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Simple Summary  Cats are the most popular companion animals in New Zealand. Many owners form close relationships with their cats and these relationships, along with other factors in cat owners’ lives, make end-of-life decisions complicated. Veterinarians can help make owners’ end-of-life decisions easier if they understand the personal factors impacting such decision making. We set out to explore how owners of older and chronically ill cats make end-of-life decisions in New Zealand and the role that their veterinarian plays in the process. We interviewed cat owners who had recently had their cat euthanized. Cat owners mentioned nine areas of concern. Four were animal-centered concerns: cat behavior change, pain, signs of ageing, and the benefits of having an outside perspective. Five were human-centered concerns: veterinarians understanding owners’ relationships with their cat, normalizing death, the need for a good vet to manage end of life, veterinary validation that owners were doing the right thing, and a desire to predict the time course and outcome for their cat. End-of-life decision making is complex, and the veterinarian’s role is often poorly defined. Our owners appreciated the expertise and validation that their veterinarian provided.    Abstract  Cats are the most common companion animals in New Zealand. Advances in veterinary care means that cats are living longer and there are many older cats. End-of-life decisions about cats are complicated by owner–cat relationships and other psychosocial factors. Our study explored the ways in which end-of-life decisions were being made by owners of older and chronically ill cats in New Zealand and the role of their veterinarian in the process. Qualitative data were gathered via retrospective semi-structured interviews with 14 cat owners using open-ended questions. Transcripts of these interviews were explored for themes using template analysis and nine themes were identified. Four were animal-centered themes: cat behavior change, pain was a bad sign, signs of ageing are not good, and the benefits of having other people see what owners often could not. Five were human-centered themes: veterinarians understanding owners’ relationships with their cat, normalizing death, the need for a good veterinarian to manage end of life, veterinary validation that owners were doing the right thing, and a strong desire to predict the time course and outcome for their cat. End-of-life decision making is complex, and the veterinarian’s role is often poorly defined. Our owners appreciated the expertise and validation that their veterinarian provided but continuity of care was important. Future research aimed at exploring the veterinarian’s perspective during end-of-life decision making for cats would be a valuable addition to the topic.

“What Would You Do?”: How Cat Owners Make End-of-Life Decisions and Implications for Veterinary-Client Interactions