Strange growth in ear

[felinexpress]

Sad to report that the vet found mast cells in the smear. She is only three years old and right now she is out of her head from the drugs they gave her, crawling all over the cage in our bedroom and trying to get out. She has a trimline collar on and has to be settled for a few days before I can let her have her freedom. I am looking for my one book Cancer and Your Pets, I know I have a copy of it somewhere here- but I have to hide my books or they tend to get baptized. I want to read up on this cancer and find out what her odds are. The vet said in cats the prognosis is better than with dogs- but she will be monitored from here on in. Traci, he told me that if the cancer does return it will go to the spleen? Does that sound right to you? I am so sad for her and now I need to go and see if I can calm her down. He said one of the drugs can make kitties hallucinate. he found the mast cells in the large growth not the smaller ones. Once he found them in one growth, I don't think he looked further.

[Traci]

MA,

The buffy coat smear shouldn't be used as a sole diagnostic, since mast cells can circulate at any time (like an allergic reaction). The presence of mast cells on the smear are not confirmative.

Did the vet excise ALL THREE growths? Were all TOTALLY excised? (large and clean margins, leaving no trace of infected tissue behind). If benign, the majority do not usually reoccur after removal.

Were ALL THREE growths localized to the ears? Was the third growth near the ear or elsewhere?

If he suspected anything related to the spleen, then he would have considered an FNA of the spleen, liver or lymph nodes. As a matter of fact, the lymph nodes might have been a good consideration for an aspirate sample to see if they were reactive or also contained mast cells. Do you know if he aspirated the lymph nodes?

It would be rare for a reoccurance from a growth on the pinnae to metasticize to the spleen, UNLESS there was already metastasis internally on or near the spleen (or the liver or intestine). A splenectomy is usually "curative" if there is otherwise no metastasis elsewhere in the body.

A MCT might reoccur to the pinnae IF the excision was not complete. In this case, either a second surgery to remove the remaining tissue can be done in a couple weeks post-recovery or radiation therapy. the latter is what most vets would recommend.

Is the specialist also an oncologist? Board certified? If not, your best bet is to have him consult with one - you can get him to consult with them at OSU-CVM. They can review the pathology report and recommend best course of action and treatment.

Don't jump the gun on this just yet, if at all. AS LONG AS this vet got clean margins upon excision, excised ALL the growths, there is an equal chance they are benign, and no internal or spleen involvement. That said, you should be prepared however, for a potential lymph node FNA or ultrasound guided spleen FNA, depending on the pathology report.

Please, make darn sure you get this vet to consult with oncologists at OSU-CVM (or any equally accredited veterinary university/teaching)

As for the hallucinogenic effect, it is probably from ketamine. It can take several hours for the effect to wear off. Keep her comfortable and do not offer food or water until she is alert, then in small amounts until tomorrow when you can feed her normal amount.

Depending on how wide the incisions are, keep a close eye on the fit of the e-collar, you don't want it to rub against raw tissue, open wounds, etc. The e-collar is a must to prevent self-trauma, scratching and pawing at the incisions though.

[felinexpress]

Thank you again for the information Traci. He did take off all four growths- he had found another one when he got in there to look. One was on her ear wall, two on her ear flap and one under her other ear. He said he believes he got it all.

I moved her upstairs to a large, dark closet because she was hurting herself in the cage. She is hissing and spitting and growling at me. In all the time she has been here with us, she has never shown any type of aggression. I gave her a tiny bit of food which she ate sparingly- but I am just going to leave her be with only flashlight checks after midnight. I am sure she has been through it today and if she is hallucinating, she probably doesn't even recognize me.

[Traci]

Did the vet prescribe pain medication to be given at home?

If not, call him FIRST thing in the morning and demand it!!

Cat's ears are one of the most sensitive areas on the body, if he didn't prescribe pain medication for a multiple surgical procedure, shame on him!! It is not typical for a cat to be agressive like this after a surgical procedure/anesthesia unless she is wakening to PAIN!

It is doubtful she is hissing/spitting/agressive due only to ketamine, ketamine usually leaves them "drugged out", and they can thrash about shortly after waking from anesthesia but it doesn't cause hallucinogenic effects like hissing/spitting. My guess is she is in pain.

(DO NOT GIVE ANY HUMAN PAIN RELEIVERS - CALL VET FOR Rx)

Again, check the e-collar and make sure it's not rubbing on the wounds. If it is, every time she moves her head, it could be excruciating pain!

[felinexpress]

First of all, I would NEVER give any cat any human pain reliever unless the vet specifically told me to. Her collar is fine, it is a soft fabric collar and it isn't rubbing against her ears. She was given a pain shot that I was told will last for 24 hours. I have metcam here- but I don't want to use it because I was told the shot would hold her.

She does hate the collar- but I would rather leave it on then have her tear out her stitches. The one growth the core was pretty deep and she was under for awhile for this procedure. The other growths were smaller but he had the most problem with the larger growth- the one in the photo.

Traci, you have to understand I live in a rural area where livestock is the prime concern for most vets. This one vet is the BEST vet for cats in the area- the FS works out of Portland which is 3 hours from me. I trust this vet and will only ask for him to work on my cats not any of the others at the clinic.

I'm doing the best I can with the means available for me. Just because Fiona is a stray, doesn't mean that I don't want the best for her- but my hours at work have been cut down to only 20 hours per month. Regardless of what "they" say- the economy right now sucks. I used to work at least 120 hours a month so finances have had a big hit.

My hope is by tomorrow morning, Fiona is back to mostly her loving self. if not, first thing I will be beating down their clinic door (they do not have a 24 hour service number). Please don't scold me about what I am doing- I honestly can't bear it, not right now. Mike is doing poorly- and my day has been very stressful. I am near tears at this point and I just want Fiona to be okay, but I know from past experience when you open up cancer to the oxygen, bad things can happen. I am hoping we are over the worst of it.

[Traci]

MA, I wasn't scolding you.

I was scolding the vet, IF he never prescribed pain medication, which I was not aware of, and therefore asked you. I wasn't scolding you.

Also, your vet, no matter who he/she is is obligated to consult with his/her peers if or when they are not experienced enough or cannot reach a diagnosis or not equipped to diagnose. You said this kitty had been seen by 4 vets and none of them could tell you a thing. Granted, I don't know what all he's said to you.

If the specialist is worth his weight, then great, but all I have to go on to help, is what is posted here by the owner.

Part of my job here is informing pet owners they have options. Mainly attempting to steer them in getting their own vets to consult on the owner's behalf. Vets who don't or won't do so, in my opinion, are not doing enough and not doing right by the pet.

It's not a matter of how much you trust a vet. If the vet is scaring you needlessly, that's not good practice. Sure, he might have experience with this, but as a vet, he knows NOT to make assumptions until the final pathology report indicates so. And that's the impression I'm getting, that he is making comments and scaring you. Maybe he's trying to prepare you, I don't know, but it is usually best to withhold such comments until something definitive warrants them.

Again, for what it's worth, I encourage you to try to remain positive and hopeful, with all I know about this type of tumor, it's entirely possible they are benign. Yes, there is a possibility of malignancy, but in absence of any typical symptoms, at this point, it very well could be benign.

I'm simply trying to explain how the steps are taken in cases like this. Whether you choose the steps to pursue is up to you. But when you're fearing cancer, when it might not be, I try to alleviate some of that pressure on you, if and when I can.

I know the costs can be astronomical at times. Trust me, been there, done that, still doing it. I can't make decisions for owners, I can only try to help them consider the options and help them understand what their vets are doing.

I apologize if I said anything to make you feel bad, I assure you, that was not my intention, I too want what is best for Fiona and you. She's been through a lot already and I know you have a full plate as well.

Please keep me updated. And know she is in my thoughts and prayers.

[felinexpress]

Sorry Traci, it has just been a day here. Mike is in the hospital fighting with shigella and I am just emotionally exhausted. Despite placing 9 cats and 4 kittens in homes this year- I still need to get my numbers down- but very few people want to adopt.

I just checked on her and she is mellower now. No spitting, no hissing no aggression. She likes her new closet and there is nothing (like the underside of the furniture) to bump her ears on. She has eaten and drank and used the litter pan.

Like I said, I have Metcam but I don't like using that drug much. Her ears look good and hopefully by tomorrow she will be back to her normal self. She hates the collar and I don't know how long she has to wear it? Three days maybe or do you think longer.

Again, i am sorry that I misread your tone of your posting. I do appreciate all you do for all the cats and their owners and especially how many times you have coached me through some tough situations.

[Traci]

If the vet gave her a pain med injection during surgery, it is not necessary to give metacam tonite. However, if he prescribed it for home use and the Rx label indicates when to start it (most likely tomorrow), then please follow his directions. It is probably very small doses, most likely only 2 or 3 doses, and is effective for pain. Metacam is also an antiinflammatory, so it will also help alleviate pain in that regard (it is especially helpful in surgical procedures).

I understand your apprehension about metacam and I share that apprehension. But generally, the effectiveness outweighs the risks. If you are uncomfortable about using it, by all means, ask the vet for something else, I would suggest buprenorphine, but be warned, it has sedative-effects, and won't target inflammation like the metacam.

She should ideally wear the e-collar until her scheduled recheck (I assume he scheduled a recheck for around 7-10 days?) The reason being, with almost all surgical procedures, the incision sites will at some point start to itch, and the last thing you want is for her to reopen healing incisions by scratching or pawing and introducing bacteria. I know it's a pain in the rear, but ultimately, best for her to heal those incisions quickly. The trimline collar is so much easier for them to adjust to, as opposed to the plastic ones. Tomorrow, she'll probably be more used to it and will settle down more. Just check the fit two or three times a day to make sure it's not too tight or not too loose. Since one of those excisions was fairly deep, you don't want to risk her self-traumatizing the areas.

[felinexpress]

They just gave me V.A. L. Syrup with Butorphanol Mixture. She is ten pounds and they say to give her 1-2 cc 3-6 hours as needed for pain. She is less aggressive since moving to the closet (I think she was bumping her head on stuff and hurting herself even more) and in the closet there is nothing she can jump on or bump on. It is all cleared out and I just have her food, water, litter pans and nice soft blankets in there for her. I'm also playing the Harp Of Hope on the CD player which has helped a lot.

Should I give her 2 cc's initially? She is 10 pounds. My vet is in surgery and I had a friend pick up the meds and she forgot to ask. I think you would answer me quicker than they would anyway.

[Traci]

You have to ask the vet, since I don't know the mg amount per cc he mixed up. If it states the mg per cc (or mg per ml) on the Rx label, post back and I can tell you further.

I would give 1 cc now, then call the vet. If you can't get ahold of the vet within 3 hours, then give another cc. After that, wait 4-6 hours for the next dose unless your vet states otherwise in the meantime.