Contemplating Exploratory Surgery- Advice is Needed!

jknyc

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Hello, I am the parent to a sick 14 year old DSH. Except for the occasional hairball issues my cat has heretofore been the epitome of perfect health. Once a year check ups was the norm for him. His entire life his weight had hovered around 14 pounds and at one point he was even weighed at being 16! This all changed in approximately April of 2009. Prior to this change in April 2009 his weight went down to 12 pounds and he was coughing up hairballs more often then normal. My vet, who has been my cats vet for years told me that the weight loss was not abnormal for older cats and suggested we switch him over to hairball control food.

Then in April 2009 his coughing, turned into hacking then vomiting. We brought him into the vet and this is the start of a very long, emotionally draining and physically taxing period for my baby. Because he had been vomiting more than normal and not just hairballs, my vet switched him over to Eukanuba Low Residue GI and said to watch and see if he reacts better. He suspected IBD. We waited 3 weeks but my baby did not seem to be getting better. My vet then suggested a GI Barium (xray) test (May 2009) which he sent to a specialist to be confirmed. Results stated that there was thickening in the intestinal walls. Could be IBD or lymphoma. My vet gave him a shot of Depo Med (long lasting steroid). This is suppose to help both IBD and lymphoma. My cat did not improve. If anything he got worse. One week after the Barium GI my cat seemed to go down hill. I called my vet, in and out for subcu fluids and at one point he vomited 17 times in 2.5 days. my vet finally suggested I go see a specialist.

Latter part of May 2009 - We went to see an internal medicine specialist and was given the options of ultrasound, endoscopy or exploratory surgery. I opted for the ultrasound and endoscopy but did not do the exploratory surgery at that time. I was worried that perhaps my baby was too weak to have this procedure done. I wanted to find out what was wrong with him in the least invasive way possible.

Results for the endoscopy came back as being not lymphoma. But the specialist said that because he was given the Depo Med, she would feel more confident with the results if it came back as being lymphoma. He was given a slurry to help sooth his esophagus, cerenia for his nausea and prednisolone. Treatment as if he had IBD.

In the beginning, with him being on cerenia and prednisolone he was eating better. Got him up to 1 can of AD food a day. There was a period for about 1 week or so where no vomit occurred. He was a normal kitty. He was taken off the cerenia, because it was not suppose to be a long term solution, in June and then began to occasionally vomit again. His vomiting was maybe once every 1 to 1.5 weeks or so at this point. The specialist actually stated that I should reduce his prednisolone to half tablet twice a day instead of the full tablet twice a day. Called primary vet and he said hold off and continue with whole tablet twice a day until a bit later. So I didn't cut my baby's dosage until July 2009.

Vomiting continued and increased to about 3 times a week. Spoke with primary vet and he stated that with IBD its all about control and that he will never not vomit. So him vomiting occasionally was normal. Weight lost continued and then about 3 days ago my baby decided that he did not like the AD food. So now I've decided to change primary vets to someone who has a background with the Cornell Feline Health Center. Took my baby to the new vet on Sunday and spoke to him about what I should do. The new vet gave me ZD food and I have mixed it with the Eukanuba Low Residue GI food yesterday and today.

I also tried tube feeding him for the first time yesterday. 6ml of AD food. I was torn up about it but I know he has to eat. Yesterday during the day he ate hard kibble (less than a handful) and is passing bowel. Late last night I gave him a handful of ZD and the Eukanuba mix drizzled with Tuna Water and toasted in the microwave. He didn't eat it when I gave it to him but this morning I noticed that it was mostly gone! Today he has so far eaten about 1/3 a cup of the hard kibble. Which is more than yesterday! Plus no vomit!!

They don't know why the steroids are not working. My cat is not eating much and is continuing to lose weight. They don't have any definitive results of it being lymphoma or IDB. My cat is slowing starving himself to death. He keeps on getting worse and worse. Exploratory surgery seems to be the only option at this point. If I don't move forward with the exploratory surgery he will surely die. If I do move forward with the exploratory surgery he may die. I need to know what is wrong with him so that I can help him fight it.

Almost $4000 in vet bills/alternative foods/meds and etc later I am at wits end. What hurts me the most is the fact that he acts so normal. He still retains, for the most part, his inquisitiveness, his affectionate nature, and his personality. When I see him go by himself to his food bowl to eat it makes me feel like he wants to fight and be better. When I notice that he has eaten from his bowl it gives me so much hope. Misplaced or not I cannot help but feel that he hasn't given up and I would never forgive myself if I didn't feel like I did my absolute all in helping him. Even if he only lives for another half year to a year. I don't want to feel guilty that I didn't do enough.

Any advice and possible alternative diagnoses would be appreciated. Thank You so much in advance and I apologize for the long post.
 

nekomania

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First of all 14 years is fairly old for a kitty. I think you're one of the luckiest cat owners to have been fortunate enough to not experience any emergency or expensive vet care until now.

If you had not tried everything else already I wouldn't reccommend exploratory surgery. But if you have exhausted all other options and kitty still isn't eating on his own and losing weight, I would definately be grasping at any string that was offered to me.

Be sure to of course always seek second opinions, there may be something that another vet knows or has dealt with whereas your regular vet may not have ever seen anything like this before.

I'm sorry I can't offer much advice because I've never been in this situation. All I know is that it sounds very alarming and certainly stressful, and that if I was in your shoes, I would seek a second opinion on the surgery and if both vets thought it was a good option, I would definately go for it.



What is your kitty's name? I'm sorry if I missed it in the post.
 
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jknyc

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His name is Nabia. It means butterfly in Korean. I had never had a pet before so when I first brought him home I thought he was a girl because he had lavender eyes and nipples on his belly. He was a supermarket kitty from a neighborhood in New York City.

I was calling him Nabia for about a week before I took him to the vet. Surprised me when the vet told me I filled the form out wrong. That he in fact was a Male and not a Female. But the name kinda stuck. So I ended up with a 14-16 pound male named butterfly.
 

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My little Shadow had an abdominal exploratory surgery about a month ago. We knew she had a small tumor in her colon (via a colonoscopy), but at that time we thought it was benign. The purpose of the surgery was to remove the tumor, biopsy it, as well as to examine her other organs, make sure everything else was ok (the xray and ultrasound did not reveal anything, but according to my best friend who is an emergency veternarian, the exploratory surgery may sometimes reveal something visually, or tactically). The incision was 3/4 of her abdomen, so it was pretty large.

The surgery itself went well, but the recovery was probably one of the most difficult things. For my little kitty, it took about a month, but others will recovery much faster, since my kitty had complications due to the removal of the colon tumor (she first stopped eating due to the pain and we had to have a food tube put in, then she developed an abscess at the incision site due to the colon surgery )

She's now almost fully recovered, though the diagnosis is now that she had intestinal adenocarcinoma. I'm glad we opted for the surgery because it gave her a chance that she may be cured. The surgeon told us that he felt around the organs and did not feel or see any other abnormalities, so that gave us a sense of reassurance that we did the best we could.

So I would say overall, despite a few rough recovery period, I think it was worth it for us. I'd be happy to answer any specific questions you might have but in the meantime, sending to your baby from my me and my baby
 

darlili

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A friend's 14 year old cat recently did have the exploratory surgery, after a long course of various treatments - this kitty was slowly losing weight, pooing outside the box, some vomiting, and just didn't act right about eating - but bloodwork was great, other than finding some thyroid problems. Anyway, the surgery was able to positively diagnose IBD. I forget the meds this cat is on, but so far, it's been a good recovery, and she's put on weight and seems so much better. She does go for blood tests every few months now. But, it was a big decision to have the surgery - both financially and whether it was worth putting the cat through it. But this cat has been a fighter and seemed alert and active, even with her down times.

Could your new vet maybe get a second opinion for Cornell? Just so you know what all your options are?

Prayers for you and your Butterfly - I hope you can get a good diagnosis. My friend's vets pointed out that so many of the digestively-related illnesses are incredibly hard to diagnose without resorting to invasive tests - and most vets will try treating symptoms first.
 
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jknyc

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I was so excited because he started eating the kibble food yesterday of his own accord. Unfortunately around 5 am this morning he threw up again. All the food. But he went back to his kibble and started eating again. I don't even know what to say or think at this point. I am so disheartened. Thank you to the people who have posted responses to my initial post. I truly appreciate you taking the time out to respond.
 

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Is he eating too fast? Try putting something inside of the bowl - a baseball (cleaned, of course) works well... This should slow down her eating some. Also try to elevate the food bowl.
Have you tried simpler foods? She might have food allergies, or intolerance?? There are some foods for allergies that you could try, both wet and dry. You can also complement her diet with some boiled chicken and rice.
For upset stomachs, I would choose the simplest diet possible...
What does this primary vet say about this surgery?
 

littleraven7726

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My 12 yr old just had exploratory surgery in June. Starting around Christmas he had started losing weight. He was down to a skeletal 8.2 lbs or so when he had his surgery. His bloodwork and thyroid had been all normal. Trial treatments for Thyroid and Pancreatitis didn't work. After the exploratory surgery (which he healed from very well) he's on prednisone pills and his health has picked up. We have to get him weighed soon, but Mike & I are very sure he's gained. He doesn't feel all bony anymore. He's still thin, but not scarily thin. His appetite has improved a lot.

Nabu was only (and barely even) eating Fancy Feast Medleys and Fancy Feast Appetizers before his surgery. Now he's eating his normal foods again.
 
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jknyc

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For those of you who have gone through the exploratory surgery what sort of recovery time did you go through? Will he be able to jump onto the bed? Or should I get a sort of playpen area and enclose him off in that area with his blanket, litter box and etc? Will he be able to eat by himself? How long would you recommend I stay home with him? How long was average hospital stay? The new vet indicated that it may be 4-5 days which would include, pre-op testing and etc, the surgery and possibly 1-2 days of recovery in the hospital.

I think I'm pretty set on going through with this surgery. Thank you guys once again for all your post! They all give me hope!

Anyone who has gone through this surgery could you please tell me what the post surgery care at home was like?
 

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It's a very difficult decision, and you need to bear in mind that even exploratory surgery is not certain to result in a diagnosis. This is what happened to my little Charlie. She lost more than a quarter of her body weight (and was vomiting a lot), but all non-invasive tests showed nothing abnormal. Eventually we took her to a specialist, whose scans also showed nothing. As a last resort, he opened her up, found nothing visibly wrong, and took lots of biopsies, all of which came back negative (she's 13 years old, BTW).

She got over the surgery very well, but we were still no nearer a diagnosis and had no treatment options other than diet and more steroids. However, over the next few weeks she stopped vomiting and her weight stabilised. She hasn't put back any of the weight she lost, but at least she is not losing any more.

As for the surgery itself, I took her to the hospital in the morning, and collected her the next morning. She was fully active and eating as soon as I got her home, and needed no special care at all, except for several visits to our local vet just to make sure that everything was OK and that the zipper along her belly was healing up.

It's been a long, traumatic and expensive business, and we're still not sure it's over. Would we do it again (the surgery, I mean)? No, I don't think so, not unless there were some other evidence that there was something to be found.

But, only you know your kitty and how strong he might be. I just hope my experience helps you in making this hard choice for him.
 

littleraven7726

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Originally Posted by jknyc

For those of you who have gone through the exploratory surgery what sort of recovery time did you go through? Will he be able to jump onto the bed? Or should I get a sort of playpen area and enclose him off in that area with his blanket, litter box and etc? Will he be able to eat by himself? How long would you recommend I stay home with him? How long was average hospital stay? The new vet indicated that it may be 4-5 days which would include, pre-op testing and etc, the surgery and possibly 1-2 days of recovery in the hospital.
Nabu's surgery was complicated by the toe amputation so he couldn't get around well at all when he came home. I spent the night with him in our spare room, which doesn't have much for high perches at all (window level is the highest). I slept on our inflatable Coleman mattress for several days. He had everything he needed in there with him: food, water & litter. He definitely wasn't feeling very good for a while. I stayed home with him the day after his surgery to make sure he'd be ok. My husband had the day after that off (a Friday). By then he was doing a lot better.

Edit: Nabu had pain medication for 3 days following surgery that really helped.
 
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jknyc

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Thank you everyone for taking the time to post. I truly appreciate all the feedback that I have been reading. I really didn't know where else to turn. Not many people around me are cat people and the ones that are have not had any similar experiences - everyone I had asked just told me "I'm sorry,He's old, Oh my cat died at 10..." It's been a very difficult period for me and so I appreciate this forum that much more because I have been given insight into this procedure/process by people who have gone through similar procedures.

In regards to the point that Baz made - I feel the same way in that I wish I had some sort of guarantee that this really huge step was going to be the step we take in finding a diagnosis, but I realize, going forward, that there is no guarantee. So for the most part I'm left with assessing how I would feel and what would possibly happen if we didn't do the surgery.

If I didn't do the surgery I feel that perhaps I would just be waiting for him to starve and vomit himself to death. At least with doing this surgery I am taking a step to find that possible diagnosis. Right? I mean what else can I do?

Is it the right step, I don't 100% know. I even have thought about how I would feel if he should not make it out of the operating room. I know I would be devastated but at the same time, with time I would hope that I'd be able to reconcile myself with the fact that I kind of had no choice. None of the other tests helped. If someone gave me another option, that was less invasive, I would jump for it in a heartbeat. I just need to feel like I am doing something, not just twiddling my thumbs while watching him continue to starve and vomit. I don't want to regret not being aggressive enough in this battle that I am waging with this unknown opponent.

I wish that there were alternative diagnoses available but all I keep on hearing is IDB or lymphoma. I even thought maybe it could be that some sort of food allergy was developed, or related to the fact that he caught a field mouse last winter, but all the vets seem to think that it is either of the two aforementioned diseases. I think I even asked if it was possibly related to the fact that my cat used to love eating bugs. I've thought of every outlandish thing under the sun to no avail. This really is a last resort.
 

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Do what is in your heart.... If it was my kitty, and I could afford, I would also do any and everything possible... Your love for him is beautiful... Keep going, keep strong - I will say a prayer for both of you.
 
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jknyc

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Thank you for all your positive thoughts and prayers. We will need it! I have arranged to drop my baby off at the vet tomorrow morning for pre-op test procedures. Please keep us in your thoughts and prayers!

Does anyone have any suggestions as to what sort of questions and or requests I should make to the vet beforehand? Because he is a new vet I am a bit nervous.
 

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Originally Posted by jknyc

Thank you for all your positive thoughts and prayers. We will need it! I have arranged to drop my baby off at the vet tomorrow morning for pre-op test procedures. Please keep us in your thoughts and prayers!

Does anyone have any suggestions as to what sort of questions and or requests I should make to the vet beforehand? Because he is a new vet I am a bit nervous.
Praying for you both. It really sounds like you don't have much choice, I hope it goes well.
 
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jknyc

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Today is Nabia's surgery day. He had pre-op testing and etc done yesterday. I stayed out late last night because I dreaded the idea of going home and him not being there. Cannot help but worry about him being so sad and stressed at the vet's overnight and how angry he will probably be that I've left him there. I'm so nervous and too scared to call the vet. Please keep him in your thoughts and prayers.
 

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Many prayers - and I feel horrid when it was only a drop off for a dental cleaning or a bladder ultrasound, so I can only imagine how nervous you are right now. But, God willing, when you get him home, you'll be surprised and how quickly he'll 'forgive' you.
 
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jknyc

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Thank You!

In May I dropped him off for a 'half day' to get his GI Barium contrast done and when we got him back he was so out of it; wonky from his sedatives, grumbling from being unhappy with the effects of whatever was in his system and being poked and prodded all day. I can only imagine the state he will be in this time around. I really am hoping and praying that his recovery is quick and that they will finally be able to give me a more definitive answer as to what is wrong with him.
 

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many many vibes for your little one... for a quick recover, and for this to be the solution for her problem...
 
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