Cat has a tumor-need advice

[MS]

About 2 months ago, my 14 year old Russian Blue (female) cat started defecating outside the litter box. We have only seen feces, which leads us to believe she is using the littler box to urinate. This was extremely unusual behavior for her. Our vet probed us about changes in the household (there were none) and took a blood test. He also felt a small mass in her lower abdomen which at the time he was not concerned about. The blood test came back normal.

About 2 weeks ago, we noticed the situation getting much worse. Instead of wet stools, we found small spots of diarrhea all over the house, and she was vomiting frequently. When we returned to vet, he advised that the mass which was about a centimeter in diameter 6 weeks previously was much larger (about 1.5-2 inches). He also noticed that she was dehydrated. The vet took an x-ray which both confirmed that she had a tumor and indicated that she was severely constipated (it looked like 3 sausage links in her intestines). At the time the vet advised us that we could proceed in one of 3 ways. 1) perform surgery to remove and biopsy the tumor, 2) try a steroid to see if will reduce the mass of the tumor, or 3) euthanise the cat due to her advanced age and prognosis. During this visit, we left the cat with the vet so he could administer an enema to help her pass the compacted stools. We definitely weren’t ready to give up on our old friend, but also didn’t want to put the cat (and us) through invasive (and expensive) surgery that might only serve to make our cat miserable at what appears to be the end of her life. We decided to try the steroids. After a week and half on the steroids, the vet noticed no change in the size of the tumor. Also, because the steroid had a detrimental effect on her immune system, she developed a minor upper respiratory infection. The vet suggested we continue with the steroid a little bit longer and prescribed an anti-biotic for the URI, and as a possible, but remote solution to the diarrhea (in case its cause was bacterial). We also had a frank discussion about euthanasia during this visit.

Our cat is still leaving spots of diarrhea all over the house, and she appears to be straining when she does this. It looks like she really wants to go, but can only release tiny amounts of feces. She is also vomiting frequently. On the flip side, she still has a full-appetite and continues to take great pleasure in receiving affection. My wife and I are at a crossroads. We are not ready to give up on her, but we also don’t want to unnecessarily extend a life that appears to have diminishing quality.

Any thoughts on additional and/or alternative treatments and insight into her condition would be helpful. Sorry for the long post, I just wanted to provide all the info we had.

Thanks.

[jason]

the usual feline respondant on this board is unavaliable but i have some suggestions.

perhaps if the antibiotics are continued enough to remove the uri then surgery can be performed to remove the mass.

i dont think alternative medicine is a direction to take (usually isnt anyhow), this case is rather serious and requires the careful and educated prognosis of a trained vet.

as others, im hoping for a happy ending to this. hopefully some other educated folks can chime in here.

[davet]

this is just san opinion based on no real knowledge of the facts but...i think you are doing no more prolonging the cat's discomfort by the use of steroids and antibiotics...it appears that there is nothing medically that can be done...IMHO i think you should opt for surgery with the codicile that if it appears that the tumor is too wide spread to remove, to allow the vet etiehr to close up or euthanize...it may sound cruel to do surgery on an old cat but never underestimate the recuprative powers of cats.....i ahve seen young and old ones survive after proceedures that would have killed a human...again this is just an opinion and may not relate but either do nothing, which i think is being done by giving prolongadive medication...i would opt for surgery as soon as possible and done by, if possible at a surgical center.you may have noted that i had to put myt 19 0r 20 year cat so 14 is not really that old . Sll thids is subkect ot the vet on the scene who knows more about the cat's health than i do...i personaly would chance the surgery with the options above.....good luck.....hope it works out and just remember Cats are tough old critters....-cbh-dvm

[davet]

you may have noticed , i did not correct the above for errors...after rereading, i should have...

[MS]

Davet/Jason:

Thank you for your prompt replies. Our vet did not seem overly enthusiastic about the surgery option. His concern was that it may only provide temporary relief, and that most tumors like this were usually cancerous.

My wife and I are struggling to determine whether pursuing an invasive course of action is for our benefit or for the cat’s – especially considering the vet’s reticence . Last year another old friend passed away at 17. For the last 3 years of her life she was diabetic requiring insulin shots twice a day. After she passed, we came to the conclusion that while we were grateful for the additional time advanced veterinary medicine allowed us to spend with her, that the quality of her last year of her life was so diminished it was more for our benefit than hers.

Davet, our cat is a Russian Blue and we have been advised that purebreds do not live as long as mutts (just another thing we are factoring into our decision).

We know our problem is not unique, but that doesn’t make it any easier. Once again, thank you for your responses and your kind words.

[Jackie]

Hello MS,

First, I am sorry that your cat is ill. I know how difficult it is to make choices with a well loved pet.

Before I go on let me make it clear that I am not a vet and am not offering medical advise, only my personal experience with a well loved cat, Henry.

Last week I found myself in a somewhat similar situation with our ten year old cat Henry. We had treated him for over a year with prednisolone and diet change for what we thought was an inflammatory bowel. Last Monday a barium x-ray revealed a massive tumor in his stomach and blockage in his intestines.

We chose to euthanize Henry because he was unable to keep food down, because it was not clear he could survive a surgery for a biopsy and not likely that a surgery would help extend his life. The decisive point was our knowing that Henry was not getting better, that he was in pain and that we were able to help him move beyond it.

For further medical information you might try a website called VeterinaryPartner. You can also have questions answered by a vet at that site.

I encourage you to consider well the information your vet offers, the information you gather elsewhere, to evaluate it and listen to your own inner guidance. Above all be compassionate with all involved...you, your kitty, your whole family during this difficult time.

I'll keep you all in my highest thoughts.

Jackie

[Auntie Debbie]

I'm so sorry your kitty is so ill and your choices aren't the greatest. I can't offer much advice, but if you click onto Debbie's Feline Health on the left side o he board under Favorites, you will find some links on Cancer under Cancer and/or Oncology under the Feline section of my website. Once there please find the site Thensome which has a slew of links on cancer, treatments and other message boards and support groups that may be of some help. I hope there is something that can be done to help your kitty. I know how difficult all of this must be for you both and your are all in my thoughts and prayers. Please keep us posted, okay?

[Traci]

MS, I have to agree with Davet on this one (and speaking from experience with cancer)

The most notable reasons for exploratory surgery are the persistent diarrhea and vomiting, and I am assuming your vet located the tumor in the intestine....a resection might be able to be able to be done. While it is still less than 3 cm, it may be able to be successfully removed (providing there is no other evidence of metastisis, did your vet find anything unusual on chest x-rays, i.e., lungs?)...I'm not sure that 2 weeks of prednisone is long enough to shrink this tumor, but in intestinal lymphoma or cancers of this type, you really can't afford to wait for the pred to shrink the tumor, it could take some time longer.

You said bloodwork was done, but do you know exactly what profile was done? I'm assuming the CBC which helped your vet determine the degree of dehydration, but anything else, i.e. full geriatric blood panel including thyroid function? If none of this was done, I would certainly opt for it immediately, and also check heart function carefully (probably opt for ECG) so that you are fully prepared for anesthesia candidacy.

If your vet is hesitatant about performing surgery, he is probably hesitant because either kitty is not a good surgical candidate at this point (i.e., any other primary health conditions going on?, drastic weight loss recently? bloodwork to monitor liver or kidney function revealed problems)....or 2) he is not comfortable or confident in his ability to perform this type of surgery, in which I would ask for a direct referral to a vet who IS experienced in this surgery and lymphoma/cancer treatment in general. As Davet mentioned, you need a confident and experienced surgeon.

If you elect NOT to do surgery, you may need to prepare yourself for the inevitable. WITH surgery, your odds are not great, but one never knows until you've got that experienced surgeon going in and doing their ultimate best. He will not truly know until he is in and determines the extent of the problem, size and type of tumor, evidence of metastisis, etc. A biopsy will confirm the tumor type.

If you elect the surgery, please get a full pre-surgical blood screen done prior, as well as complete heart function testing (ECG)....the actual veterinary surgeon may even suggest an ultrasound, but not sure if that's necessary, unless your current vet could not locate the exact area of the tumor upon x-rays.

If this were my kitty, I would opt for surgery to remove the tumor. I would understand that complications could develop, especially slow recovery or complications during recovery, but I would also have done so under the premises that I gave my kitty my all. Without surgery, you may only be adding a few months to her life (if that, impossible to diagnose here, predict a prognosis, etc). Again, only my opinion, this is a decision you should carefully discuss with your wife and of course with the surgeon who will be performing the surgery.

My thoughts and prayers are with kitty and you, I know the difficulty, frustration and emotional rollercoaster you're enduring.....(((HUGS)))

[MS]

Traci:

Thank you for the quick response. I believe the vet did a complete blood analysis. The bill mentioned a Vetscreen, CBC and T4 (cost $126.50). When he gave us the results after the 1st office visit (before he became concerned about the large tumor) he remarked that the blood work indicated her levels were very good considering her age.

The tumor appears to be larger than 3cm. It looked to be almost 2".

He only did one x-ray, and the only things he commented on were the tumor and the compacted stools.

At this point my wife and I are leaning against the surgery. We’ve been advised that most intestinal tumors are cancerous, and that even if the surgery, recovery and chemo/radiation went well, at best we’d only be extending her life a few unpleasant months. (Is this an accurate assessment?) However, we are very troubled with the idea of euthanizing her, because between the bouts of straining to defecate, dripping spots of diarrhea and vomiting she looks basically OK. It’s very difficult to fathom that one day she could be sitting on our laps purring while receiving a belly rub, and the next day we’re bringing her into vet to put her to sleep.

On an unpleasant side note, we are not in the best financial position to pursue costly vet treatments. If the prognosis was more positive, cost would not be a non-issue, but it isn’t so it is.

Thanks again for the information and your kind thoughts. My wife and I have been overwhelmed by the support we have received from the “online feline community.”

[Traci]

MS, don't know if you've seen this yet on the site, but if it helps, it's worth reading....When Is It Time? ... this page outlines some careful evaluations to help you gauge quality of life.

The decisions you're faced with are not easy ones to make. You question the what-if's and try to look at all angles, but what is most important ultimately, is quality of life. If you are electing not to persue surgery, then you may be able to treat symptomatically or conservatively to treat symptoms as they occur.

My only concern is that you might opt for a second opinion if possible, perhaps with a feline oncologist, nearby veterinary university if possible....on the offchance your vet simply is not experienced or equipped to confirm the diagnosis. You don't yet know if this is lymphoma or the exact type of tumor, etc, I would want you to make absolutely certain and exercise your options before automatically assuming non-treatable cancer. While it does seem a potential, you would also want to rule out severe inflammation, IBD, or even an obstruction of some sort (could be any obstruction, i.e., compacted hairball, swallowed an object, or even a combination of obstruction and bacteria, etc). In this time of uncertainty, I wouldn't want to leave anything unchecked at all.

Please consider another opinion quickly..let us know what you find out.

Continued prayers and good thoughts for your sweet kitty.....