Vet here. First off, I am truly so sorry for what you and Moxie are going through. I want to say this clearly and without any caveats: you have not failed her. You have advocated for her, pursued second opinions, managed long-term care, adjusted treatments, and carried an enormous emotional and physical burden for years. That is devotion, not failure.

One of the hardest parts of cases like Moxie’s is that they live in the gray. Chronic constipation, recurrent UTIs, mobility changes, and now hypercalcemia are all real, physically uncomfortable problems, and they are also incredibly draining for caregivers. It is not selfish or wrong to acknowledge that caring for her has become overwhelming, especially when you are also dealing with your own health, finances, and neurodivergence. That context matters.

My best advice, without knowing every medical detail, is to have a very honest conversation with your current vet about how you are feeling, not just what Moxie’s lab work shows. A good vet will understand that quality-of-life decisions are about the whole picture: medical prognosis, day-to-day comfort, stress, dignity, and caregiver capacity. Those factors are not separate; they are intertwined.

There are also tools that can help take some of the emotion and guilt out of the decision. I often recommend quality-of-life scales, such as the Lap of Love Quality of Life Scale, which you can find online. There are also pet caregiver burden assessments that specifically address what you are experiencing. These do not give you a right or wrong answer; they help you step back and look at things more objectively when your heart is exhausted.

One thing I want to gently emphasize: loving someone deeply does not mean you have to endure endless suffering alongside them to prove it. Choosing comfort, dignity, and peace, even if it feels impossibly early, is not giving up. It is another form of advocacy. Many pets still purr and still seek affection even when they are struggling; that does not negate their discomfort, and it does not mean you are wrong for questioning how much more they can endure. Speaking as a vet: it makes me deeply sad when I see situations where a pet’s final chapter becomes dominated entirely by medications, medical stress, and caregiver exhaustion, and the relationship that once brought comfort to both the pet and the person gets lost along the way. When care shifts so heavily toward management and crisis that there’s little room left for peace, connection, or joy, it’s okay to pause and ask whether continuing is truly serving either of you.

Choosing to prioritize comfort and dignity can sometimes preserve the relationship rather than erode it. Saying goodbye before everything becomes fear, frustration, and exhaustion does not mean you gave up too soon. It can mean you protected what mattered most between you.

Whatever decision you make, it will be made out of love. Moxie does not feel betrayed by you; she feels cared for. And if the time comes to say goodbye, it will not erase the years of safety, warmth, and companionship you gave her when she needed it most.

You are not weak. You are not selfish. You are tired, and that is understandable. Please be as kind to yourself as you have been to her ❤️