My 12 y.o. siamese, Koko, has been diagnosed with a mass in her lung, measuring 2.2 cm by 1.3 cm (showed up on ultrasound). She's had a persistent dry cough for the past two months, like she's trying to cough up a hairball.
The vet says this is very rare and has not ever seen such a case. Koko seems in good health otherwise, but the cough slows her down as she can''t exercise or play like she used to. I'm going to ask for a needle biopsy, but they think it's a bronchiogenic carcinoma. It has also been suggested that if it's cancer, that it may have metastasized from elsewhere, although I don't see any evidence of anything else wrong with her.
I am not anywhere near a large city where an oncologist could be consulted. My vet has suggested having the mass removed (probable lobectomy) by a vet that travels here once a month from another city. I'm at a loss as to what to do. Koko is on 2.5 mg. of prednisone 2x/day which seems to help the cough somewhat, but I realize this is only a temporary fix.
I've heard that surgery in the thoracic area is very risky, and the mass is somewhat close to her heart. I'm inclined to think I should go ahead with it, but I'm not sure what her prognosis would be without the surgery. I love her dearly and would like to spend at least a few more years with her. Any thoughts on this?
Re: Cat diagnosed with primary lung tumor
I'm not sure it's feasible to wait for the oncologist, depending on how long that wait is. For this reason, what CAN be done is your vet can teleconference with a specialist from ANY nearby vet university or specialist of his choice. Three such veterinary oncology departments I would suggest are Colorado State U (Fort Collins), Wisconsin State U (Madison) and Gulf Coast Vet Specialists in Houston, TX. All are the number one oncologist departments in the nation, each having the most recent advances in oncology and the chemotherapeutic protocols.
Your vet can fax your kitty's records, discuss x-ray findings and get the latest info and direction from any oncology specialist in which to proceed. They may or may not suggest surgery, depending on the type of neoplasia suspected, location, and general health status of your kitty (you would also want a pro surgeon in oncology for that procedure). Ideally, this should be staged, with a biopsy to determine what type of neoplasia is present, this ensures the chemotherapeutic protocol treatment is chosen most efficiently.
You are right to be concerned about another area as the primary location of a tumor or neoplasia. Lung tumors usually signal metastisis from another area, so your vet should now be investigating other potential areas, whether this be blood, intestinal, lymph involvement, immunological, bone, infectious disease related, etc. Further x-rays may be necessary, but you also may need to opt for an ultrasound if x-rays and additional bloodwork do not reveal anything significant. I would at least start with an immunological blood profile, additional x-rays if necessary, and go from there, depending on other findings. The oncology specialist can help direct your vet on which testing should be done first, or if more diagnostics will need to be addressed.
Don't wait on this, lung tumors are usually fast progressing, and without staging and biopsy, it's nearly impossible to advise further. The sooner you get this staged and know what you're dealing with, the sooner treatment can be discussed. Ask your vet to consult (teleconference) with a specialist ASAP.
Your vet can fax your kitty's records, discuss x-ray findings and get the latest info and direction from any oncology specialist in which to proceed. They may or may not suggest surgery, depending on the type of neoplasia suspected, location, and general health status of your kitty (you would also want a pro surgeon in oncology for that procedure). Ideally, this should be staged, with a biopsy to determine what type of neoplasia is present, this ensures the chemotherapeutic protocol treatment is chosen most efficiently.
You are right to be concerned about another area as the primary location of a tumor or neoplasia. Lung tumors usually signal metastisis from another area, so your vet should now be investigating other potential areas, whether this be blood, intestinal, lymph involvement, immunological, bone, infectious disease related, etc. Further x-rays may be necessary, but you also may need to opt for an ultrasound if x-rays and additional bloodwork do not reveal anything significant. I would at least start with an immunological blood profile, additional x-rays if necessary, and go from there, depending on other findings. The oncology specialist can help direct your vet on which testing should be done first, or if more diagnostics will need to be addressed.
Don't wait on this, lung tumors are usually fast progressing, and without staging and biopsy, it's nearly impossible to advise further. The sooner you get this staged and know what you're dealing with, the sooner treatment can be discussed. Ask your vet to consult (teleconference) with a specialist ASAP.
..........Traci
Re: Cat diagnosed with primary lung tumor
Thanks for such a quick response to my question. I've just had a needle biopsy done and the cells are being forwarded to a specialist...so I'm waiting for a reply. She's no longer on prednisone and the cough has lessened considerably, so I don't think it was helping.
Is it possible for a cat to have cancer and still appear well? I'm wondering if this is some kind of benign tumor. Besides the cough (which she's had for about 3 mos. now) she seems perfectly o.k.
I will post the results of the biopsy when it comes in, and whatever treatment options that are suggested.....just in case anyone else has a cat with similar problems.
Is it possible for a cat to have cancer and still appear well? I'm wondering if this is some kind of benign tumor. Besides the cough (which she's had for about 3 mos. now) she seems perfectly o.k.
I will post the results of the biopsy when it comes in, and whatever treatment options that are suggested.....just in case anyone else has a cat with similar problems.
Re: Cat diagnosed with primary lung tumor
What sort of biopsy was performed, was it a cutaneous needle biopsy or did your vet actually perform exploratory surgery to get a tissue/mass cut biopsy sample? Not knowing that, and at this point, since you didn't mention your vet's findings during the biopsy, it's really hard to say. (invasive surgery to explore a mass on the lung would allow your vet to see the mass visually, whereas a needle biopsy can only give your vet an idea/educated guess and the pathology lab will have to be the expert on cell indentification taken from the needle biopsy)
As for your question, most types of cancer do not present obvious signs of ill health until late stage disease (and depending on the location of tumor, type of tumor, malignant vs benign). Since it is in the lung space/area, the coughing symptoms you note would be the most obvious, but labored or distressed breathing, vomiting, other symptoms could yet present. (there are a miriad of symptoms associated with various types of cancer, each depends on the above mentioned factors)
Just curious, and this may be reaching since it seems the lung is most involved, but was heartworm ever tested for and ruled out? Was fungal disease ruled out?
Unfortunately, you will have to wait for the pathology report to know how best to proceed. When are you expecting the biopsy report?
As for your question, most types of cancer do not present obvious signs of ill health until late stage disease (and depending on the location of tumor, type of tumor, malignant vs benign). Since it is in the lung space/area, the coughing symptoms you note would be the most obvious, but labored or distressed breathing, vomiting, other symptoms could yet present. (there are a miriad of symptoms associated with various types of cancer, each depends on the above mentioned factors)
Just curious, and this may be reaching since it seems the lung is most involved, but was heartworm ever tested for and ruled out? Was fungal disease ruled out?
Unfortunately, you will have to wait for the pathology report to know how best to proceed. When are you expecting the biopsy report?
..........Traci
Re: Cat diagnosed with primary lung tumor
I should have the needle biopsy report in about three days (fine needle aspiration). There was no exploratory surgery performed. I was also curious about whether it could be lungworm, but my vet says in this area it's almost unheard of.
Just wondering though, if roundworms can migrate to the lungs? I know she had them last year but was treated for them.
I'm also curious as to whether it could be a fungal infection. I'll have to wait for the biopsy results I guess. I'll post as soon as I find out!
Just wondering though, if roundworms can migrate to the lungs? I know she had them last year but was treated for them.
I'm also curious as to whether it could be a fungal infection. I'll have to wait for the biopsy results I guess. I'll post as soon as I find out!
Re: Cat diagnosed with primary lung tumor
No, roundworms are a gastrointestinal parasite......lungworm could be a potential concern, but I would think your vet could make an educated guess on them by x-ray evaluation.
Please do post an update when you know more....in the immediate sense, watch your kitty's breathing patterns closely, and don't hesitate in the least to notify your vet at once should a breathing problem present itself, or any other obvious signs of illness.
Please do post an update when you know more....in the immediate sense, watch your kitty's breathing patterns closely, and don't hesitate in the least to notify your vet at once should a breathing problem present itself, or any other obvious signs of illness.
..........Traci
Re: Cat diagnosed with primary lung tumor
Just an update on my cat's tests. The vet just phoned and said that the needle biopsy results don't reveal anything. They could find "no identifiable cells" (does this mean the test didn't turn out or there was nothing to find?). He said we would almost certainly rule out lungworm and fungal infection.
I'm wondering if this could be a benign growth that's been there for awhile. I remember last winter that Koko began making a "sighing" sound on expiration, usually during the night. She still makes the same sound, and now has the cough.
The vet will confer with the ultrasound specialist here in town and will call back tomorrow to decide what to do. I don't see any point in surgery if they don't even know what it is, and the vet agrees.
Another option is to repeat the needle biopsy. It was a pretty stressful event for Koko, though. They shaved her side and she was bruised from the iv and sick from the anaesthetic. It's also risky because the "mass" is right beside her heart.
The coughing generally occurs when she wakes up in the morning, and a couple of times during the night...maybe once or twice during the day. I've been adding a bit of flax seed oil to her food as it's supposed to shrink tumors in animals....could be my imagination but she doesn't seem to be coughing as much.
It's a mystery...I don't know where to go from here.
I'm wondering if this could be a benign growth that's been there for awhile. I remember last winter that Koko began making a "sighing" sound on expiration, usually during the night. She still makes the same sound, and now has the cough.
The vet will confer with the ultrasound specialist here in town and will call back tomorrow to decide what to do. I don't see any point in surgery if they don't even know what it is, and the vet agrees.
Another option is to repeat the needle biopsy. It was a pretty stressful event for Koko, though. They shaved her side and she was bruised from the iv and sick from the anaesthetic. It's also risky because the "mass" is right beside her heart.
The coughing generally occurs when she wakes up in the morning, and a couple of times during the night...maybe once or twice during the day. I've been adding a bit of flax seed oil to her food as it's supposed to shrink tumors in animals....could be my imagination but she doesn't seem to be coughing as much.
It's a mystery...I don't know where to go from here.
I had asked this before, was she ever tested for heartworm? (not the same as lungworm) If not, I would get that done ASAP.
Again, fungal infection should be ruled out.....your vet could have attempted to get a cytology sample while she was under anesthesia the first time. Otherwise, you can still opt for a serum blood serology to rule out fungal diseases.
Did your vet consult with any other oncologist? (I would)
May I ask where you heard that flaxseed shrinks tumors? The prednisone, if your vet feels she can benefit, would be the option in shrinking a tumor, but since this mass is yet unidentified, I would again suggest a consult with a pro oncologist (again, can be done via phone with veterinary university) before attempting another needle biopsy.
Again, fungal infection should be ruled out.....your vet could have attempted to get a cytology sample while she was under anesthesia the first time. Otherwise, you can still opt for a serum blood serology to rule out fungal diseases.
Did your vet consult with any other oncologist? (I would)
May I ask where you heard that flaxseed shrinks tumors? The prednisone, if your vet feels she can benefit, would be the option in shrinking a tumor, but since this mass is yet unidentified, I would again suggest a consult with a pro oncologist (again, can be done via phone with veterinary university) before attempting another needle biopsy.
..........Traci
Re: Cat diagnosed with primary lung tumor
Just another update. I've been trying to get in touch with the vet who did the ultrasound but she hasn't returned my calls. Another vet at that clinic called to give the results (posted above). This is really frustrating because I've spent over $1,200.00 in tests so far (x-ray, ultrasound, needle biopsy) and I'm getting nowhere with this. They just keep telling me they have no idea what's wrong.
I asked whether they could telconference with a specialist and they're saying that not much can be determined just from an ultrasound or x-ray. I'm sure they'll do it for more $$$$, but I probably still won't get an answer. They won't even test for heartworm or fungal infection because it so "highly unlikely".
If I go to another clinic I'll have to start from scratch as far as tests and the costs involved.
On a more positive note, my cat is still doing fine and isn't coughing as much or as often.
I asked whether they could telconference with a specialist and they're saying that not much can be determined just from an ultrasound or x-ray. I'm sure they'll do it for more $$$$, but I probably still won't get an answer. They won't even test for heartworm or fungal infection because it so "highly unlikely".
If I go to another clinic I'll have to start from scratch as far as tests and the costs involved.
On a more positive note, my cat is still doing fine and isn't coughing as much or as often.
Re: Cat diagnosed with primary lung tumor
You wouldn't have to start from scratch, per se, as you already have an ultrasound film and x-rays in hand, along with all current medical records to present to a new vet. At your request, your first vet can fax those records.
"So highly unlikely" is not a diagnosis, and if they in the least suspected a mass or tumor, fungal disease, heart worm, respiratory disease and other problems need to be ruled out. More conservative approach would be rule out allergies and asthma.
A healthy normal cat does not cough, not persistently, something is amiss, and I strongly suggest a second opinion. Since there was an initial suspicion of a tumor or mass, you don't want things left to chance.
"So highly unlikely" is not a diagnosis, and if they in the least suspected a mass or tumor, fungal disease, heart worm, respiratory disease and other problems need to be ruled out. More conservative approach would be rule out allergies and asthma.
A healthy normal cat does not cough, not persistently, something is amiss, and I strongly suggest a second opinion. Since there was an initial suspicion of a tumor or mass, you don't want things left to chance.
..........Traci