My lovely Katie has cancer

[ldg]

Any further word on Katie? :cross:

 

[katiesmummy]

Update on Katie - good news but some uncertainty !  advice appreciated!  There is no sign of cancer in liver or spleen which is great - however the cytology results on cells from intestine are "inconclusive" in that the mass/abnormality gave insufficient cells to reach a diagnosis. However the ultrasonographer was "confident" that he was looking at an intestinal tumour when he did the needle aspiration biopsies on intestine, spleen and liver. He did say that he was undecided about liver and spleen and that the abnormalities could be age - related and indeed that appears to be so. We have 2 options  - monitor Katie and see how she goes or subject her to an operation for removal of the mass, intestinal resection and a subsequent biopsy of mass so we would know what it was. Katie has now not been sick for 9 days - she is eating well, happy and purring and her normal self! that makes it all the more difficult to put her through an op at present! Apparently endoscopy can't be done because the problem is in the ileum which is not accessible via endoscopy. The cytology was done twice by different people and both times was inconclusive. As far as I am concerned Katie is asymptomatic at present though she has lost some weight so this is something which will be monitored next week when we take her to the vets. I would like to know what others think and if anybody else has had results whuch were of an inconclusive nature. The vet feels that Katie's vomiting symptoms ( which made me take her to the vets in the first instance) could have been furball related and not connected to the abnormal finding in the intestine . I asked if she could perhaps have IBD but was told probably not as the intestinal lumen was clear and this would normally be inflamed in IBD. I also asked if Katie had maybe had this " abnormality" since birth but was told that the ultrasonographer thought that unlikely. Advice and comments gratefully appreciated - meanwhile Katie is tucking into a plate of poached salmon fillet in butter !

 

[ldg]

Wow, this is a tough one! Our Lazlo has lymphosarcoma, his is a mass in his stomach that has not spread. It was not operable, but he is responding really well to chemotherapy. When we discussed cancer(s) with the oncologist, we were told that masses other than in the esophagus and stomach were more difficult to treat, as they're typically non-operable, and as they grow, the problem becomes one of blockage, e.g. the cancer may not directly cause the death of the kitty. (Sorry to be so frank here, but I think you need the information).

However.... she's asymptomatic, and the biopsy was inconclusive. Further, your Katie is 20 years old... she's lived a long and wonderful life, and surgery may be more of a problem for a lady... of her age, so to speak. Lazlo, on the other hand, is 9. If surgery had been an option, we would have taken it. :nod:

I think you need to give it a few days, and find some quiet time to let your heart explore the options. :heart3:

But here's some input I might want before taking that time:

What is the risk to her of having surgery now? Of course, surgery at any time is always a risk, but what are current health and age-related risks?
Because if you wait, and it turns out she could have benefitted from the surgery... will she be strong enough THEN for the surgery?
A question we always ask the vet treating our kitty... if this were YOUR cat, what would YOU do?

Katie has lived a long and wonderful life. Is it worth putting her through the surgery? Even if it is... what type of cancer? Most likely lymphoma, right? Because if it IS cancer, and does grow - would chemotherapy without surgery an option in the future? For Lazlo, it had shrunk the "massive" mass in his stomach (8mm) by 40% in two months of treatment. The specialist wasn't overly happy with this, but we've taken to calling him "Dr. Doom and Gloom," because HIS definition of remission is the tumor GONE. And while that's great... the fact of the matter is that Lazlo obviously feels great. Only about 15% of cats do not do well with chemo. They may not feel well for a few days after the chemo treatment, but with attending medications (prednisone, an appetite stimulant, and anti-nausea medication - and sometimes an antacid), they do very well. That said, with lymphoma, the odds of remission with chemo are about 50%.

And with animals, the goals of chemo are completely different than in people. With animals, the goal is quality of life and comfort. With people, chemotherapy is much more aggressive (and thus all the side effects due to toxicity issues), because the goal is increasing the length of life. Many people - most, according to our vets - opt not to treat cancer, but instead make kitty as comfortable as possible until it's time. :heart3:

Things to consider... how does your kitty deal with vet trips? Lazlo handles them fine, and doesn't overly stress. I have no problem getting all of his medication into him, and it's not stressful for either of us.

So if you opt not to treat via surgery now, if in the future she'd need chemotherapy... would that be a problem?

I don't think I answered your questions... but I hope this has helped.

 

[katiesmummy]

Update on Katie - good news but some uncertainty ! advice appreciated! There is no sign of cancer in liver or spleen which is great - however the cytology results on cells from intestine are "inconclusive" in that the mass/abnormality gave insufficient cells to reach a diagnosis. However the ultrasonographer was "confident" that he was looking at an intestinal tumour when he did the needle aspiration biopsies on intestine, spleen and liver. He did say that he was undecided about liver and spleen and that the abnormalities could be age - related and indeed that appears to be so. We have 2 options - monitor Katie and see how she goes or subject her to an operation for removal of the mass, intestinal resection and a subsequent biopsy of mass so we would know what it was. Katie has now not been sick for 9 days - she is eating well, happy and purring and her normal self! that makes it all the more difficult to put her through an op at present! Apparently endoscopy can't be done because the problem is in the ileum which is not accessible via endoscopy. The cytology was done twice by different people and both times was inconclusive. As far as I am concerned Katie is asymptomatic at present though she has lost some weight so this is something which will be monitored next week when we take her to the vets. I would like to know what others think and if anybody else has had results whuch were of an inconclusive nature. The vet feels that Katie's vomiting symptoms ( which made me take her to the vets in the first instance) could have been furball related and not connected to the abnormal finding in the intestine . I asked if she could perhaps have IBD but was told probably not as the intestinal lumen was clear and this would normally be inflamed in IBD. I also asked if Katie had maybe had this " abnormality" since birth but was told that the ultrasonographer thought that unlikely. Advice and comments gratefully appreciated - meanwhile Katie is tucking into a plate of poached salmon fillet in butter !

 

[katiesmummy]

thanks Laurie for your very informative reply -  you basically echo all my concerns exactly! I asked the vet what she'd do if it were her cat and she said that really she'd want a specific diagnosis - and I tend to agree. The vet said that Katie's age should not be a preclusion to surgery - she is a physically strong cat ( had 5 teeth out 10 months ago and was playing within an hour of coming round from anaesthetic!) she is on tablets for hyperthyroidism, hypertension, and renal insufficiency along with renalzin as a "phosphorous mopper-upper". she has regular bloodwork and all her haematology is in normal range for her age. She is a very laid back cat and although I don't know any cat who enjoys going to vets , she takes it all in her stride and is very placid. As she was recovering from her ultrasound last week, the vet told me she was purring away in their " cat ward" - though I suspect this may have been the effects of the buprenorphine! Tablets are no problem as she has them in butter, ham, clotted cream, philadelphia cheese etc! I am going to enquire further about the less invasive endoscopic biopsy as it seems that some vets feel that it is possible to examine the ileum. Our vet is excellent though she freely admits that intestinal physiology is not her forte, so I may get a referral to a specialist - either an oncologist or a GI specialist. As you say if this is a malignancy I want to "nip it in the bud" before It gets worse. Of course there is the risk of peritonitis from any intestinal op - regardless of the animal's age. It's a dilemma - Katie, i wish I could ask you what I should do!!! Thanks again Laurie for your support and big purrs to Lazlo who is doing so well xxx