Maybe everyone feels guilt when a pet dies. It is an end game consisting of decisions that you alone must make on behalf of someone you love, with utterly insufficient data to be able to choose with even the slightest degree of confidence. Streaming away from these critical temporal points are other timelines that may have taken you to the same final goodbye, worse situations, or a fantastical miraculous land of no regrets.

Our family cat Scrabble died at the princely of 22. Over ten years later, I still regret not staying up through the night so I could have been beside him when he passed.

Two years ago, my cat Tallis contracted a disease that filled her chest cavity repeatedly with liquid. I chose humane euthanasia rather than see her choke to death. But we were waiting for one final set of laboratory results and I still wonder, if we’d just hung on could we have found a cure?

And when Cassie’s fever soared on Monday night, I made the decision not to take her to the emergency vet.

A slightly blurry photo, but one of my favourites of Cassie trying to grab and wedge two toys into her mouth at once, July 2021.

Less than one year after I began fostering Cassie from the Japan Cat Network, I noticed that she has quite bad halitosis and—suspecting a tooth problem—I took her to the vet. The cause turned out to be a tumour in her throat that a biopsy revealed was malignant lymphoma: an incurable form of cancer in cats. The average life expectancy is 6 - 9 months, although I was later told that the range is so broad as to make that figure of little use. I received the medical results one year after my cat Tallis had died, almost exactly to the day. I responded to this display of sick humour by the universe with a jerk of my middle finger, and a determination to give Cassie the best possible chance at a longer life.

Cassie was treated at Hana Animal Clinic, where the vet does a huge amount of pro bono work for the animal shelters, which included covering Cassie’s care as a foster kitty. I really have no words for how grateful I am for this help. Cassie handled the cancer treatment like a trooper and all seemed to be well until the end of May. What started as a simple-looking illness became a steady stream of problems that weren’t obviously related to the cancer, but we just couldn’t seem to stabilise. There were weeks when I visited the vet every evening, either travelling across Tokyo to Hana with a round trip of 3 hours, or paying to see a more local vet. The latest and most severe illness had begun the previous Thursday, when Cassie had a seizure that sent me scrambling for a taxi to get us to the emergency night vet clinic.

The cause of her seizures proved unclear, with the two most likely possibilities being dehydration or a brain tumour. Both could be linked with her existing cancer, which might have moved to the brain or simply messed with the efficiency of the circulation system. She was put on an IV drip at the clinic and I picked her up at 5am. Within an hour of returning home, she had a second seizure.

I took Cassie up to Hana later that morning and returned with enough medicine to open a small vet clinic in my kitchen. I had suppositories in case she had a seizure, injections of antibiotics and steroids, and fluid for a subcutaneous drip that I hung from a floor lamp. We passed a very tense weekend that proved to be mainly uneventful. Cassie’s ears were hot, which suggested she might be running a fever, and she was slightly wobbly when she walked. But she otherwise seemed to be recovering. She also had a surprisingly big appetite which allowed me to absolutely stuff her with wet food for additional fluids. By Monday, I was starting to breath more easily. Maybe we had cracked the fluid problem and if I could just get enough water into her, we would be OK.

Then Cassie had a third seizure. The seizures were not long, but Cassie was clearly shocked afterwards, going to hide in a corner with large saucer-sized eyes. Hana did blood works, and added anti-seizure injections to our home vet clinic.

The fever didn’t abate. By Monday night, Cassie’s ears were almost painfully hot and she was pacing restlessly. I gave her some subcutaneous fluids. And then I made the immensely difficult decision to keep her at home and not take her to the emergency vet.

My reasons could fill a book. Cassie’s blood had been checked at Hana only a few hours before, and had raised no red flags. So it was not likely the night vet could find the problem and whip out a miracle cure. The antibiotics she had received over the weekend had seemingly not touched the cause. The only hope would be that the emergency clinic could fight the fever with an anti-inflammatory medicine and an IV drip (faster than a subcutaneous drip as it goes directly into the bloodstream). I have no idea if that would have been enough to get us through the night.

Then even successful treatment might only have pulled us through this one night. Without the discovery of a non-cancer diagnosis, we could be in exactly the same situation tomorrow, or next week. Since the end of May, we had seemed trapped in a never ending round of shoring up a dam that was determined to break.

And if the fever couldn’t be broken, or if it were a red herring and the problem was brain related, Cassie might die at the emergency clinic where I couldn’t be with her.

But there were also reasons that I desperately didn’t want to admit were factors. In the past month, we’d visited the emergency vet twice. The first time the bill had been 15000 yen. Last week the bill had been 55000 yen (about $400, although with the weak yen, a better feel would be $500). For a full overnight IV drip, I might expect a bill of around 100000 yen. If it were likely we could cure Cassie, I’d snap my credit card to get it paid. But the probability that this might be a regular trip made my knees quake.

And the stream of medicines Cassie now needed were also a continual concern. Due to the COVID-19 pandemic, I had not visited my family in the UK for approaching three years and worry that I might regret not going was a creeping presence. Work also required travel that was difficult to avoid long term. Yet, there was no solution for Cassie’s care that I felt comfortable using. Either the environment would be very stressful (such as a cage in the pet hotel at the vet), or the care would be less than what I felt I could provide (for example, with a visiting pet sitter). Cassie might therefore pass away either in an environment where she might think she had been abandoned, or due to her temporary carer missing clues to her condition. This caused me to cancel a planned trip to the UK in June when Cassie was not recovering well from her latest infection. I had not felt able to rebook.

So I made the decision to stop fighting.

I made Cassie beds with cooling ice packs, offered her ice water and wet food and decided to keep her at home unless she appeared to be in significant pain. And as I sat through the night, the voice in my head kept saying,

You put a price on her life.

The last reason concerning the difficulty of Cassie’s care had not really been a factor in that night’s decision. It just hung around my neck like a guilt-laden noose for recognising that there would also be relief if Cassie’s illness was not drawn out. But if the emergency clinic had been free, I probably would have tried one last time. Because maybe this time we would find a cure. This time, Cassie might be stabilised and fight the cancer for a few more months.

I know this is ridiculous. Of the alternative timelines, more than one would have led to her dying at the vet clinic. Others would have led to weeks of vet visits as Cassie continued to battle illness upon illness. But… there’s the one where a miracle is found and Cassie’s condition is stabilised. This is the timeline of my imagination, where the cancer doesn’t come back quickly, the seizures stop and the medicine is reduced. It probably doesn’t exist. But I cannot prove that.

Despite a 10 year age difference, Cassie and Norah were incredibly fond of one another.

And so I felt guilty as I sat beside Cassie through the night as she faded away. Guilty as I stroked her ears and told her she was a special cat, a loved cat, and a wanted cat. And guilty now as I write the reasons that will never seem enough for not risking everything to chase that final timeline.

I know that if any of the first three reasons had not been true, I would likely have made that journey to the vet that night. And in the end, Cassie was able to pass away at home, I hope relatively peacefully, with me right beside her and knowing that she was loved. It was what I said I wanted when we embarked upon the cancer treatment. But when the clock runs out, it never seems like enough.

I took Cassie to the pet cemetery where I took Tallis two years ago. I still really like the temple, with its shrine always packed with treats that loving pet owners have left for their departed furry family. I now wonder if they too all have their own wistful timelines.

As I left Cassie, I promised I would always love her and that I would look after Norah, she didn’t need to worry. And for probably the only time in the last few months, my brain offered one kind comment that I think Cassie would have told me if she could,

No. Norah is there to look after you.

This wasn’t an easy post to write. I will never know if this was the kindest timeline, or if there is one that might have been better. But I feel I am maybe not the only person having to live with that uncertainty. If you are too, please know you are not alone.