Normal Lipoma Growth?

My 16 year old cat, Ella, has had a whirlwind of a time the last few weeks. She had a pseudo-pregnancy and infection (not sure if there was a connection between them), during which her mammary glands became substantially enlarged. She also got extremely constipated to the point where she had to have an enema to get things going again. She was given an antibiotic shot, and then a different antibiotic when the first didn't make a difference.

Now, she's halfway through the second antibiotic and seems to be doing better- not as lethargic & not as restless (those seem mutually exclusive, but she somehow seemed to pull both off). And her mammary gland enlargement has disappeared; however, she is still acting hormonal (for lack of a better word)- she enjoys having her belly rubbed and seems to act like she's nursing. She is also very needy, following me and my husband around the apartment most of the day. 

After the mammary glands decreased in size, we noticed a lump near one of her nipples on her belly. We immediately took her in, as we had never noticed it before, and with everything going on with her hormones, I was immediately worried it could be mammary cancer. However, the vet was not very concerned. He said it felt like relatively normal mammary tissue. 

My husband was worried the vet might have been feeling the enlarged mammary tissue, not the lump,  so he took her in again (I was on a business trip) and the vet said it was likely a fatty deposit, and to keep an eye on it for growth. Upon returning from the business trip, I noticed that the lump was bigger than it was when I left. I've, of course, called the vet's office and let them know. I am waiting for the vet to call back. 

So, I'm wondering what is normal growth for lipomas (fatty tissue). Is it possible lipomas could grow over the course of a week? Does anyone have experience with lipomas? I am a worry-wort of a cat parent, so I take Ella in for everything (especially since she's 16). I just think that I won't stop worrying until we get a biopsy, even if the vet sill says it still feels like a lipoma and not to worry. I also worry that, if it is cancer, that the vet might not be moving as quickly as he should be to prevent cancer from spreading. My limited experience with this vet so far has been very much "lets wait and see what happens," which is a hard pill to swallow when it's your baby not feeling well and acting completely differently. I know lipomas do grow, but how quickly do they grow? If the vet recommends waiting and watching it, should I go with it, or insist on a biopsy?

For some context, Ella was very likely fixed when she was a kitten (we had an ultra sound done and she has no uterus); however, when she lives with a male cat, she will go into heat as if she was never fixed. The vet said this could be caused by leftover ovarian tissue or by her adrenaline gland. 

Thanks very much for you help and insight!

I don't know much about lipomas but I noticed this thread was in danger of being buried, so I thought I'd reply in order to bring it to the top of the pile. 

I know that fatty sebaceous cysts grow very rapidly and can look and feel like a lipoma/lymphoma.  It could easily be a hard, lumpy, cyst.  I would have thought that a benign lipoma would grow at the same rate as a malignant lymphoma, and both are dependant on location and the particular aggression of the lipoma/lymphoma in question.  Some lipomas/lymphomas will remain at the same size almost indefinitely, whilst others will suddenly start to multiply at an alarming rate.  So, I'd ask for a biopsy if you're worried, as it's the only way to be sure, and if it is malignant, every second counts.

If her oophorectomy (the removal of both ovaries) were incomplete at the time of her spay surgery, there might be still be ovary production of oestrogen & progesterone.  In which case, and I'm hazarding a very wild guess, she might be pre/post-menopausal, if she were a strong producer of these hormones, which it sounds like she might be, what with the false pregnancy, engorged nipples, and whatnot.  These hormones, if left rampant and unchecked, might also cause breast cancer (be that malignant or benign) in a pre/post-menopausal female, so again, I'd trust your instinct and insist on a biopsy.  (But, adrenal glands, do indeed, produce secondary hormones.)

I'd also ask to see a different vet as the one you've seen doesn't seem very empathetic to your clear concern.

If you can afford it, peace of mind is priceless.

I hope some others with more experience and a greater understanding (rather than my wild stab in the dark) will chime in with advice for you.  In the meantime, know that at least I am thinking about you and Ella   

I am a human doctor, not a vet, but I have experience in human lipomas and a canine lipoma. Human lipomas grow slowly over months to years, a canine lipoma in a Staffordshire Bull Terrier grew at approximately  seven times faster than a human lipoma and was very large over eighteen months, when the human lipoma was still small. 

Extrapolating to felines, one would expect them to grow faster than a Staffordshire Bull Terrier but certainly not as fast as to show a perceptible increase in size in a week, more a perceptible increase in size over weeks.

Your vet sounds as if he knows what he is doing by a watch and wait approach, but you should certainly go back to the vet if the lump is growing as fast as to be perceptibly larger in a week.

Incidentally malignancies are usually hard and lipomas feel soft.

Please keep us posted,

With all regards,

Geoffrey

Thank you both for your responses! I have spoken to the vet who recommended a fine needle aspirate, so I have an appointment for Monday morning. What concerns me at this point is that the lump seems to be changing rapidly. It started off relatively flat a week ago, was larger, round and soft yesterday, and today seems to be a little smaller and harder- which makes me think it might be a cyst responding to her hormones, though from what I've read, mammary lumps are almost always tumors, which are almost always malignant- I can't find much online about cysts in cats, just tumors. So I want to figure out what's going on and and treat it as soon as possible if it is cancer.

This is happening in the midst of so many other symptoms (the pseudo pregnancy, sudden constipation, gas, vocalization, restlessness, and neediness), but her blood work looks good (aside from signs of infection) and she hasn't lost her appetite- if anything she is eating more. It seems so strange that all these things are happening at once.

I will keep you posted on any developments. Thanks again for your responses!

Just a quick update: this morning, the vet performed a fine needle aspirate, and could see fat cells, cells that looked like they were from a cyst, and other cells that he wasn't sure about, so they are sending it in to a pathologist. The vet warned that we may need to remove the lump.

The vet's office thinks that her behavioral changes might be simply a result of her aging and possibly dementia. 

We are continuing her on antibiotics in the mean time, and when we run out, we will bring her in for blood work to see if the antibiotics took care of her elevated white blood cell count. 

Thanks again for keeping me and Ella in your thoughts!

I got a call from the vet this morning, and it looks like mammary cancer. We have an appointment to have the tumor removed on the 10th, but the vet warned that mammary tumors often recur. We'll get the lump out and then go from there. 

Thank you again for your thoughts and support!

Oh dear, I've just dropped several inches.  I can imagine how scared and worried you must be      

Please keep us updated.  And feel free to share your frets and woes between now and then, as I'm sure they will be ever-increasing.  10 days seems like eons to wait....  

There's some good advice on this page about dietary requirements & supplements for cats with cancer:

http://www.littlebigcat.com/health/cancer-prevention-and-treatment/

Take care  

It is an awfully long time to wait, and I am pretty distraught - but it was the soonest they could get her in. Since we noticed the bump about 10 days ago, I am worried it could grow significantly in the next 10 days.

Thank you very much for that resource! I am going to focus my energy on making sure we are doing everything we can for her in the mean time.

So, after talking with a friend who is a vet tech, I decided to shop around for  earlier surgery dates, and ended up getting an appointment with a new vet for tomorrow, with surgery scheduled for Friday. While i'm nervous about going to a new vet out of nowhere, all of my googling is saying that the sooner it can be removed, the better. And it will help with my peace of mind, which is an added bonus. 

In other news, Ella seems to be more-or-less back to normal as far as hormones go- she is not acting like she is nursing anymore or nearly as needy, though she is still letting us know that something is wrong by vocalizing and being grumpy. But, she's always been a bit of a curmudgeon, even when she was younger, so in a way it is a bit reassuring. 

I'll continue to keep you posted as the saga continues. 

Brilliant.  I've been meaning to ask you to do that very thing but I'm so easily distracted and forgetful, sorry.  I'm relieved that you had the foresight to get on the case anyway.  10 days was an obscene amount of time to make you wait for an emergency elective procedure.  I actually thought it very mean of your last vet not to bump you up the list, I'm sure there would be dental operations that could have been postponed.  But that's by the by now.

Don't be nervous about your new vet, they've stepped in as your night in shining armour, and are bound to be good     

Well, I just realized that I accidentally booked a surgery with an emergency vet, which doubles the cost of the surgery (which is unfortunately not an option for us), so I've NOW got an appointment for surgery on Monday with yet another vet, but I'm going to keep calling around to see if I can get her in before the weekend. Wish me luck!

5 days and counting...

Good luck  

Your wishing worked! Through an amazing stroke of luck, I found a vet that can perform the surgery tomorrow morning, and I have to say that when I found the vet (after hours of calling around), I cried tears of joy! I will give you another update when I pick her up, which I hope will be tomorrow afternoon. =)

Wow, that's super amazing!  I'm over the moon for you both.  I'm literally smiling from ear to ear!  

I dropped Ella off at the vet about an hour ago, and will be picking her up in about 7 hours. The vet noticed ANOTHER mass developing on her other side, so we will be removing both today. The appearance of the other mass has ruined my optimism, and I'm afraid that removing the masses won't be enough to delay whatever is happening. The vet warned that she might have abnormal reproductive tissue leftover from when she was fixed, but that looking for it would be invasive, and like looking for a needle in a haystack. I'm not sure I want to put her through an invasive surgery when we aren't even sure if it will help her.

I am, however, very happy with this vet, who took all of my concerns seriously, and seemed much more proactive than the vet I have been going to (and charged about half what my other vet quoted me). It's unfortunate that this vet is so far from where I live, or I would return for all of my cats (I have three). 

Again, I can't tell you how nice it has been to have someone to report progress and concerns to through all of this. Thank you so much for all of your thoughts and well wishes!

I'm pleased this new vet is better, vets can be very hit and miss and I've learned through experience not to trust them blindly.  I have lost cats through vet mismanagement of medicine.  

I'm sorry to hear that Ella may be worse than hoped for.  But we won't know for sure for 7 hours, so the dreaded wait is on.  Thank goodness it's being done today though and not in another 8 days!  

I look forward to your bringing her homes and your next post.

Lots of love  

I'm so sorry you're going through this. My cat also has mammary cancer and it's rough.

It's great that you are pushing for fast treatment. Early diagnosis and treatment is 100% the right thing. Unfortunately, the veterinary oncologists we have been seeing say that this type of cancer is usually quite aggressive (a good overview here: http://www.vet.osu.edu/vmc/companio...logy/common-tumor-types/feline-mammary-tumors). You're right that you may have to consider more extensive treatment, depending on the pathology. We ended up doing a full mammary chain/lymph node removal on both sides, and are following it up with chemo. The normal chemo they use (doxorubicin) made her feel pretty crappy and also seemed to affect her kidneys, so we switched to cytoxan and she's doing much better. But of course, there are tradeoffs to putting her (and our bank account) through all of it. In our case, her tumor was smallish, low grade, and had not spread to her lymph nodes, so we think it's worth it to try. Plus she handled the surgeries and cytoxan well and is still acting like herself. We've been trying to take our cues from her.

Sending you and Ella good, healing thoughts. Fingers crossed the surgery goes smoothly and you get some positive news on the full pathology. I'm so glad you've found a vet who is taking this seriously. It sounds like you and Ella are in good hands.

zygote said:

 
I'm so sorry you're going through this. My cat also has mammary cancer and it's rough.

I wanter her 

It's great that you are pushing for fast treatment. Early diagnosis and treatment is 100% the right thing. Unfortunately, the veterinary oncologists we have been seeing say that this type of cancer is usually quite aggressive (a good overview here: http://www.vet.osu.edu/vmc/companio...logy/common-tumor-types/feline-mammary-tumors). You're right that you may have to consider more extensive treatment, depending on the pathology. We ended up doing a full mammary chain/lymph node removal on both sides, and are following it up with chemo. The normal chemo they use (doxorubicin) made her feel pretty crappy and also seemed to affect her kidneys, so we switched to cytoxan and she's doing much better. But of course, there are tradeoffs to putting her (and our bank account) through all of it. In our case, her tumor was smallish, low grade, and had not spread to her lymph nodes, so we think it's worth it to try. Plus she handled the surgeries and cytoxan well and is still acting like herself. We've been trying to take our cues from her.

Sending you and Ella good, healing thoughts. Fingers crossed the surgery goes smoothly and you get some positive news on the full pathology. I'm so glad you've found a vet who is taking this seriously. It sounds like you and Ella are in good hands.

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Thank you so much for that resource, and I'm so sorry you're going through this as well. How did your cat react to the mammary chain removal? I called my first vet's office up--prior to finding the vet who performed the surgery--to ask if a mastectomy might be a better decision, and the vet tech I spoke to said that it was such an invasive surgery that, at 16, my cat would likely not recover well. But I've also stopped trusting that vet since that conversation. 

Chemotherapy is the next thing I expect to discuss with the vet, though I am sure it depends on pathology. I am afraid that I will negatively affect Ella's quality of life by putting her on chemo, and I think after she recovers from her surgery that her quality of life will be my top priority. I am hoping my new vet will have a better handle on putting together a proactive treatment plan that doesn't sacrifice her quality of life. 

How long ago was your cat diagnosed? It sounds like her situation--as far as mammary tumors go--was a good place to start. I am glad that she is still acting like herself- I think that is a fantastic sign!

Brian007 said:

 
I'm pleased this new vet is better, vets can be very hit and miss and I've learned through experience not to trust them blindly.  I have lost cats through vet mismanagement of medicine.  

I'm sorry to hear that Ella may be worse than hoped for.  But we won't know for sure for 7 hours, so the dreaded wait is on.  Thank goodness it's being done today though and not in another 8 days!  

I look forward to your bringing her homes and your next post.

Lots of love  

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I am sorry that you've lost cats because of bad choices on the part of your veterinarian. That is so heartbreaking.  I don't have any reason to believe that my vet was handling my situation poorly, but I could tell that something was very wrong with Ella, and it rubbed me the wrong way that my vet didn't seem as concerned or as proactive as I would want me vet to be. I am so glad that I decided to find another veterinarian, but now I'm trying to decide what to do about the rest of her care - do I take her in the car (which stresses her) for more than an hour for each vet visit? Or find one nearby? (Maybe a combination of both?) After realizing how overpriced my last vet was, I definitely need to find another just to sustain any sort of treatment (and I have three cats so--- it adds up over time). 

Anyway, we're home now and dealing with the dreaded Cone of Shame and the clumsiness that entails. 

CatCurmudgeon said:

 
Thank you so much for that resource, and I'm so sorry you're going through this as well. How did your cat react to the mammary chain removal? I called my first vet's office up--prior to finding the vet who performed the surgery--to ask if a mastectomy might be a better decision, and the vet tech I spoke to said that it was such an invasive surgery that, at 16, my cat would likely not recover well. But I've also stopped trusting that vet since that conversation. 

Chemotherapy is the next thing I expect to discuss with the vet, though I am sure it depends on pathology. I am afraid that I will negatively affect Ella's quality of life by putting her on chemo, and I think after she recovers from her surgery that her quality of life will be my top priority. I am hoping my new vet will have a better handle on putting together a proactive treatment plan that doesn't sacrifice her quality of life. 

How long ago was your cat diagnosed? It sounds like her situation--as far as mammary tumors go--was a good place to start. I am glad that she is still acting like herself- I think that is a fantastic sign!

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In our case, we noticed the lump around May last year and assumed it was fatty tissue like you. We had no idea mammary cancer was so common and aggressive, or we would have taken her in when we first felt it. But we didn't take it seriously until we noticed it getting a little bigger/harder in September. Even once we got the diagnosis from our local vet, we couldn't get in to see the oncologist until October. I think it being low grade has really helped us. It sounds like hers grows more slowly than Ella's (but you can't know for sure what you're dealing with until the pathology comes back).

You're right that it is a pretty invasive surgery. For that reason, they do each side separately and let the cat recover in between. She had the mammary chain with the obvious lump (2.4 cm) removed in early November. Then she had the second surgery in early January. (We would have done it a few weeks sooner but the holidays interfered.) It is an invasive surgery, but she handled it even better than we thought she might, especially at ~14. I will say that since we are in a major city, this was all done at a high quality teaching hospital with entire oncology and surgery departments. They are used to doing these procedures and have a good protocol for pain management afterwards. She had to stay at the hospital for 2-3 days after each surgery while hooked up to a tube providing pain meds directly to the wound. Once she was home, we had to keep her confined to one room for two weeks while it healed. She certainly didn't act like she was in too much pain - she kept trying to jump on everything even though she wasn't allowed. Quality of life is also really important to us, and we felt good about doing the second surgery since we handled the first one so well. We also have a lot of trust in the quality of the hospital and the vets there, which makes a huge difference. Has your new vet done many radical mastectomies on cats before?

I was also nervous about chemo, but the vets said that the goal is different in animals than it is in humans. It's about extending quality time, not about finding a cure. Doses are lower to minimize side effects, which is why they don't get great cure rates for aggressive cancers like this one. The goal is to keep the cat as comfortable as possible for as long as possible. It basically always comes back, it's just a question of how long that takes.

Like I said above, she didn't react well to the first type they tried. She didn't vomit or anything, but she stopped eating. With drugs, we were able to get her to nibble enough to prevent fatty liver, but she lost some weight and it was pretty stressful until it passed. We actually were going to stop chemo until the vet suggested switching to the other one that tends to have less side effects. She's pickier about food than she used to be, but at least with this chemo, she'll eat. She still has a few rounds left, but for now, X-rays are showing no signs of cancer recurrence in the mammary tissue or any spread to the lungs. And we reevaluate how she's doing before each round of chemo to decide how to proceed.

So our motto has been to take the treatment plan one step at a time, and listen to the cat.

I'd recommend doing a search for mammary cancer on this site. There are some old threads that I came across on google (it's how I found the site in the first place) that gave some different perspectives for some different cases.