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Oral tumor - no hope

11K views 35 replies 14 participants last post by  Arianwen  
#1 ·
Two and a half years ago, I took in a small cat (Jenny) who was on the street and really needed some help. I had some challenges with her, if you look at my previous threads you can read about her a bit..

Anyway, I noticed a couple months ago that she wasn't eating quite right. She's a tiny cat and has never been a big eater, but the change was noticeable. Otherwise, she was still acting pretty normal.

Right about this time, she lost a piece of tooth after eating (I was watching her closely), and then things quickly improved. I thought, well, she must have had a bad tooth, and it came out, so now it feels better.

I felt along her jawline, and she seemed to have some swelling along her lower jaw. I made an appt with her vet clinic, thinking abscess.

The vet took one look inside her mouth and immediately didn't like what she saw, taking her straight away for X-rays.

The X-rays showed what was a bony growth taking over a small portion of her lower, right jaw. The tumor had forced out the tooth I saw her lose.

The vet immediately proclaimed it was likely cancer, and that there was little recourse except for palliative care. She did briefly discuss the possibility of surgery to remove that portion of the lower mandible, but that option was never seriously discussed.

She sent her home with a shot of Convenia, just in case this was some form of abscess, or if there was an infection coinciding with the tumor. She also wanted to see her back in 10 days to check progress. She also gave me an Rx for Tramadol, in case Jenny started having discomfort.

Jenny had a very good 10 days, she gained back some weight and seemed to respond positively to the Convenia shot. She was eating well, and acting normally. Maybe not her full energy levels all the time, but still upbeat and doing her usual things. I didn't feel the need yet to give her any of the Tramadol..

The vet was pleasantly surprised she'd had a good 10 days, but felt the tumor and said it did feel larger to her. The option of starting her on prednisolone was briefly discussed, she said she would give me a Rx to start it anytime I wanted..

She sent her home and said let her know immediately when there was a change for the worse.

I've of course researched quite extensively, and I see how pervasive these types of oral tumors are in cats. Even tho the vet didn't feel the need to biopsy the cancer for certainty, the vast majority of these types of tumor are squamous cell carcinoma, for which there is very little treatment other than radical surgery. This type of cancer also has a high recurrence rate, even tho it does not often spread beyond the tumor site.

Doing some searching, I see that forum member laurief lost a cat to this horrible cancer, and that she faced the same lack of recourse that I'm facing..

So, anyway, that's where I'm at. Jenny is not an old cat, the vet places her as middle aged at most. Her body would still have many good years left, but this tumor will grow and grow until her ability to eat is so compromised, that she will have to be euthanized.

Maybe the prednisolone would slow the tumor growth a bit, make her more comfortable, but when to start it? She's still eating well now and is still bright. Rather start it too early than too late...?

There's a NSAID called piroxicam that I see is sometimes used to good effect with this type of cancer, perhaps I should inquire to the vet..

In the meantime, it's just very hard to know this tumor is just going to grow and grow, and there's nothing that can be done. I just feel terrible for Jenny, she deserves more..

In the meantime, of course I'm doing all I can to make her remaining time as pleasant as possible...

Thanks for the feedback..
 
#2 ·
I'm very sorry, I don't know much about cancer in cats, and I really hope that the vet is wrong, and that it's not a malignant tumor. I know he didn't think it needed to be biopsied, but I think I would want one. Hopefully you will get some better advice here from someone who has dealt with this. I'm so sorry you are dealing with this.
 
#3 ·
Pokey,
I'm so sorry:'( I know I'm probably looking at the sad fact, that one of mine, will develop Stomatitus at some point, so he gets checkups...
One of things I learned, it that the lower jaw on cats, is very thin, as compared to a dogs lower jaw, this is what makes surgery so iffy for a cat with lower jaw issues...there's just not a lot of bone to work with...

To find out that Jenny has, what does sound like cancer in her jaw, is Heartbreaking...
I am so glad you saved Jenny, and have given her Love and care...no matter what, she's known love, and that's because of you...
I wish I had some words of useful advice for you...
All I can offer is (((HUGS))) and Prayers...
Sharon
 
#4 ·
Feline Oral Squamous Cell Carcinoma is a horrible disease, and yes, I did lose my beloved Noddy to it. If he had been a younger cat, I might have gone for the radical jaw surgery, but he was already in his late teens, and he already had other physical issues. I just couldn't see putting him through that sort of surgery at his age.

What I recommend for you, though, is to get that biopsy immediately so that you have a firm diagnosis, then schedule a telephone consult with one of the veterinary oncologists at Colorado State University's Animal Cancer Center. They offer these telephone consults for free, and you can schedule it either with yourself or with your vet. Before the phone consult, you will need to email or fax them copies of ALL of Jenny's test results and exam reports from your own vet (blood tests, x-rays, pathology report, etc.). The more information you can get to the Cancer Center, the more useful your phone consult will be. The oncologist can tell you about this type of cancer, including any available treatments or management strategies. If you provide adequate information about Jenny, the more accurate and targeted the information they can provide in return. Here is a link to the Cancer Center's consult request page:

Colorado State University Flint Animal Cancer Center - Fort Collins, Colorado - Consult Service

Don't waste a minute, whatever you decide to do (including starting the pred). This is a VERY aggressive and fast-growing cancer. Every second counts!

Laurie
 
#5 · (Edited by Moderator)
So sorry to hear this. This truly must be horrible for you. The last thing I want to do is to give you false hopes or something, but it might be worth it to take a look at the nutritional side of things.

Right now there is research done into looking at something called a Ketogenic diet and how it might starve cancer cells. The short version is that cancer cells need glucose to live, but healthy cells can live on fat. By limiting all carbohydrates (and increasing fat intake) the cancer cells do not have fuel and die.

The research is very premature and controversial, but since cats are obligate carnivores anyway it might be worth a shot since a ketogenic diet won't harm them in any way. This would probably mean eliminating all dry cat food and or making your own cat food. Read more here about the "keto diet".

Ketogenic diet - Wikipedia, the free encyclopedia
 
#6 ·
Pokey,
I'm so happy that Laurie responded to your post! She is so knowledgeable about some of these things...and I know some of the knowledge was sadly learned the hard way...

Michelle's post sounds interesting...
That could be something to run through the Animal Cancer Center, that Laurie recommended...
Please keep us posted.
(((HUGS))) and Prayers,
Sharon
 
#7 ·
The fact that cancer cells feed on sugars (carbs) is not new information. I read about that years ago. I do believe that cutting ALL carbs out of Jenny's diet would be a very wise move, assuming she will adequately eat a carb-free diet. Please note here that carb-free does NOT necessarily equate with grain-free. Many grain-free foods are packed with carbs in the form of high carb fruits and veggies.

Pokey, you mentioned piroxicam. I am completely unfamiliar with that drug, but it would certainly be worth discussing with a veterinary oncologist.

Laurie
 
#8 ·
I lost my darling Trixie several years ago to the same problem but at least she was well over 20 at the time. She was "fine" for quite a while after diagnosis and was never in apparent pain. I made the decision to have her PTS at home when she had developed a problem with drinking and dehydration. I was in consultation with the vet all the time (my practice was probably sick of me) but it did mean that I felt I had chosen the right time.
 
#9 ·
Almost 10 weeks since my original post, and these days it's all about wondering when Jenny's had enough. She's done remarkably well since her diagnosis, most of the time she's eaten well and pretty much been herself. She's been receiving Convenia and Depo Medrol shots every 2-3 weeks and has done well with them. She was an almost impossible cat to pill before the tumor (imagine after), so those shots have been a blessing in supportive care.

But the tumor grows ever bigger, and now infiltrates and surrounds her right jaw back to front, as well as underneath her pallet. She has some remaining back teeth that are surrounded by tumor and I believe are really troubling her, as her chewing seems to have become more difficult. She had a very bad week and we were preparing to stop with her.

On the day of her appt, she seemed to rally a bit. I told the vet my concerns, and we agreed to another series of shots, and see how she was doing a couple days later. Another appt was made to end things on Friday if she continued to decline.

But, the shots did help again. She's been eating better and easier, and her attitude has also improved somewhat. She uses her scratcher with great enthusiasm, jumps on the beds, and still head-butts me over and over while purring. I have no doubt she's in considerable discomfort, but it's hard to pull the plug when she's still doing some normal, happy things. I know the general rule is better too soon than too late, but it's really hard, as I don't have to tell anyone here..

So I think I will cancel Friday's appt, and hope she can get thru the long holiday weekend continuing to hold her own.
 
#10 ·
I just saw this thread. I am so sorry about Jenny's battle with cancer. I will be praying that whatever time Jenny has is filled with happiness and pain free. I really hope you guys have a wonderful and restful long weekend. Hugs!
 
#12 ·
Enjoy every minute you're together with her. The 'when' decision is never easy and often followed by regret. Don't allow regret to enter your minds, you've done well by Jenny to show her love and take care of her physically since she joined you. I wish you and your wife well.
 
#13 ·
You've been so fortunate and done extremely well to keep her reasonably comfortable for 10 weeks. I wish I'd had that much time with Noddy after his diagnosis. I do know, though, exactly what you're going through right now. I've been through it with three of my cats since the end of October. We cling to any sign of continuing quality of life, and try to turn a blind eye to the other side of things. That blind eye, though, actually sees every struggle and painful moment. Eventually, that "other side of things" will overwhelm any remaining quality of life, and you'll make the unavoidable decision. You're in such a horrible place right now, and I'm so very sorry for you and Jenny.

Be sure you have access to an emergency vet over the weekend, just in case. I lost Weasel this Mother's Day. For some reason, my animal family's most critical emergencies often seem to happen on holidays.

I wish you and Jenny the best possible outcome. My heart breaks for you.

Laurie
 
#15 ·
There are some articles about hospice care for cats. Might learn something, might just feel reassured by others in the same situation.
I don't really remember much of the time after my sweet Cricket's FIV went into full blown AIDs. I wish I had reached out, others with creative minds may have found natural pain killers, appetite stimulants, etc. My heart is with you.:2kitties
 
#16 ·
Many thanks to all for your kind words and advice, it is so much appreciated. Jenny had a good morning, spending several hours stretched out and sun-bathing next to a big glass door, and she did well on the pate slurry I mix up for her too. Hopefully she can maintain this level through the long weekend, at least. Thanks again!
 
#17 ·
We had a beloved kitty Biggy who had oral cancer as well. We had it cut out twice, the first time it grew back very slowly - in fact we hadn't noticed it was back, but once that was cut out again, it grew back with a vengeance the second time :( It was so sad. He loved eating, and still would. He still played. Still wanted to lay on our laps but it became hard because the irritation of the tumor would cause him to shake his head and saliva would get on us. It was very sad the day we decided we had to put him to sleep.. we played with him one last time before leaving. It is hard, but it wasn't going away. Sure, we could have had it cut out again, but it would likely be back in another 3 months just as bad, if not worse. I hope you can enjoy your time with your kitty and that they remain comfortable until either they pass along, or you let them pass along.
 
#18 ·
Jenny has a vet appt tomorrow, and it's looking very much like it will be her last. The shots she got 10 days ago did marginally improve her (tho not as much as they had previously), but the last few days have been pretty tough. She looks miserable, and acts like it too the majority of the time. Her energy levels are extremely low. With gentle encouragement she does make courageous attempts at eating her "slurry", but she has to take frequent breaks to grab at her mouth and painfully "chew", even tho the food itself requires no actual chewing. And there's often bloody drool that disrupts the efforts. Am I to wait until she can't eat at all? No thanks.

So, I think we're at the end of the road. She's really not truly meeting any quality of life markers anymore. I could probably drag things out for another week or more.. who knows.. but I'm at peace with ending things here.

Thanks again to all for your input and advice.
 
#20 ·
When Trixie had to be put down with a similar problem, it was a hard decision but we knew it was coming - as you do now. The vet came to the house for her and she had a good last morning sitting on the keyboard and being fussed but although she was purry and cuddly, she was also becoming dehydrated and wasn't eating. It was a good loving send off - I wish you the same. But it will hurt. I consoled myself with the fact that one day I will cuddle Trixie again - I don't know where you stand on such things but I hope your baby will be waiting for you when your time comes.
 
#21 ·
I think Jenny saw me out the window yesterday literally digging her grave, cuz she decided to perk up in the evening. She was also pretty good this morning. So.. I couldn't bring myself to end things today. Instead she got some more shots..

I was 95% convinced this would be it, but apparently I need 100% to make the call. I hope we both don't regret it.
 
#24 ·
Her body would still have many good years left, but this tumor will grow and grow until her ability to eat is so compromised, that she will have to be euthanized.
Three months to the day after I wrote this, it's exactly what happened at 11am this morning. Jenny had an extremely rough few days, and it was time to let her go.

Tiny little Jenny felt everything very intensely. Her dislike for the other cats in our household was matched only by her devotion and affection for her people. She fought an amazingly courageous battle against this insidious disease. I'm almost more angry that this happened to her than I am sad at her passing. But life, whether for people or cats, is seldom fair.

Godspeed, girlfriend.
 
#26 ·
Bless you - I had to make the same decision with Trixie for the same reason but it is never easy. All you can do is tune into them as much as possible and take their guidance as to when they are ready to move on. You are a good owner.