Gastric Tumour  

I have just got home from the vet. My lovely cat & friend Marmite, has a suspected Gastric tumour.

She has had sickness for about 2 months which was successfully controlled with some steroid injections indicating a possible pancreatic problem. However her 2nd monthly injection seemed to have little effect & she started being sick again. I tried to spread out her feeding times with small amounts over a day & even got up at 4am to feed her. But she started being sick at night, after drinking water. The night sick was brown water. Last night she was not sick, I think because I did not feed her at all after 9pm because she was fasting for 12 hours for the x-ray. I had mopped up some of the watery sick the night before & it was tested today & found to contain blood. Marmite has been a good girl at the vets all day today & has had a series of x-rays which indicate an irregular shaped lump on one side of her stomach.

The vet has given us 3 options, which we have over the weekend to decide.

Note. We live on a small island & do not have easy access to the very best equipment. Specialist visits usually involve a 4-hour ferry trip to the UK. We do not have insurance, we also do not have much money, but will find the money to do whatever is best for Marmite.

We do not have the facility on the island to do an endoscopy & biopsy. We do have an endoscope, but a biopsy would need to be taken by an invasive operation.

Option 1

Refer Marmite to an oncology specialist in the UK. They would have the best equipment & best surgeons available. They could do an endoscopy, take a biopsy & refer back to us to decide on the next step. If necessary, they could operate on the tumour. The costs would be substantial.

Optionally, we could bring her back to the Island for any operation, therefore giving the vet the additional information of what type of tumour is present.

Option 2

The vet here could operate & expose the stomach where she could check for a tumour from the outside of the stomach. She could also check whether the cancer has spread to any other organs. On that information, if the cancer has gone too far, or the stomach tumour is too large, she could either stop any further work & sew back up again, or enter the stomach to take a large biopsy & try to remove the tumour.

Option 3

If Marmite does have a Gastric tumour, the chance of survival is low. We could manage the pain & let her go when it is best for her.

Please help.

Thank you so much for your replies & especially to LDG for your helpful post which has given me some hope.

I seem to be at a crying stage, so won't be able to write very coherently at the moment. Marmite, appears not to be too bad. She is doing most of her regular Marmite things & we had a short play earlier with some string & her favourite bubble-wrap. She is an indoor only cat & I have an interest in cat behaviour. I have noticed that occasionally the will settle somewhere unusual, which could indicate that she is in occasional pain. She is not hiding or refusing contact. She is eating normally, although I am feeding her meals in two parts with about an hour & a half between. Last night, she was not sick & slept with us on the bed as usual.

Reading my old posts, I think that Marmite started to get problems back in April this year. I have tried to contact my old vet in the UK, but was only able to speak to the emergency receptionist due to the weekend. I was able to confirm that they do have the correct equipment. It would be a long trip though, 4 hours by ferry, then another 6 by car. It feels that the trip would be unfair on Marmite. I think that I will take Monday off work to try to sort out all my questions with the vets. I will ask about the needle biopsy, I'm not sure why the vet didn't suggest this. Is a needle biopsy possible with stomach cancer? I was also not offered ultrasound. Maybe again, they don't have the equipment. I wasn't told about chemo either. I am going to spend some time looking at getting a loan, I can't face not being able to do everything I can for my friend.

Thank you so much. This takes away the feeling of hopelessness that I had earlier.

I seem to be on the verge of crying all the time, but am trying to keep strong for Marmite. We have been playing again & I give her my time every moment that she wants it.

I think that I am heading for a decision to ask for her to be referred to the Liverpool University Oncology Hospital. They look to have the best equipment & best experience in this area. If there is a chance of helping Marmite, I think that they would be the best option. The trip would be a 4 hour ferry crossing, then probably an hour in the car. The issue here on the Island just seems to be that the vets just don't have the advanced equipment available.

I am taking Monday off work to arrange everything I can & talk to the vets, also the bank to try to finance it all.

I found out about this only yesterday about 28 hours ago. Sitting here now, watching Marmite sleeping on her radiator bed, it feels like I've been in this state for a month. Friday seems a very long time ago.

I have called my vet this morning & asked them to refer her to a specialist. They were happy to do that & I got a call from Liverpool University small animal hospital within a few hours. I have booked Marmite in to see them next Monday. They had an appointment ready for her this Thursday, but I simply could not get Marmite there in time. We live on an Island & the ferry company is now in the off-season, so we have trips to the UK only at certain times of day. I considered flying her, but Marmite would have had to travel as cargo & I could not put her through that. Next Monday, they will start tests on Marmite to get the type & stage of cancer. If necessary, they will also operate. Marmite will be at the hospital for between 2-7 days.

Meanwhile, I have called my bank & asked for a further advance on my home loan, called a mortgage in the UK. This would give me a secured loan for the same period as my mortgage & at relatively low rates. Although with quite high costs to set up. At least if I get this, I would be able to afford to do whatever was needed for my Marmite.

http://www.liv.ac.uk/sath/

I hope to God that I have done the right thing for my little friend.

Thank you so much for your kind words.

Today I received the confirmation letter from the University hospital & the ferry was booked yesterday. The bank haven't called back at all yet. I really could have done with getting that moving, at least I would have warning if they are going to refuse me. If they don't call tomorrow, I will try to get a bank loan instead.

I am managing Marmite's food to keep her sickness under control. I feed her half her meal in 4 dishes, so she has to hunt around for her food. (Although the dishes are always in the same place). I then feed her the second half of her food in the same way about 1½ hours later. I make sure in the evening that she has finished her food before 8pm. When we go to bed, she always sleeps in our room on the bed next to me & I give her 3 little yummy treats. I pretend to hide them & I have always done this for her. I feel now that I'd like to give her a whole packet of treats because she likes them so much. But I try to be strong & keep with the program as at this level, it doesn't make her sick & I need to keep her strong for the operations. Marmite's last sickness was a little bit in the night last Saturday.  If she is sick, it seems to be between 4am & 6am when she gets up for a drink of water & use her toilet. The vet told me that it takes 2 hours for food to get through a cat's stomach. I really don't understand how that ties-in with her sickness early mornings.

I'm not sleeping well at all & am starting to feel "drained" all the time. I suppose that is normal?

Thank you Laurie

As I seem to have the sickness under control right now, I don't really want to treat Marmite with anything else until I get the diagnoses on Monday. I also doubt that the vet would want to prescribe anything so close to the tests, unless Marmite gets ill. We can get Bach's & I already have Feliway spray. I will check out the Back's remedies.

The sick is different, depending on the time of day & time after a meal. Before I split her meals into two parts, she was sicking-up partly digested kibble. Sometimes she sicked up the kibble very soon after she had eaten. Now I have that under control she has not been sick like that for over 2 weeks. Her sick at night was just a brown water type substance & she has not sicked this since Saturday. A month or so ago, she sicked up some whitish foam in the night, but I think that her steroid injections seem to deal with this. She has not sicked this foam up again The only treatment she has at the moment is her slow-release steroid injection, which she had about 2 weeks ago, it should have another 2 weeks of slow release left in it.

I also thought that she may have been sick due to an empty tummy. I set the alarm for 4am a few nights to feed her a small amount of food. But it made her sick. It seems that food in her tummy at night makes her sick. I expect that the specialists on Monday may be able to explain that one.

The bank hasn't called today, which is a real concern. I will call them tomorrow & try to look at other options. On Monday, I am going to need to pay half of the initial test fee. I can handle that, I think.

Marmite is getting my attention every moment that she wants it. A little earlier this evening, we've been playing in the bubble-wrap again. There was a pesky piece of string in there somewhere! When Marmite is awake, I sit talking to her. I love how she looks into my eyes, especially when I say her name. She also sometimes watches my lips when I talk to her. Sometimes , when I say her name, she has the cutest silent meows ever. At night on the bed, I stroke her until she is ready to sleep. I stroke her if we wake up in the night too.

Tiredness is creeping up on me, time for bed I think.

We are on the early ferry tomorrow morning. No breakfast for little Marmite as she has to fast for the tests.

I am hoping for the best for my little friend.

We got back early this morning.

Marmite is at the hospital & they have done some tests yesterday, mainly with the bloods. Her pancreas is normal, as is Folic acid & Vit B12. Her urea is elevated at 9.2 & creatin (?) at 132. a single result is not enough to diagnose, but it may be that she has some renal disease which can be treated by diet. The ultrasound showed that there is no mass in the stomach or intestines. The is a large ulcer in the fundus region at the top of the stomach. There may be several causes of this, from acid to a possible small tumour & the ulcer may also be cancerous. During her tests yesterday, they detected a slight heart murmour & this will need to be check before anaesthetic. They will do a heart trace today & depending on the results, do the endoscopy either Thursday or Friday. They will also take a small biopsy of the ulcer to determine it's type. Marmite will then be ready to come back home either Friday or Saturday. With the possibility to return for further treatment, or have further treatment at our local vet under the university supervision.

I will write more later.

We were prepared to stay if necessary, but the clinical vet told us that they needed her for several days.

With today's heartscan & heart trace, they have found that the heart murmour is due to HCM (Hypertrophic cardiomyopathy). It's affecting her right heart ventrical & they are doing further lab work on this tomorrow. They say that as it is not the left ventrical, then anaesthetic should be fine. However during any procedures, they will have a heart expert on hand. The further tests should ensure that any anaesthetic is as safe as possible for her. They say that this sort of issue is not unusual in a British Blue Shorthair cat.

They will give Marmite a rest tomorrow & give her further medication to treat the ulcer & her renal disease which is very early in it's progression. The endoscope & biopsy procedure will be done on Thursday, Marmite will be ready to come home on Friday afternoon. I will be booking the ferry tomorrow. The full biopsy results will take several days & we should have them by next Tuesday. When they will discuss with us the next steps. These may be either with our local vet or back at the university.

The trip yesterday was very tiring, it must have been awful for poor Marmite & now she is at the hospital on her own. On the trip back, we noticed that the car got very cold at night on the car ferry. I have ordered a microwave pad which may not arrive in time. So we may take a Thermos flash & a hot water bottle for Marmite to keep warm on the way home. I have a meeting with my bank tomorrow as our credit cards are taking a big hit with this. I'm not sure that the bank will help.

The bank didn't go very well, I'm self-employed & it seems that banks no longer have self-certification lending. I will have to look at other options.

Marmite is having a scope today & they will also take a small biopsy. We will be collecting Marmite on Friday & have booked our ferry tickets. The microwave heat pad has not yet arrived, so we will use the hot water bottle for the return ferry trip.

We will not know about the biopsy results until Tuesday. When she gets back, we are going to have 2 oral medicines to give to her for the ulcer & associated pain. Marmite is impossible with pills, but we can scrunch them up & add water to use a syringe. This will still be extremely difficult to do & we will have at least a month of using the medicine. On Friday, they will talk to us about the early signs of renal disease & also her heart problems - both of which have been caught early by the tests. The cardio people have said that the heart is not bad enough to need treatment, but needs regular monitoring. The early renal disease will probably need a special diet.

The endoscope procedure was today. They looked at the ulcer & took a biopsy. They noticed bumps around the ulcer on the stomach wall. This could mean either severe irritation from the ulcer affecting the wall, or that the ulcer is on top of a cancerous growth.

We are collecting Marmite tomorrow. I miss her so much.

We have got back home a few hours ago. Marmite is here with us, she is fine & was VERy pleased to see us, but very stressed after the hospital & the long trip. Also, we are having to give her 3 lots of oral medicines, 3 times a day. We started it earlier this morning & both my wife & I got scratched. The medicines have to be squirted into her mouth. They are for pain relief, stomach acid reduction & to clear the ulcer. We got so tired on the trip, that we are going back to bed in a moment. I hope that Marmite will settle today, we are trying to give her some space. We will need to do a better job with the next medicines.