Tag: diagnosis

diagnosis

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…..