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Freya Date – Day 1 AA (After Amputation)

Well, I’m calling it Day One. Day One After Amputation.

Today, 21 December 2012, I picked Freya up at the vet’s in the afternoon. After a hefty bill was paid (come on down pet insurance people!! Show me the money!! Wait – mixed metaphors there – who cares!) and pain killer prepared and antibiotics obtained (liquid form please) I see her.

She’s in a cage. She has a Cone of Shame. She is so pleased to see me!! I am so pleased to see her too! She’s moving around. Woops, bit unsteady there. Oh no, there it is. Not so bad really. Feel relieved. FYI, my vet used internal sutures, no staples, immeasurably less confronting.

I pick her up – it’s so quick there’s no time to wonder about right way and wrong way, she’s just in my arms. Then carry her to the carrier, she practically lunges at the thing. I think I actually got a face full of absent leg as she clambours in.

Back home and out she gets, weaving and listing,  into the luxuriously appointed recuperation room (the front room I use as a sort of library). I spent the last two nights clearing out obstacles and moving in a mattress for me and boxes for her, and decorating it appropriately.

It’s also Xmas and instead of heading home to Taree to my Mum’s, I’ll be here with the cat (don’t worry, I will be temporarily adopted for Xmas dinner). So I made the house a bit more festive and the recuperation room positively glows with candles (battery operated tea lights), crystals, flowers, colourful throws and beautiful pictures. It’s to be my home too for a few days (possibly longer as my bedroom is upstairs and that is where she normally sleeps, and I’m not sure how long until stairs are OK) and it needs to be beautiful and uplifting. The stuff I’ve read said make it dark and quiet and calm, keep her confined and all that, but I also chose to make it beautiful and inspiring.

She wanders slowly, listing to one side, staggering almost. Her front paws are a bit awkward as she lies down then gets up again. But lying down seems to cause no concern. Of dear, the Cone of Shame came off. Watch and observe if she licks the wound …. back goes the cone of shame (not agreeable to Freya at all).

She sees me prepare some food, lots of miaowing in agreement. Woofs it down, liquid pain killer and all – cone a challenge. The vet said she hadn’t eaten while she was with them, so really pleased to see that. She hasn’t gone to the kitty litter tray yet, which may pose a challenge.

Realise I need to give her some anitbiotics. Prepare the syringe and rapidly find out the ‘arrangement’ she and I had come to after her first surgery is null and void as the cone prevents me grabbing her by the scruff on the neck and prising  open her mouth. Dang. Darn. Drat. Review her known eating habits (all food fair game) and think if I hide it in some smelly tuna/broth then she might take it that way. Successs!!!

Right now? I’m creating posts on my laptop while lying stomach down on the mattress and Freya has taken up one of her favourite positions, curled up between my legs. Euphoria. Bliss. Contentment. Hope.

Freya at home after surgery
Freya at home after surgery
Close up of internal suture incision - no exterior sutures or staples
Close up of internal suture incision – no exterior sutures or staples
Freya at her food bowl on Day 1 after amputation
Freya at her food bowl on Day 1 after amputation

Bring on Day Two.

Surgery and Survival

We lay on the bed together that morning. I was reading – Freya was sleeping.

I turned a page and Freya scratched an ear … with a left hind foot. I stared. Part of me, the flippant ‘hide your pain’ part of me was all ‘enjoy that while it lasts’. Another part was quietly weeping inside.

Not all tears are an evil? (Take refuge in Tolkien) But I felt so bad.

I placed her in her carrier and off we went to the vet’s.

I took deep calming breaths. Did absolutely no good.  Tears were a constant pressure behind my eyes.

Hold it together!! You’re a professional person. You know it is the only option. Hey, there are people who are having much worse days than you. You have the money for the operation (your heart bleeds a little for those posts and pages you’ve seen in your frantic scouring of the internet for all the information you can find where they know their finances cannot give them a choice).  You take another breath. Still no good.

The vet is lovely and warm. He smiles. He explains the best of care will be taken. X-rays will be taken. That new lump I think I found the other day (all of a sudden amputation is a preferred option to ‘I’m sorry it’s no use’) will be checked.

All I know is that my little Freya will soon be on a table and not all of her will go back in her cage.

Tears. Fears. Composure gone. Tissues essential. Small talk and then no talk. Small talk again.

Leave. Now.

The call came. All clear. No additional lumps found. Surgery clean. Out from anaesthetic. All good.

More tears.

Not all tears are an evil.

Specialists and Speculation

So, all seemed fine. The way ahead was clear. Observe and then act.

But my vet said he’d like to consult with a veterinary specialist oncologist on management of Freya. OK thought I. No worries. Probably really good to get a specialist to give a second opinion. So, we took a lymph node sample, which came back clear ie no cancer cells (yay!). And off to the specialist all the information went.

Freya paying attention to her leg after biopsy
Freya paying attention to her leg after biopsy

The report came back from the specialist on 12 December 2012. Remember, since 21 November 2012 we had been having bandage changes every four days and so much was going well. The raw patch was brilliantly healing and the vet was really pleased. And then there it was.

Written down (and forwarded in full by my vet).

Preferred treatment – Amputation

I suppose it wasn’t  so much of a shock as I’d had some time to get used to the fact that this was the way it would eventually go. It was good to see in the report that amputation for her likely type of tumour “could potentially be curative”. There was however a note that “reports are mixed regarding survival for cats with these intermediate grade tumours” (Freya has a likely Grade 2 tumour ie intermediate) so it is of course no guarantee, but I think it is preferable to both radiation and chemo which were raised in the report (both lesser treatment options).

It was also sobering to see that if no action apart from surgery was taken that “Depending on the study…, median survival would be expected to be 4 to 9 months”.

The report also directed me to http://www.fabcats.org/owners/disabled/amputee.html for some stats about owners of amputee cats, with the salient points as follows:

  • The only differences noted by owners were that amputee cats tended to be less active and moved slower – in all other aspects the cats were generally no different following amputation.
  • Pain after the operation was noted in 36% of cases and recovery time seemed to be 2 weeks for those in no to little pain and up to one month for those perceived to have been in pain
  • When asked if they thought their cat had a normal quality of life, over 90% of owners believed that they did.
  • When asked whether they would make the same decision if they knew then what they knew now, 95% of owners said they would.

So, I sent an email back:

Message understood.

Let’s pick a date.

How does 20 December 2012 suit you?

Good.

Book it in.

<Oh God>

Discovery and Diagnosis

You know how it is. Things seem fine and then out of the blue something catches the corner of your eye.

But a brief trip down memory lane first. I first met Freya when she was three weeks old and brought into my workplace with her mother and the rest of her litter.  She was the only grey kitten in the litter and I took to her straight away. So, after some research into a potential name and an internal confirmation that I was ready to take on a serious feline commitment, she moved in. That was nearly nine years ago. Since then she has terrorised geckos in Rockhampton, been aloof to visitors, made the move from Queensland to Sydney with me, and surveyed her world with justified disdain. When people meet her for the first time I remind them that cats used to be worshiped as gods in Ancient Egypt, and Freya remembers, so treat her like a goddess and you’ll be fine: hands off, approach with caution and provide offerings at regular intervals. What did I expect, after naming her for the goddess of the Valkyries?

Freya at home in a favourite box
Freya at home in a favourite box

Anyway, to the present. On 7 November 2012  I noticed a lump on Freya’s rear left leg (her hock for those who know, which didn’t include me until now). And then I looked more closely and saw it was quite a large, raised, solid, hairless lump which actually went around the inside of her leg as well, although that area still had hair. More than a bit alarming. So, I rang the vet for advice and ended up taking Freya in the next morning for some tests. Freya wasn’t limping, wasn’t in pain (touching the area did not elicit a cranky reaction) and her food intake hadn’t not been affected, so I took some heart from that……

Then the vet said it was definitely a tumour of some kind and the tests would tell us more. So, started the emotional roller coaster for me as you’d imagine, with many visions running through my head and feeling pretty gutted that I’d missed such an obvious lump.

Anyway, they took a fine needle aspirate and the  results seemed to show the tumour was borderline benign/cancerous. The vet also said that he thought the tumour was located in a place that was not readily visible and so it could easily have been overlooked for a while – so feel a little bit better about that aspect of it.

The upshot was, Freya was booked in for surgery on 21 November 2012  when the growth was removed as an excision biopsy and the mass sent off for further testing. Well, once they had a look, the news wasn’t good. The tumour was quite entwined with the muscles and tendons in her leg and so not all of it was able to be removed. Further, that type of growth pattern is apparently associated with malignancy.

And that was when the word was first mentioned …. amputation.

The vet said it is ‘better’ to have a rear leg amputated than a front – I say surely it is better not to have it removed at all … but I get what he is saying.

Well, the results of the biopsy were available 24 November 2012 when I took Freya in for a bandage change. And they were not good. A soft tissue sarcoma – and whilst ‘locally invasive’ (code for whopping great lump I suppose) they ‘generally do not undergo metastic spread’. So, for bad news it wasn’t as bad as it could have been. Nonetheless, the advice from the vet, was to reconfirm amputation and so it was booked in for 28 November 2012.

Then, the day before the operation, Freya managed to remove the bandage on her leg and so I had to take her to the vets to get a replacement one (she had a skin graft and an open wound so even a day with that exposed would not be good). Anyway, the vet was impressed by her calm demeanour with the bandage change (they had called her a cat with ‘personality’ when she was at the vets’ – we know what they mean). He also commented that her skin graft was healing really well and that the open wound was beginning to granulate over (apparently that’s a good thing) and she was in no pain. So, he looked at me and said, I think we might let this leg heal and just keep an eye on the regrowth of the sarcoma and when that happens, that’s when the leg will be removed. He couldn’t put an estimate on that of course, it could be weeks, months or more.

So, that seemed all for the good. Amputation off the agenda for the moment. Sure, a delaying tactic only, but hey, I was good with it.

But of course, why have this blog if that was the end of the story…..