Found a thumb-size lump under my kitty's armpit

A little back story on my boy Ralphie. He's 7/8 years old and never had many issues up until a few months ago. We had to take him in to get a chipped tooth removed, and he came through that fairly well, but he HATES going to the vet after that. ANYWHO....

Lately he has appeared to be normal, eats normally, goes potty normally, but seemed to sleep more than usual. I picked him up last night and noticed a thumb-sized bump under his left arm. It felt fairly firm and did not seem to move much. We took him to the vet today and he went nuts, so they had to sedate him to get bloodwork and a biopsy done on the lump. He also has lost two pounds in the past three months since we took him last.

Results to come soon, but the vet talked about tumors, fibrosarcoma, some kind of granular tumor, and possible hyperthyroidism. The vet said it does not appear to be attached to his rib, but is under the muscle. At this point I am severely worried that he's basically getting a death sentence, and if that is the case, my wife is going to be devastated. I've researched fibrosarcoma, kitty cancer, and hyperthyroidism, and they all appear to be common but major surgeries that involve major cost and trauma to them. From what I have read, a lot of these issues are fairly grim in terms of survivability. From what I read, anywhere from 6 months to 4 years depending on many factors. 

Is there any benefit to putting them through all of the trauma and stress of a surgery for a hyperthyroid, or a fibrosarcoma, or is it better just to get them pain medication and let them live out what ever time they have left? I just don't feel comfortable putting him through all of that, then pumping him full of medications afterwards. 

It's a fairly complex question, and I love my two cats, but I don't have the finances to be driving around the state going to specialists if it comes down to it. 

I can't speak to the possible cancer/tumor, but I can speak to hyperthyroidism. Hyperthyroidism can be controlled with medication, and my brother's cat had it for years. She ended up dying of a different issue, but the hyperthyroid meds brought her back from the brink of death.

I completely understand about the finances part though. It's horrible to think that you may spend more money than you have or go into debt, put yourselves and your cat through massive stress, and then not even have a cat make it through a procedure, or die shortly after. I hope others have some more answers for you on here, and I also hope that your cat's vet has good news for you and not bad.

dennison45 said:

 
A little back story on my boy Ralphie. He's 7/8 years old and never had many issues up until a few months ago. We had to take him in to get a chipped tooth removed, and he came through that fairly well, but he HATES going to the vet after that. ANYWHO....

Lately he has appeared to be normal, eats normally, goes potty normally, but seemed to sleep more than usual. I picked him up last night and noticed a thumb-sized bump under his left arm. It felt fairly firm and did not seem to move much. We took him to the vet today and he went nuts, so they had to sedate him to get bloodwork and a biopsy done on the lump. He also has lost two pounds in the past three months since we took him last.

Results to come soon, but the vet talked about tumors, fibrosarcoma, some kind of granular tumor, and possible hyperthyroidism. The vet said it does not appear to be attached to his rib, but is under the muscle. At this point I am severely worried that he's basically getting a death sentence, and if that is the case, my wife is going to be devastated. I've researched fibrosarcoma, kitty cancer, and hyperthyroidism, and they all appear to be common but major surgeries that involve major cost and trauma to them. From what I have read, a lot of these issues are fairly grim in terms of survivability. From what I read, anywhere from 6 months to 4 years depending on many factors. 

Is there any benefit to putting them through all of the trauma and stress of a surgery for a hyperthyroid, or a fibrosarcoma, or is it better just to get them pain medication and let them live out what ever time they have left? I just don't feel comfortable putting him through all of that, then pumping him full of medications afterwards. 

It's a fairly complex question, and I love my two cats, but I don't have the finances to be driving around the state going to specialists if it comes down to it. 

Click to expand...

It's premature to be discussing therapies/surgeries for cancer when you don't have a diagnosis.  It could also be a fatty benign limpoma.  And as @ManeMelissa said, hyperthyroidism can be controlled though medication, and even through a new prescription food.

Thank you both for your reply. The reason I am discussing therapies/surgeries is that I like to cover all bases. It helps me cope with any possibility. With that being said, Ralphie's bloodwork came back, his thyroid function was normal, but his white cell count was sky high. He must have some kind of infection that his body is fighting off (not sure if this is an indicator of something malignant or not) and his biopsy came back inconclusive.

The vet advised keeping him on the antibiotics until they run out next Tuesday and to keep an eye on his lump for any changes (shrinking, etc.) and told us if there are no changes by then that they recommend surgically removing it. Though I know it will be another traumatic event for the little guy I believe that it would be for his benefit to get it removed and my wife and I have agreed upon that.

I have had cats in my family household for years and years, I grew up with them, etc. This is the first pet that I have had any health issues with, and while our vet mismanaged the last issue with Ralphie, I feel that they have gained our trust back by their actions when we took him for this, and the main purpose I posted this thread was to get a little peace of mind and reassurance as this is something that others have been through, and I have not.

I had a cat with a lump about the same size as the one you describe.  It was cancerous but very slow growing.  I will try to find the name of it.  It was surgically removed once but it grew back.  It really didn't bother him and he ended up living until almost 19 years old.  

   for Ralphie fighting off the infection!  Let us know how he does. 

dennison45 said:

 
Thank you both for your reply. The reason I am discussing therapies/surgeries is that I like to cover all bases. It helps me cope with any possibility. With that being said, Ralphie's bloodwork came back, his thyroid function was normal, but his white cell count was sky high. He must have some kind of infection that his body is fighting off (not sure if this is an indicator of something malignant or not) and his biopsy came back inconclusive.

Click to expand...

Fair enough!

I guess my wife said she noticed it when he was younger but it was much smaller and they did not really think much of it, but it has since become what it has. Thank you for the reply!

dennison45 said:

 
I guess my wife said she noticed it when he was younger but it was much smaller and they did not really think much of it, but it has since become what it has. Thank you for the reply!

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We all hope it works out for the best for you and your cat.

Just a quick update. Ralphie has finished his antibiotics, he seems to be doing better. We scheduled the removal of his lump for April 2. The vet recommended it be removed since the biopsy was inconclusive. It seems like the lump has gotten bigger but it does not seem to have caused any ill effects.

The only concern I have is general skittishness of inanimate objects. It just started happening today. He stared at the curtain next to him then took off like it was some kind of threat. He had done that before as well, and I am not sure how to interpret it. I would do that with couch pillows and the recliner as well. Just kind of weird. 

**Update**

My wife and I returned home last evening from jogging, and we happened upon some cat throw-up. The second thing we noticed was that Ralphie was up on the table, which he normally does, however, when my wife went to pick him up and set him on the floor, she noticed a second lump, this time the opposite side near the end of his ribcage. This one was bigger than the other one, which we have scheduled for removal this coming Thursday.

Not sure what to make of it but now I am getting scared for his well-being. I am hoping that these are not cancerous, but I am more afraid that he's going to be further traumatized by this and will have to live in pain the rest of his life. Just not sure what to make of it right now. My OCD is kicking in and my mind is swimming.

Try to stay calm they could all be benign. If pain becomes an issue there are some excellent pain MEDS out there like bupeprenorphine as an example.

Your concern is perfectly normal. Some reassurances of note:

A mass that has slowly grown is much less concerning than one, for example, that was first palpable a few weeks ago and has fast become nickel sized.

Hyperthyroidism wouldn't be a concern unless the mass was in the neck. Nothing remotely related to the thyroid is in the armpit (axilla of the forelimb).

Inconclusive usually means enough cells/tissue weren't aspirated to be visible on cytology (on the slide under the microscope). This can be due to too small a needle being used, such as a 25 gauge tiny narrow needle. Can be due to the mass being so small that even the tip of a needle is bigger than its center, which is a tiny mass indeed.

Infiltrative implies the mass is not merely subcutaneous, but spread through a muscle, or started in the muscle from the beginning. This can be inflammation from an injection, such a subcutaneous or intramuscular injection of sedative or vaccine. Low on a forelimb is a common place to inject both of these. If it was new, in addition to the mass over the ribs, allergic wheals/hives would be on my list of rule outs, but not if that mass in the armpit was noted many months to years ago initially.

An internal medicinist or an oncologist perform many fine needle aspirates every day, both of masses and lymph nodes. They may be more successful getting a representative sample of the growth in the armpit. Sometimes, better skill and the right needle are needed to get some cells/tissue successfully.

A punch biopsy, under mild sedation, with a single suture knot or two, is an option to consider also, rather than a full mass removal and general anesthesia again. Excising a mass from a muscle is more involved, including the radio-ulnar nerve that runs up the leg; if this nerve is struck/poked/cut during surgery, he won't be able to use that forelimb. If it does need excision, aka full removal, as wide a margin as possible should be removed with it, and the full mass sent to the lab for a histopathology. A veterinary pathologist will be able to discern if it's only inflammatory cells versus a benign or malignant mass.

Considering it's not just a subcutaneous mass, if removal is recommended, I'd go with a surgeon, not a regular, family vet, to remove it. They and their nurses are much more accustomed with anesthetizing, supporting, compensating, and "surgerizing" such atypical patients with lumps. They can do a nerve block, infiltrative blocks, wide margins, and are better prepared for blood pressure changes due to stimulation/pain while intra-op. A surgeon will perform surgery faster, and has likely removed many infiltrative masses from cats before, compared to rarely for a regular vet.

At minimum, consulting with a surgeon and getting their opinion on the 2 masses would be of great benefit. Regular vets are somewhat limited by their lack of experience and training in surgery. Your vet would learn what to look for in future cases of infiltrative cat lumps after reviewing the findings of a board-certified surgeon.

I do hope Ralphie has no worrisome tumors and your concerns are eased soon. Depending on which kind of WBCs were elevated, it could be due to infection, or allergies, or inflammation, or parasites. He may not have an infection, and just inflammation due to periodontal disease, for example. Good Luck with him!

-Becky

Oh no, you and your wife must have been so discouraged when you discovered that second lump! You will know more when the first is removed. Then they will be able to look at it better and truly determine what was going on with it.

About Ralphie's skittishness, he's been through a lot lately with vet visits and antibiotics, but he's also no doubt sensing you and your wife's fear and anxiousness. That's a lot of stress for a little cat, so as of now, I wouldn't be too concerned about any general skittish behavior. My cat is skittish for a whole day or two after people visit our house because it stresses her out so much, and she takes a full day to recover after a routine vet visit.

April 2nd is coming up soon, I wish you, your wife, and Ralphie all the luck!!

Just wanted to give everyone an update and a big 'thank you' for all of your advice. 

My wife and I came home from work last night, and tried to feed Ralph, and he ate a little, but had trouble breathing, so we rushed him to the vets. He was very stand-offish with everyone, and they had to wrap him in a towel to get an x-ray. The x-ray was not good quality, but they found fluid in his abdomen and lungs. They told us they could do a tap, but there was a 20% chance he would survive being sedated, and even then, the prognosis of him surviving his procedure to remove the lumps on Thursday they did not give us any good news. 

We knew then and there we would have to put him at peace. The poor little guy has been struggling, and it was extremely hard decision to make, and the vets reassured us that even if he made it through this sedation and the next procedure, that it had all the markings of lymphoma, and that he would likely last only a few months afterwords, and that chemo would only prolong his life a few months, but he would still have to go through all of the stress of being driven back and forth, etc. 

We feel we did what was best for him and he is now free of pain, and we will miss him incredibly. 

What a beautiful photo of your little guy.  

The TCS Team offers our condolences on the loss of your sweet boy.  In accordance with TCS policy, we will lock this thread now.  Please consider posting a tribute to your kitty in our Crossing the Bridge forum:  

http://www.thecatsite.com/f/19/crossing-the-bridge