Mandibulectomy

[Jennifer1984]

Hello, a week and a half ago my cat had a radical mandibulectomy for squamous cell carcinoma and I was hoping to find other people whose cats have been through this to get some advice. Did your cat learn to eat again? How long did it take? How soon did you introduce food? Thanks.

 

[nurseangel]

Hi, I am sorry to meet you under these circumstances. I've never been through this exact situation, but DH's "office cat" had to have a tympanectomy. We left his favorite cat food at the emergency vet's office, where he was kept for two weeks. He had a cone around his neck at the time and wouldn't eat for them. We went up twice a day to visit and feed him. I would advise consulting your vet as soon as possible to get the answers for your questions. Since your cat's surgery is directly involving the jaw, I understand this is a very tough situation for you. Is your cat still at the vet's office and on fluids? My guess is the vet should have recommended other options if there wasn't hope for a recovery and a chance at a fairly normal life. I wish you the best. Please keep us updated on your cat's condition. My prayers are with you both.

 

[silent meowlook]

Hi. I have known one cat that had it for the same reason.
The cat has a feeding tube in right? That is what you use to feed. With the cat I knew, there was no hope of her ever being able to eat on her own again. This was about 15 years ago. But I just don’t see it being possible.
It is a painful procedure and cats get phantom pain like people. Make sure they give you some decent pain meds for the kitty.

 

[FeebysOwner]

Hi. I presume, under the circumstances, your cat has a feeding tube? At least that enables you to continue to provide him/her nutrients, but still allow you to offer food by mouth when appropriate. I could find no related information on this site doing a search (sorry). It might be of benefit to join one of the forums related to cancer cats (see link below - it is free) and ask for guidance in getting connected to a more specific forum relative your buddy. Our best wishes and thoughts are with you and hope you will keep us posted.
[email protected] | Home

 

[Jennifer1984]

She's been home about a week now after four days at the vet. They told us some cats learn to eat again, but it could take up to three months. But didn't give any advice on reintroducing food. Yes she has a feeding tube. I saw a case study where only 12% of cats never learned to eat again, but maybe they only had partial mandibulectomies? She's on gabapentin for pain and currently tapering off prednisolone.

 

[Jennifer1984]

Thanks for the link for the cancer group.

 

[silent meowlook]

I was wrong thinking they don’t regain the ability to eat. The following is a link to a study Outcomes of cats with oral tumors treated with mandibulectomy: 42 cases - PubMed

 

[silent meowlook]

This is probably the same study.

 

[Jennifer1984]

Yep that's the study I read. I'll e-mail the surgeon to find out more about feeding her. He wasn't at her discharge, just the vet student.

 

[botolo]

Hi! I was wondering if you had any new development. My cat might have to do the same surgery.

 

[Jennifer1984]

Hi! I was wondering if you had any new development. My cat might have to do the same surgery.

Sorry about your cat! Squamous cell carcinoma? Not really any new developments unfortunately. It's been two and a half months and still not eating/drinking. They said it sometimes takes up to three, but I'm not optimistic. I'd get the surgery ASAP if you're serious about it. We kinda got the run around and by the time they did it the surgeon took as much as he could, but couldn't get clean margins. We got electrochemotherapy done to hopefully take care of the last cancer cells. Otherwise she is feeling good and doesn't seem to be in pain anymore.

 

[botolo]

This means that you are feeding her through the feeding tube in the esophagus, right? How would you consider her life quality now? Also where did you get the surgery? I am in Los Angeles and it’s so difficult to find doctors that will even consider doing this. They all say “mandibulectomy does not work” but at the same time I see online many doctors with successful procedures on cats.

 

[fionasmom]

Have you tried asking for referrals to the specialty clinics like Animal Specialty Group, now owned by VCA, on Colorado Blvd in Los Angeles? There are others locally in LA and Orange County as well. I have never had this surgery on a cat, but did lose one years ago to oral squamous cell carcinoma. I agree that if you are considering this surgery that you need to do it as soon as possible.

 

[botolo]

I am moving as quick as I can. I noticed the symptoms (drooling) end of last week. I got the visit with the primary vet this Monday, biopsy and CT scan on Wednesday and I am now trying to move fast to find potential treatments.
I have already scheduled an appointment with the oncologist to consider chemio and radiation therapy once we get the biopsy back.
I have also contacted many specialty centers in the area but most of them just tell me “mandibulectomy does not work well on cats”.

My Frustration is that there are many sources online discussing successful mandibulectomy on cats with oral cancer.

Outcomes of eight cats with oral neoplasia treated with radical mandibulectomy - PubMed

Reconstruction of a mandibular segmental defect with a customized 3-dimensional-printed titanium prosthesis in a cat with a mandibular osteosarcoma - PubMed

I am going crazy trying to find a doctor who is familiar with these procedures.

 

[Jennifer1984]

Yes she has an e-tube. Quality of life is good I'd say. She still enjoys life, just would be better qol if she could eat on her own. Our oncologist was against surgery too. Kept pushing radiation even though online radiation alone had mixed results and surgery and surgery/ radiation was best. Her tumor was growing very aggressively and already very big. I dont think radiation alone would have done much for her. Plus it's many treatments and general anesthesia every time. Iowa state small animal hospital did the surgery. Maybe if there is a vet school by you they would be more open to the idea. I am very surprised that in socal the vets are so unwilling. It's true that cats generally don't tolerate the surgery as well as dogs, but my cat is in the minority of cats who won't eat again.

 

[fionasmom]

I am a little surprised as well that you can't find anyone in So Cal. Can you get to UC Davis or contact them for a reference?

 

[botolo]

Hi Jennifer, how is your cat doing? My cat may go into surgery in the next few days. I am so scared right now.

 

[Jennifer1984]

Hi Jennifer, how is your cat doing? My cat may go into surgery in the next few days. I am so scared right now.

So you found a surgeon! That's good. Gabby is still doing fine, but not eating or drinking. They did have to take her whole lower jaw. Hopefully if they caught your cat's cancer quick enough they might just take part of the jaw, that might make it easier for them to figure out how to eat again too. Gabby requires more care then the normal cat, but I still don't regret doing doing surgery. They discovered the cancer four months ago and it was growing fast, so she probably wouldn't be with us today without the surgery. I need to feed her four times a day, clean her feeding tube stoma, make sure her tongue stays hydrated because now it hangs out, clean her up because now she can't groom.

 

[botolo]

I am glad to hear that Gabby, while not eating, is still doing well. For Holly we will know more on Monday. In theory they have to remove a big chunk of the lower jaw, they are talking about radical mandibulectomy. The left jaw is compromised and the right jaw is partially compromised. This evil tumor moves very very fast. She always did well, I just noticed some drooling a few days (3 or 4) before bringing her to the vet and, boom, the cancer was already all over the place in her mouth.

 

[botolo]

Jennifer, can you tell me a little bit more about the first couple of weeks when Gabby came back from the hospital? Holly just came back yesterday and we are taking care of her. Just wanted to know what to expect in the next few days in term of Holly's energy, pain management, etc.