cancer in older cat - surgery or no? advice pls

I was just wondering if anyone has had any experience with an older cat coming down with cancer and having to decide if surgery was a good option or letting the cat die naturally was the better way? I have a 15 year old cat who was recently diagnosed with a mast cell tumor in her spleen. The vet and oncologist told me they could remove her spleen, but there are lots of things that could go wrong in surgery due to her age and she also has early kidney disease. Without surgery, she might only last 3-6 more months, and with surgery, she might last another year. I really don't know what to do. The surgery and recovery will probably be painful and scary for my sweet cat, but I have no idea where the cancer will spread and how painful that will be either. So I'm looking for tips or advice from anyone who's been through it or has a thought on the subject. Thank you!

I haven't been through it, but I am familiar with the diagnosis, due to other people I know. Cancer is really painful, and I'd venture to guess that kidney failure is really painful too.

I guess if it were me, I'd have to decide a.) how much money I have for ongoing care. I would not only make a choice based on this, but it is a consideration for anyone, unless you can absolutely afford thousands of dollars in vet care. If I could afford the costs, then it would not be a factor.

b.) What are the odds on the cat surviving, and having few complications. If the odds are high that complications are going to develop and the kitty is going to be in constant pain, you're probably going to make the decision later on to euthanize.

c.) The biggest question is, after talking to your vet and finding out all the information.. what is your gut feeling on it? How long do you want the cat to stay with you in comparison to the problems and potential pain it's having. If the possibility that it might live a relatively pain free life for the next year and have a "good quality" time, then I'd say it's worth taking the risk of surgery. It just depends on what the outcome could be.

You could make the decision to do the surgery to attempt to extend kitty's life..and if it turns out right, and the life is extended, then it's definitely worth it. And if you end up having the surgery done, if there are complications, and if you feel the pain is too great for kitty...then you can make the decision to euthanize, or die naturally.. although with a painful disease, I'd choose euthanasia.

What are your thoughts on it?

I would have a long talk with the vet but if I were you I would probably opt to have the surgery. The biggest challenge will be her kidneys so you will definitely have to go through a board certified oncologist probably in consultation with a board certified internist. It takes extra care but it can be done. My friend's cat has had chronic kidney failure for 4 years now and he had surgery for a fibrosarcoma this past summer. He did fine and is still doing fine so it definitely can be done.

If the vet considers her to be a candidate for surgery overall, then it's definitely worth considering.

I definitely don't have unlimited financial resources (I'm a grad student, living at home, and making minimum wage) and the surgery would cost about $2000, and then there's post-care costs to factor in as well. And while that's definitely a consideration, I feel like if a vet were to tell me surgery is going to be really helpful for Samantha, I would go into debt in a second for her, lol. I do have some savings that could potentially cover the surgery.
Neither the vet nor the oncologist could really give me solid odds or chances on survival rates or benefits of the surgery. They said older cats often don't do well under anesthesia, so she could die on the table, and because her kidneys aren't functioning perfectly, that would be a potential complication as well, but they couldn't definitively tell me "the odds of the surgery being successful is 50% or whatever."
As for my gut feeling on this - it honestly changes every 5 minutes. One second, I'm all - "we're doing surgery! we have to get that spleen out because I don't want to lose her so soon" and the next second, I'm thinking "I can't make her go through something so painful and scary when maybe she's ready to go and she just wants to die quiet and peacefully all curled up in bed." It really breaks my heart to think of her dying on an operating table. And sometimes I feel like I'd be making a selfish decision if I went for the surgery - like I want to put her through all this trauma just because I'm not ready to let her go. Sam is at least not in pain right now. Besides weight loss, her appetite is fine and she's still the happy adorably sweet cat I've loved for so long. I really am torn on this and hoping someone can have a few tidbits of wisdom to add to the jumble of thoughts in my brain. Thank you.

Well, I can understand you not wanting her to have her last thoughts be of an operating table. For whenever the time comes, if it's euthanasia, keep in mind that some vets will make a house call. Mine would and was going to except that I ended up euthanising my dog at emergency hours.

Some vets absolutely won't give you any advice. Some vets will say, you know, it probably is more ethical and kind to the animal to euthanize now. Some will let you make the decision and then tell you it was the right one. It's always hard to tell. Pin them down on whether the chances are good or bad.. and if they say every animal is different, ask them what the past cases have been and what the odds were on them.

I think that I would be considering either letting her pass naturally, or saving her the pain and having her put down. It's so difficult, and there's probably no right answer. Truly, with this situation, what the right answer is, is what you feel most comfortable with. If Samantha only has a year to live at best, some of that time is going to be painful and it's entirely possible that it will be most of that time.

Maybe the best way to think of it is .. if it were you, and you were facing the situation that Samantha is with your own health.. what would you want? Would you want to live every possible moment, or would you rather circumvent the pain, leaving your last moments on earth in happy thoughts..

I guess it sort of falls back to your religious and moral beliefs. If it were me, I think I'd want to go happy before it all happened, but I know some people would be wanting to hold onto every last moment, no matter how painful.

It's a really tough decision. I'm happy to talk with you about it, though, if it helps you to work it out.

My prays for you and your sweet kitty. I hate making choices like these, as far as going threw it myself i haven't. But my friend had a cat around the same age as yours it was a 14yr.old altered male. He had a bladder problem, he was treated for a heart problem etc. Then he appeared to have cancer, she did the surgery he had slight bleeding complications but came out alive. As far as pain goes the vet gave her pain meds to control it. Of course it did not take it all away he had some pains now and then but it was far less than what it would of been. I'll ask her what she was using as far as pain meds.

But he is stilling kicking at 15 1/2 he will be 16 in early April he is a pure-bred ragdoll. The sweetest little thing but not only has he lived longer than they thought he isn't in much pain and is doing good. Every case has its own set backs but honestly do some research ask you vet how many sucessful cats came threw over the age of 12. Look it up online i'm sure theres a lot of help out there you just got to put your claws in the dirt to find it. Good luck and i wish you many days a head with your kitty.

Thank you for all your kind replies. I really appreciate being able to talk it out with other like-minded people Talking to non-pet people, I feel like I have 3 eyes and a horn because I'm worrying so much about my sweet cat. I'm sure I will change my mind about a million times before I come to a decision on this. I definitely don't want her to be in a lot of pain, and either way I go, there's bound to be some level of that. I know my vet said she could put Sam on steroids and other pain killers if I don't go for the surgery, but I just don't know how cats deal with a terminal illness like cancer. My cat is very quiet and not too vocal when she's upset or in pain (when she got urinary infections when she was younger, she didn't cry or act odd at all - the only way I knew she had one was when she started spraying), so I'm worried I won't know when she's in pain due to this, or if she's hurting a lot after the surgery if we go for that route. Sigh... there are just too many unknown factors that make this a very tricky and tough decision.

Yep, you're going to have to pin your vet down and say.. what are the statistics. It's possible that if you have the surgery that Samantha may live a lot longer than expected. Doctors certainly aren't infallible. There is always the option of making other decisions if you have the surgery and then see that she's not doing well.

I had a dog, about a year and a half ago, that we finally had to euthanize (mentioned earlier). He'd suffered some sort of neurological disease that affects older dogs, and was very much like a stroke. After the initial episode.. and a couple of weeks of keeping him confined, he got much better, but very slowly declined over the course of about two years. It got to the point where he just wasn't "in there" any more. He was drastically losing weight, and he had to be picked up and carried in and out. Half the time I'd take him out, and he wouldn't go, and we'd come back in and boom, on the carpet. Eventually he suffered several more seizures, within one week, and I finally forced the family to make the decision that it was his time to be put down. He couldn't keep his balance, he was falling and hurting himself, he wasn't in there.. at that point we knew it was the right thing to do.

It's just very hard to tell, but the vets need to come off of the truth about what the statistics are, how many they've seen come through this surgery okay, how many they've seen pass away or have complications. Also, they need to tell you the full blown out details of what the chances and so forth of what kind of pain Samantha would be suffering if things don't go right.

Once you know that, it will be easier for you to make a decision about what you want to do.

Aprilly,I'm so sorry your Samantha has cancer. I really feel for you, having to decide whether to put her through the surgery or not.

I lost my 13-year-old tabby Tiger to cancer of the jaw not quite two years ago. The cancer was already in the bone by the time it was discovered, and the treatment options were limited and wouldn't have given her much more time. Chemo might have ruined her quality of life immediately, and according to the websites I checked would probably have given her only a few more months. The most "successful" treatment, removal of the jaw plus radiation, would probably have given her no more than several more months, and put her through a nightmare. (I ran across one site about a cat whose owners had been told by a vet that the surgery-plus-radiation treatment, which is also expensive, would give their kitty two more years of life, maybe more, but that site had no updates after the first few months, and the kitty was in very sad shape by then, with his owners admitting his personality had changed completely. I asked a vet about this later and was told he'd never heard of any cat who'd received that treatment living close to two years, and the sites I checked gave only a 10% chance of the cat living a year after that drastic treatment.) So I opted for palliative care, took Tiger home to love her and make her as comfortable as possible for her remaining time with me, which turned out to be only a few short weeks -- but they were good weeks for her, happy weeks. I gave her the painkiller Metacam, and when it no longer reduced the pain enough that she could eat, I had to let her go and she was helped to the Bridge. During that short time the tumor grew from the size of a pea to the size of a large marble, huge on a cat's tiny jaw. But with the Metacam, it rarely seemed to bother her at all, until that final weekend.

The survival time for your Samantha if she has the surgery, the splenectomy, could well be longer than it would have been if I'd put my Tiger through surgery, and I'd hope that the recovery would be rapid and of course this wouldn't be as disabling as having a jaw removed. I did some googling on this last night, was too tired to type a message after I'd finished checking websites, but I'm going to post those links below so you have the information.

There didn't seem to be much agreement on how long a kitty will typically survive after removal of the spleen for this type of cancer. I saw median survival times from 11 months to 19 months, but that is the median and some cats will live only a few months after the surgery, while others might live as long as a couple of years. This type of surgery usually won't get all the cancer. It will grow back, but you've bought time by removing most of the tumor.

That is, if your kitty is one of the lucky ones. Some of the cats who had the surgery died before what would have been the median survival time if they hadn't had the surgery. I don't know if any of these groups included the cats who died during or immediately after the surgery itself -- apparently they didn't, since there were no references to those cats -- and surgery, as your vet told you, is always riskier for an older cat.

It's been pointed out here that if you opt for the surgery and Samantha is suffering afterward, you can choose then to let her go. That's true. I do want to add, though, that the complications from anesthesia and surgery can add greatly to the medical costs, and since you're concerned about finances you should be aware of this. I know someone whose cat was recently anesthetized for a diagnostic procedure, something that she'd been assured was routine and pretty safe, and it wasn't, for that cat, because of a problem with the anesthesia. The kitty went temporarily blind and then had further health crises right after that, and though the kitty eventually recovered and could go home, the cost of the intensive care dealing with those complications added thousands of dollars to the bill. This is something you should consider the possibility of if the surgery itself is already going to be difficult for you to afford. There are organizations that can help with vet expenses, though, and this page

http://www.handicappedpets.com/servi...ncialHelp.html

lists some of them. (Although that's on the Handicappedpets.com website, the help available isn't just for handicapped pets.)

If you decide not to opt for the surgery, a painkiller will help if and when Samantha needs one. I'm not sure how cancer of the spleen progresses in cats. In dogs, tumors of the spleen will usually eventually cause internal bleeding as the spleen ruptures, and this isn't always painful, according to what I read years ago when I was trying to help someone whose dog had died unexpectedly after what was later discovered to be a spleen rupture. The dog had simply seemed very tired, then had lost consciousness, with no indication of any pain, and what I'd found online then also seemed to suggest it was unlikely that death had been a painful one. Your vet should be able to tell you what you can expect if you opt not to put Samantha through the surgery.

There are also holistic approaches to fighting cancer. I know very little about herbal and homeopathic treatments, couldn't recommend any of those, but there are lots of studies suggesting that certain nutritional supplements such as Coenzyme Q10 and vitamin C can help, and I could help you find links to information on those later, such as the National Cancer Institute's web pages on Coenzyme Q10 (which I wish I'd known can sometimes help fight cancer when my Tiger was dying; I just knew then about CoQ10's ability to help with heart problems, though, didn't learn it could help fight cancer till last year).

Here are the links to those pages with info on the type of cancer Sam has:

http://www.veterinarypartner.com/Con...=0&SourceID=42

http://www.vetinfo.com/cmastcell.html

http://www.vetsurgerycentral.com/spleen.htm
(This page is mostly about spleen surgery in dogs but also has info on cats.)

http://maxshouse.com/Oncology/mast_cell_neoplasms.htm

I hope this info helps.

Cindy / SinbadsMom

That is a rough decission to make. The only advise I can offer is to listen to your instincts. I don't envy you one bit.

Originally Posted by mzjazz2u

That is a rough decission to make. The only advise I can offer is to listen to your instincts. I don't envy you one bit.

Click to expand...

I can only add wiegh quality of life vs quanity ... For me I have it clearly stated that if something happens to me that the oldest be PTS ( she is 18.5 currently) if my mom is unable to care for her ...

Thank you everybody for your thoughts, ideas, and compassion. I'm still undecided about the surgery, but I've been doing lots of research online and trying to weigh the odds. It's hard to figure out whether Samantha's quality of life will be best with or without it. For right now, she's fairly healthy. Every once in a while she has shaking spells (caused by the release of too much histimine from the mast cells the vet thinks) and they're preceeded by vomiting and diarrhea, which of course is no fun for her, but the shaking doesn't seem to hurt her - she just lies on the couch and shivers, no crying or anything. But on good days, she's as active and purr-y and happy as she's ever been. I don't know if we go through with the surgery whether these symptoms will disappear (if they are connected to the spleen at all) and then reappear down the line when (probably not if) the cancer reoccurs. So it feels like the question is, does she want to deal with it twice, or just once? The oncologist I talked to couldn't really say what symptoms she would experience if we didn't do the surgery - he said it depends on where the cancer spreads to. He guessed that she'd experience similar symptoms to what she has now - weight loss, vomiting, etc, along with a general malaise and flu-like symptoms, and I don't know if they're something that's going to get so bad, I'll have to put her to sleep or whether the cancer will just take her in her sleep. I feel like I have so many questions, yet the more information I get, the more uncertain I am.

Is there a chance they can get all of the cancer, or only reduce it?

is your cat in pain now? functioning okay? if its already in a compromised health situation with the kidney thing, surgery sounds like a bad idea. I love my cat, but if he was in the same situation I'd not get the surgery. like you said its going to be painful and probably traumatic for your cat, might end its life sooner, and besides 15 years is a good long life for a cat. It was a tough decision to have my last cat put down, but she was in pain and I had nowhere near enough money to afford treatment. I couldnt justify putting myself badly in debt to get treatment for a cat that was already 14 years old, especially since like in your situation there was a chance that she'd just die anyway. I hope this doesnt sound bad but nothing helps you get over the loss of a cat like getting another one. Thats what I did, and I dont regret my decision at all.

I think I would do what ever I felt I had to do, if there is a chance then I would do it. But that is me, I really think that you are the only one who can decide what to do.

All the wonderful people here will tell you what they would do, and it will probably be about 50/50.

We treated our beloved Sambo for a couple of years for his different ailment, he was blind, and had other things wrong with him. We did not decide to put him to sleep till the vet told us it looked like his little body was shutting down.

I am sending hugs and prayers from Mississippi for you and Samantha.



Please keep us updated on how she is doing.

Have you narrowed it down to an either/or yet? Or are you still considering all options? Something that occasionally helps me is doing a pros/cons list. This might seem a really simple way to do something concerning a decision that is so tantamount, but.. mostly it will just help you work through your biggest pros and cons, and help you figure out what you feel most strongly about. At least that's the way it works with me.

I'm so sorry you're going through this.

I can only say what I would do. If it were only a matter of gaining the cat an extra half a year, and that year was likely to be painful, I wouldn't choose the surgery. Quality of life is my main guideline in deciding what to do and what not to do.

Though I know it's very hard to put a pet to sleep when you see any life left in him.

If you do opt to not have the surgery, there are may be palliative medicines your vet can give you to help your cat not be in pain. Opiates, steroids, etc. It may be that the cat could experience a relatively pain-free and happy last few weeks or months at home.

You've had some fine replies, I will try not to just repeat what anyone has said.

My experience has been of my kittes with kidney failure, one lived almost 4 years (and his passing was unrelated to his kidney issues), one is over 2 years, and another over 1+ years.

I did put my 14+ y.o. through bladder surgery (and then we found crf, ?diabetes, hypert...and more, he just kinda began not functioning well)..and despite the issues since, he is stable and happy and now 171/2. I did decide against doing more than an u/s and fine needle biopsy of liver tumors because of his current age..but if it had been when he was 14 or 15, I probably would have proceeded.

You have the uneviable task of weighing all of this against quality of life and how much further it may extend your cats life.

I can share a lot re managing the kidney failure, but re cancer, my experience has not been good, so no comments there.

Thank you, thank you, thank you again for all your great support. I'm so glad I decided to post about my dilemma, as it's really helped hearing everyone's thoughts.
My options are pretty much either/or now - do the surgery and hope for the best, or let the cancer take its course and give her pain meds to ease her time left. I've tried doing a pros/cons list but with everything so uncertain, it's remarkably hard to do.
According to all the information I've read online, the surgery would not cure the cancer, but rather get rid of the largest source of it (her spleen), and then she would be symptom-free (possibly) for a while until a new tumor began to grow. So the pro of surgery is she could have maybe an extra 10 months of cancer symptom free life (that's if she falls in the average survival time of gaining an extra 12 months, minus maybe 2 of surgery and recovery). The cons to that would be the potential complications that her kidneys might interfere with the anesthesia or she could die earlier than the average survival time (a few research studies claimed some cats died as early as 10 weeks after surgery). I feel like every potential pro I can come up with has a very strong con against it.
Her quality of life right now is pretty good I think. She still has a strong appetite (one of the big signs that mast cell tumors are progressing rapidly is loss of appetite) and while she's lost weight, she's managed to gain a couple ounces back lately. She also has the sporadic shaking, vomiting, and diarrhea, but after they're over, she's fine and acting normal. She does have early kidney disease that's going to keep progressing no matter whether she has the surgery or not, but she's on medicine right now to hopefully slow it down.
I'm still hopping back and forth from A to B and back again, and coming up with new questions all the time.

I am so sorry for you and your cat. It's a tough place to be.

I don't think there is any right or wrong answer, or one answer for all situations.

I can only give you my experience, this one with my golden retriever. He was dxed with a tumor on his spleen. He was 13 years old and also had severe, yet manageable, hip dysplasia. Basically, the vet told me that if he did survive the surgery, it would likely only prolong his life temporarily. And that with his hip problems and age taken into consideration, it was very possible he would never bouce back from the surgery and walk again. As hard as it was to want a longer time period with him, we knew that we would only be prolonging the misery for him. We knew that we were only trying to beat a clock that was on the final countdown. So, we brought him home and cherished every single day. No more watching his weight, treats whenever he wanted. Cuddles and hugs as often as possible. Took tons of pictures of/with him. He ate hamburgers and steak and french fries, LOL. It was a long goodbye, we knew it and it gave us some time to prepare for the fact that he was not going to be with us much longer. And he did really well up until the very end.

OTOH, we had a 1 1/2 yo cat who we tried everything to save, and I would have tried more, it just couldn't be done. The shame was, it was a disease that can be survived...he just was too far gone to turn around. It was devastating.

For us, it depends on how old the animal is, what a realistic prognosis is, if this would improve their quality of life or just prolong their life. For us, quality of life is the bottom line.

I will keep you in my thoughts and prayers. I know how difficult it is. I wish you peace in your decision. {{{HUGS}}}