By Ingrid King

Recently, two friends had to make difficult decisions about medical care for their cats, and it got me thinking about what a challenging task this is for so many of us. Advances in veterinary medicine make it possible to treat medical conditions in pets that would have been a death sentence a decade ago.  From chemotherapy to kidney transplants, pets can now receive almost the same level of medical care as humans.  But just because these treatments are available doesn't necessarily mean they're right for each pet.

Pandora is an 18-year-old calico in chronic renal failure.  It's unclear which stage her disease is currently in, because my friend has chosen not to pursue medical treatment beyond the basics:  Pandora is on medication to control her high blood pressure, and she gets a thorough check up every six months to monitor her lab values.  Pandora goes through phases were she doesn't want to eat and becomes withdrawn, but so far, she has always bounced back after a few days.  My friend has chosen to keep Pandora comfortable at home, and when that's no longer possible, she'll be ready (or as ready as any of us will ever be) to let her go.

The decision for Bob, a 14-year-old orange tabby , was more difficult.  He's FIV positive,  and an ultrasound a couple of months ago showed a large mass that was wrapped around his liver.  Without a biopsy, there was no telling what was going on.  Surgery is always a risk, but especially for a senior FIV positive cat.  The surgeon told my friend that, in a worst case scenario, if it was cancer and it had spread, she needed to be prepared to authorize euthanasia while Bob was still on the table.  On the other hand, there was also a chance that the mass could be removed, and Bob could have many more months, if not years, of good quality of life.  My friend agonized over this decision, and eventually decided to have the surgery done.  The mass was removed, and as of this writing, Bob is undergoing chemotherapy for lymphoma.

Not every pet owner would have made these decisions for their cats.  In Pandora's case, some would choose more aggressive treatment and more frequent visits to the vet, and possibly hospitalization for IV fluids.  In Bob's case, some would have elected to forgo surgery and just let him live out however much time he may have left without intervention.  These situations are never black and white, and there is no one right decision.  The only wrong decision in these cases would be indecision when it translates into pain and suffering for the pet.

So what factors should a pet owner take into account when faced with making medical decisions?

The most important thing is to get all the facts first.  Be sure you understand the medical condition your pet is dealing with.  It can be difficult to know what questions to ask your veterinarian when faced with a frightening diagnosis, so don't be afraid to ask follow up questions once you've had a chance to process the initial information.  Make sure you understand all the treatment options, along with cost, side effects, and prognosis for each option.  Get a second opinion and/or go see a specialist if you're not comfortable with what your veterinarian tells you.

By all means, research your pet's condition on the internet, but use common sense and look for sites that present facts and not just anecdotes and opinions.  Dr. Nancy Kay, the author of Speaking for Spot:  Be the Advocate Your Dog Needs to Live a Healthy, Happy, Longer Life has written a series of fantastic articles about how to find accurate pet health information on the internet.

Once you understand the medical facts, the decision becomes more personal.  Factors that come into play are your pet's temperament, your comfort level with providing any follow up care that may be required at home, and your finances.

In my years of managing a veterinary practice, a question many clients often asked was "what would you do if it was your pet?"  I wish I could have answered it, but I couldn't.  I couldn't because, first of all, I'm not a veterinarian.  I also couldn't have answered it because what I would do for my pet could be completely wrong for the client's pet.

But after having faced having to make difficult decisions for two of my cats in recent years, I now have an answer I would give these clients.  For me, it comes down to this:  Listen to your heart.  After weighing all the factors, try to set aside your fear and worry for your pet long enough to connect with your center.  Some call it gut instinct, or intuition.  And then make the best possible decision for your pet.  Because when it comes down to it, the one thing you know better than all the veterinarians in the world combined is your pet.

Photo of Bob by Robin A.F. Olson, used with permission.  You can follow Bob's progress on Robin's blog, Covered in Cat Hair.