No, it's not always easy to tell.

My Max (RIP) was a perfect example of that. Max developed osteosarcoma
in his right maxillary bone -- the cheekbone/upper jaw area, just below
his eye. It invaded into his mouth, totally moving one of his molars so
that it was eventually facing inwards, toward the middle of his mouth.
He had a lot of bleeding during this ordeal, & a large abcess above
that tooth. He also had insulinoma.

When Max was dx'd w/ the cancer, our vet gave him only a few mos to
live. Every time Max seemed to be going downhill, we started saying
goodbye to him, getting ready for that last vet visit.

Extremely long story cut short: Max lived w/ his osteosarcoma for an
amazing *9 months*. Every time we scheduled that last vet visit, he
perked up, was playing, bouncing around like a kit (he was a rescue, so
we had no idea how old he was, but he was probably 8 or 9 at the end).
He *never* had any problems eating, although, closer to the end, he was
mainly eating soup. He *never* lost that sparkle in his eyes, until the
morning of his very last day. He suddenly started bleeding from his
mouth, harder than he'd ever done before, soaking the shoulder of my
t-shirt, & for the very first time, his eyes just told us, "I've had
enough of this. Please make it stop." We took him in to the vet
immediately. That vet visit was the 4th "final visit" we'd scheduled
for him during those 9 mos. He didn't even fight the mask delivering
the iso -- he took a long, deep breath, as though he knew this was the
beginning of his release.

Yes, there were a few people who were critical of me for letting him go
on for so long. But, seeing him every day, giving him his meds, keeping
a close eye on his condition, as well as having constant monitoring
from our vet, I KNOW I did not let him suffer for a single minute. That
time was time he was *meant* to have, & he enjoyed every single second
of it, I know. But the minute HE made it clear to us that he wasn't
having fun anymore, that was all it took. But, until that time, even w/
a horribly misshapen face & occasionally bleeding gums, he was happy,
playful, & loving till the very end. It was an honor to be his hooman.

Lin

[Posted in FML 6917]