Month: July 2014

The vet told me how calm and relaxed Kender was being the whole time she was there.  They even contemplated not putting the cone on her.  But of course, as soon as I set her carrier in the car she started meowing and trying to get her cone off!  Within 5 minutes of being out of her carrier at home, she had her cone off…but not before spilling water all over her head in the process.  And a few minutes after that I had to stop her from trying to lick her incision.

I sat with her for a little while so she could have some cone-free time.  During which she peed and just laid there in it, like she didn’t even notice.  This worried me a tad, but it is more than likely a combo of anesthesia after effects and the pain meds.  She didn’t seem to notice much when the water spilled all over her either.  Changing her blankets and cleaning her up as best I could sure got her riled up though.

She seemed really glad to have some pets and loves for a while, purring most of the time.  My five year old came in a gave her lots of lovey pets, too.  Sadly, I eventually had to put the cone back on her so I could go get kiddos ready for bed.  I set up our video monitor we use with the toddler so that I could make sure she kept her cone on this time.  She fought with it off and on for a while, spilling her food in the process this time, but it’s stayed on and she’s been resting for a while now.  I need to give her a dose of Buprenex soon, but also feed bad about waking her now that she’s finally settled down!  But allowing her pain to get worse is no good either.  Hopefully she’ll be moving around a little better tomorrow and using the litter box.

Despite all the pictures I’ve seen on other blogs, her surgery site still surprised me a little.  Her pelvis seems far more pronounced than in the other pictures I’ve seen.  And her incision is not a single straight line like the others I’ve seen, but more of a T shape.  Also, with all the hair shaved off, I realize she’s chubbier than I thought 😉

 

I took Kender in bright and (way too) early this morning for her surgery.  They first did x-rays while I waited to check for any metastisis.  She said they looked all clear to her.

Originally, she was going to do Kender’s surgery first so she had longer to recover before coming home.  But upon further thought, she decided to do her second.  Her kidney levels were slightly elevated a few weeks ago, so she wants to give her an hour or two on IV fluids before putting her under anesthesia to minimize risks.

I should expect a call about how everything went around noonish (Pacific time), so I’ll update then!

**UPDATE**

Just heard from the vet and everything went great!  She has her pain patch on and she did a one-time antibiotic injection, at my request, so I don’t have to attempt to force Clavamox drops into her after all of this.  She is NOT good about taking medication and I was worried about having to fight her in her condition.  The Buprenex she’ll be taking is a small dose and she’s not as bad about taking that.  I can pick her up in about 3.5 hours to come home!  HUGE thanks to everyone for the emotional support today 😀

 

This seems to be my mantra lately.  They say hindsight is 20/20 and I’ve sure been shown that a lot this past month.

I wish I had….

…waited for an appointment with my usual vet and/or listened to my gut and pushed for a more definitive diagnosis when it was telling me this was not an abscess.

…not put Kender through the pain of lancing and draining an abscess that didn’t exist.

…skipped the biopsy and instead opted to have the whole leg tested post-amputation, rather than putting Kender through even more pain of a biopsy that yielded very little useful information.

I know holding onto all of this and stressing about it does nothing productive at all.  But I’ve always had a hard time letting go of the past and moving on.  Plus, seeing my poor track record so far makes me scared that the next decision I make will be another wrong one.

The oncologist suspects it’s likely histiocytic sarcoma or tarsal lymphoma.  I can find next to no literature on feline tarsal lymphoma, but the oncologist said it is something they are seeing more of recently.  The oncologist said each of these should be treated with chemotherapy in addition to amputation.  The research I’ve done shows a disparity in whether chemo is necessary for histiocytic sarcoma or not, but I’m no expert.  Of course, to do chemo we would need a definitive diagnosis to determine which drugs to use.

The vet recommends sending in the amputated leg for two reason.  One is to be certain we have clean margins.  The other is that they may be able to get a definitive diagnosis from another area.  But if they can’t, then they would have to do immunohistochemical staining to get a diagnosis.

I wish money didn’t have to play a role in all of this, but it does.  The credit cards can only take so much.  We’ve essentially “wasted” $700ish so far on antibiotics, abscess draining and the biopsy.  So I’m also faced with the decision of what to do post-amp.  Chemo or no?  If we are going to do chemo, do we test the leg for margins (how much will this matter if we are doing chemo anyway) and hope they can also get a definitive diagnosis?  Or just jump straight to the staining, which costs about $100 more than histology of the leg?

Of course, this all may be moot if the pre-op x-rays show the cancer has already spread throughout her body, which is a very real possibility with how long it’s been.

I wish I had…a crystal ball to tell the future with.

Kender’s swelling was kind of starting to worry me, so I called the vet this morning to ask about it.  She wanted us to come in to look at her just to make sure it didn’t look infected from her biopsy.  This also gave me a chance to ask questions about her surgery and recovery.  The biopsy results weren’t in yet, but she called the lab and they said she’d have them sometime today. She’s going to do Kender’s surgery first that day, so that she has all day to be observed during recovery.  They don’t have anyone there from 6 pm to 7 am so the plan is for me to bring her home that evening.  If any emergencies arise, I can take her to the after hours emergency clinic.  She’ll get hydromorphone before, during and after the surgery to help with pain and come home with a fentanyl patch on.

Just got a call with the results.  Unfortunately, they’ve left me with more questions than answers.  They classified it as a round cell sarcoma, but could not definitively diagnose the type.  Narrowed it down to synovial cell sarcoma, histiocytoma or lymphoma.  I’m really hoping it’s not lymphoma since it will likely have spread by this point.  She said they could do immunohistochemical staining to the samples to try to get a definitive answer, but the results can take up to two weeks to get back.  She’s also going to consult with an oncologist about the results and should hear back from them by Wednesday. We both still think that amputation is best at this point due to how quickly it is growing and the amount of pain/discomfort she’s in.  Plus, waiting for the staining results only gives the cancer more time to potentially spread.  For the first two types, amputation is usually considered the best course of treatment anyway.

It just dawned on me that I should have asked about doing x-rays to see if anything shows up there.  If it’s already spread all through her body and she doesn’t have much time left, amputation doesn’t seem like the best choice.  I’ll discuss that with her when she calls about the oncologist consult.

I was really starting to feel at peace about this whole thing and accepting that she had cancer, but amputation would more than likely treat it.  Now I’m back to facing the reality that my cat may need to be euthanized.  I’m ready to get off this roller coaster now.

I was really hoping we’d have the biopsy results back by Friday so I didn’t spend the entire weekend wondering about them!  But oh well, it is what it is and I’m doing my best to be patient.  Hopefully, we’ll hear back tomorrow (Monday).  I’ve also made a list of questions to go over with the vet when she calls with the results.  So I guess on the plus side, it’s given me more time to work on that.

I’ve also been working on cleaning out our spare room for Kender to be in after her surgery.  Right now it’s a combo storage/play room, so I have my work cut out for me to make it safe and comfy for her to recover in.

Her poor little paw seems to get a little more swollen every day.  It must be so horribly uncomfortable for her.  I’m glad she has some pain meds (Buprenex) to help with the discomfort.  You can see in the pic below how huge it is compared to her other one.  I know amputation surgery is a very serious operation, but I’m glad it’s an option that will (after her recovery period) relieve her of this horrible discomfort and pain.  I’ve had a cut off baby sock over the leg to keep her from messing with the stitches from her biopsy.  Most of the time she only seems slightly annoyed when I change it out with a fresh one.  But last night, when changing it, she about took my hand off.

I was so freaked out about the thought of taking off her leg before.  And I’m sure that I’ll have a mini-freak out when I actually drop her off for the surgery.  But after hearing all of the positive outcomes here and seeing how much pain and discomfort she’s in now, I wish we could just get it over with already and start on the road to recovery!  Four more days to wait…

Saw our usual vet today.  I really wish I’d just held out for an appointment with her when this whole thing started.  She always takes to the time to listen and discuss things with me.  Oh well, regret won’t help anything now.

She took some x-rays of Kender’s leg.  The bone looks really good, so not chondrosarcoma or osteosarcoma like I was fearing.  But the soft tissue looks questionable.  The vet strongly suspects fibrosarcoma at this point.  She took a few punch biopsy samples of the area to send off to the lab.  We should have the results in 2-4 business days.  The swelling in her paw is getting so much worse.  It’s most likely from the growth restricting the lymphatic system from draining.

If it’s fibrosarcoma, then amputation is usually sufficient treatment.  The vet said it can be really aggressive locally, but doesn’t usually spread to other areas. If it’s going to be cancer, then I hope it’s that because chemo and amputation is not a very realistic option. Even amputation I am iffy on since she’s so old.  I’m really nervous about doing chemo since the kids could be exposed to it, especially because Kender is notorious for not using the litter box to urinate when she is upset or not feeling well.

Her surgery schedule fills up quickly, so I made the first open appointment of 7/31/14 for the amputation in case that’s the route we decide to take.

 

My poor kitty is getting worse. Dr. Google has me strongly suspecting cancer…

Trying to get the “should’ves” and “what ifs” out of my head so I can sleep. I know they help nothing and just bring me down, but still so hard to kick them out of my head.

The area is still just as inflamed as when I first noticed it (maybe more…hard to compare now that it’s shaved), but is hotter and the rest of her leg is more swollen than before. She also favors it a lot more now…before she was walking normally. Her kidney values were also slightly raised when they did her pre-op bloodwork, which I read certain bone cancers can damage the kidneys due to rising blood calcium levels. I wish I’d just done an x-ray in the very beginning.  I know it’s really rare, even more so for females, but the whole thing has progressed almost exactly how chondrosarcoma is described. But I really hope I’m wrong cuz that doesn’t look good for her if I’m right.

I had a recheck appointment scheduled with our usual vet for 7/25, but I’m calling in the morning to see if I can get anything sooner.

After 5 days of antibiotics, Kender’s leg was getting worse.  The lump area seems slightly larger and warmer and the rest of the paw is noticeably swollen.  I tried to get an appointment with our usual vet, but she doesn’t have an opening until Tuesday afternoon.  I didn’t want to see the same vet I saw on Monday, so I took her to a different office where a friend of mine worked as a vet tech.  They requested and reviewed the records from my usual office and did a thorough exam on her.  The vet felt the best course of action would be to sedate her and lance/drain the “abscess”.  Now I’m wishing I had just done this in the beginning, but was hoping to spare her going through this!

The vet said it looked pretty atypical when she drained it. Just some bloody fluid and none of the usual pus.  Said it could just be because she’s already been on antibiotics for a while. But there was also a harder area that she said could be an underlying problem, but is hard to tell with all the inflammation without doing further tests. If it isn’t vastly improved in a week, she recommends doing a biopsy and/or x-rays to see if those can give some answers.  Her kidney levels were also slightly high on her pre-op blood work.  Not enough to be really worried about now, but we should recheck them in a few months to make sure they aren’t getting worse.  She gave us a couple days worth of pain meds and said to continue the antibiotics previously prescribed.

I’m starting to feel worried about this whole thing now.  I had a good cry with Matt tonight…I really feel like we might be dealing with something more serious.  I hope I’m wrong.

 

Kender’s leg hadn’t really changed much over the long weekend.  I had given her some Benadryl and it seemed like it maybe helped a tad with the swelling, but the main lump in her ankle was still there and felt slightly hot now.  I called our vet’s office first thing in the morning.  The vet we usually see didn’t have any open appointments for 2 days, so I agreed to see one of her associates that morning instead.

The vet seemed somewhat distracted as I was relaying to her how/when I first noticed this and that I suspected some sort of bite or sting.  On two separate occasions she asked me the same question twice.  She said it was most likely an abscess from a prior wound that we hadn’t noticed until now, most likely from a fight with another cat since I’d told her she goes outside.  I told her I thought that was highly unlikely because there was NO scabbing or signs of any wound on her, there are no other cats in our neighborhood except for our other cat and she never leaves our fenced backyard.  This discussion took about 5 mins.  She told me she was going to prescribe antibiotics and offered to lance/drain it that day as well or gave me the option of trying the antibiotics first.  Since I wasn’t convinced it was an abscess, I took the less invasive approach and took antibiotics only.  She offhandedly mentioned we could do an x-ray to rule anything else out, but didn’t elaborate from there.  The next 5 mins she spent lecturing me on her being a few months late on her vaccines, especially since I let her outside and that we should for sure be vaccinating her at her recheck appointment in 2 weeks.  Overall, I got the impression she was more worried about the vaccines than the lump on her leg.

I’m to give the antibiotics until they are gone and come back in 2 weeks for a recheck, or sooner if things get worse.

[Note:  Posts from here until 7/25/14, the day I started this blog, are back-dated from facebook posts/personal recollection.  Kender is my 14 year old gray tabby DSH.]

Not a great way to start the holiday weekend…just let Kender inside before bed and noticed one of her back legs is really swollen and tender. She looked a little glassy/weepy eyed too. Think she got bit by something.  She stayed out way later than usual tonight.

Upon closer inspection, it isn’t so much swollen…more like a lump…wasp maybe??  Thankfully, she doesn’t have the symptoms of a black widow bite (at least according to what I found on Google).