Home hospice is not a decision to stop care. It is a shift from measuring cure to measuring comfort, on a schedule, with a vet who knows the plan. Five numbers, taken daily, tell you more than any single examination: weight, food taken, water and urine, resting breathing rate, and a pain and interaction score. The moment 2 of them go wrong together, the plan changes.
Write the 5 numbers on a sheet on the fridge, one column per day, and photograph it before each call: 7 days of numbers beats a description of one bad night.
Five indicators, and the line that matters for each
Weigh on the same baby scale, at the same time of day, before feeding. Food is measured in grams offered against grams left, not in appetite words. Water is hard to measure in a bowl, so count urine clumps and their size instead. Breathing is counted asleep, for 30 seconds, doubled. Pain is scored on behaviour, since cats do not show it by crying.
| Indicator | Target or red line | How to measure | Frequency |
|---|---|---|---|
| Weight | Losing more than 5 percent in 2 weeks | Baby scale, before the first meal | Every 2-3 days |
| Food intake | Under 50 percent of the usual grams for 2 days | Weigh the bowl, subtract what is left | Every meal |
| Urine and stool | No urine for 12 hours, or no stool for 3 days | Count clumps and note size | Twice a day |
| Resting breathing | Over 30 asleep, over 40 is urgent | 30 seconds asleep, multiply by 2 | Twice a day |
| Pain and interaction | Score of 3 or more on a 0-4 scale | 6 behaviours, 5 minutes of watching | Twice a day |
Weight is the slowest signal and the most honest. A cat that loses 5 percent in 2 weeks has lost 150 g on a 3 kg frame, which is invisible by eye and obvious on a scale. A cat that eats 40 percent of its usual grams for 3 days needs a call even if it still walks to the bowl.
Scoring pain without a cat that cries
Use 6 behaviours, each scored 0 to 2, and add them: hunched posture at rest, ears flattened or rotated outward, squinting on one side, tail flicking while still, reluctance to move the head to the flank, and no grooming for 3 days. A total of 3 or more out of 12 is worth a call; 6 or more means the current pain plan is not working. Watch for 5 minutes before scoring, at rest, without calling the cat.
Medication is set by your vet; common starting ranges are gabapentin 5-10 mg per kg every 8-12 hours, buprenorphine 0.01-0.02 mg per kg on the gum every 8-12 hours. Ask what to do about a missed dose and what the ceiling is, then write both down. Never stack 2 NSAIDs, and never use acetaminophen or ibuprofen, toxic to cats at any dose.
Breathing, and what the number is telling you
Count only when the cat is asleep and the rib cage is moving quietly. Normal is 16-30 per minute asleep; 30 is the alarm line, 40 is tonight. Also watch the shape: breathing with the abdomen, a head extended forward, elbows out, or the gums turning grey-blue is not a number problem, it is an emergency regardless of rate. A rate that rises from 20 to 28 over 3 days, then to 34 on the fourth, is a pattern you can only see with a log.
The 24-hour vet line, set up before you need it
Find out which clinic covers nights in your area, get the direct number rather than the switchboard, and confirm in writing that they will see a hospice patient at 02:00. Ask 3 questions when you call: what dose of the rescue medication to give, how long to wait before calling back, and what would make them say come now. Put the answers and the on-call number on the same sheet as the 5 indicators.
Keep a transport kit by the door: a carrier with a top that opens, a towel that smells of home, a copy of the medication list, and 200-400 RMB in cash.
Home layout for comfort, not for cure
Bring everything within 3 m of the bed: water within 1 m, food within 2 m, litter within 3 m with a 10-15 cm entry. Add 2-3 nesting spots at different temperatures, because a cat in pain cannot regulate its own heat well; aim for 22-24 C in the room, and use a covered heating pad on the lowest setting under a towel, never directly against skin. Keep the room quiet after 21:00, dim 1 lamp rather than switching on the ceiling light, and leave a radio at low volume if the house is otherwise silent.
Change bedding daily and check 4 pressure points: elbows, hips, ribs and the base of the tail. A cat that stops moving develops a sore in 3-5 days. Reposition it every 4-6 hours if it will not move itself, and put a non-slip mat under the bed.
Food and water when appetite is going
Offer 4-6 small meals a day instead of 2, warm the food to about 37 C to release smell, and stop measuring success in full bowls. A cat eating 60 percent of its resting energy need is holding; below 40 percent for 3 days is a conversation about appetite stimulants, feeding tubes or a change of goal. Water target is roughly 40-60 ml per kg per day, and a cat that stops drinking needs subcutaneous fluids discussed the same week, not the same month. Appetite work for a cat on chemotherapy is in chemo side effects.
Quality of life, scored weekly
Score 5 domains from 0 to 10 once a week, same day, same person: eating, drinking and urinating without help, movement, interaction with the household, and obvious signs of pain or breathing effort. A total under 25 out of 50, or 3 consecutive days where the cat has more bad hours than good, is the point to book the conversation rather than the emergency visit. The score is not a verdict; it is a way to notice a slope while you are still standing on it. The published version is in the quality of life scale.
Five things to set up this week
- Print the 5-indicator sheet, one column per day, and put it on the fridge with a pen attached.
- Weigh the cat tonight and write the number down; it is the baseline everything else is compared to.
- Call the night clinic, get the direct number, and ask the 3 questions before you need them.
- Move water, food and litter within 1-3 m of the bed and fit a 10-15 cm litter entry.
- Score quality of life today and put the next 4 Sundays in the calendar.
The work of hospice is small, repeated measurements and fast adjustments. Done that way, the last weeks are usually quieter than the months of guessing that come before them.
Frequently asked
How do I know when it is time to say goodbye?
Use numbers rather than a single bad night. Score 5 domains from 0 to 10 weekly, and treat a total under 25 out of 50, or 3 days in a row where bad hours outnumber good ones, as the point to book the conversation with your vet. Loss of interest in food, breathing above 30 at rest that will not settle, and pain that no longer responds to the current plan are the three signals owners most often report in hindsight.
What should be on hand for a home hospice cat?
A baby scale for weighing, a printed daily sheet with 5 indicators, the direct number of a clinic that covers nights, a written medication list with doses and ceilings, and a transport kit with a top-opening carrier and 200-400 RMB in cash. Also keep a spare supply of the prescribed pain medication.
Is it cruel to keep a cat at home instead of hospitalizing it?
Not if comfort is measured and the plan is shared with a vet. Home hospice works when 5 indicators are recorded daily, pain is scored twice a day, and there is a written rule for what counts as an emergency. Hospitalization is better when breathing is unstable, when fluids or oxygen are needed, or when the cat cannot be kept clean and warm at home.