Dear Max,

Once we treated your arthritis pain, you became more active and social again. You were always the cat who prefered to be with me, so the feeling was mutual. I loved it when you would cuddle into my lap, knead and drool a little.

One day when you were seventeen, you simply stopped eating. This is not an unusual sign of illness in a cat, and sometimes it’s the only thing that says there’s something not quite right.

Anorexia in a cat is a reason to take your cat to the veterinarian as soon as possible. It can mean something easily treatable, like a fever or change in food management, or it can mean something much more serious and difficult to treat like kidney or liver disease.

I brought you to work with me the next day, and the blood testing showed advanced kidney failure. Most cats would have been losing muscle or vomiting regularly by this time, but you had shown no signs of illness.

We also checked your blood pressure. High blood pressure is often associated with kidney failure in cats, and yours was elevated. High blood pressure is often silent in our pets.

Then I got ready to start some treatment. We gave you fluids under the skin and an appetite stimulant pill. I picked up blood pressure medications. Giving you medications by mouth was going to work okay, because you would let me pill you. This, not unexpected, disease was something we could manage.

And then you had sudden neurological changes, as if you’d had a stroke. You had a hard time walking, but couldn’t rest comfortably. You had vision changes, and most heart-breaking of all, you didn’t seem to recognize me anymore.

When we got home that afternoon, I had a difficult conversation with my husband. A cat with kidney disease and high blood pressure was one thing. That was something we would be able to treat, and probably improve your quality of life for a while.

Once you were blind and didn’t recognize us any more, then what were our options? Treating you with anti-clot drugs and putting you on IV fluids while we waited to see if your signs would improve over the next few days was possible, and may have helped. But it did truly break my heart to see you pacing at the back of the carrier, weaving and crying out.

Unfortunately, it was time to say goodbye.

Oh, Max, this wasn’t a decision we took lightly. Were there things we could do for you? If I started looking, I could probably find lots of things to try. Would they help you? Unknown. How long would they last? Also, unknown.

We were on the knife-edge of your life and death. The decision came up so quickly. Two days ago, as far as we knew, we had an old but relatively health cat. But then, in a flash, we were trying to predict how much quality of life we could give you.

I completely empathize with pet owners who have to make these choices, with little time and little to no warning. The pressure to make a decision that was the best thing for you, my Max, was immense. And we did the best we could.