As a cat enters his or her senior years, a number of age-related diseases can develop. Many of these can be managed if they are caught early enough, but eventually, there will come a time when treatment is no longer an option and palliative (end-of-life) care must be instituted. The goal of palliative care is to manage symptoms and keep the cat comfortable until the end. It can take anywhere between 3 days and 3 weeks, depending on the stage that your cat is in (Pre-active dying or active dying).
Let’s find out in which stage your cat is, and how to care for him or her in the last few days of life.
How long does it take a cat to die? (2 phases)
Dying occurs in two phases, pre-active and active dying. The dying phase is highly variable for each cat and can vary depending on the underlying disease.
The pre-active dying phase lasts approximately three weeks. During this time, the body begins to shut down and will have good and bad days.
- Waning thirst and appetite: The cat may be reluctant to eat, or eat less than usual. Hand-feeding strong-smelling food can help.
- Lethargy: Spending more time sleeping, and generally less active.
- Restlessness: The cat may be unable to find a comfortable position due to pain or discomfort.
- Withdrawal or clingy behaviour: Some cats will withdraw into a quiet part of the house on their own, other cats prefer constant attention.
- Loss of interest: No longer participating in day to day activities he or she once enjoyed. Playing, greeting you at the door, chasing insects.
- Grooming less: The cat spends less time grooming, longhaired cats may develop mats.
- Sleeping more: During the final weeks, many cats will spend more time sleeping.
The active dying phase in cats lasts up to three days. At this point, the body is actively shutting down and death is near.
- Complete loss of appetite: As the body is in the active phase and is shutting down, it no longer requires nutrition for energy. Do not force the cat to eat if he or she does not want to.
- Decreased urine output: By this stage, the cat is no longer drinking and the organs are not functioning effectively, urination may decrease or be absent.
- Urinary or fecal incontinence: As the muscles in the pelvis relax, the cat may urinate or defecate. Incontinence pads placed under the cat are recommended. Remove as soon as soiled to protect the cat’s skin.
- Cognitive changes: Cats with liver failure can experience changes to cognitive function as toxins build up in the body, this may include seizures, agitation and confusion.
- Lethargy: The cat is now spending most of his or her day sleeping, and has little energy to walk to move.
- Blue/grey gums: Reduced blood oxygen levels and decreased circulation can lead to a blue/grey tinge in the gums.
- Drop in body temperature: The body is less able to regulate body temperature as the cat nears death. Maintain a stable temperature in the home.
- Changes in breathing: Breathing patterns may change, sometimes the cat may breathe quickly or the onset of apnea, with pauses between breaths.
- Death rattle: As the cat loses his or her ability to swallow, secretions build up, which causes the characteristic death rattle.
Related content: End of life care for the dying cat
Is it okay to let my cat die naturally?
Nobody wants their cat to suffer, unfortunately, most life-ending diseases do involve pain and discomfort. While many of these symptoms can be managed, there comes a point where palliative care is no longer effective and we must make the decision to give our cat a peaceful end. This can cause immense conflict among caregivers. When is the right time? Is it too soon or too late? By the active phase of dying, treatment options have run out and we can give our cat the greatest gift of all by ending their suffering by euthanasia, which means ‘good death’. The cat may live a day or so longer if allowed to die naturally, but there is no quality of life left.
How to care for your dying cat
The goal of hospice or palliative care is to maximize the cat’s comfort and minimize suffering in the final weeks. During this period, it is important to work closely with the veterinarian who can prescribe medications where necessary to relieve discomfort and suffering. Here is what to consider:
1. Pain relief:
Cats are hardwired to hide signs of pain and discomfort, and the caregiver must learn to recognize signs of pain. This includes:
- Hunched over appearance or stiffness
- Loss of appetite
- Hiding and withdrawal
- Aggression (when touched) or personality changes
There are several options the veterinarian can recommend to relieve pain.
- A transdermal patch that provides continuous pain relief
- Oral tablets
Never administer human painkillers such as ibuprofen, aspirin or tylenol/paracetamol to a cat. Cats lack the necessary liver enzyme to process these drugs and can be fatal if ingested even in small amounts.
2. Symptom control:
The terminally ill cat can face a range of symptoms such as seizures, nausea, vomiting, pain. It is up to the caregiver to relay symptoms to the veterinarian who can prescribe the right medication to make the cat more comfortable.
3. Nutritional support:
The nutritional requirements of a cat who is near the end of life are going to differ from a healthy kitten or adult cat. Loss of appetite is a common side-effect of pain and nausea.
Ensure the cat receives adequate nutrients, and in some cases, prescription diets to help manage or slow down the progress of a condition. Your cat’s veterinarian can prescribe a high-nutrition food such as Hills a/d. You can also add tasty treats to the top of the cat’s food such as a small sample of tuna, or a gourmet cat gravy such as Dine Creamy Treats (available in sachets from your supermarket).
If you are still struggling to get adequate nutrition into your cat, speak to your cat’s veterinarian. They can recommend a high-calorie gel such as Nutrigel and/or appetite stimulants, or insert a feeding tube if all of the above methods fail. Hand or syringe feeding carefully warmed foods such as cooked chicken breast or soft canned food can sometimes help.
At the very end, the cat will stop eating and drinking completely; this is normal as the cat’s body is shutting down. Do not force the cat to eat, as this can cause an already gravely ill cat to choke. Learn more about nutritional support for sick or dying cats.
4. Fluid support:
Dehydration is a common side effect of many life-ending diseases as well as a reduction in thirst due to feeling unwell and underlying conditions such as kidney disease which affect the ability of the kidneys to concentrate urine. Signs of dehydration include poor skin tenting, dull eyes and tacky gums. The veterinarian can teach you how to check for signs of dehydration by lifting the skin at the back of the neck to see how fast it springs back. Fluids can be administered by mouth using a syringe.
5. Make adaptations and provide physical comfort:
Set up an area for the cat; it should be close to human interaction, but not a high-traffic area. A bedroom is an ideal place. Keep the bed, litter trays, food and water bowls nearby. If the cat is well enough, regularly put the cat in his or her litter tray and then place back in their bed. I have found all of my cats have remained mobile right up until the end, but those last few days, they were unable to move more than a few feet. Do not expect a cat in the final stages to have to navigate stairs or travel long distances for food, water, or to go to the toilet.
6. Cleaning up after the cat:
Fecal and urinary incontinence are common towards the end. Regularly check the cat for signs of wetness and clean immediately to prevent urine or fecal scalding. Nobody wants to lie in their own mess, and that includes a terminally ill cat. If an accident does occur, clean the area with an unscented baby wipe or a warm, damp cloth to avoid urine or fecal scalding which can lead to serious pain and infection.
Place plastic sheeting between the bed and a blanket, or a puppy training pad on top of the blanket to stop the bed from becoming soiled.
7. Provide emotional comfort:
Every cat is different in the level of comfort they want. Some clingy cats seek out solitude towards the end; other cats want and need the comfort of their human companions. Let the cat lead the way. Keep a close eye on cats who want solitude without being intrusive. For the cat who wants to be near people, let them. Spend time with the cat, talking, gently stroking and comforting him or her.
Lear more about end-of-life care for a dying cat.
How to tell if your cat has died
The key signs that show your cat has died include the following:
- Loss of muscle control. The muscles which control the bowels and bladder loosen which can cause urination and defecation.
- Eyes. The eyes are open and the pupils remain dilated/large (see image below) and fixed even in response to light:
3. No pulse or heartbeat: press against the rib cage over the heart. With the cat standing, feel the pulse just behind the elbow.
4. No signs of breathing: Watch for the rise and fall of your cat’s chest to determine if he is breathing or place a mirror right in front of the cat’s nose (very close) to see if it fogs up a little bit. If it fogs up, the cat is breathing.
5. No response to verbal stimuli. Try calling the cat’s name or clap loudly and watch for a response.
Learn more: how to determine your cat has died.