirtazapine)
- Specific pain relief for cats
- Warm, fragrant wet food
3. Comfort at home
- Warm bed in a quiet area
- Water and food nearby
- Accessible low litter box
- Affection if they accept it (some want distance)
4. Quality of life assessment
HHHHHMM scale (Villalobos):
- Hurt (pain): is it controlled?
- Hunger (hunger): is it still eating?
- Hydration (hydration): is it drinking or need fluids?
- Hygiene (hygiene): is it grooming or dirty?
- Happiness (happiness): is it responding to interactions?
- Mobility (mobility): can it get up?
- More good than bad (more good moments than bad?)
If most are “no,” it is time to consider euthanasia.
Euthanasia: the hardest choice
When pain is uncontrolled or quality of life is poor, euthanasia is an act of love.
What to expect
- sedation (the cat peacefully falls asleep)
- final injection (heart stops in a few seconds)
- without pain
- you can be present (if you want)
At home
Many veterinarians offer at-home euthanasia: the cat falls asleep in its favorite spot, without the stress of the clinic.
Cost: €150-300 (more expensive at home, but it is sweeter).
Grief
Losing a cat is losing a family member. It is normal:
- crying, depression
- guilt
- “Seeing” the cat at home
- wanting another immediately vs waiting years
Nothing is “wrong.” Everyone processes in their own way.
When to get another cat
There is no rule. Some people:
- adopt a new cat immediately (to fill the void)
- wait months/years (to honor the memory)
- never get another
Everything is valid. Listen to yourself.
Final advice
Recognizing the signs of end of life in cats is not “thinking the worst”. It is being prepared to love until the last moment. Veterinary visits, palliative care, comfort at home, informed decision about euthanasia: these are acts of love. Your cat has given you years of companionship. The last gift you can give is to let it go with dignity.
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