We recently got the diagnosis that our 16 yo cat has congestive heart failure.

After debating back and forth for a while, even our vet said that, given her other health issues (diabetes, cataracts, almost no teeth, etc.), treatment likely wouldn’t give her much more time. There’s also still a risk of a saddle thrombus (?) even with medication, and she’s already been having trouble with balance in her back legs for the past few months. Not to mention that she absolutely loathes oral medication (apparently it’s also the type of medication for CHF treatment), and she is stubborn enough to refuse food too, which would be difficult as she must eat before we can give her insulin.

It breaks my heart as we thought her recent behaviour changes were just part of getting older. She used to love sitting on us, or us hugging her, but over the past few months she’s stopped this and has been hiding more, and she pants after going up the stairs.

We’ve made the decision to have her put to sleep next week, but I can’t shake the guilt.

She still seems normal in some ways, doesn’t “look” sickly. Still sleeping most of the day, occasionally wanting a cuddle, and not in any obvious pain. The only clear sign of struggle is her breathing when she’s stressed (e.g. when we clip her nails).

I know cats can hide pain really well, but I still can’t shake the fear that I might take away other potential years or months she might have. At the same time, I am also worried about leaving it too late, risking her more serious pain. We adopted her at 11, and she came with many issues (obese, diabetes, ring worm etc.) but we managed to get her to lose over half her body weight, and she has been taking insulin very well over the past 4 and a bit years.

When they seem okay on the surface, how do you cope with the guilt of making that final decision for them?