Just as people are living longer than they did in the past, cats are living longer too. The percentage of cats over 6 years old has almost doubled in the last 10 years and the aged cat population is growing. Within the past 5-10 years, veterinary medicine has seen some significant improvements in treatments for the ailments commonly faced by ageing cats. Like people, cats do not live forever. They age at different rates - some slow down at the age of 8, others remain spry into their teens or early twenties. Most glide gracefully from middle age into old age, simply slowing down their pace of life. They experience old age in different ways and at their own pace. Grey hairs appear round the muzzle and in the fur (some owner therefore refer to older pets as "silvers"). An elderly cat grows thinner; its backbone, hips and shoulders become more prominent as it loses the insulating layer of fat under the skin. It may become rickety or unsteady on its back legs and its senses are less acute.

These are all signs of "winding down". Older cats exercise less and sleep more, they groom less thoroughly and less often. They lose their appetites. The early stages of this decline are so gradual that owners may not notice it. Recognising subtle signs early on can slow the rate of decline, but at the end of the day, ageing and death are natural processes and unlike humans, cats do not seem to fear the end.

The average cat life-span is 12-14 or 14-16 years depending on which studies you read. Pet food manufacturers recommend senior formulation foods for cats over the age of 8 and many vets consider the cat geriatric when it reaches 10 years old. Generally, once your cat is over 12 years old, it is an 'older cat' and its needs and habits change. Popular belief has it that one year of a cat's life is equivalent to 7 human years. In fact, kittens mature faster than human children and the rate of ageing slows down to one year equalling only 4 human years after only 2 years as the equivalence chart below shows:

Ageing is a natural process. The body processes wind down and some functions (reproductive ability) and faculties (hearing, cognition) diminish or are lost. The metabolic rate declines and everything slows down. This makes an older cat less tolerant of anaesthesia and certain drugs and less able to regulate body temperature. It feels the cold more and suffers more in extreme heat. Its calorie needs decreases but the need for easily digested protein increases because its digestive processes are less efficient.

Older cats have less immunity to disease and their injuries heal slower. Hormone-producing organs no longer regulate themselves efficiently making older cats more prone to conditions related to malfunctioning glands. The senses gradually become less acute though cats adjust their lifestyles to compensate. Progressive deafness is the most commonly observed change. Sight becomes less acute. Senses of taste and smell may diminish and the cat may become faddy. Reflexes are less acute and the body is slower to repair injury damage.

Physical signs include: cloudy eyes, hearing loss; thinning fur; feels the cold; loose skin; prominent spine, shoulders and hips; loss of muscle tone; stiff joints or lameness and grey hairs around the muzzle and in coat. Behavioural signs include: less tolerance of environmental changes; sleeping more deeply and more often and generally being less active. Some older cats become more irritable or cantankerous due to deafness and/or joint pain, while others mellow with age. Most become more laid back and sociable with those they regard as friends. These are all age-related changes, but sudden mood changes may indicate illness or injury. A cat which starts hiding, becomes unsociable or which seeks constant reassurance may be unwell, so ask your vet to check that all is well.

Although old cats are usually laid back with visitors, they dislike major disturbances in their home environment. If you are holding a noisy party, put Puss a in warm, quiet "safe room" with his bed, food, water and litter tray. He can avoid the noise and disturbance and feel safe, secure and relaxed. There are notable exceptions and some cats - old or young - regard parties as prime lap-hunting, attention-seeking time, but even these require a safe place to retreat to when they tire of socialising

Many older cats remain active in their teens or twenties, though ageing cats tire more easily and start to take things easy. They should be encouraged to take moderate exercise to keep them healthy, but play sessions are shorter and more sedate with little of the athleticism of youth. Reduced exercise means you must trim his claws more often (see later). Older cats are often very companionable; enjoying attention and relaxing in your company so it can be a rewarding time for you to indulge your nurturing instincts. Ageing cats adapt their lifestyle to cope with any incapacity; slowing down gradually, seeking warm, comfortable spots and spending more time asleep. They sleep more deeply and are harder to rouse, so don't suddenly disturb a sleeping cat or it will be startled, especially if its hearing is fading. This deep slumber also shows that the cat feels safe.

As cats grow older, stiffer and lose muscle tone, high surfaces (windowsills, shelves, kitchen counters, your bed) become inaccessible unless you provide a ramp or box as a stepping stone. Tables and counters may become cat-free zones and ornaments be are less likely to be overturned. The cat's curiosity is unabated, but he no longer exerts himself or his muscles are not up to the jump. Instead of active pursuits he may turn his attention to socialising quietly with you. He may prefer to sit near you rather than on your lap. This is not a snub; depleted fat stores means he is bonier and finds your lap uncomfortable. Put a cushion or folded blanket on your lap to make it more comfortable when he wants a cuddle. If he is allowed in the bedroom, spend an half-hour or more sitting up in bed reading with your legs tucked under the duvet or quilt - he will find that the duvet makes a supportive "hammock" between your legs.

Middle-age spread (through overfeeding and under-exercising) eventually gives way to boniness as subcutaneous (under-skin) fat stores become depleted. The spine, shoulder blades and hips are more prominent; his muzzle appears "sharper" and the eyes more prominent as fat around the face is lost. You may notice changes in how he moves as he becomes stiff and "rheumaticky". He may stand with forelegs wider apart as degenerative changes occur in the joints, giving him a saggy, barrel-chested appearance. This may also help increase his chest capacity and breathing as the heart and lungs work less efficiently. This is nicknamed "clockwork kitty" syndrome as his movements give the impression of a wind-up toy.

He may develop a tendency to walk on his hocks due to muscle wastage in the hind-legs. This also restricts running and jumping. Hock-walking is also associated with the after effects of saddle thrombus (see later). He becomes generally less supple and finds it harder to curl up into a tight ball so a larger cat bed may be necessary. Beanbags mould themselves to his shape and provide support while the polystyrene beads in a beanbag will retain heat and help keep him warm. Fleece-covered cat hammocks are comfortable, but make sure he can get in and out of it easily.

Older cats often become talkative, spending less time physically active and more time expressing their opinions. Some are seeking reassurance, but others take a chatty interest in your activities. Not only do they enjoy your company, they tell you how much they enjoy it! Some of the increased vocalisation (especially increased volume) is due to deafness - the cat literally can't hear himself speak.

Extremely old cats may become forgetful, suffering "senior moments", staying outdoors in bad weather or wandering and becoming lost. These are signs of senility though the cat may enjoy several more months of reasonable health if senile behaviour can be managed. Cats which wander and become lost should be confined indoors for their own safety. If you have an escape-proof garden they can venture out in good weather or they may go out on a harness and lead. A senile cat which house-soils should have a veterinary check-ups to determine whether this us a physical problem or senility. Providing several litter trays around the house may help for a while, but when age-related problems become too acute you must review the cat's quality of life and consider euthanasia.

If it is any reassurance, a cat which lives long enough to become senile has survived far beyond the life-span of a wild-living cat. Few feral cats or wild animals reach senility; as a wild animal loses its faculties it becomes prey for something else, dies through self-neglect or through misadventure. A cat which lives long enough to become senile has probably had a comfortable, nurtured life and this fact may comfort you if you choose euthanasia because of senility and related problems.

Although the senses decline, old age doesn't always mean disability. In cats, the disability usually occurs gradually enough for it to compensate. Even sudden disabilities (amputation, stroke) are less drastic than you might think because an older cat is generally less active and notices his limitations less than an active, younger cat. As a cat ages, sight and hearing deteriorate, often so gradually that you don't notice anything until the loss is total. Your cat compensates by relying more on remaining senses, especially smell, to guide him through his daily routine. Because older cats have a more relaxed approach to life, most appear unperturbed by failing hearing or sight. The problems of deafness and failing sight can be counteracted by a caring owner. Failing sense of smell is more problematical as it causes loss of appetite. Though there is no need to become over-protective, it is worthwhile being aware of some disabilities which may afflict cats.

The loss of a leg through injury may sound catastrophic but 3 legged cats adapt well. A recent amputee needs time to adjust, but once recovered is as agile and active as any 4 legged cat and soon resumes previous activities with little sign of being handicapped. He needs help grooming areas that were groomed by the now-missing leg, but will otherwise be as active and independent as before. The fact that an older cat is generally less active means he is less troubled by the limitation of 3 legs.

A deaf cat is easily startled because he can't hear you approaching. He sleeps more deeply because the lack of sound gives him a false sense of security. Deaf cats can learn to recognise hand signals or the flashing of a torch (flashlight) to call him in for meals or at night. At close range, sharp hand-claps may still gain a partially-deaf cat's attention. Deaf cats cannot hear danger signals such as cars, lawnmowers or barking dogs. If he goes outdoors (or could escape outdoors), make sure he wears an elasticated (or break-free) collar bearing his address and write 'I AM DEAF' on the collar to help people who find him on their driveway or in their garden. A noisy collar bell helps you to locate him when he is in motion. It is safest to confine a deaf cat to a safely fenced garden or indoors.

In June 2003, a German acoustics expert announced his invention of a hearing aid for cats. Hans-Rainer Kurz, a hearing aid specialist, took two years to develop the hearing aid with help from experts at the Vetenarian University in Hanover. They developed a tiny device, which can be implanted in the cat's outer ear. Herr Kurz has already had success with a similar aid for dogs. He admitted that the device would not cure totally deaf cats, but could help those with severe hearing difficulties. The hearing aid ensures that the cat is able to take the usual acoustic signals and re-work them into sounds in the brain. Quiet sounds that hearing-impaired cats had never heard before would become distinguishable. The feline hearing aid currently costs around £300.

A cat which bumps into things may be losing its sight. A cat blind in one eye is easily startled by sudden movements on his blind side. Blind cats are easily disoriented and must not be allowed to roam; indoors only or indoors with access to an outdoor enclosure is best. He may enjoy walking in the garden using a harness and lead and these trips can be enjoyable for you both as you can observe what things attract the attention of your cat. Make sure he wears an elasticated collar stating his address and disability in case he escapes and becomes lost.

Blind cats rely on scent and memory to find their way around so keep furniture, food and litter in the same place and don't leave obstacles in unexpected places where he could walk into them. Carrying a blind cat around will disorient him so if you do move him, place him at floor level somewhere familiar e.g. his feeding or sleeping area so he can easily get its bearings. Sound is very important to a blind cat and many enjoy playing with jingle toys or rustling paper (e.g. paper grocery bags).

It is rarer for a cat to lose both hearing and sight. Such cats are far safer indoors as they can easily become lost or hurt outdoors. Many adapt well and still enjoy life, relying on their sense of smell. The fact that older cats are less active anyway means that they are less distressed by these problems than you might think. If you feel that your cat is distressed by its condition, you should discuss the matter with your vet who may recommend euthanasia, especially if the cat has other age-related problems as well.

True strokes are uncommon in cats and those that do have them usually recover faster and more completely than humans though they may remain slightly lopsided. Following a stroke, the cat may be temporarily blind or partly paralysed and may lose control of bladder or bowel. Most vets advise a "wait and see" approach. Once the initial effects have worn off, many cats go on to live very long, healthy and happy lives with little more than a head tilt, minor tremor or slightly wobbly gait as a reminder.

Saddle Thrombus (described in more detail later) is sometimes called the feline equivalent of a stroke and can cause permanent weakness of the hind legs. Affected cats may need ramps or steps to compensate. He may temporarily lose control of bowel or bladder depending on the severity of the damage. One of my elderly cats recovered well, but afterwards she always leaned on the wall when going up or down stairs.

Ageing is affected by both genetics and environment. Good genes are down to luck or careful breeding, but the environment can be managed. There is a danger of becoming paranoid - whatever you do, you must accept that your cat is not immortal. Keep a diary or file detailing your cat's vaccinations, diet and weight. If you can, record its heart-rate, breathing rate and temperature - your vet will show you how and tell you what the normal figures are. If your cat becomes sick, injured or behaves unusually make a note of this since cats often behave totally different in a vet's consulting room! Your observations will help the vet work out what, if anything, is wrong with your cat. Some cats do developed unexplained and harmless behavioural quirks, don't panic - this is called "being a cat".

Some diseases are hereditary and reduce life-expectancy. Genetics is a key factor in determining the rate of ageing, how well cells multiply and how well the body repairs itself. Providing good health care for your cat right from kittenhood assures its genetically determined life span. If you don't know much about your cats past history, the "good health care" routine starts with you! Cats are resilient creatures and many rescue cats reach advanced ages, especially mixed-breeds as these have "hybrid vigour". Breed influences longevity and Oriental/Siamese breeds appear to live longer than Persians. Years of selective breeding has had the side-effect that some breeds are genetically predisposed to conditions which shorten life - the reverse of hybrid vigour.

With improved owner education, neutering, vaccinations and modern vet care, cats are living longer than ever before and spending proportionally more time in their senior years than their ancestors. A modern cat averages 12-16 years compared to 6-8 years in the 1930s i.e. life expectancy has doubled. Whether an indoor or indoor/outdoor lifestyle influences this is down to the locality and whether the outdoor access is free-ranging or via an enclosure. In some areas indoor/outdoor cats average 8 years, elsewhere they average 12-14 years. In the UK, my indoor/outdoor cats average 16 years, with several reaching 19-21 years (the exceptions died of kidney disease and of cardiomyopathy, neither condition being linked to their lifestyles).

Where outdoors is too dangerous, an indoor lifestyle prolongs life. Where outdoor dangers are moderate or minimal, it is up to you to judge whether your cat should enjoy outdoor pleasures. Remember - your cat lives for now, help him enjoy every minute of 'now'. Some people consider the risk of infectious disease means indoors-only, others accept that the risk to a neutered cat is relatively small and that fatal accidents also occur in the home. Weigh up the risks and make an educated decision. What is right for your locality may be wrong for someone else's locality.

Neutering and vaccination are important. Neutering extends a cat's life-span and reduces the risk of contracting several deadly viruses. Vaccination protects against some of the diseases prevalent in your area. Good diet, good observation of your cat's habits and regular health checks are vital. Older cats are less active and have a reduced metabolic rate, so you must adjust their food to their decreasing activity level to prevent obesity. Noticeable or sudden weight loss signals serious problems so be aware of your cats normal weight and note any changes. Only prolong relatively healthy or active life, never prolong the life of a suffering cat. The subject of euthanasia is discussed later.

Your own observations and prompt veterinary attention when required prolongs healthy life. Early detection of illness and early treatment are important for older animals whose resistance is often reduced. There are many excellent books on cat care available from bookstores and libraries. Many rescue shelters, veterinarians and feed suppliers also produce leaflets on cat care. This supplemental information is geared towards older cats.

Cats need plenty of fresh, clean water. 60%-70% of their body weight is water. In the wild, they get most of their fluid requirements from prey. Cats fed on dry food require more drinking water than cats fed on canned foods. They are sensitive to the taste of water; some dislike the chlorine taint of tap-water so let tap water stand for a while, or use filtered or mineral water. Some cats dislike the smell of plastic so use glass or ceramic bowls. Rather than walk to his bowl, a dehydrated older cat may drink the closest available liquid e.g. cold tea or coffee; so place his water and food close to the cat's resting place.

Cats are obligate carnivores. Their teeth and bowel are adapted to slicing and digesting meat. 75% of their diet should be meat. They cannot digest fruit, vegetables or cereal though these items can provide bulk in the diet. If you want your cat to be vegetarian then you must question your reasons for owning a creature whose entire body and whose behaviour patterns are adapted to meat-eating and who evolved as a predator. It is ethically wrong to force a cat to be vegetarian diet just to fit in with an owner's belief system. You should adopt a house-rabbit instead.

Older cats have different dietary needs to kittens or active, younger cats. His digestive system is less efficient and he requires several small, easily digested meals a day. In the UK, look for "complete" (means nutritionally balanced) on the label; "complementary" means a treat food. In the US, look for "complete and balanced product for maintenance" with a statement that it meets AAFCO (Association of American Feed Control Officials) requirements. The UK body regulating pet food is the PFMA (Pet Food Manufacturers Association). Waltham Nutrition Centre (UK) researchers consider that changes to the digestive system begin to take place around 7 years of age and that cats aged 7+ require food containing easily digested protein.

There are "life-stage" foods available for Older Cats and formulated to suit a less efficient digestive system or to combat obesity. Senior cat formulations provide easily digested protein, but are expensive and some cats dislike them. Unless your cat has problems with regular cat food, or is becoming obese, an ordinary complete and balanced formulation plus fresh drinking water is usually adequate. Rather than impulse-buy life stage foods, ask your vet if your cat really needs them. Don't be emotionally blackmailed into buying an expensive product if your cat is healthy on regular brands of food.

In the US, some proteins are considered hypoallergenic e.g. lamb, rabbit, turkey or duck. This is not strictly true; those proteins are simply uncommon in many US cat food formulations and cats may not been exposed to them often enough to develop an allergy. In the UK, lamb, rabbit, turkey and duck are among the most common ingredients and just as likely to trigger an allergic reaction as beef or chicken. In the UK, venison may be used in hypoallergenic diets as it is rarely found in UK cat foods. Horsemeat and whalemeat would also be hypoallergenic for the same reason, but are taboo in Britain.

Cats enjoy a variety of tastes and textures: canned (UK: tinned) food, semi-moist pellets, dry food (UK: biscuit, US: kibble) and occasional treats of cooked meat, fish, egg or even a small amount of fruit or vegetable. Your vet will advise you on nutritional matters, but be aware that he may get commission for selling certain brands of non-prescription food in his clinic. Prescription diets are necessary to control diabetes, heart, liver or kidney disease, obesity, digestive or urinary problems or food intolerances. Cat food ingredients basically simulate mouse-in-a-can or mouse-in-a-biscuit. Your vet may recommend nutritional supplements for certain individuals. If your cat eats a balanced diet and has no digestion problems, supplements are unnecessary and could upset the balanced nature of the diet.

Many British cat nutritionists recommend canned foods for their better bulk (combats constipation) and high fluid content (for healthy kidneys). If you use canned food, clear away or refrigerate uneaten food or it becomes stale or fly-blown and may cause digestive upsets if eaten later. If you find canned food wasteful, buy smaller cans, foil trays or pouches. They are more expensive weight for weight, but may save money due to less waste. If the large cans are prescription foods, ask the vet if the product is available in small cans or biscuit form.

American cat nutritionists recommend dry foods but American cat magazines give frequent advice on combatting constipation caused by these energy-dense, low-bulk foods. Many cats enjoy dry food and the crunchy texture helps keep teeth healthy. Cats which eat dry food require plentiful drinking water. Some dry foods are marketed as reducing stool bulk and odour. This is entirely for your convenience (litter tray emptying) and can cause problems such as constipation since the cat's bowel is designed to handle a certain amount of bulk. Cats on concentrated foods require smaller portions and often overeat because their stomach does not feel full. You may have to accustom your cat to canned food as he ages since a toothless cat often gulp down dry food which leads to indigestion, regurgitation or vomiting of undigested biscuit. Most dry foods can be softened with gravy and the old problem of dry food causing urinary tract disorders has been overcome with modern formulations.

If you cat has problems without teeth, you can chop canned food to a manageable consistency. Some pate-consistency food can be mashed with gravy, tomato juice (from canned fish), sardine-oil or warm water. Dry food can be moistened with gravy. Liquid foods (e.g. Liquivite) are complete foods but can be used to soften biscuit. Meat-based baby food is a treat of ill or convalescent cats, but is not balanced for cat consumption and may contain onion in the ingredients. Onion is toxic to cats and causes Heinz body anaemia.

Some cats need extra roughage in their diet to combat weight gain or constipation. Older bowels may become lazy and require more bulk to keep things working smoothly. Try mashing one or two teaspoons of bran, porridge oats, canned pumpkin, cooked rice, cooked pasta or cooked mashed potato into canned food. Some older cats also enjoy warm porridge or hot oat cereal on cold mornings, but this is not suitable for cats with lactose intolerance.

Your cat's sense of smell deteriorates with age, causing poor appetite or faddiness. Strong smelling canned food may overcome this. Cats are good at manipulating their owners into serving favourite foods, which may not be what is balanced and best for it. Unless you enjoy preparing balanced gourmet meals for your cat (possible but time-consuming) resist being manipulated as this risks dietary imbalances.

Signs of poor diet include thin, dull coat, excessive shedding or dandruff, weight loss, vomiting, diarrhoea, yellow teeth and mouth odour. A cat which wobbles as he walks is probably receiving too many calories for his level of activity. Any cat which has difficulty eating or has lost its appetite should be examined by a vet in case there is an underlying problem. A suddenly increased appetite, especially if coupled with weight loss or poor condition, also needs to be investigated.

Older cats becomes less agile as arthritis develops and muscles begin to atrophy and will reduce their physical activity. Moderate, regular play sessions promote muscle tone and suppleness, increase blood circulation, and help maintain bowel condition. During play watch out for laboured breathing or rapid tiring that may suggest the cat has a disease; quit playing when the cat tires. It may be necessary to relocate food dishes and litter boxes for cats with advanced arthritis and muscle atrophy. If you have a garden, but it is to dangerous for the cat to go outdoors alone, try slow gentle walks (or long sit-downs on the grass!) using a harness and leash. A dose of fresh air can perk up a cat no end.

Older cats may not wear down their claws as quickly as before, so more frequent trimming is needed. They may not use scratching posts as frequently to remove the outer sheath of their claws. Check claws weekly and trim when necessary. Overgrown claws snag on carpets or furnishings, sometimes causing injury as the cat tries to pull free. Badly overgrown claws cause discomfort and problems with walking. A cat trims his back claws by chewing off the loose claw sheathes. A cat without teeth can't do this so back claws also need attention.

Claw-trimming is not difficult, especially if the cat is docile. A vet can show you how to trim claws. An older cat's claws also become more brittle and may not fully retract as the muscles become less efficient. A scratching post is still recommended (and helps to stretch and exercise leg muscles), although an older cat may use it less or its use will be less effective.

Adult cats spend a third of their time grooming. This decreases as they grow older, less supple and less energetic. They need more help with grooming and keeping clean. Some only groom after meals or only groom easily accessible areas (face, chest). Senile cats may stop grooming entirely. Extremely old cats may pay little attention to their own hygiene, but appreciate it if you help keep them clean, comfortable and sweet smelling. If you have two companionable cats they may groom each other. As well as keeping the coat in good condition, grooming helps to establish a strong bond between cats and between cat and owner. Daily brushing can be relaxing and enjoyable quality time for both of you.

Brushing removes dead hairs from the coat and helps prevent matted fur. It stimulates blood circulation and sebaceous-gland secretions in the skin, making skin and coat healthier. A fine toothed comb removes skin parasites. The area under the tail sometimes needs a gentle wipe with a damp tissue or pet wipe. Few cats like having their belly combed; there is no need to press the point unless the belly fur becomes matted. While grooming your cat, check for unusual lumps, bumps, wounds or external parasites. Unusual or unexplained lumps or wounds should be examined by a vet for appropriate treatment. External parasites can be controlled by treating the cat and its environment with recommended pesticides.

Grooming reduces the formation of hair balls by removing loose fur before the cat swallows it during self-grooming. Hairballs can cause problems for an older cat because his stomach and bowel may become lazy and more easily obstructed. If he does not self-groom, his coat quickly develops mats. Cats use their teeth to "comb" out mats, so cats with painful, few or no teeth have problems in preventing mats. Daily brushing prevents shaving or clipping later on. Mats are commonest on the flanks, inside thighs, "armpits" and ruff (of longhairs). Mats containing cat litter or faeces can form under the tail or on the back legs. Mat breaker combs are useful and may prevent the need for de-matting under anaesthetic.

Longhaired elderly cats may become messy around the backside because they cannot do the necessary contortions to reach this area. Few cats like being combed in this area so you may want to trim the fur under the tail (britches) to stop faeces, cat litter and mud sticking to it. Cats rarely need to be bathed, but if he becomes very dirty a bath may be necessary. Most cat care books will tell you how to do he is completely dry before allowing it outdoors.

Hairballs (fur balls, trichobezoar- literally "hair-stone") cause vomiting. Cats swallow hair while grooming and this must come out of one end or the other! If it accumulates and doesn't pass through with food, it is regurgitated in a sausage-shaped mass of compressed fur which is either grey or stained by food colourings from a recent meal ("red hairball syndrome". Cats sometimes eat grass to trigger hairball regurgitation. A hair ball too large to be regurgitated or excreted causes intestinal blockage. This is more common with cats fed on dried food which lacks fibre. He develops a swollen belly and either diarrhoea or constipation depending on where the hairball is stuck. A laxative or fibre supplement may resolve the problem, but sometimes surgery is needed. If he is prone to hairballs, a higher fibre diet, non-digestible fat/oil (liquid paraffin, petroleum jelly) or mild laxative (Katalax or a hairball paste) may be needed in future.

Hairballs which pass through your cat may dangle from his anus because strands of fur in stool are attached to fragments of stool still inside the body. If these cannot be pulled free with very gentle pressure, you can snip the dangling stool free with scissors. This occasionally occurs with longhaired cats.

Older cats are susceptible to tartar build-up and oral diseases such as gingivitis (inflamed gums) and stomatitis (inflamed mouth lining). Some illnesses cause mouth or tongue ulcers. Signs of mouth problems include bad breath, drooling, yellow-brown tartar build-up on the teeth, pawing at the mouth (especially after eating) and poor appetite. Severe gum disease causes painful red and swollen gums, loose teeth and pus seeping from tooth sockets. Bacteria from infected gums can get into the bloodstream and cause other problems. Cats do not tolerate mouth pain well and may stop eating or grooming because the mouth is sore.

Try to check your cat's teeth and gums regularly for signs of tartar or reddened gums and ask for a dental check up at vaccination time. Dental problems are more common in cats fed exclusively on soft foods. Dried food, fed as part of the cat's diet, has an abrasive action on teeth and helps to keep them clean. There are also specially formulated cat treats (e.g. Pounce Tartar Control, Whiskas Dentabits) whose size, shape, texture and chewy consistency help clean the teeth as the cat bites into them. Australian vets recommend feeding raw chicken wings for their abrasive texture; claiming that the bone is not hazardous if it has not been cooked. In the wild, cats teeth are kept clean when biting into tough muscle meat, bone and biting through skin or rind of the prey. Some cats even chew on rough materials (fabric, tough leaves) to remove trapped particles in their teeth.

It is possible to slow down the loss of teeth by regular check-ups and teeth-cleaning but your cat's teeth may eventually wear out regardless of diet. Some cats are genetically more prone to gum disease (as an auto-immune condition). When the teeth have gone, it may be hard for them to eat dried cat food. They swallow it whole and may suffer indigestion and vomiting. Most toothless cats manage very well on softer foods and many manage well on dried food with small biscuit size or even develop hardened gums which allow them to eat biscuit food.

It is possible to clean your cat's teeth to remove plaque and prevent tartar build-up, but he needs to become accustomed to this when young. Preparations such as "Logic" toothpaste can be rubbed onto his teeth without requiring a brush. You could gently rub his teeth and gums with a piece of gauze or veterinary toothbrush soaked in special mouth rinse or coated with cat-specific paste. Human toothpaste is not suitable - he won't like the taste, it makes him drool and may be toxic if swallowed. If your cat has a build-up of tartar, get the vet to de-scale his teeth under anaesthetic and remove any teeth which are beyond saving. Afterwards, establish a regular teeth-cleaning routine. This requires patience if he has never had his teeth brushed or cleaned before!

General anaesthesia is riskier in older cats, but this should not prevent any dental surgery. Modern anaesthetics are becoming ever safer and modern vet clinics are well-equipped and have trained staff. Surgery should be carried out when your cat is well - sooner rather than later as loss of appetite cause additional problems. Prompt action at the first signs of mouth problems could save your cat's teeth and prevent gum infections.

After a dental operation, your cat needs softer food while his gums heal. I have known cats tuck into their favourite dried food within a few hours of going home which shows how much better they feel once painful teeth have gone. Others remain miserable for a few days as the gums are sore and they must be persuaded to eat. Your vet may prescribe antibiotics or painkillers and will explain how often to give them. Your cat will need a post-op check up to ensure his gums are healing. When mouth problems are resolved, your cat's appetite and normal grooming usually soon return. Many cats get a new lease of life after dental work, grooming neglected areas and becoming more active once the source of pain has gone.

Mature healthy cats sleep deeply for 15% of their lives and doze for a further 50% of the time, longer if bored. They are fully awake for 35% of their time (6-8 hours a day) mostly at dusk and dawn as this is when cats usually hunt. Older cats may sleep as much as 18 hours each day. Cats come back to full alertness faster than any other creature; but older cats sleep more deeply, are slower to rouse and may be disoriented on waking. Deaf cats sleep deeply because they can't hear sounds around them and have a false sense of security.

Most cats are happy to sleep in a blanket-lined box or on chairs or beds. If you want to buy your elderly cat his own cat bed or basket choose one large enough that he does not have to curl up tightly; older cats are less supple and less able to fit themselves into small cat beds. Most elderly cats find beanbag beds comfortable as the polystyrene beans retain heat and support a rickety body or stiff limbs. Position his bed away from draughts as cats dislike draughts. This is particularly important with older cats as they have less insulating fat and cannot withstand extremes of temperature as easily as youngsters. Most cats automatically seek out the warmest spot in the house so placing his bed near a warm radiator at night keeps him warm, especially in winter. A covered hot-water bottle or a heated pad (electrical or microwaveable) designed specially for pets (from pet-shops or vet clinics), is useful if he feels the cold or is recovering from illness.

Many cats like to sleep through cold spells and an older cat usually snoozes through the colder months. Shake out his bedding frequently to keep it fresh and vacuum it or dust it with flea powder to kill parasites. The bed or blanket should be laundered regularly to freshen it up and remove flea eggs. Make sure it is completely dry before allowing him to sleep on it again as sleeping on damp bedding is unhealthy.

Some older cats call out at night when the house is quiet (more often if they are deaf) and they feel lonely or in need of reassurance. Placing his cat-basket in your own bedroom may solve this. Many people allow their cat to sleep on the bed and as long as both you and the cat are healthy this is safe. Other cats become more settled and call less; you'll quickly discover if he is a night-time caller. Cats are naturally most active at dusk and dawn and this is when most of the crying out occurs. Some cases are due to hyperthyroidism, but most are due to seeking reassurance when you are out of their sight.

Your older cat has less energy, so place his food, water and litter box closer to his resting place e.g. in the same room. He will not appreciate climbing stairs every time he needs water or his litter box. If he can't easily reach these, he may not drink enough and may house-soil. This is not laziness, it is due to age and infirmity. An indoor litter tray is advisable in wet or cold weather even if he normally goes outdoors for his toilet since cold and wet weather can make him hypothermic. If he wants to go outside for the toilet, don't let him stay out for long. If he gets cold or wet, towel dry him and put him in a warm room or near a heater until he is completely dry. If he suffers from senility, you may need to bring him indoors as senile cats are forgetful of their own wellbeing and may let themselves become completely soaked.

Older cats are usually less adaptable to changes in their environment. If his territory is suddenly or drastically altered, this is stressful. Some stress may be unavoidable, but extra attention and a "safe room" full of familiar-smelling items (bed, toys, its blanket, some of your worn clothing etc) can help.

Many cats enjoy spending time outdoors (where the environment permits this) and a little daily exercise helps keep his body healthy and mind active. He may stay close and "supervise" you in the garden. He will probably become home-centred and less likely to go exploring, except for senile cats which may wander aimlessly. If he has poor sight or hearing, make sure he is in a safe place when you want to mow the lawn. Other garden hazards include pesticides, other chemicals, poisonous or irritant plants and dangerous or venomous wildlife. A special enclosure or supervised walks on a leash may allow him to enjoy the outdoors in safety.

Cats enjoy sunbathing, whether outdoors or indoors on a windowsill. Sunshine provides warmth and helps provide Vitamin D. A folded blanket or cat bed placed in an open greenhouse or conservatory may be appreciated, but be careful not to accidentally trap him in the greenhouse as older cats are less resistant to dehydration and heatstroke. If he regularly sunbathes outdoors, take precautions against skin cancer - dab non-toxic sun-block cream onto his ears and nose, especially if these are white or pale coloured. The last thing he needs is an operation under general anaesthetic to remove cancerous ears. Bushes, or a crate placed on its side, provide shade while allowing him to remain out in the fresh air. In hot weather provide extra drinking water to prevent dehydration.

Although most older cats use a cat flap, some lack the strength to push one open, particularly if it is stiff or heavy. A very rickety cat cannot cope with a cat flap, even if he used it when younger. If the cat flap causes problems, remove the flap section during the day and fasten a piece of cloth or light carpet in its place. Even indoor-outdoor cats should be kept indoors at night to prevent theft or accident so ensure that there is some way to secure the flap at night; this also prevents strange cats from entering the house at night.

Older cats may become more sensitive to some things in the environment (allergens) but less sensitive to other things (acquired immunity, built up tolerance). The commonest problem is flea allergy which causes scabs, itchiness and hair loss. Anti-flea treatments are essential to prevent flea allergy. Oil of Evening Primrose supplements help promote healing of damaged skin, but Tea Tree Oil is toxic to cats and is absorbed through the skin. Cats may become allergic to moulds, pollen, plants, household chemicals, plastic feeding bowls and food ingredients. Trial and error or allergy tests may identify the cause and the most usual treatment is to avoid the allergen.

Special provision should be made for an older cat being boarded for any period of time. A familiar object, such as a blanket or toy, may prevent him from becoming too distressed in a strange environment. A better alternative is to have him cared for at home by a neighbour, friend or relative. Other traumatic experiences include the introduction of a new pet or family member, or moving house.

Since most older cats are happy to spend more time dozing, they will be quite happy if a neighbour pops in several times over a couple of days to feed them. If you are taking a longer holiday you may want to find a cat sitter or use your regular cattery or boarding establishment, informing them of any dietary preferences or behavioural quirks. UK owners looking for a cattery for the first time should look for one which has been approved by the Feline Advisory Bureau, your vet or your friends. Other countries have their own cattery approval systems.

There are plenty of publications and websites with feline health care information, the following is supplementary.

An adult cat adopted from a rescue shelter may already have been neutered (altered) or you must sign a contract to have it neutered. If you have adopted an unneutered stray, you should have it neutered. Neutered cats live longer. Neutering tackles feline overpopulation as well as antisocial habits. Neutered cats are at reduced risk from Feline Leukaemia Virus (FeLV), Feline Immunodeficiency Virus (FIV), mammary tumours (females), pyometria (womb infections) and injuries 1. sustained through fighting. Even later neutering can prolong your cat's life.

Keep Cat Flu (Calicivirus) and Feline Infectious Enteritis (Distemper) vaccinations up to date as your cat ages. It is tempting to let these lapse, but older cats have less efficient immune systems. If an adopted oldie hasn't been vaccinated, or you aren't sure about this, you can start vaccinations at any age. Depending on where you live, vaccinations are available for Cat Flu, Enteritis (Distemper), FeLV, Chlamydia, FIP and Rabies. Your vet will advise on which are required in your area.

Rabies is an acute viral infection of the central nervous system and is found in America and mainland Europe, but not in the UK, Hawaii, Australia, new Zealand and several other declared rabies-free states. It is spread by saliva e.g. bites or saliva entering broken skin. Wild animals such as bats, racoons, skunks and foxes may carry it. After being bitten by a carrier, it takes 4-8 weeks for your cat to show symptoms. He will act oddly and may become restless or excitable or reclusive. He will later go into body spasms, may become aggressive (cats more often become withdrawn) and even paralysed. Where rabies is prevalent cats require a rabies vaccination at 3 - 6 months of age with annual boosters. Rabies is incurable and dangerous to humans so a rabid cat must be destroyed. A cat which has been bitten by a potentially (unconfirmed) rabid creature must be specially quarantined for observation to see if he develops the disease.

The most common skin parasite of cats are fleas. Indoor/outdoor cats may also pick up ticks. Fleas and ticks are more problematical to older cats and may cause anaemia and skin problems as his body is slower to repair itself. Many cats suffer an itchy reaction to flea bites. Use a flea spray or flea powder formulated specifically for use on cats and in accordance with manufacturer's instructions. Flea collars are convenient, but less effective, and must be elasticated for his safety; some cats are allergic to them. Skin-drops (on the back of the neck) and food additives are available with the drawback that the flea must bite the cat in order to be zapped. Treat the surroundings as well, but never use an environmental product on your cat as environmental flea sprays are highly toxic if applied directly to the cat.

Tapeworms, roundworms and other internal parasites affect older cats as well as young cats, particularly cats which go outdoors. If he goes outdoors, treat him for worms, especially roundworms, every 3 to 6 months. Indoor-only cats may require less frequent treatment. Information about cat parasites specific can be found in most cat books and your vet will tell you of parasites common in your area. Vets consider that most healthy cats can tolerate some internal parasites (often with no symptoms), though older cats may suffer anaemia, lethargy and malnutrition due to their less efficient digestive systems.

Cats sometimes regurgitate their food, especially if they bolted it or scavenged something indigestible. Vomiting (throwing up, puking) is the forceful expulsion of stomach contents. Regurgitation is usually voluntary and less violent. Some cats eat grass to trigger vomiting. Cats, especially longhairs, regurgitate hairballs unless groomed regularly. Unexplained vomiting which lasts for more than 24 hours or is accompanied by diarrhoea or other symptoms must be investigated. Vomiting may be a symptom of disease, injury or poisoning. Vomiting and/or diarrhoea can lead to dehydration if left untreated.

Many owners see their cat eating grass and expect it to vomit soon after. Grass is a purgative, but is also eaten for reasons -additional roughage, a natural nutrient supplement, it tastes good. Make sure the grass your cat eats is free of chemicals. Indoor cats require a pot or tray of grass, those with no access to grass may eat houseplants, many of which are toxic. Spider-plants (chlorophytum) are a favourite because they are grass-like. Chlorophytum itself is non-toxic, but can absorb environmental toxins.

You may know what has caused the vomiting and decide it is no cause for alarm. If the vomit contains white worms (roundworms), the cat should be wormed. Other common causes include change of diet, rich food, overeating, bolting food, hairballs, spoiled food, eating non-food items, poisoning, viral or bacterial infection and over-excitement. Frequent comiting may be due to stomach ulcers, kidney or liver disease, diabetes, various types of cancer. Some cats have a hereditary condition of the oesophagus (food-pipe) or cardiac sphincter (valve at top of the stomach which usually prevents regurgitation); these conditions can worsen with age and are usually treated by placing the cat's food bowl on a chest-height stand so the cat eats standing up.

It the cause is a simple stomach upset, withhold food for the remainder of the day to allow his stomach to settle, but provide plenty of water. Provide small portions of bland food for the next few days or until he is visibly recovered. If the vomiting is due to food intolerances; try a different variety or different brand. Organic cat foods (e.g. Yarrah) or ones without artificial additives may help. A Selected Protein prescription diet may be required. If preservatives are the cause, a fresh meat diet with nutritional supplements may be required. Non-preservative usually have a shorter shelf life. If vomiting is due to eating inappropriate items, you must restrict access to these items!

Vomiting convulsions place a great strain on an elderly cat's system, using up energy and causing muscle strain. Continued vomiting causes serious dehydration. In brain experiments, scientists forced cats to retch or vomit continuously; the cats died from exhaustion and dehydration in under 24 hours. If your cat vomits, provide clean, fresh water so it can rehydrate. If he is under veterinary supervision or convalescing, the vet may recommend you provide an electrolyte drink (e.g. Lectade) or may use intravenous rehydration/feeding to reduce the strain on its stomach.

Occasional vomiting and regurgitation is normal, but continued or repeated vomiting or regurgitation is a sign of an underlying or more serious problem. If you suspect the vomiting is not simply indigestion or hairballs, visit the vet promptly. The earlier the cause is diagnosed, the more successful the treatment is likely to be. Visit the vet promptly if your vomiting cat has diarrhoea, is lethargic, won't eat or drink, or the vomit contains blood.

What goes in must come out so keep an eye on your cat's litter tray or toileting area and learn what is 'normal' for your cat. Some cats produce softer stools than others. Some foods may cause looser or firmer stools, but be alert for signs of worms, constipation, diarrhoea or bloodstained stools and take him to the vet if you see anything abnormal.

Diarrhoea (watery stools) occurs when the large intestine doesn't reabsorb liquid from digested food. This may the body rushing through waste matter (e.g. in cases of infection) or a malfunction of the gut. The most common cause is dietary upset or milk intolerance. A change of diet, internal parasites, antibiotics and steroids can also cause diarrhoea. Most of these causes are easily treated though it takes time for the cat's system to settle back down to normal.

Diarrhoea causes dehydration. If it persists for 48 hours or is bloody or your cat is also vomiting then see the vet. If your cat is seriously dehydrated, the vet will inject fluids subcutaneously (under the skin) or into the abdomen (peritoneally). If the cat continues to lose fluid, he may be put on an intravenous drip at the clinic.  American owners are recommended to take a stool sample (and a urine sample, if possible) from a sick cat to the vet, but this is not the norm in the UK where the cat may be kept in for overnight observation instead. In the US, the vet may take a blood sample for analysis; in the UK the cat will probably stay in overnight for this. It is harder to get a stool sample from a cat which toilets outdoors.

White or cream coloured stools may indicate liver and pancreas disorders or be the result of a recent barium meal/enema used by the vet to investigate a gut problem. A few smears of blood may reveal a rectal disorder (like haemorrhoids caused by straining) but dark blood or lots of blood in the stool indicates bleeding inside the gut and is far more serious. Inflammatory Bowel Disease (IBD) is more common in older cats and can cause liquid "cowpat-like" stools as the bowel no longer absorbs liquid.

Constipation happens when stools move too slowly through the gut or come to a complete halt, clogging up the gut. Constipated cats strain and have tender bellies. The commonest causes are hairballs, too little fibre in the diet (dried food is convenient for the owner, but produces small, hard stools which do not give the gut a good workout) or it may be due to an intestinal disorder. A cat laxative (e.g. Katalax) or liquid paraffin resolves most cases, but sometimes an enema or even surgery is required - especially if the blockage is due to a foreign body in the gut. Do not try to give your cat an enema at home - you could cause damage to his gut and he will almost certainly resist violently. Sedation is usually required.

Constipation is a common ailments of older cats. Bulk-forming agents, such as wheat bran, or other sources of fibre mixed with commercial cat food can help prevent hairballs and other blockages. Sometimes, surgical removal of the obstruction is necessary. Laxatives and hairball medications should not be used more than once a week unless recommended by a veterinarian, because they interfere with absorption of vitamins. Frequent constipation requires veterinary investigation. Some cats need their bowels expressed manually due to nerve damage.

Faecal incontinence (loss of bowel control) may be due to problems with the anal sphincter/rectal muscles or due to degenerative spinal or nerve problems. Amputation of the whole tail can reduce control of the rectum (tail muscles help squeeze out the contents of the rectum). Stools may be passed as the cat changes position or walks. If the involuntary motions are watery or soft, a bulking agent may produce firmer stools which the cat can control better. Some problems can be surgically treated, but if the problem is degenerative it will get worse, the cat may suffer paralysis of hindquarters and euthanasia may be required.

Older cats drink more water, but dramatically increased thirst indicates kidney problems, cystitis (inflamed bladder) or urethritis (inflamed "pee-pipe"). Kidney problems are more common in older cats as their kidneys work less efficiently (this is discussed elsewhere). Cats with cystitis pass frequent tiny amounts of urine, sometimes bloodstained or containing mucus (slime). Cystitis causes discomfort and must be treated by a vet. There are other reasons a cat might start to drink more so any unexplained increased thirst must be investigated by a vet. Make sure your cat has plenty to drink at all times - this keeps the urine dilute and prevents dehydration. If he doesn't drink water often, flavour the water with a little tuna juice or meat gravy. Canned food has a higher liquid content.

"Feline Lower Urinary Tract Disorder" (FLUTD) or "Feline Urological Syndrome" (FUS) is a general name for non-kidney urinary problems. FLUTD is more common in older cats. There is no single cause, but many contributory factors including diet, stress and a hormonal link. Symptoms and causes include cystitis, urethritis, tumour in the bladder/urethra, bacterial infection, injury to the bladder/urethra or kidney stones, bladder stones or "gravel" in the urine. Stones and gravel are less common than they once were - they were associated with dried cat foods, but modern formulations eliminate the problem in all but a very few susceptible cats. Stones are a build up of crystals or mineral deposits; either calcium oxalate or struvite, depending on urine pH. Urethral plugs are soft plugs of accumulated material containing minerals, blood, cellular debris and protein, blocking or partially blocking your cat's urethra ("pee-pipe").

If your cat has problems urinating or urinates every few minutes, see the vet at once. If he can't urinate at all, the kidneys can't function, infection sets in and he may die in 36-48 hours from blood toxicity or the pH of the blood changing. The vet will remove obvious blockages and may drain and flush out the bladder using a catheter. Rehydration and antibiotics/anti-inflammatories may be required. In male cats, frequent blockage can be surgically corrected by widening the urethra. The vet will probably prescribe a high-energy, low ash content food with reduced magnesium, calcium and phosphorous and ingredients to adjust the pH of the urine and prevent further problems.

Urinary incontinence (loss of bladder control) occurs in older cats if the bladder sphincter doesn't work properly or the bladder doesn't send "full up" signals in time for the cat to reach his litter tray. He may dribble after urination (sphincter doesn't shut off the flow), at times throughout the day (sphincter cannot fully hold back the urine) or when asleep (sphincter relaxes). It may also be caused by injury to certain nerves or to the brain. Stress incontinence (when coughing/sneezing) may be due to an infection which requires antibiotic treatment. Urinary incontinence is involuntary and should not be confused with house-soiling in senile cats or scent-marking (a behavioural problem).

Medication, hormone therapy or surgery may resolve the problem, but an immediate concern is keeping him dry and comfortable or he will suffer urine burns from sitting or lying in urine. Various types of bedding allow urine to seep through a stay-dry top layer into a washable absorbent layer. Stud-pants (a sort of diaper used for breeding male cats which spray) help if the cat tolerates wearing them. A low stress environment and several litter-boxes may reduce the problem by allowing him to quickly reach his toilet.

Cats sometimes need surgery. If pre-anaesthetic blood tests show mild liver or kidney problems, your vet may suggest feeding an appropriate prescription food for a few weeks before surgery to further reduce any risks. Before surgery your cat will be given a pre-med injection. He will be anaesthetised by injection and kept under using a gas anaesthetic. His pulse and breathing are monitored during the operation, just as for a human operation, and he may be given intravenous fluids during, and after, his operation. Heated pads are used during and after operations to keep him warm and he will be given pain-relief.

After returning home, he should be kept warm and quiet for a few days and may sleep off the effects of the operation. Your vet may provided painkillers since human painkillers are poisonous to cats. Your vet will give more detailed information on post-operative care and on going back for a check-up. Your cat will usually let you know when he feels fully recovered, but always follow your vet's advice and contact him if you notice any problems or have any concerns.

As cats grow older, they become less resilient to illness or injury and recover more slowly. They may develop stiffer joints and a more relaxed pace of life to compensate. Cats are generally healthy creatures and fairly low-maintenance even as they age., but when they are unwell they tend to hide their symptoms. Many vets run "Older Cat Clinics" and recommend that cats over 5 years old have a veterinary check-up every 6-12 months (equivalent to 2-3 years in humans!) so that problems can be caught and treated early. A benefit of "Older Cat Clinics" is that you can meet other owners of older cats and compare notes. Annual vaccination time is another opportunity for a health-check.

In the US, a full health-check may include physical examination, weighing, checking stool sample, urine sample, blood sample and possibly tissue biopsies, X-rays or ultrasound scans. In the UK (due to the indoor/outdoor lifestyle and toileting outdoors rather than in litter trays) collecting samples would require an overnight stay at the vet clinic and are not done routinely due to the stress of hospitalization - your observations are therefore important.

Cats nowadays live much longer than in the past, and the fact that some ailments are more common in older cats doesn't mean that your cat will necessarily develop them. A great many cats reach their teens and twenties with little or no sign of deterioration. The following symptoms are worth reporting to your vet as they help him to make an early diagnosis of a problem before that problem becomes serious. Remember: prompt diagnosis prolongs life. 

Sometimes your cat will need an unscheduled visit the vet. Most good cat care books contain information about ailments which can affect cats of all ages. Accidents including poisoning will mean and unscheduled emergency visit.

Many household and garden items are toxic to cats and are listed in cat care books. The list includes unexpected items such as chocolate and onion. Aspirin, other human medications, ethylene glycol (antifreeze) and slug pellets are seriously toxic to cats. Chemical poisons may burn the mouth and throat making the cat paw at its mouth and drool. Behavioural effects include lethargy, restlessness, anxiety, confusion. Other symptoms include vomiting, staggering and collapse. Poisoning may be fatal or may cause sickness depending on the toxin, the quantity swallowed and the age, weight and health of the cat (this is why medical drugs have dosage per pound/kilo bodyweight). Making the cat vomit may cause more harm than good as the vomit may scald the throat and mouth. Seek emergency vet attention; if you know what the cat has eaten tell the vet and take with you any container to help the vet determine the best treatment.

The following symptoms in an older cat should be investigated by your vet.

Don't delay in taking your cat to the vet if you are concerned about its health. Although the cause may turn out to be trivial, your vet would much rather declare your cat fit and healthy than have to tell you that an illness has progressed too far to be treatable. It is more effective to treat problems early on, ensuring a healthier, longer life. While at the vet clinic, your will give you cat a check-up and may note symptoms which you have missed.

Not all tablets can be crushed into food and some cats simply cannot be pilled using conventional methods. I have owned cats which could not even be pilled by vets aided by a veterinary nurse! Ask if there is are alternatives e.g. liquid medication or injections. If not, you may have to accept that your cat will not live as long as a medicated cat and be prepared for euthanasia if or when he deteriorates.

Get the vet to demonstrate how to give a pill or refer to an illustrated cat book. You may need someone to restrain yopur cat or you may have to wrap him in a towel. Watch him to make sure he swallows the pill before releasing him and watch for a few minutes afterwards in case he regurgitates the pill. Feeding a kitty treat afterwards usually prevents regurgitation!

Other methods include a pill gun from the vet or pet store, placing the pill inside a hollow cat treat or mixing it with canned cat food. Cats often eat around the pill (they can smell it even if you can't) so you must crush it thoroughly and mix it well in strong-smelling food to mask the smell and taste. Other methods I have found useful include putting the pill inside a piece of cooked sausage or a ball of cheese; if these foods are rare treats then the cat will eat it before you change your mind! I have also found crushing the pill and mixing the powder with a small amount of milk, water or gravy and spooning or syringing the liquid into the cat's mouth to be useful as the cat instinctively swallows the liquid

Powdered medication can be mixed with strong smelling cat food. Sardines/pilchards in tomato sauce are ideal if your cat likes these. Otherwise you may have to mix the powder with liquid and syringe-feed it to your cat.

Injections are given into a muscle or under the skin (subcutaneously). It is often easier to inject a cat than a human as the fur hides the sight of the needle going in. Ask your vet to teach you the technique. Skin is surprisingly hard to puncture and you will probably have to inject water into a number of oranges to learn how to get the speed and pressure right.

Signs of pain include trembling, shivering and crouching. It may be hard for you to identify the source of the pain (especially if it is an internal problem) and cats may respond badly to your attempts to do so. Human painkillers such as aspirin, paracetamol, acetaminophen or ibuprofen are lethal to cats. Warm compresses may help if you can locate the source or already know the cause (e.g. arthritis). Warmth and sleep are great pain-relievers and a hot-water bottle wrapped in a fleece and placed in the cat's bed may help. Unless the cause of pain has previously been diagnosed, see the vet promptly.

Learn to read your cat's body language and learn what is normal for him when he is contented. That way you will more quickly recognise signs of illness, discomfort or distress. Cats in pain or distress often purr as a way of reassuring themselves; this confuses owners who recognise purring as a sign of all being well. Purring realises endorphins (the body's own pain killers and feel-good chemicals, actually very similar to opiates) to help reduce the pain.

Many owners like to use complementary (alternative) treatments and some vets are qualified in certain alternative therapies. Speak to your vet before giving homeopathic or herbal remedies as these may interact with prescription drugs, making them less effective or making your cat ill due to their combined action. Non-drug complementary treatments such as acupuncture, massage, Bach Flower Remedies, crystal therapy, faith-healing, prayer etc are usually safe. I have never known a cat suffer prayer-allergy. Some vets can refer you to acupuncturists or other complementary therapy practitioners. If you seek the practitioners yourself, it is still common courtesy to tell your vet. Some conventional treatments have complementary alternatives, some do not. I have successfully used Evening Primrose Oil long-term instead of corticosteroid treatment for feline skin problems.

Be careful about nutritional supplements as these can unbalance a balanced diet. Certain vitamins are toxic in large quantities or may accumulate to toxic levels in the liver or fatty tissues.

Most serious injuries and diseases can be treated but surgery and medication may be expensive. Some may be prohibitively expensive if you don't have a high income or plenty of savings. For this reason, a growing number of owners take out pet insurance. Policies differ, but most cover courses of treatment or one-off treatments (e.g. emergency surgery). Many insurance firms will not allow you to take out a policy on a cat aged over 10 years unless it has been insured previously. This deters some people from adopting older cats from shelters. Despite the apparently scary list of things which can go wrong, older cats are generally robust and healthy and the benefits of companionship outweigh any additional costs.

An alternative to pet insurance for veterinary bills is to arrange instalment plans for paying veterinary bills. This must be arranged in advance will only be granted if you are already a good client (i.e. you always pay your bills) at that clinic.

The ageing process increases susceptibility to certain disease. An older body is less good at repairing damage or repairs are incomplete or faulty. This results in degeneration. Some organs start to malfunction due to accumulated wear and tear or to cellular changes so diseases due to degeneration and dysfunction become more common as cats age. The age at which degeneration begins and the rate of degeneration is mostly genetically determined, but is influenced by the environment and slowed by early detection and medical treatment. However observant you are, cats are good at hiding symptoms and may be very sick by the time you notice anything and see the vet. You might wonder why this is. It is an evolutionary survival trait - a sick cat attracts the attention of a larger predator; hiding symptoms may be great in the wild, but presents a problem in the home where early detection means treatment is more likely to be successful.

There are many excellent cat care books (many are well illustrated) detailing feline ailments. You can also do a web search, email an on-line vet or phone your regular vet. This section concentrates on conditions more common in older cats.

The kidneys filter the blood and remove metabolic waste products which are excreted in the urine. If these waste products (e.g. urea) are not removed, blood toxin levels rise making your cat ill. The kidneys are usually the first organs to wear out. Kidney disease is ultimately fatal; early diagnosis can slow its progress. Some breeds are susceptible to kidney problems e.g. hereditary polycystic kidney disease (PKD). Due to the wear and tear of a lifetime of service, the kidneys wear out. Chronic nephritis (inflamed kidneys) resulting in scarred and shrunken kidneys, is the most common cause of chronic kidney failure in older cats.

Chronic kidney disease (Chronic Renal Failure, CRF) is a progressive, fatal condition as kidney function progressively decreases and don't filter the blood properly. At the same time, protein is lost through the kidneys and can be detected in the urine. Supportive treatment (special diet, dialysis, drug treatment) can extend your cat's life and give good quality of life for several months but he will lose too much kidney function to survive. He may show no symptoms until only 30% kidney function is left and his blood urea levels are extremely high. Symptoms of kidney failure include poor appetite, weight loss, increased or excessive thirst, increased urination, bad breath, mouth ulcers and vomiting. If he goes outdoors he may show an unusual preference for drinking greenish standing water or pond water. In the later stages he may suffer seizures or coma as toxins accumulate and circulate in the blood and affect his brain. Death due to blood toxicity is slow and usually unpleasant as other organs are being poisoned.

As kidney function reduces, they produce more urine to flush out the metabolic wastes and your cat drinks more water. This is the body's version of dialysis. The kidneys can only process a limited amount of fluid per day. Potassium, an essential mineral, is lost in the urine and low potassium levels in the blood (hypokalaemia) further damages the kidneys, causing a vicious cycle. Your vet may prescribe potassium supplements to counteract this. The effects of kidney failure can be reduced, but not cured, by medication and a low-protein, low-sodium, low phosphorus diet, which produces fewer waste products. These foods are commercially available in the US. In the UK they are available on a vet prescription. Plenty of fresh water is crucial.

Due to the cat's low blood volume, human-style dialysis (fluid therapy) on a kidney machine is not possible. Your vet may inject extra fluid into a vein, under the skin or into the abdomen. This increases the blood volume, blood pressure in the kidneys is increased and they filter better. The effect is temporary and frequent dialysis is distressing to most cats and may require regular anaesthesia which is riskier for older cats.

In the US, kidney transplants are experimental procedures in cats. The donor cat can survive on one kidney, but when the donor ages it will probably suffer kidney failure at an earlier age as there is less kidney tissue to begin with. Owners of the recipient cat must undertake to provide a loving, permanent home for the donor whose life expectancy has possibly been reduced in order that their cat lives longer. There is a huge cat overpopulation problem in the US. A sensible (but unpalatable) solution is to remove kidneys from anaesthetized cats due for destruction and then euthanize them immediately. This would eliminate the need for donor cats and use tissues which are otherwise incinerated.

In the UK, a new drug treatment for CRF was announced in 2001. It is still being trialled and is not yet generally available from vets. Fortekor is a daily tablet which can increase survival time by up to three times. It works by normalising the blood pressure within the kidney so they filter much better. It also reduces urinary protein loss. Fortekor is not a cure, but it slows down progression of disease and gives the cat a good quality of life.

In 2003, British vets gave their approval for cats to have kidney transplants in the UK as long as strict guidelines were adhered to. The issue went before the general council of the Royal Council of Veterinary Surgeons (RCVS) in London in autumn 2002. In february 2003, its members sanctioned the practice of feline kidney transplants, which could cost up to £8,000. The RCVS expects only a handful of cases in the UK in the early years.

Some of Britain's main animal charities had expressed ethical concerns about the procedure, particularly regarding the issues of choice and consent. Both the RSPCA and Blue Cross said they are worried that, unless stringent guidelines were passed, animal welfare could be at risk for both the donor and the recipient. However, the RCVS insisted that guidelines would be robust and that members of surgical teams would have the appropriate qualifications. While RSPCA officials were pleased that the RCVS was taking the matter seriously, they remained opposed to the treatment because of the long-term health implications for both cats.

According to RCVS president Stephen Ware,it was important to note that the decision to carry out the procedure would be a clinical veterinary decision in the first instance, and would depend on the condition of the patient and the suitability of the potential source animal.

"It's not going to be something done by a normal practice on the high street. It would be done at approved centres with a team of veterinary surgeons with all the relevant qualifications." Advanced specialist equipment would be needed, such as that found at the six veterinary teaching centres in Edinburgh, Glasgow, Bristol, London, Cambridge and Liverpool.

Kidney transplants for cats have been available in the USA for several years where the owner of the recipient cat must provide a good permanent home to the donor cat. Although donor cats appear to live happily with only one kidney, it is likely that signs of kidney deterioration will occur earlier as the donor has only 50% of its original kidney capacity. This reduces the donor cat's life expectancy. Because of this, some owners and cat workers believe that only kidneys from cats euthanised for other reasons (injury, overpopulation) should be used in transplants.

While sympathetic to owners of ailing cats, Messybeast is opposed to kidney transplants unless (a) the donor is permanently adopted by the recipient's owners and (b) it would have been euthanized had it not been selected as a donor or (c) where the donor is being euthanized due to injury. Because the donor cats will have compromised kidney function and are likely to suffer renal failure earlier than cats with two kidneys (due to loss of kidney capacity), an owner is essentially trading the life expectancy (or even the life) of the donor cat in order to prolong the life of the recipient cat.

2. CANCER

A cat's chances of developing cancer increase with age, but cats are less prone to cancer than are dogs or humans. Cancer occurs when normal cells go rogue and start to multiply out of control. Something goes wrong with the genes inside the cell and it doesn't know when to stop. This may be a random hiccup in the cell or may be due to cell damage due an accumulation of carcinogens (cancer-causing substances) in the body because the liver is not good at removing these. Infectious-diseases or poor immune system are also factors. Chemotherapy can give some cats a short-term remission from some types of cancer and therapies (including homeopathy) may be given to improve the immune system.

Feline Leukaemia Virus (FeLV) causes lymphosarcoma. FeLV is contagious, but vaccinable. It is always fatal because of persistent secondary infections (a bit like secondary infections and cancers kill human AIDS sufferers). Symptoms are variable and non-specific so a blood test is needed. Tumours associated with FeLV commonly occur in the lymph nodes, kidneys and intestines and might only be detected by blood tests, X-rays, ultrasound scans or biopsies. Lymphosarcoma is incurable and ultimately painful. Euthanasia is recommended.

Unspayed or late-spayed female cats are at increased risk of mammary (breast) tumours. Approximately 85% of mammary tumours are malignant and the cancer often spreads to other tissues. If detected early, surgical removal can give several more years of active life as happened with one of my oldies. The tumours generally recur and become more aggressive. My own cat had a second surgery 3 years after the first. She recovered, but the tumours re-grew and affected multiple sites in her body within 3 months of the second surgery and she was euthanized 3 months after that.

Early detection is essential to improve the prognosis and some types of cancer can be "cured" completely by radical surgery e.g. amputation an affected limb. The symptoms are often non-specific and confusing, so general debility (persistent general malaise) or unusual lumps and bumps should be investigated by the vet.

Skin and coat reflect internal health, any changes indicate problems inside. The hair is naturally thinner between the eyes and ears; this becomes more obvious as the cat ages. Fur may cease to grow underneath a collar. Dull, dry, oily and/or unkempt fur (so called "staring" coat) are signs that something is wrong. Fur-plucking and sucking are sign of stress. If you groom your cat regularly you will spot any changes, these could be minor or could be early warning signs of another condition.

As your cat gets older his skin becomes more fragile and less elastic. His fur may thin as his body expends less effort on maintaining his coat. Skin irritations and wounds heal more slowly. Age-related nutritional deficiencies and hormone problems can affect his skin and fur causing alopecia (balding), flaky skin and feline acne. Oil of Evening Primrose (Efamol, Efavet) in the diet is beneficial to the skin. Some owners wipe Tea Tree Oil on the skin, but this is toxic to cats. Tea Tree Oil toxins are absorbed through the skin (faster through broken skin) and build up in the liver and fatty tissues because the cat cannot break them down. Older cats have less fatty tissue so they are at greater risk from Tea Tree Oil toxins building up in the liver.

If you notice skin or fur problems, get the vet to rule out disease or serious disorders. Poor coat and skin may be treated with fatty acid supplements. Oil of Evening Primrose contains naturally occurring hormone-like substances can sometimes be used in place of corticosteroid treatments for example if the steroid treatment causes unpleasant side effects. 

Older cats may suffer chronic degeneration of muscles, joints and vertebral discs. Vertebral discs are cartilage disks between the segments of the backbone; these are the culprits in "slipped" discs. Arthritis occurs when the cartilage at the end of a bone (where the joint is e.g. the knee) wears away. The ends of the bone are no longer protected - a little like not having enough oil to lubricate parts of a car engine.

Many owners refer to their cats as being "rheumaticky", meaning he has stiff joints or is limping. If his joints become painful, he becomes less active and may become lame, stiff, reluctant to move or may suddenly stand still after getting up (due to painful joints). He may become irritable or vocal due to discomfort and may resent being handled or even stroked in certain places. Osteoarthritis is the most common form of feline arthritis and is a degenerative condition of the cartilage at the ends of the bones; it erodes away. Sometimes it results from an injury or disease. Rheumatoid arthritis is less common and is an auto-immune condition where the body attacks its own tissues, resulting in arthritis.

The vet may need X-ray to confirm the diagnosis. Treatment varies according to the type and severity of arthritis. It can't be prevented or cured, but the pain of inflamed joints can be alleviated. Anti-inflammatories and painkillers help in the earlier stages. Steroids and certain supplements may also be used. You might try a cold compress to cool the joint and reduce swelling, but most cats don't like damp things being applied to their body. Cod Liver Oil (Vitamin A&D fish oil) helps lubricate the joints while certain food supplements help support or build cartilage. Acupuncture helps in some cases.

Hyperthyroidism (overactive thyroid gland) is one of the most common endocrine (hormonal) problem in older cats. It seems to be becoming more common, but vets are not sure whether this is because it is genuinely on the increase, whether it is due to lifestyle and/or longevity or whether it was previously under-diagnosed or mis-diagnosed. My first cat exhibited symptoms now associated with hyperthyroid, but in her lifetime the diagnosis was "Old cats just get thin and bony" (she lived to the age of 19 and was not in any pain).

Hyperthyroid is due to the thyroid glands producing too much thyroid hormone. The thyroid may be enlarged or may have a tumour. This speeds up the metabolism and the rate at which your cat burns calories; it may damage the heart and kidneys as they must work harder. Left untreated, it can lead to heart, kidney or liver failure. Symptoms include hyperactivity, rapid heartbeat, scruffy fur, drastic weight loss as weight is burned off, increased appetite, bulky plentiful faeces (e.g. lots of soft, putty-coloured faeces), thirst and increased urination. Your vet can diagnose hyperthyroid with a simple blood test. He may perform a biopsy (tissue sample) of the thyroid gland to check for a tumour. Treatment includes radioactive iodine treatment (effective but expensive), chemotherapy (for a tumour), surgical removal (common with very good success rate) and oral medication (pills). A cat can have both thyroid glands removed and still enjoy excellent health, often without medication as sufficient thyroid hormone is produced elsewhere in its body.

Hypothyroidism (under-active thyroid gland), is due to the thyroid gland not producing enough thyroid hormone. It is rare in cats and can be corrected with hormone supplements. Symptoms include hair loss and dry skin, weight gain despite appetite remaining the same, lethargy and irritability.  

Some cats born with heart defects show no symptoms until later in life, when there is increased stress on the heart and circulatory system. Heart disease usually occurs in middle-aged cats (6-8 years old) often as a result of another condition such as hyperthyroidism or kidney disease. Many symptoms of heart disease (lack of energy and appetite, decreased activity, long rest periods) are overlooked because they are also symptoms of normal old age. More obvious symptoms are a tendency to lie flat on the breastbone and reluctance to move from that position. Your cat may pant or breathe with its mouth open due to fluid building up in his chest leaving less room for his lungs to expand. His hind limbs may be suddenly paralysed, his paws will be unusually cool because they have a poorer blood supply. In extreme cases, lack of oxygen supply gives him a bluish-grey tongue and/or gums and he loses consciousness after mild exercise (including walking).

The most common form, cardiomyopathy, causes the heart muscle to enlarge or thicken. This causes a strain on the heart which beats faster to compensate. As the heart loses its ability to pump blood, other organs are affected due to poor blood pressure. Fluid leaks out of the lungs and accumulates in the chest causing respiratory symptoms. Parts of the body furthest from the heart (the paws) feel cool and may be pale due to poor blood supply. Your cat will be generally lethargic and may even faint. Heart disease is serious; a number of modern drugs may improve the condition temporarily though these do not work for all cats.

Anaemia (lack of iron in the blood) is common in older cats. There are many causes including parasites, poor diet, internal bleeding etc. Anaemia is easily detected by blood tests and treatment includes detecting and treating the cause as well as treating the anaemia itself. Potassium, present in blood and cells, is essential especially for muscle cells including the heart. Lack of potassium causes severe muscle weakness. Milk lack of potassium (mild hypokalaemia) in older cats is associated with lethargy and low activity levels, poor appetite, poor coat and mild anaemia.

Thromboembolism (blood clots) can occur in cats of all ages for a variety of reasons. Saddle Thrombus is more common in older cats and is often referred to as a "stroke" as the effects resemble a stroke. It occurs when a blood clot blocks the artery serving the hind legs at the point where the artery forks into two branches. This can cause severe damage to the hind limbs due to a temporary or permanent loss of oxygenated blood. If the clot moves and your cat recovers, there will be fragments of the clot in the bloodstream and these may hit the lungs, heart or brain. After saddle thrombus, a cat may be left with a characteristic hock-walking gait due to muscle damage. Some cats have a good quality of life for several years under veterinary treatment.

Feline upper respiratory tract infections (FRTIs) range from "colds", caused by various viruses, through to full-blown "cat flu" caused by Feline Calicivirus (FCV, also called Feline Rhinotracheitis Virus), Feline Herpesvirus (FHV) and Chlamydia. Regular vaccinations protect against cat flu. Cats with colds or cat flu need supportive treatment. They can't smell their food and may lose their appetite. Symptoms include puffy, reddened eyes, runny eyes and runny nose. He will probably snuffle and sneeze and mucus will build up around his nostrils. Only one of these viruses is theoretically transmissible between cats and humans - this is Chlamydia psittaci; it is not a major cause of cat flu and humans are far more likely to catch it from infected parrots as psittacosis. It is possibly transmissible between cats and humans, but in practice I know of no cases of psittacosis being caused by cats. However colds and cat flu are easily transmitted between cats through sneezing and nasal discharge.

Short-nosed breeds are more likely to suffer from (or show symptoms of) respiratory tract ailments as their nasal passages are more easily clogged up. Older cats tend to have an acquired immunity to the viruses, however secondary bacterial infections may be more serious to an older cat. Warmth, rest and prescription antibiotics and decongestants are required. Humidity (steam bath) may ease breathing. Disinfection of his surroundings removes infectious snorted-out mucus.

Pneumonia can be a complication of cat-flu and is usually due to a secondary bacterial infection. Symptoms are like severe flu and he produces lots of mucky (yellow/greenish) mucus, either coughed up or snorted out of the nose. His face becomes crusty with dried mucus and he will look pretty miserable. With no sense of smell, he may refuse to eat or drink and may dehydrate. Force feeding may be needed.  Prognosis depends on his general state of health.

Diabetes is caused by degeneration of insulin-producing cells in the pancreas (in the Islets of Langerhaans to be precise). Decreased insulin reduces the ability of body cells to take up glucose (sugar) from the blood; this is Type I diabetes (diabetes mellitus). It is more common in middle-aged and older cats and is being diagnosed more frequently in cats. Whether it is genuinely on the increase, whether it is more common because of longevity and/or lifestyle or whether was previously under-diagnosed or mis-diagnosed is not known. Obesity is a contributory factor and cats are becoming progressively more obese due to living entirely indoors or becoming bored and inactive.

Symptoms include unquenchable thirst, excessive urination, diarrhoea, dehydration, lethargy (even coma) and a ravenous appetite yet the cat loses weight. There are 2 types of diabetes and the vet will test the cats blood or urine for glucose levels to see if the pancreas is producing the right amount of insulin. Depending on which type of diabetes your cat has, the condition can be controlled by diet and/or by daily insulin injections or oral hypoglycemia (sugar-lowering) agents, which aid in the metabolism of carbohydrates. A high-fibre diet helps regulate the rate at which nutrients are taken into the body cells. Several small meals each day will keep blood sugar levels more stable.

Type I diabetes (diabetes mellitus, sugar diabetes) is due to your cat producing too little insulin. This is the most serious and most common form. He cannot properly metabolise sugar in its blood and sugar is excreted in his urine. Insulin injections are required. Some cases respond well to insulin pills and there is progress with insulin nasal spray in humans which may also become available to cats. Your vet will train you to give insulin injections and to test your cat's urine.

Type II diabetes (too much insulin) is less serious and less common; it is found in older cats who have been consuming too many sugars (carbohydrates) over a long period of time. They have worn out the insulin producing part of the pancreas. A high-fibre, low-calorie diet may be prescribed.

In comparison to humans, cats do not have very efficient livers. They are specialised carnivores and rely on their prey's livers to have done the work beforehand. The liver can regenerate itself to some extent depending on how badly it is damaged and whether it can be "rested" for a while. Obese cats are more prone to liver disease. A common symptom of liver failure is jaundice - the skin turns yellowish as the body tries to get rid of toxins through the skin; by the time this is noticeable the damage may be irreversible.

Breaking down toxins is hard work and just like other parts of the body, the liver degenerates. Toxins (such as Tea Tree Oil) accumulate in the liver if they cannot be broken down. Liver tumours may also occur. Liver disease symptoms include vomiting, lethargy, poor appetite and jaundice. Neurological signs also occur - such as bizarre behavioural traits - caused by toxic chemicals reaching the brain and triggering strange behaviours. There is no cure for degenerative liver disease, but a prescription diet reduces the strain on the liver so its remaining function lasts longer. Medication helps reduce the signs of disease. As your cat gets older, he may need food which puts less strain on his liver.

Your cats can suffer liver damage from not eating for 2 or 3 days. When his stomach is empty, his body uses up fat stores for fuel. Unfortunately your cat's liver is not very good at metabolising fat for energy and fat begins to accumulate in the liver. Next, the body burns muscle for fuel. The result is weight loss, diarrhoea, anaemia and a general wasting away.

Hepatic lipidosis (fatty liver disease) happens when fatty deposits accumulate in the liver. As well as generalised symptoms of illness; your cat will produce pale faeces and dark urine. If he can be persuaded to start eating again, his liver starts to function correctly. He needs highly nutritious food quickly, perhaps via a feeding tube through his skin and directly into his stomach. However, symptoms may not be noticed until the damage is too severe to be reversed. Afterwards he may need a low protein, lower fat diet to ease the strain on his liver.

Senility is a gradual process and may be barely noticeable until the cat begins house-soiling or an indoor/outdoor cat gets lost frequently or wanders erratically. Just like the kidneys, liver and heart, your cat's brain degenerates and his memory and behaviour change. Genetics plays a part in determining when and how fast these changes occur - sometimes as young as 12 years old, sometimes not at all, even in a cat of 20+ years old. Stray and feral cats rarely if ever live long enough to become senile. If by chance a feral cat becomes senile, or if a senile cat is abandoned or becomes lost, he soon falls prey to a predator or to misadventure caused by his own diminished cognitive (thought) function. A rare disorder called Feline Spongiform Encephalopathy (FSE), the feline analog of BSE prion disease in cattle, may resemble senility in much younger cats which have eaten BSE infected feeds.

A senile cat is forgetful of his own well-being. He may venture into risky areas, be unable to find his way back home, not remember to come in from the rain or be unable to find his litter box or food bowl. He may yowl, seem confused, demand feeding because he has forgotten that he has just eaten not because he dislikes the food you served (if led to the food bowl he starts eating at once rather than waiting for you to serve more desirable food). He may become incontinent because he forgets to control his body functions, not from bowel or bladder disease. He may show repetitive behaviours such as walking in circles, plucking fur or aimless movements. Anyone who has seen programs about Alzheimer's Disease in humans will recognise similar symptoms in their cat, though they may choose to deny that it is happening. Your vet will determine whether the behaviour is due to illness, injury (e.g. head trauma) or senility.

Some cats remain clean but become "delightfully dotty" or "slightly scatty". Given help with grooming, several litter-boxes to prompt their failing memory and a safe environment, they remain contented pets, remaining happy in their own slightly confused manner and with no awareness of their reduced circumstances. A senile cat who wanders must be confined to the house and/or an escape proof garden or outdoor run.

At present there is no treatment for feline senility though senile dogs benefit from a drug called Anipryl which the natural destruction of the neurotransmitter dopamine in the brain. Because senility is progressive, the effect of the drug wears off over a period of time. It has prolonged the quality of life for some dogs for 6-12 months. Many canine drugs are toxic to (or not licensed for use in) cats so there is currently no equivalent feline treatment. This is likely to change as veterinary medicine continues to advance.

Note: In 2003, I learnt that Anipryl (and generic version "Selegeline") had been approved for use in the USA. It has proven useful for managing diminished feline cognition due to aging, with some cats having their condition successfully managed for up to 2 years. In some cats it can make a significant difference in mood and temper as well as reducing the effects of senility.

A seizure or convulsion is sudden, uncontrollable and often violent thrashing. Muscles contract and spasm violently and erratically, your cat may fall over and may lose bladder and bowel control. He may scratch and bite and as with human epileptics, the usual advice is to avoid interfering except to prevent him from injury. If you need to restrain him to prevent injury or must move him out of danger, either wear leather gauntlets or cover his body with a towel, coat or blanket and restrain him that way. Lie him on his side if possible. If you have to pull his tongue forward to prevent choking, you will almost certainly be bitten, but this may be a small price to pay unless there is any danger of rabies.

Unless he is a known epileptic, a fit (seizure, convulsion) indicates a serious problem e.g. head injuries, infectious disease, brain, tumour, allergy, undiagnosed epilepsy, liver disease or poisoning. The cause must be diagnosed and treated appropriately. Although you may be panicking, make a mental note (and write it down later) of details to aid diagnosis e.g. rapid heart beat, hyperventilation, bluish tongue/gums, odd behaviour before the fit etc. If the fit lasts more than two minutes or several fits occur in a 24 hour period, make an emergency visit to the vet. Some fits remain unexplained one-off occurrences due to a combination of conditions that are never repeated. Some cats die during or after a fit, possibly due to a brain haemorrhage or an undiagnosed condition reaching its crisis point.

True strokes are rare in cats. Either kitty-strokes are milder than in humans because of differences in the brain structure and function, or cats simply recover faster and more completely than humans. Following a stroke, your cat may be temporarily blind (permanent blindness is less common) or partly paralysed and may lose control of his bladder or bowel. Most vets advise a "wait and see" approach. Once the initial effects have worn off, many cats recover fully with little more than a head tilt, minor tremor or slightly wobbly gait as a reminder.

Some cats become anxious and yowl as their sight and hearing deteriorate. Night-time calling usually occurs at dusk and dawn (cats are naturally crepuscular i.e. active at dusk/dawn) especially in the evening after you have gone to bed and he feels lonely. Try letting him sleep in the bedroom near you, or install a baby intercom and use it to talk to him (if he is not deaf). He may yowl in the daytime if you suddenly go out of his sight - he requires reassurance. Yowling also accompanies senility and deafness and sometimes high blood pressure (hypertension) which may be associated with kidney failure. If there is no medical cause, some cats respond to anti-anxiety medications. If you don't want to use prescription medication you could try Bach Flower Remedies (Rescue Remedy or one of the anxiety-specific remedies). 

The previous sections have described how to keep your cat happy and healthy as he ages. Unfortunately, there may come a time when the kindest and most caring thing you can do for him is provide a gentle exit from the increasing ravages of age. Ultimately it is not fair to prolong his life any longer. Degenerative changes are too far gone, a terminal illness has reached its distressing final stages or his behaviour and habits are now unmanageable.

Ideally you would like him to die peacefully in his sleep, and he may well do this. You may be familiar with the idea that injured, sick or very old cats 'go off to die', but unaware that they die from dehydration, starvation or self-neglect because they are unable or unwilling to drink, eat or even seek attention. If he goes missing and never returns, you will never know whether his end was painless or protracted. Disappearance or sudden death causes much anguish because you had no time to prepare and no time to say goodbye in the way that you wanted. As your cat grows older, you have an opportunity to come to terms with the inevitable, but when the end comes it will always be "too soon".

With recent advancements in cat care and medical knowledge, your cat can enjoy reasonable health into old age. Many old cats die peacefully, but some reach a point when life is no longer enjoyable and the owner must decide if euthanasia is kinder in order to prevent further suffering. Euthanasia is an act of love towards a cat no longer able to enjoy life. "Euthanasia" literally means 'gentle death'. Other terms you may hear are 'put to sleep', 'put down', 'put out of its misery' or, less kindly, 'destroy'. Veterinary staff may use the term 'humane destruction' which is another technical term for euthanasia. It is a caring act, not a callous act therefore it is not "murder".

The decision to end a life is never easy. It causes much soul-searching and it takes courage to assume this last responsibility to a much loved pet. In most countries there is also no easy human comparison although many would like to see the same compassionate act made available for suffering humans. The cat/owner bond is very special so it is easy to become emotionally caught up in keeping your cat alive when your own common sense tells you the end is approaching. A good vet helps you to decide when it is time to let go, but only you can make the decision.

Put yourself in your cat's paws and consider things from the its viewpoint:

** Is his quality of life now reduced so much that he is no longer happy?
** Is he so old and frail that life is a burden to it, not a joy?
** Is he distressed and there is no way of relieving its distress?
** Is he suffering incurable pain or discomfort which cannot be alleviated by drugs?
** Has he been severely injured with no hope of recovery?
** Does he have an progressive or age-related condition which can no longer be alleviated or managed?
** Has he reached the final stages of a terminal illness?
** Have degenerative change made him behaviourally unsafe to himself and/or his owners?

The bottom line is:

** Is this any life for my much loved pet, or is it merely an existence?

Cats live for the here and now. What matters to a cat is the current quality of life not its life expectancy - cats have little concept of future time. An illness may be temporarily treatable, but ultimately reaches a point when the cat no longer enjoys life. He is visibly distressed, withdrawn or incontinent. Having seen him when he is happy and healthy, you will recognise when he is miserable. A caring owner understands their final duty towards their cat is to prevent further suffering by procuring a swift, painless release from life. Sometimes, a terminally ill or injured cat is given life-prolonging treatment because the owner cannot yet come to terms with its condition. It is hard to come to terms with mortality in general.

Modern drugs are extremely fast-acting and the end is very peaceful compared to the distressing later stages of a terminal illness or age-related illness. Your vet administers an overdose of anaesthetic by injection and the cat falls into a painless and final sleep. If, during its life, your cat has been a cherished member of your family, this is the last, and often most compassionate, duty you can perform for him.

Though the act provides a gentle death, it is irreversible - you cannot change your mind halfway through and can feel like a betrayal of trust. Some owners feel they have murdered a trusting friend, others feel guilt at deferring the end for "too long". With an old and frail cat it is tempting to wait another day or another week, hoping that he will die naturally in its sleep so you don't have to make the decision. The reality is that he will linger uncomfortably, finally succumbing to dehydration, starvation, suffocation or to gradual poisoning from liver or kidney failure.

Cost of treatment may be the deciding factor at a very early stage. Unless the cat is insured, the owner has savings, can get a loan or the vet offers a pay-by-instalments plan, any available treatment may simply be too expensive.

In order to make a wise decision you will want to know about your cats condition and whether treatment will gain your cat some borrowed time.

** How much do I know about my cat's illness or condition?
** Is he in pain, distress or mild discomfort?
** If I can alleviate his pain will he have a reasonable quality of life for a period of time?
** Are there any new treatments available for his condition?
** Is there a surgical option - and is it fair for my older cat to have surgery?
** What about a second opinion or a specialist opinion?

** Can I afford the treatment?
** Can I administer treatment e.g. tablets, injections, prescription diet, manually expressing its bladder and/or bowel?
** Will he physically resist treatment?
** Is pain relief alone an option (even though it means a shorter life expectancy)?

** How fast will he deteriorate without treatment?
** How fast will he deteriorate with treatment?
** How fast does his illness progress and what are the signs of deterioration?

Most vets recommend that life be prolonged only while the cat has a reasonable quality of life. While a second opinion may be helpful to you (some vets specialise in certain conditions), don't prolong life in the hope that the umpteenth consulted knows of a treatment or a that a medical breakthrough is imminent. A second opinion may be useful because different vets have different specialisms or be unfamiliar with the ailment or with cats in general. In these cases a good vet knows his limitations and should refer you to a specialising vet. Many vets and owners use the internet for information. Among the good articles, there are sensational articles and charlatans. Some omit to mention the (high) failure rate or that the treatment is experimental (laboratory animals, small field trials).

Find out about your cat's illness or condition. Ask your vet to explain it in simple terms and ask sensible questions. Write down your questions so you don't forget any. Treatments you see on the internet may be offered in one country or locality but not be available elsewhere, or not be feasible due to lack of expertise. Some treatments are not affordable. Your vet may give you information leaflets produced by veterinary associations or welfare associations. He may know of specialists offering experimental treatments. They may be situated some distance away which means a lot of travelling or leaving your cat as an in-patient. The word 'experiment' does not mean vivisection - it is more like an advanced hospital offering experimental treatments. Whether the treatment is successful or not, your cat will not be made to suffer unnecessarily. Lessons learnt from treating it may help other cats in the future.

If you have any misgivings about experimental treatments, then discuss these. If the veterinary hospital offering the treatment is some distance away, you may decide that travel and separation will distress your cat or that you simply cannot afford it. As the owner, you know your cat better than anyone else and a good vet respects your decision if you decide against further treatment and will help make your cat comfortable using treatments his clinic can offer. Choose what you believe will cause your cat least distress.

When faced with the difficult choice of whether or not to attempt life-prolonging treatment with no guarantee of success, I sometimes have to say, "He's had a good life, I will not prolong it just because I can't bear the thought of losing him."

** What sort of life expectancy does my cat have with/without treatment?
** Will treatment prolong life or merely prolong suffering?
** Will the treatment or side-effects cause distress for either of us?
** Do my other cats risk being infected or can they be innoculated?

Having learnt that your pet is cannot be cured or is deteriorating, you will probably ask 'how long has he got?' Some conditions begin slowly but the rate of deterioration speeds up as the effects become cumulative. Other conditions progress rapidly after symptoms first appear. Many cats reach an advanced stage of their condition or illness before showing symptoms. Cats also differ in the way they cope with illness and respond to treatments. There may be no hard and fast forecast about life expectancy, just general guidelines and knowing what signs signal further deterioration. Knowing whether the cat has days, weeks or even years of relative health will affect your decision.

Vets give estimates of life expectancy depending on the normal rate of deterioration according to textbooks and their own experiences, the stage of illness/deterioration the cat is currently at, the cat's age and its general condition. They normally advise as to what sort of quality of life the cat can expect and for how long. I've had elderly cats live very comfortably on "borrowed time" for 3 times the estimate while others managed only a third of their estimated "good quality life expectancy".

As your cat's condition deteriorates and the euthanasia decision gets closer; it is gets harder because you may have nursed and bonded more strongly. His rate and stage of deterioration can be measured by blood, urine and stool samples, tissue samples, X-rays and ultrasound scans (depending on the nature of the condition). For example, the levels of urea and creatinine in the blood gives an accurate measure of kidney function. The higher the levels, the worse the problem. Dialysis, diet and drugs can slow chronic renal failure, but not reverse or halt it. Once urea levels reach a certain threshold, death is inevitable and unpleasant so most vets recommend euthanasia before that point.

Assess the side-effects and risks of treatment. Modern anaesthetics are very safe, but weekly anaesthesia for dialysis sessions is stressful for an older cat's body. Can your cat survive comfortably, albeit for a shorter period, without a potentially distressing course treatment? How will he react to a severely restricted lifestyle? Some diseases are infectious though he may stay relatively healthy for a while but can you keep him from infecting other cats?

Remember - he thinks in terms of current quality of life, not of life expectancy. His concept of the future is limited to the short term. He doesn't make long-term plans. Age is a winding down, it is a natural process not a disease. You can treat many of the distressing symptoms related to age, but no-one can cheat death forever. Without death, there would be no room for the newborn.

** Will other commitments prevent me from giving medication or from getting my cat to the vet regularly?
** Who will give treatment when I am away from home for any reason (e.g. work)?
** How often must he go for check-ups?
** Does my vet do house calls or out-of-hours appointments?
** Must I take my cat for check-ups at the clinic because it needs specialist facilities/equipment?
** Can I afford long-term treatment for the cat?
** Do I have pet insurance and does it cover this sort of treatment?

Life-prolonging treatment may mean daily medication and nursing but not all owners can cope with this and an extremely uncooperative cat may be impossible to medicate at home. Can you both manage daily trips to the vet clinic for treatment? A determined cat may resist all attempts to nurse it until it is too weak to resist, by which time treatment may be ineffective. You may have to settle for a shorter life expectancy without medication.

You need to know what side-effects to expect and whether you can cope with them - some medications cause diarrhoea or behavioural changes. In some cases, side-effects outweigh the benefits of treatment. Sometimes, the economics of the situation will be a major factor. Don't feel guilty just because you couldn't afford a particular treatment. You have no guarantee that the treatment would have worked in the case of your cat. The important thing, from your cat's point of view, is that you provide it with a good home and good care during its lifetime and that you do not let it suffer or allow it to lose its quality of life.

You cat needs plenty of water and he loses almost as much fluid in his saliva when grooming, as he does through urination. He can become dehydrated due to frequent urination, diarrhoea or vomiting. Watch for frequent drinking, dry nose, mouth or eyes and lethargy. Do a pinch test. Lift (tent) the skin off your cat's back and pinch it. It should be elastic and bounce back in a second or two; if not, he is probably dehydrated. Your vet will determine the cause of the dehydration and treat any illness. If your cat is seriously dehydrated, your vet may administer fluids intravenously, subcutaneously (under the skin) at the scruff of the neck or peritoneally (into the abdomen). If your cat isn't drinking voluntarily, you may have to give him water by dropper or syringe, but don't squirt in too much as he may choke or water may end up in his lungs.

Your cat must eat when he is sick, but may lose his appetite (anorexia) because of a blocked nose. Cats rely heavily on their sense of smell to trigger their appetite. He can be tempted with special treats such as grilled chicken or poached fish. Use strong-smelling food or warm up canned food to body temperature to make it more tempting or hand feed him (he cannot see morsels right under his nose; if he cannot smell them, he doesn't know they are there). If all else fails he can be syringe fed with liquid food until it he eats of his own accord. Cats can suffer liver damage from not eating for 2 or 3 days so it is important to get food into him to prevent this from happening.

You could puree some cat food or make a meat broth and carefully syringe feed your cat if it refuses all food. Vets and pet stores may stock liquid cat food - in the UK a canned liquid food for convalescent cats (Liquivite) is available from larger pet stores. Your vet may prescribe a drug to jumpstart the appetite, e.g. Valium, and investigate the reason for appetite loss. If all else fails and the cat can expect a good quality and reasonable length of life once recovered, your vet may insert a tube into the cat's stomach for feeding. In cases where the mouth or oesophagus are recovering from serious injury, this may be the only option. The tube is held in place with a bandage and a highly nutritious "glop" is syringed directly into the stomach. If this is because of mouth problems (e.g. a seriously broken jaw), you may have to continue this treatment at home. 

Your cat's weight depends on its size and breed as well as his age and general condition. If you can just feel his ribs under his coat it is probably the right sort of weight. Protruding bones mean an underweight cat or one so old that it has lost the fatty layer beneath the skin. If you can't feel his ribs at all then he is probably overweight. Weight loss may not be hard to detect in a longhaired or obese cat. Fluctuations of 1.5 Kg (3 lb) over 3 months should be investigated, but minor fluctuations are caused by drinking, eating, urination and defecation. Monthly weight checks (weekly for ill cats) are advisable.

Some diseases cause wasting (cachexia) in the advanced or terminal stages. Many cats which die a natural death stop eating in the 48 hours before death - the body basically shuts down. Euthanasia is indicated if the cat is in distress at this time, otherwise provide a warm soft bed in a quiet place so that he passes in his sleep.

** Is he going downhill?
** Am I witnessing deterioration, the final crisis or just a hiccup?
** Is further treatment possible, or humane, at this stage?

Eventually his condition deteriorates, whether due to illness or to the physical and/or mental effects of sheer old age. Gradual deterioration goes unnoticed unless you are very observant or physically examine him regularly. Certain symptoms mean he has reached the final stages. He has no more enthusiasm for life, maybe no interest in life. He may be unable to rest comfortably, stand or even control his bodily functions. He may not know where he is, recognise you or be fully aware of his surroundings. Even if he is alert, I have known cats to simply sit there, in no apparent pain but not interested in food or water, awaiting their end in a what appears (to humans) a calm, dignified, accepting manner.

Right towards the end, a cat is often unable to hold his head up. He may rest with his head drooped and his nose touching the surface in front of him. I have always considered this a warning sign. I have also noted that the digestive system closes 48 hours before death, even if the cat continues to drink small amounts. This shutdown may hasten the end through dehydration. Other organs may also close down and, if you are lucky, the cat will fall into a coma and be unaware of anything more. If this is the case, place the comatose cat somewhere warm, quiet and dark at floor level if it has not already chosen its final place (often under a bed or in a cupboard/closet). Every few hours check to see whether breathing has stopped. Breaths may come in gasps at long intervals, but as long as the cat is unconscious it is not suffering.

You may choose to take your unconscious cat to the vet to hasten its journey. This will usually be done with a gaseous anaesthetic, or possibly by injection directly into the kidney or heart rather than trying to find a leg vein.

Finally, you might not be able to defer the decision any longer. Modern drugs are extremely fast-acting and the end is very peaceful. The final stages of a terminal illness, however, can mean a painful, prolonged end. If, during its life, your cat has been well-cared-for, you owe it this last duty - a gentle death and not a slow one. Previous sections will have given you an idea of warning signs.

In making the decision it is helpful for owners to understand how euthanasia is performed. Euthanasia in domestic pet clinics is by anaesthetic overdose, usually by injection into a vein or kidney, sometimes by gas if the animal is distressed by handling. Unlike the horror stories about human executions, it is very swift because of the animals low bodyweight. The knowledge that euthanasia lives up to its literal translation of 'easy death' and is painless and fast while a 'natural death' may involve convulsions, haemorrhaging, starvation/dehydration and, in the terminal stages of many illnesses, pain, may be the decisive factor.

Sometimes it is possible to delay euthanasia for a day without causing suffering for example where he has a terminal illness or is extremely old and the euthanasia is planned in advance. You may wish to give him a last night of pampering, his favourite foods or foods which were normally forbidden. This is a time in which to say goodbye and reassure him that he is very much loved. However, if he is suffering, or is already under anaesthetic, he will not enjoy having his misery prolonged.

Your vet will usually ask you to sign a consent form giving permission for your cat to be euthanized (put to sleep). This is a legality required to show that you consented and that the vet did not act against your wishes. Two common examples are given below.

Sometimes a vet must euthanize seriously ill or badly injured stray cats for which the owner cannot be found. If this happens to your cat, please bear in mind that he has acted to prevent an already dying cat from suffering.

If you are agitated or upset, your cat detects this and becomes upset himself. However, he does not know why you are upset and he does not know that this visit to the vet is any different from other visits e.g. for vaccinations. However upset you are, stay calm and reassure your cat. He reacts to your behaviour; he does not understand the word "euthanasia". He may sense that his time has come, but as far as we can tell, cats are not upset at the prospect of their own death.  

In pet cats, euthanasia is performed by an anaesthetic overdose injected into the vein of a foreleg. Some fur will be clipped from his foreleg first. In some cases, the vein can be difficult to locate and occasionally a couple of attempts may be needed to find it. In elderly or sick cats where the veins have collapsed, the injection may be made into a kidney or the heart. A veterinary assistant, or you yourself, gently restrains your cat while the injection is given. If he is held firmly, but gently, this causes little or no distress. If he is extremely difficult to handle, he may have to be placed in a 'crush cage' with sliding sides and sedated first; this is less stressful than trying to corner and restrain an agitated cat.

Most owners want to know how quickly it happens after the needle has been inserted. It happens very quickly. The cat loses consciousness within seconds of the injection starting and death follows a few seconds later. If you are holding him, you will feel him exhale, relax and become heavier in your arms. Urine may trickle from his bladder as the muscles relax. The vet will check for a pulse or eyelid-flick reflex and if there is any chance at all that the cat is deeply unconscious, he will give a second injection into a kidney or the heart. Your cat will not be aware of a second injection if it is needed.

Most vets place the cat into a natural looking sleeping position (he will look as if he has fallen asleep) and close his eyes since animals do not always close their eyes when they die. Because all the muscles of the face have relaxed, his lips may pull back into what looks like a grimace. This is simply due to relaxation of the muscles and to gravity and is not a sign of pain, but can cause concern if you did not expect it.

This is a personal decision. Some owners feel that it is their last duty to be there. Others prefer not to be present. Many take a friend or family member with them for emotional support. Most vets allow you to remain with your cat during euthanasia if you wish. If he refuses, ask why and ask for another vet at the practice to perform the euthanasia with you present. If you become distressed, this upsets your cat and make him harder to handle which is traumatic for all concerned. Your vet understands that this is a difficult time and will only ask you to leave if you become so upset that it is impossible for him to perform the euthanasia. If you remain calm this reassures your cat and makes the end very peaceful.

Not all owners wish to be present and there is no shame in this. Some people simply cannot stand the sight of injections. Your vet will allow you to say goodbye to your cat and leave the consulting room. If you are taking your cat's body away with you, he will call you back in afterwards. Your cat will be treated with as much respect and dignity whether or not you are present.

If you have provided a towel or blanket, your vet will normally wrap or cover your cat's body. Otherwise, he may place him in a black bag. This is not a sign of disrespect, it is for hygiene and your own privacy. A few veterinary practices have a place where you can sit for a few minutes afterwards and regain your composure. If you do need a few moments before you are able to leave the surgery, tell the veterinary assistant. Alternatively they may be able to help you back to your car, but bear in mind that they are unlikely to have the time to sit with you.

If you are willing to pay a call out fee, your vet will euthanize your cat in your own home. Both you and your cat may find this less traumatic than waiting at the vets surgery. However, locating your cat when the vet arrives may be a problem as he knows the best hiding places. Many cats have been put to sleep enjoying a last meal of cream or salmon. In the case of a home visit where a veterinary nurse is not available, and the vet does not feel that you are able to restrain the cat, he may sedate the cat first and then inject into the kidney or heart. This is less distressing for all concerned than trying to restrain an agitated cat.

Do not be surprised if your vet makes a hasty exit afterwards, he does not want to intrude upon your grief and he will have other calls to make.

The price varies from area to area and vet to vet, but £15 to £25 is the normal price range for euthanasia ($30 in the US). It will be more expensive if there are other fees involved e.g. for tests, operations or if the vet performs the euthanasia in your own home.

Vets understand that it is difficult to write cheques when you are in a state of shock or grief. If you are a regular customer he may send you an invoice after a couple of days. Alternatively, you may be able to prepay when you arrive at the surgery - ask about this when you make the appointment and arrive a few minutes early. If you pay in advance or by invoice, you may be able to leave the surgery by its back door rather than walk back through the waiting room.

Many cats die peacefully of natural causes or by euthanasia. Although this is expected or even planned, it can still be a shock when it actually happens. Although the owner of an elderly cat half-expects something to happen, if he dies suddenly or in an accident this is more traumatic for the owner and feelings of grief are compounded by feelings of anger and often guilt.

Following an accident of any kind (outdoors or indoors) it is all too easy to say 'if only I had done this instead of that', but you had no way of knowing that he would meet with misfortune. Sudden death is often due to a sudden stroke or heart failure or to an illness or condition where there were no symptoms for you or your vet to detect. A post mortem, should you request it or agree to your vet's request to perform one, may identify the cause of death. It is unfair to yourself to feel guilty at not noticing signs of illness if there were no signs to for you to detect, but you may wish to discuss the death with veterinary staff. They can often reassure you that death was quick and painless. Try to think of the good times you enjoyed together and, although it is hard, try not to feel guilty about an event you could not have foreseen.

Just as with euthanasia, you need to decide how to deal with his body. If you cannot bury your cat, many vets will allow you to leave his body at the vet surgery where the body can be dealt with by the vet or be collected by a pet cemetery or pet crematorium if you make appropriate arrangements. The following sections may help you decide what to do.

Sadly, a number of cats go missing never to return. This is very upsetting because you do not know what has happened to him and you have no physical body to serve as a focal point for grief and other emotions. There is always that faint hope that he will turn up safe and well one day. As time goes on and it becomes apparent that this won't happen, you need some way to 'let go'. You may find it helpful to hold some form of memorial service or wake to commemorate a missing cat. Without a body to bury or cremate, some find it helpful to bury their cat's favourite toys or blanket to serve in place of a grave, or to have a small memorial plaque made either for his 'grave' or for indoors next to a photograph.

Because there is no sense of resolution, the natural grieving process is delayed. It is hard to use common sense to decide how much time passes before a missing cat is 'presumed dead'. Having a memorial service or burying his 'personal effects' may allow you to let go and to feel all the emotions associated with pet death. It is unfair to yourself to hold out hope indefinitely. When a cat goes missing and there is no way of being absolutely certain what has happened, it is natural to grieve for longer and harder to come to terms with the fact that you may never see him again. This is why it is helpful to have something, such as a memorial service, symbolic grave, plaque or photograph, to serve as a focus for your feelings.

It is impossible to say exactly what emotions cats feel, but if you have any other cats they will certainly be aware that someone is missing from their lives. It is unlikely that they mourn in the human sense of the word, but there will be some behavioural changes as they adjust to the gap in their lives. If they were sociable, the surviving cats may search, cry out or even pine. They need individual attention and reassurance. If they were unsociable or indifferent to each other, the survivors might simply rearrange themselves into a new hierarchy, dividing up their former companion's territory between them. Sometimes the surviving cat(s) blossom if they were previously bottom of the pecking order.

If there is no danger of infection then this is a personal choice. Some owners say that the surviving cats do not search for a companion, having seen the body. Others say that any veterinary smells on the body disturbed their other cats. They may sniff around the body, lick him and maybe try to wake him up before concluding that their friend has gone. We cannot know what cats understand by death, but they probably have some awareness that a dead animal does not return to life. If there is no danger of infection and you believe that it will help your other cats come to terms with the loss of a companion, then by all means allow them to see and smell the body.

Some owners notice their surviving cats taking on behaviour patterns of the missing cat. There is nothing supernatural about this - certain privileges and places once accorded to the missing cat are now up for grabs. This means the prime spot on the bed or being allowed to eat in a certain place. In all likelihood, the deceased cat defended these rights during its lifetime (maybe simply by staring down its companions) and the survivors see these behaviours as being part of the hierarchy.

There are several options for disposal of your cat's mortal remains following death. In the case of a terminal illness or old age when euthanasia is not sudden or where death is expected, owners are encouraged to think about the disposal of the body in advance. These depend on where you live and on how much you wish to spend. Only in cases where the body poses a serious risk to human health (e.g. rabies, should it ever enter UK) will you be denied permission to deal with his remains as you wish. Unless your cat died of a contagious disease such as rabies, you are free to bury him, cremate him or leave him with the vet for incineration. Or, you may wish to "keep" him through taxidermy, freeze-drying, resin preservation (plasticisation) or cloning (at present tissue is banked for future cloning). The decision depends on where you live, local laws and how much you wish to spend.

Your vet can dispose of the body for you. The body will be stored in a veterinary deep freeze (for hygiene purposes) and collected for incineration by a firm licensed to incinerate animal remains or 'medical waste'. Some vets can provide individual cremation; it is best to ask about this in advance if possible so that you know what options are available to you.

You can arrange for a pet cemetery or pet crematorium to collect the body from your vet. The body will be labelled with your name and the cat's name, and stored in the veterinary deep freeze until collected. If the euthanasia was expected, you may be able to take the body to the pet cemetery or crematorium yourself.

Burial, cremation or incineration are the normal means of disposing of your cat's mortal remains. Some owners arrange to donate their cat's remains to a nearby veterinary school in the same way that people donate their bodies to medical science.

Burial is the commonest option in Britain where many people have a garden or an understanding friend with a garden (I have my apartment-dwelling friend's cats buried in my garden). Make sure local bylaws don't prohibit this. If you bury him in the garden (yard), the grave should be at least three feet (1m) deep to discourage scavengers. Wrap him in a shroud of cloth and lay him at the bottom of the hole. Fill up the hole with soil, bearing in mind that it will settle over the next few weeks. It is a sensible precaution to lay a paving slab on top to deter scavengers from digging up the body. Once it has been buried, you are not permitted to exhume an animal's body.

Bury the cat as soon as possible after death; it will begin to putrefy quickly. If this is not possible, ask the vet to store the cat in the clinic's freezer. If you do not collect your cat's body by the due date, it will be sent for mass cremation. If you bury your cat in your garden, you may wish to erect a headstone, plant flowers or a bush to mark the grave.  If you do not have a back garden or local bylaws prohibit pet burial, look for a pet cemetery (listed in the Yellow Pages, pet magazines or most vets have contact information). Most have a chapel of rest and facilities for a non-denomination ceremony (usually Christian, but you should state if you prefer a non-religious ceremony). Ceremonies and ceremonial interment must be scheduled in advance. Some pet cemeteries will collect your cat's body from the vet or from your own home.

If you take your cat home for burial, he must be buried as soon as possible (within hours) otherwise putrefaction (decay) will set in. If you cannot take your cat's body home immediately, your vet may be able to store it in the veterinary deep freeze for a day or two. It is not advisable to store the body in your domestic deep freeze. If you do not collect the body on the arranged day, it will be collected for incineration.

The second most popular option in Britain (and increasing in popularity) and possibly the most popular option in the US is cremation. Many people today choose cremation. Then you have the choice of scattering kitty's ashes in its favourite places or bringing them home in a jar. Pet crematoria are usually combined with pet cemeteries and listed in the Yellow Pages, pet magazines or your vet may have contact details. They may also have a memorial garden or columbaria (wall of niches) for pet ashes.

Pet cemeteries and crematoria offer several services: individual cremation where the ashes are either returned to you or buried at the crematorium; cremation with other animals with the ashes scattered in the garden of rest or individual burial in a cemetery plot. Pet cemeteries have no legal protection so check that it is not likely to be bought up for redevelopment.

Some cat owners have their cat "stuffed" although the results may be disappointing. Only the skin, fur and claws will be real. The eyes will be glass and the facial expression will be frozen and may appear distorted. Ask to see samples of the taxidermist's work first. However good the taxidermist is, the cat's expression rarely looks "quite right" and for this reason, many will not taxidermize domestic pets. Everything which made your cat what he was (muscle, bones, brain) will have been disposed of as medical waste.

The actual process used (the stripping out of internal tissues and bones, the "tumble-drying" of the skin) lacks dignity and appears unsympathetic, but remember that your cat's spirit (soul, essence, being) is no longer inside. You may be able to arrange for cremation of the flesh and bone part of you companion.

Freeze drying or desiccation takes approximately 6 months and slowly desiccates (removes water from) the cat's body. The cat will be put into the desired pose before freeze drying starts and some cosmetics are needed to pink-up the ear flaps, nose and other areas not covered by fur. This process is similar to natural mummification. The process is relatively new and the long term results not known. The freeze dried cat may have to be sealed into a glass container as moisture and temperature fluctuations will cause slowly deterioration of freeze-dried tissue (as they have to exhumed mummies).

Cloning hit the headlines recently when Dolly was cloned from an adult sheep. The possibilities excited cat owners who desired to duplicate a departed pet. In cloning, the nucleus of a tissue cell is implanted into an unfertilized egg and this is grown inside a surrogate mother cat. The kitten will be genetically identical to the donor cat. Cloning reproduces the genes, not any traits developed due to environment. The clone will look like the original cat but may have a different personality and grow into a totally different individual. You may begin to resent the clone for not being the cat you remember. Cloning currently has a very high failure rate. One problem is that cells have an internal clock which tells them how old they are. Your clone kitten may have been born 6 weeks ago, but all its cells know they are 15 years old. This causes premature ageing and deterioration and probably an early death. Some people are banking tissue samples from their cats waiting for the day when cloning is perfected and affordable; this may not be within their own lifetimes.

It is possible to preserve bodies by replacing the blood and body fluids with resin which sets solid. This is a form of embalming which can produce an extremely lifelike effect while leaving all internal tissues in place. Plasticisation has been used with humans (in Germany, I believe) as a form of art, but may become available for pets if there is a demand for it. It is still rare, but for owners has the advantage that the internal tissues remain intact and are not discarded as they are with taxidermy.

You will have to discuss this option with your vet while your cat is still alive; he may be able to refer you to a small animal hospital where vets are trained.

Sometimes museums or other institutions advertise, asking for exhibits e.g. of certain breeds or of oddities such as cats with extra toes. If you know that your cat does not have a long life-expectancy and do not mind its fur, teeth and claws being used in this way you may wish to contact the institution. Since taxidermy has no use for other body parts, you could ask the museum to arrange individual cremation of the remaining parts (the museum may agree to pay for this in return for your permission for taxidermy) or for their transfer to a veterinary teaching hospital (donation to veterinary science, above).

Instead of preservation of the body or cloning, you may wish to adopt a cat which is the same colour or breed as your original cat. It will be an individual and it depends on how you feel about being reminded about your old cat. Some people prefer to have a cat which looks totally different to avoid the constant reminders. Some people do not mind at all what colour the cat is because companionship (or rescuing an unwanted cat) is more important to them. Others always adopt a cat of the same breed because it will have a similar temperament and may even be related to the previous cat. There are plenty of people who have owned a black and white cat called Tiddles throughout their life figuring that they'll never forget its name even if each Tiddles is a little different to the previous Tiddles.

It is up to you as to when to adopt another cat. You may need time to grieve or you may want another feline companion at once. You may have other pets or family members who urgently need feline company. Some people put the needs of cats before their own needs and adopt a shelter kitty the very same day to ensure it has a loving home and will not be put to sleep. The timescale for getting another cat will also depend on whether any viruses or infectious agents are left in you home from your previous cat - you may be advised to wait a month for these to die. If your cat was put to sleep as the result of an infectious illness, then your vet may advise you to let a period of time elapse before getting another cat. This is to reduce the risk of infection remaining in your home.

Apart from this, it is a personal decision. Some people cannot live without feline companionship and get another cat almost immediately, sometimes within hours. Others would consider this to be indecent haste. Many owners need a period of time to come to terms with the loss of a pet; how long this takes varies from person to person. Some feel that getting another cat too quickly would be disrespectful to their former companion. A few owners take on another cat before their pet goes into terminal decline; this is only possible if the cat is sociable and there is no risk of infection.

Remember that the new cat will not replace the one you have lost. He will commemorate your previous cat, but will have a personality all his own. If you try to replace your cat with an exact duplicate, you are likely to be disappointed as all cats are individuals.

Cats have a shorter life-span than humans although we would like to think our cats are immortal, especially if a cat is relatively healthy in his late teens or early twenties. The death of a well-loved pet is on a par with the death of a child or teenage human family member, despite what thoughtless people may say. It is doubly hard if you cat was rescued by you, nursed through illness, belonged to an deceased family member or was your main companion. Grief or anger are natural reactions to the death of an animal companion. We react differently to death, but we all need time to come to terms with the loss of a close animal companion. You might seek consolation in remembering the joy that your cat brought you.

No-one who has had to make the decision to euthanize their pet cat will deny that there are feelings of loss and perhaps guilt. However you may find some comfort in having been able to be merciful to your loved one. You have taken on the pain of a loving act of mercy in exchange for sparing your cat further suffering.

It often helps to share your feelings. There are four stages of grieving: denial, anger, depression (mourning) and acceptance. Suppressed feelings are likely to resurface twice as painfully later in life or when you feel vulnerable for other reasons. I found that people who had never lost a pet could be unconsciously or deliberately unsympathetic. With so many people relying on a pet for companionship, this is unfair of them and may even indicate problems in their own relationships. However, many GPs and religious ministers are sympathetic to those who suffered pet bereavement and can offer counselling. Time is said to be a great healer, and though the pain may never go completely, time numbs the pain and makes it more manageable.

There are Internet newsgroups and bulletin boards where you can share your feelings with other bereaved pet owners. Use a search engine to look for "pet loss" and "pet bereavement" and you will find hundreds of sites offering a variety of resources, including email or online counselling. There are 'virtual cemeteries' where you can post up a photo and message of remembrance for your pet and virtual 'candle ceremonies'. It sounds macabre to some, but many pet-owners hold an online 'funeral' or service (religious or non-religious) for their cat, attended by cyberspace friends and these can provide reassurance as people exchange feelings and anecdotes about their pets life. You may wish to place an obituary in a cat or pet magazine.

I adopt older or ill cats. Over the years, I have seen many of them die. I have also seen how other people react to me. Some are embarrassed because they have no experience of pet loss. One manager granted me compassionate (paid) leave so that I could arrange burial. Another (with experience of elderly cats) granted unpaid leave for the day of euthanasia and the burial the following day. When I likened the loss of my 11 year old cat to the death of a child I was verbally abused by many people in my office who said that the comparison was not valid because a cat can be replaced, but a child can't be replaced. These were people who placed very little value on the life of a pet and their attitudes were hurtful (and some were deliberately spiteful). They have no comprehension of the effect of pet-loss on caring pet-owners, especially on pet owners who are single, childless or widowed (where the pet was a final bond with a deceased partner). I decided to choose better friends who would support me in my grief even if they did not agree with how I felt.

Children and cats often have very special bonds. The cat is a playmate, companion and will never, ever pass on any secrets told to it. He attends dolls' tea-parties and get pushed around in a pram as well as many other indignities. He is there when a child is sick, he scares away the monsters when a child is scared of the dark. He eats things sneaked from off the plate. Often he is simply there giving unconditional, non-judgmental love. So, when he cat dies, the child may take it very hard.

Don't tell a white lie in the hope of making things easier; it can cause a lot more distress than the truth. One of my friends was told that her adored cat had been sent to a farm to live happily with other cats. Later the parents changed this to "he ran away". She waited at the garden gate every evening for over a year until her parents told her the truth. All that she gained from the experience was a feeling that parents were not to be trusted and a feeling that she never had a chance to properly grieve for her cat's death.

Death is hard for a child to understand, so help him to understand that death is natural and happens to very old and very sick animals and people. A child's experiences are all learning experience; knowing about death can help him to cope later on when elderly family members die. If your child is young, don't use the euphemism "put to sleep" as the child may expect the animal to wake up and return or try to exhume the body; some children develop a fear of going to sleep in case you bury them. The may be upset at the thought of their cat waking up in the dirt. Explain that the cat was very old or very sick and that the vet couldn't mend it (children often think in terms of mending things). Explain that vets do make sick cats better but that sometimes cats are just too sick and that the vet helped it to die without being in pain; otherwise the child may think that vets kill animals and may become distressed when another animal goes to the vet for routine treatment.

If you have to leave your cat at the vet clinic for disposal, let your child say goodbye before the body is deep frozen (avoid mentioning freezing in case junior attempts to freeze your other pets). Involve your child in a remembrance service at home to provide a focus for their grief; it isn't simply a case of "out of sight, out of mind". Make sure he has a photographs to remember the cat by.

Ask your child to help with any funeral or burial service; for example choosing a blanket or a teeshirt (may be an old one belonging to the child) to wrap the cat in or a cat toy to be buried or cremated with it. Children don't understand that their cat can't feel anything and may worry that he will be cold under the ground; you might say that he will be warm wrapped in a towel. If you choose a burial service or cremation, your child can help to choose a coffin (casket) or an urn. I have known older children put great store by the fact that they helped mum or dad make the coffin - anything from decorating a cardboard box, to helping with real woodwork.

If you have a service, ask the minister for one that celebrates life rather than being at all morbid. If you choose hymns or songs, your child can choose a favourite even if it adults may think their choice is not the most suitable for a dignified occasion - you probably already have ways of coping with death, you are trying to reassure your child. If your child is involved in after-death arrangements, it may help in their understanding that death is natural and permanent.

If you are religious you may say that God cares for animals too and that your child will meet his pet in heaven one day (this can neither be proved no disproved and is therefore, not technically a lie). Many religions believe in reincarnation or that animals have souls, albeit simpler ones than humans and since animals cannot commit sins, they are assured of a heavenly place. Some spiritualists consider that animals have a species communal soul and that pets develop individual souls because they come to understand that they are distinct individuals.

If you are not religious you may say that older animals die to make room for baby animals and so that everything can grow and renew itself. As a young child, all my goldfish were buried beneath certain trees because they "helped" the tree to grow strong and tall. I came to feel that my pets lived on as part of the trees. As an adult, I can look out on an especially vivid patch of my lawn which is exactly the same size and shape (a sort of comma shape) as the elderly cat I buried last year. For one year at least I have a visible living memorial of my cat and her contribution to the continuity of life.

Whether you are alone or have a family to join you in thinking about your cat, focus on the good times you had together and remember the happiness and pleasure you gave to each other. Talk about funny events in your cat's life, not about the last few days or weeks when your cat was going downhill. Think about how you would like to be remembered - for the good times in your life. There are several ways of commemorating your cat.

You might choose a memorial plaque or stone planter placed in your garden even if you did not bury your cat there; maybe it can mark a favourite spot where your cat liked to sit. If you don't have a garden you could have a small engraved plaque or a special urn for your cat's ashes indoors. Some people turn this into a small "shrine" with a photo or painting and one of your cat's favourite small toys on a shelf; and they light a small candle or incense stick on important dates. You might hold a commemoration service with sympathetic family members and/or friends; if you are a single person this could be with any remaining pets - they are not judgemental and expressing your feelings aloud may help you.

Some people plant a tree (or adopt a tree) or name a star after their pet and receive a certificate in recognition. You might sponsor an unhomeable shelter kitty or sponsor a shelter pen - you will help many other cats as well as commemorating your own; the shelter may allow you to place a small metal plaque on the pen or on a memorial wall. Some people express gratitude for the years of pleasure their cat has given them by volunteering a few hours a week or during a holiday to help out at an animal shelter or other voluntary organisation involving animal welfare.

If you enjoy writing, write a poem or short article about your cat and pin it up at home or share it with others by posting it to a web-site, newsgroup or bulletin board. You might keep a journal of your feelings and memories to create a written tribute. It could be a scrapbook or illustrated biography of your cat or your life with your cat; this could be a private book or some pages on the web to help and reassure others. If you are artistic, you could paint a portrait or make a model, tapestry, rug or other item bearing your cats image.

The timescale for adopting another cat depends entirely on you. You may wish to pass through the stages of grieving first or you may wish to get another feline companion as soon as possible. Most people need to let several weeks elapse. Some people never get another cat, feeling that they are being somehow unfaithful to the memory of their previous cat. Sadly they are denying themselves the pleasure of continued feline companionship. This may be due to unresolved grief issues which require counselling. People who work with animals frequently get another cat much sooner (sometimes within in hours), because they have "a vacancy" for a cat which may face destruction. They feel the same amount of grief, but for them the best way to remember their cat (possibly also a rescued cat) is to save another life.

Sometimes the decision to get another cat is made because the children, or possibly other pets, require a cat companion. Some dogs and certain sociable breeds of cat react this way; they may not even be best of friends, but they rub along together and just need each other's company. I have encountered 5 very grief-stricken Golden Retrievers who were only perked up by the addition of a new cat to rule the roost.

Pets enrich life and provide you with non-judgmental companionship. I know a woman with terminal MS who would have given up and died years ago if it wasn't for her cats giving her a reason to get up each morning. Unlike dogs, cats do not require a great deal of space or daily walks, making them better suited to smaller homes, less active people or those who work full-time. People who share their homes with pets suffer less stress, may retain their physical and mental faculties for longer and live longer. Stroking a pet aids relaxation and lowers blood pressure. Cats provide the opportunity to care for and nurture another living thing, one which gives unconditional and undemanding love. Cats have an independent streak, but they are also good listeners and despite the views of non-cat lovers, many cats are highly sociable with selected people and are as demonstrably affectionate and devoted as dogs.  They also provide a topic of conversation helping you to meet and chat with likeminded individuals, either in the flesh or on the web.

You can never replace the cat you lost but you can adopt or purchase another to share your life. This will be a new cat with his own personality and behaviour, not a replacement cat. Though he may physically your previous cat, especially if he the same breed, his personality is its own. Some people prefer to have a cat which looks totally different to avoid the constant reminders. Some people do not mind at all what colour the cat is because companionship (or rescuing an unwanted cat) is more important to them. Others always adopt a cat of the same breed because it will have a similar temperament and may even be related to the previous cat. As I wrote earlier, there are plenty of people who have always owned a black and white cat and always named it Tiddles, figuring that they'll never forget its name even if each Tiddles is a little different its predecessor.

If the previous cat was poisoned, stolen, killed by another animal or a person, or run over, you may decide against adopting another cat unless you can keep it indoors all the time or have a safely fenced garden. If you are an older person, you may decide that a kitten is too lively and may outlive you. Adopting an older cat makes sense as you can share the quiet times. If you have other pets in the house, they may or may not accept an intruder. Most will get used to each other if they have been used to other feline companions and will eventually establish a pecking order and divide up or timeshare territory even if they do not become good friends. Make sure that all have been vaccinated and do not pose a health risk to each other.

This depends on yourself and on any remaining pets. If you have other older cats they may resent the intrusion of a lively kitten - or they may get a new lease of life as mentor to the kitten. If you adopt another older cat you will have some idea of its personality (from the previous owner or the shelter) and can adopt a laid back, non-competitive cat which will not threaten your surviving cats. I find that where all the cats are older, lack of energy and desire for warm sleeping spots usually overcomes aggressiveness!

Where you should your get a new cat from depends on whether you want a pedigree or non-pedigree pet and on the animal shelters in your area. Some owners specialise in taking on older or disadvantaged cats from animal shelters and making their remaining years happy and comfortable. Such cats may repay your kindness a thousand-fold. You may know of a friend unable to keep his or her own cat due to changed or diminished circumstances.

If you want a pedigree cat, check breeder advertisements in cat magazines or visit cat shows. In the UK, cats are not bought or sold at cat shows, but breeders take enquiries and may take bookings. Sometimes there are variants (cats which don't quite match the standard) available at lesser cost. Pedigree rescue societies specialize in rehoming purebred and pedigree cats which have lost their homes; these cats are usually older and may have no papers, but are nevertheless loving purebred cats. Beware of kitten-farmed "purebreds" (see below) many of which are not pedigreed at all. Some cat shelters also have purebreds and you might find pedigree lookalikes at cat shelters, due to accidental crossbreedings in a cat's family tree!

If you are looking for a moggy or non-pedigree cat, contact your local animal shelter and check your vet clinic noticeboard for "looking for home" cards. Many stray and abandoned cats end up at vet clinics before reaching an animal shelter. Vets may have clients whose cats have had kittens or who are looking for new homes for their own cats due to changed circumstances. Some vets in some countries take in and rehome unwanted cats and dogs (strays or healthy animals taken for euthanasia). If you know your pet shop to be reputable, there may be a rehoming noticeboard there.

Beware of newspaper/noticeboard adverts, people selling kittens from a box in a shopping centre, many pet shops and markets/boot fairs. Though there are many reputable pet shops, there are too many which sell kitten farm kittens or unhealthy stock. Only acquire cats and kittens from a pet shop where you have already built up a good relationship and know them to be reputable and caring. The very best pet shops refuse to deal in live animals and will refer you to a breeder, animal shelter or vet.

Side-of-the-road vendors and kitten-farms (US: kitty-mills) are concerned with quick sales and profits, not with the health of the "product". The kitten may have a hereditary condition, be malnourished, wormy, sick and poorly socialized; some will never have been handled and are virtually wild - their docility when sold being due to fear or illness. They will have lived in overcrowded conditions, mixed with other litters from elsewhere in the county or country and be harbouring any number of infectious diseases. The mother may be sick or dying through excessive breeding and the kittens are probably removed at too young an age; by purchasing such a kitten you keep kitten farms in business. If they are purebreds, they may come with false pedigree papers and be unregisterable; not be a concern if you don't plan to show or breed, but they will still have been bred in poor conditions. Their parents were probably acquired with a neutering contract and the kitten farm will have lied to the breeder saying that the cat has been neutered or has died. Better sources for purebreds are reputable breeders, breed rescue societies, animal shelters and vet clinics.

There are many websites and bulletin boards devoted to pet loss, bereavement, on-line memorials and the sharing of memories and feelings about a deceased pet. There are also a number of books which you might find useful. If the book is not available in your own country, you may find it on the web from an online book-seller or direct from the publisher.

Caring for Older Cats and Dogs: Extending Your Pet's healthy Life by Robert Anderson, Barbara J. Wrede, 1990
Caring for Your Older Cat by Chris C. Pinney, Barron's, 1996
In Praise of Older Cats. Cats Protection (UK)
The Ultrafit Older Cat by Claire Bessant & Bradley Viner, Smith Gryphon Limited, 1993
Your Aging Cat: How to Keep Your Cat Physically and Mentally Healthy Into Old Age by Kim Campbell Thornton, et al, 1997

Absent Friend by Laura & Martyn Lee. Trafalgar Square (or Henston), 2000, Ltd. 1992.
Death of An Animal Friend Society for Companion Animal Studies, 1a Hilton Road, Milngavie, Glasgow, Scotland, G62 7DN, price £2.50 (Sterling).
Goodbye, Dear Friend by Virginia Ironside. Robson Books, 1996.
Goodbye my Friend by Mary & Herb Montgomery. Montgomery Press, 1991.
Honey-bun (inspirational book on cat bereavement) by Anne Stockton. Educare Press.
The Loss of a Pet: New Revised and Expanded Edition by Wallace Sife. Hungry Minds, 1998.
Surviving the Heartbreak of Choosing Death for Your Pet. by Linda Mary Peterson. Greentree Publishers, 1997.
Time to Let Go. Cats Protection (UK)

Bristle Face by Zachary Ball. Holiday House, 1991. Ages 9-12.
Bye Bye, Belle: (illustrated story book) Society for Companion Animal Studies (SCAS), 1a Hilton Road, Milngavie, Glasgow, Scotland G62 7DN
The Tenth Best Thing About Barney by Judith Viorst. Aladdin Books, MacMillan Publishing Co., 1999. Ages 5 and up.
Will I see Fido in Heaven? Scripturally Revealing God's Eternal Plan for his Lesser Creatures by Mary Buddemeyer-Porter. Eden Publications, 1995.
My Pet Died by Rachel Biale. Tricycle Press, 1996.