Thanks largely to dramatic advances in veterinary medicine during the past several decades, cats in general are healthier these days and are living significantly longer. But there’s a downside to this: With advancing age, cats are at increased risk for eventually being stricken with one form or another of cancer — an insidious disease that afflicts an estimated two percent of the 80 million or more housecats now living in the U.S.

Progress in medical, surgical, and radiographic treatment has enabled some types of feline neoplasia—mammary cancer and certain skin cancers, for example—to become quite manageable and often reversible if the condition is recognized early and is appropriately treated. But for other cancers, such as lymphoma, the prognosis is far less optimistic. In general, says Margaret McEntee, DVM, a professor of oncology at Cornell University’s College of Veterinary Medicine, “We don’t think of feline lymphoma as a curable condition. Even with chemotherapy, survival time will typically be on the order of six months or so, although some cats may survive for a year or more.”

In view of such a grim prognosis, the owner of a terminally ill cat faces a formidable, heart-wrenching challenge: How best to care for the beloved animal during the last weeks, months, or possibly years of its life. The challenge is essentially twofold—to ensure that the cat’s physical health is maintained to the extent possible, considering its unfortunate condition; and to keep it as comfortable and happy as possible during its remaining days.

Dr. McEntee assures owners that the typical private-practice veterinarian is well qualified to monitor the medical treatment of a cat diagnosed with terminal cancer. “But if you would feel more comfortable with a second opinion,” she suggests, “you can always ask your local veterinarian to refer you to a veterinary oncologist who focuses on cancer and pain management.” An owner should also be instructed on how to recognize breathing abnormalities and other signs that a cat may be in distress. Also, the owner should learn which pain medications—whether administered orally, by injection, or by means of a patch—can be administered at home and which must be administered only by a veterinarian.

Other important matters in bolstering the physical stability of a terminally ill cat include meeting the animal’s nutritional needs and making sure that it continues to be adequately hydrated. “If the cancer involves the gastrointestinal tract,” Dr. McEntee points out, “the animal may have trouble absorbing nutrients. Or if it has oral cancer, it may have trouble eating. It’s not uncommon that a cat with cancer will not eat well and will lose weight.” Consequently, the owner must consult with a veterinarian on the best way to resolve this problem—through diet modification, perhaps, or through the use of an appetite stimulant. As for hydration, she notes, feline cancer patients, especially older ones, can have problems with kidney function and may fail to take in enough fluids each day. If it is determined that a cat is dehydrated, a veterinarian can teach the owner how to administer fluids subcutaneously at home.

Hygiene is also important, notes Dr. McEntee. “Sometimes a very sick cat will stop grooming itself,” she says, “so the owner will have to take responsibility for that. Use a washcloth, for example, to gently wipe down the animal’s coat each day. And regularly brush the cat.” A seriously ill cat will tend to become increasingly inactive. So Dr. McEntee suggests the following: “If the cat becomes physically unable to move around, modify its environment. Move its litter box to a place near the spot where it likes to rest. And when you play with it, get down and interact with the cat on a level that is comfortable for it. Try to maintain whatever contributes to its quality of life.”

Eventually, of course, the cat will become inert, unresponsive, and clearly ready to die. By that time, says Dr. McEntee, the owner should already have made some important end-stage decisions. Most difficult, perhaps, is whether the suffering should be ended by means of euthanasia—which the American Veterinary Medical Association defines as “the good death…the act of inducing humane death in an animal. It is our responsibility as veterinarians and human beings to ensure that…it is done with the highest degree of respect and with an emphasis on making the death as painless and distress free as possible.”