How I Got Here.

I am not certain when the tumor came on, but I was boarded with my twin sister, CeeCee for most of the month of November, 2014.  My human mom’s Dad was having serious health problems out in the Midwest (he eventually passed away from these on November 17th, at the age of 91 and after a truly full life).   At any rate, the vets called mom up and asked her if she knew anything about a growth on my left forelimb.  No, she’d never seen it.  When she got back to take CeeCee and I home, she checked me out, and gave permission for surgery and biopsy within a few days.

The vet right up front said there was no way she’d be able to capture all of it.  A cat’s forelimb is very thin, and there are several major blood vessels in there.   But we could grab as much as possible, biopsy and then plan what to do.

So, that’s what happened, and I came home that night with my very first Elizebethian collar, which I spent most of the next couple days trying to back out of.  Worse yet, my sister CeeCee decided that I looked so unhappy that she felt quite justified in tormenting me.  Once I escaped from that collar, I paid her back!!  The other thing was I kept flipping it the wrong way around, so it was hard for me to eat.

Don’t get me wrong — she and I love each other, but she’s always been one for instigating things.  I’m mellow, but at the end of the day, you have to be top cat.  Or she’ll keep at it.

Anyhow.

The biopsy came back as “extramedullary plasmocytoma”, which is a tumor not well-understood in cats, but which in dogs (why oh why do I live in a dog-centered world?) is usually “benign”, which means while it may grow fast, it doesn’t tend to go systemic.

I saw a specialized oncologist on 12/23/14.  We did a draining lymph node aspiration and a urine analysis, and bone/chest x-rays.  (The x-rays were actually done back at the regular vet, but the vet here analyzed the bone work-up.)  Mom declined the sonogram.

The urine analysis would determine if there were markers for systemic cancer.  This turned up negative.

Lymph nodes collect stuff from circulation — draining lymph nodes are those which are near the site of infection/tumor/what-have-you.  They’ll be the first affected if a tumor is beginning to go systemic.  (Mom actually is a research immunologist by trade, so even though oncology is not her field, she understands the basic biology.)  So, you have to go find the lymph nodes that reside near the armpit, which in a living cat is sometimes difficult or impossible.  Nothing could be determined in my case.

The bone scan of my forelimb showed no tumor development in the bone.

I was given three options:  Radiation therapy, amputation, or palliative care.  No one asked me MY opinion, which would have been a Deux ex Machina perfect cure without a single side effect.

Mom opted for radiation initially.  The incision has to heal up a bit before it can be done — radiation damages skin.  By this point the tumor had started to re-grow.  She got down to the radiologist mid-January, taking the afternoon off from work to do so.  To be told that the appointment date and time she’d immediately written down was Wednesday at 1:30 pm instead of Tuesday at 1:00 pm.  And no, the referral doctor wasn’t in today….

It’s a 40 minute drive one way to the vetinary radiation facility.  Mom couldn’t return the next day.  She set up the appointment for the following Monday and got written confirmation.

Meanwhile my tumor was growing, and growing.  I think I could actually Watch it grow.

The following Monday we got slammed by snow and ice.  I didn’t make it then.  Mom made an appointment for the following Monday.

But on that Tuesday, she took a good look at me, noticed an ulceration, and a vast amount of new growth.  Suddenly, amputation was back on the table.   I went back in on Wednesday to the local vet.

If I had an amputation, my choice (well, mom’s choice) was the local vet or the oncologist I’d seen back in December.  Both seemed competent and had done this operation often before.  Mom went with local.

Mom planned on seeing the radiologist with me the following week, anyway, but weather intervened again.  He’s, however, been in consult with the other vets during this process.  I do recommend keeping everyone in the loop as you can.  Don’t just get one viewpoint, or just one option.  And do lots of web-surfing, keeping your BS-detectors in high gear.

Why mom went with amputation over radiation at the end:

Her self-serving reason:  radiation is a weekly process of at least six weeks.  Since the facility is 40 minutes away, this would mean having half-work-days for six weeks, on top of what any heavy storms might throw at us.  It being winter and all.  And the Driveway from Hell.

Her biological reasons:  Six weeks is good for a cat or other creature with a moderate re-growth.  This was aggressively-regrowing.  I also had the development of ulcerations, which adds to the problems with radiation and skin damage.  And, third, if this thing hasn’t gone systemic, I probably stand more of a chance of the tumor re-developing — considering this aggressive re-growth and the thickness of the tumor, by going the radiation route rather than the amputation route.

Even so, the amputation is no guarantee of success.  Some tumor cells may well have escaped over to my body at large.  My last x-ray, two days before the surgery, showed no lung involvement — a lot of systemic tumor cells rather like to migrate over into the lungs.  Not much is really known about this particular cancer in cats.  That’s why palliative care was offered as an option at both my regular vet’s and at the oncologist’s.   Plus, it is a viable option if you can’t swing the funds, or if you think a nine year old cat won’t get much benefit out of this.  (If I, Rory, were 12, the chosen option would have been palliative.  Or so she thinks at the moment.  I don’t see her being that heartless…)

Operation:  2/6/2015.