Muffin - Bad news vet visit today

I am devastated ritght now.  Muffin has been diagnosed with hyperthryoid and an abdominal mass.  He is already a special needs cat who eats prescription food because of his urinary history. He was showing decreased appetite and weight loss since the first of the year.   He had bloodwork done in February which showed then high end of normal for thyroid, but not enough to start using medicine.  The vet started him on a wet prescription food mixed with the dry and that has kept his eating until now.  He had lost almost a pound today since his last vet visit.  We did a full blood panel and an x-ray today because the vet could hear some wheezing when Muffin inhaled.  Turns out, the film shows a mass which could be either in his liver or spleen.  We talked about three options.

First, put him on steroids to stimulate his appetite, take him off the prescription food and give him what he will eat.  Basically, make him comfortable for whatever time he has.

Second, open him up and see what is there, then decide on surgery, depending for sure on where the tumor is. If he survives and heals then put him on thyroid meds.- and continue his prescription food

Third, get an ultrasound first.  Depending on where the tumor is, decide if you want to proceed with any surgery. 

What a tough spot to be in.  Muffin is twelve years old. 

I am asking prayers for him and for us to make a wise decision.  We are both a wreck right now.  I am supposed to go with my group to the nursing home this afternoon to sing and play music for the old folks there.  I don't know if I can pull it off, given what I want to do now is cry.

Thanks for the prayers.

I'm sorry for such difficult news.

I have no advice to offer you - I know what I would do, but each situation is different.

Prayers for you and Muffin. I hope you can come to a decision that you will feel at peace with.

He's a lucky boy that he has you to care for and love him.

catmom5
 

I well know how news like this can knock you back so you can barely breathe let alone think clearly. I'm really sorry you are both going through this very distressing time.  Perhaps a brief break at the nursing home will give you some time-out from the intensity of your current thoughts and make a decision clearer.

If the decision was mine, I think I'd go with a surgery or ultrasound option since I'm assuming cats can live without a spleen the way humans can and if enough liver can be left behind it will regenerate itself in time. Sometimes big masses can be benign.  Does the vet think that's a possibility, with the loss of appetite and rough breathing caused by the mass pushing into other internal organs not from the cancer?
 

I'm sorry you're going through this. Many, many for Muffin and your decision.

Surprised option #1 doesn't include meds for his thyroid - a hyper thyroid cat will lose weight at a huge rate of knots.  That plus steroids might well stabilise him for some time. 

I don't have any advise for you...just sending hugs and vibes.   

Sending many, many heartfelt prayers.

I would also like to urge you to get a whole body ultrasound as soon as possible, before you do anything else.

Most importantly ultrasound gives very precise information, plus it can show things in the abdominal and chest cavity that don't show up on X-rays. (Had this situation with my Rosie.)  In addition, using ultrasound, your vet may be able to do a fine needle biopsy.

The wheezing you mention is worrisome, the vet doing the ultrasound will have to pay particular attention to the lungs and heart and the area around the heart.

(In this very sad situation you'll want to find out as much as possible before considering surgery and whether surgery should be considered at all. The ultrasound will be very helpful with that.)

Thank you all for your kind answers.  I did go to the nursing home with my group to sing and play for the old folks there.  I am glad I did because it got my mind off this for a few hours. 

There are a lot of things to consider.  Muffin is 12 years old,a special needs cat with his diet, and now his thyroid to deal with.  Violet, our vet did give us the ultrasound as an option.  However he said that sometimes it can be real definitive and sometimes it is not.  He said it possible could show enough to make us not consider surgery. On the other hand he said if we decide to just do an exploratory surger it could be easy to determine where the mass is and if we would want to proceed.  He said a spleen mass would be easier to remove than a liver one.  He would not expect any problems with putting him to sleep.  But he said it is always possible in surgery for cats to have bleeding problems or either in healing.  I with I could turn back the pages and not be dealing with this.  I think if they opened him up and it was a worse case scenario, the vet would agree to put him to sleep then.  I hurt.  This is terrible.

I think if they opened him up and it was a worse case scenario, the vet would agree to put him to sleep then. I hurt. This is terrible.

Click to expand...

It is. And with proper testing this should absolutely not be necessary. I can't help it, I get the feeling your vet is pushing for surgery and......well....... I see no consideration for your feelings, your love for Muffin and what's really best for Muffin.

When Bernie was sick the holistic vet (of all people!!!) also started talking about exploratory surgeries and cats not being allowed to wake up.........My brain understood but my heart didn't, my heart refused to. And I knew I could never do that to my Bernie. Sometimes some vets can sound like craftspeople, doing what they've been trained to do, without an iota of compassion and consideration for the feelings of the people who love the poor sick pets.

Please give yourself time to think about this and insist on the proper test (ultrasound) instead of allowing yourself to be pushed straight into surgery without the necessary test results.

Violet, my vet is not pushing at all, merely talking about three options.  He has been our vet for twenty five years. He has seen us through tough decisions two times before now.  He knows our cats are family members. He just was saying that an ultra sound does not always give you the answers, and sometimes people decided to skip it.  He is a very compassionate vet.

Is there anyone else here on this board that has dealt with anything like this, who maybe has had a cat with operable mass or masses.

In your original post you mentioned

We did a full blood panel and an x-ray today because the vet could hear some wheezing when Muffin inhaled. Turns out, the film shows a mass which could be either in his liver or spleen. We talked about three options.

Click to expand...

So, I'm sorry, I just have to say it - with apologies - that, considering all this, an ultrasound is more than fully justified and I simply can't understand why he would want to talk you out of doing one. I really don't understand....... and it bothers me.

When one of my girls had a cutaneous tumor that was diagnosed as one of the most malignant cancers, she had blood work and ultrasound done before it was removed. The surgery was successful, no cancer cells were left behind. Yet she had another ultrasound a few months later to make sure the cancer hadn't spread inside.

I guess this and some other experiences over the years are the reasons I don't understand........ Again, my apologies. 

Please be assured I would only like to spare you unnecessary sadness and heartache.

Hi, I have been posting about my cat Toby, also 12, who also has a mass. Toby's is located somewhere between his large and small bowel. He hasn't had symptoms other than vomiting and losing weight, i.e. he is running around, good appetite. He does have gurgling and it is intestinal, not respiratory.

We did the ultrasound and they were not able to diagnose from that. Then we did a ultrasound-guided needle biopsy and they were not able to get to the mass that way either, but a lymph node test was negative- however that too, does not tell them enough. So tomorrow morning we are having the exploratory surgery. 

I don't know if this helps you but we have been told that, in the case of a mass, nothing really helps unless they can biopsy it. We went for a second opinion today and that vet said "there are so many diagnostic tools but nothing takes the place of being able to have the affected area right in front of you where you can see it and feel it". 

She is not doing his surgery. She was very honest and open and forthright though, and I appreciated her opinion. My original vet said something similar to your option #1 too. And she said if we chose that option we could not opt for surgery later on since the anti-inflammatory drugs are bad for surgeries. 

Good luck, we feel the same as you do :-( :-(. Prayers and good wishes  for your sweet Muffin. 

Violet are you a vet.  I don't understand how you read my original post and decided that our vet was trying to talk us out of doing an ulltrasound.  On the contrary.  He gave us three options to think about and has not tried to influence our decision.  He was very thorough in discussing each option.  He said some people would decide to make a pet comfortable and not consider anything at all.  That was option one.  Then he discussed option two, an exploratory surgery to find the tumor mass.  Then he said some folks would opt to do an ultrasound first because that might help make their minds up whether to proceed with any surgery.  He never passed any opinion as to what we should do.   I am already stressed and I don't need anyone to add to what I am feeling by trying to made me mistrust my vet.  I love and trust him.  He has seen us through losing two cats, Max and Speedboat, who were much loved family members.  He and his wife were all but in tears the day I held Max and they put the needle in his to end his suffering.  My vet merely said that an ultrsound might not provide a definitive answer that would help us decide whether or not to proceed with surgery. 

Thanks everyone else for the concern, hugs and well wishes.    I don't think I am coming back to look at this thread amymore because it has only upset me more than I already was.

I'm really sorry you so misunderstand what I'm trying to say. I'm trying to urge you not to skip the ultrasound because it can help with diagnosis, finding the precise location of tumors, etc. It can do so much! But most importantly it can show things that don't show up on other tests, X-rays for instance. One can see what is happening everywhere in the body, which can make a world of difference when it comes to deciding treatment for one or two particular problems.

An ultrasound cannot tell what kind of cancer a certain tumor is, but normally that's not the reason for doing an ultrasound anyway.

I think there is a big misunderstanding here somewhere and I'm deeply concerned you would believe for one moment I don't have your and Muffin's best interest at heart. And it makes me sad, very sad.

I feel the need to add something here because this is very important for all of us when we're trying to help each other.

It always makes me very sad when a helping hand reaching out is seen as a weapon intending to inflict pain and emotional suffering. One very recent perfect example of this is this thread

http://www.thecatsite.com/t/243964/nightmare

Another fairly recent example:

posts #14, #18, #20, and #23 in this thread

http://www.thecatsite.com/t/243465/toby-vomiting-and-losing-weight-fine-otherwise

I really don't know what to suggest for a remedy, except that, if anyone's feelings are hurt by a post intended to help, please ask questions, ask for a detailed explanation, but don't automatically assume the post was written to hurt your feelings because nothing can be farther from the truth.

I've been thru a lot of illnesses with my kids over the years. Given the three options that your vet suggested, I would personally chose the ultrasound as the next step. Even though an ultrasound doesn't always lead to any firm conclusion, it can rule things out and could possibly avoid the exploratory surgery. However, when it is inconclusive, then the surgery may be the only way to find out what is wrong with Muffin. I opt for surgery as a last resort, particularly in a senior cat or one that is pretty ill in the first place. Surgery is hard on a cat, even if they do fine with the anesthesia, the recovery is harder on them.

Sending big that you can find out what is going on with Muffin and to you in the mean time.

Our Lazlo is an example where the ultrasound was instrumental as a next step. He exhibited the same signs as BarbB's Toby. And x-ray revealed a mass that appeared to be in his spleen. Instead of exploratory surgery, we opted for the ultrasound. It turned out the mass was in his stomach, and because of the location, they were able to do a needle biopsy of the mass. We got biopsy results within two days. His diagnosis was lymphosarcoma. It was not operable because of it's connection to the stomach lining, but we were able to start him on chemotherapy immediately. No surgery was ever necessary.

for you and Muffin.


************************

P.S. I felt compelled to add.... Misunderstandings happen so easily when we're dealing with just written text and don't have all the information. :heart3: I'm glad you haven't had reason to be active in the health forum, but Violet is the last person to ever intentionally hurt. :heart3:

Violet said:

I feel the need to add something here because this is very important for all of us when we're trying to help each other.

It always makes me very sad when a helping hand reaching out is seen as a weapon intending to inflict pain and emotional suffering. One very recent perfect example of this is this thread

http://www.thecatsite.com/t/243964/nightmare

Another fairly recent example:

posts #14, #18, #20, and #23 in this thread

http://www.thecatsite.com/t/243465/toby-vomiting-and-losing-weight-fine-otherwise

I really don't know what to suggest for a remedy, except that, if anyone's feelings are hurt by a post intended to help, please ask questions, ask for a detailed explanation, but don't automatically assume the post was written to hurt your feelings because nothing can be farther from the truth.

Click to expand...

With 10+ years on this site, I have never felt the need to comment as I did on the other thread.

I think whenever the life of someone's beloved pet is hanging in the balance, it is always a good idea to take that into consideration when answering a post. That way people do not feel corrected or demeaned, especially during a time when they are feeling the most vulnerable and are the caregiver to their very ill cat. I thought we cleared this up on the other post but if it is coming up again, I will repeat that I did feel demeaned. I can apologize for feeling that way but when I read the post again "Please put away that grass, whatever it is..." it makes me feel the same way. 

I just put my utterly beloved Sam through a two-hour surgery (major dental) knowing full well that she might not make it, but knowing that her quality of life would be much improved if the surgery was done.  She has had CRF for nearly 3 years and was within days of being euthanized for dramatic weight loss when I decided to foster her from the shelter. She's gone through a bloody diarrhoea virus which nearly killed two other fosters and had the vets stumped, blood transfusion, Epogen treatment and was recently diagnosed with being borderline hyperthyroid. The tech told me her heart sank when she saw Sam and that her heart rate was high.  The vet (who I've been seeing for 30 years) called me that morning and went through all the problems and bad scenarios to make sure I understood the risks, although he was glad when I told him to go ahead, that I understood.  I couldn't wait at home and so sat in their waiting room for hours in case something happened and I could be there right after she died. Sam came through it, rather to the surprise of all of us, and her quality of life has been improved - for however long she has.

I only say this to indicate that I agree that when you have developed a strong relationship with your vet, and you have great trust in him/her, then you listen and make the decision together. Sometimes, you have to roll the dice, no matter that it might break your heart, because it's the wisest decision for your companion.

I'm sending lots (and I mean LOTS) of prayers for Muffin. I understand totally feeling like you're a wreck and all you want to do is cry. Boy, have I been there and having to make a decision at a time like this is heart wrenching and emotionally draining. I'll specifically pray that you be guided in the best choice for Muffin, and if he does have surgery that he comes through this with flying colors and you get the answers you need so you can proceed with treatment.

Please keep your chin up and hang in there, honey. Prayers on the way!

Lots of to you, and gentle chin scritches to your adorable Muffin.