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- Sep 14, 2020
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Hello
Thank you for accepting us! Ricky will be 15 on November 12th. I apologize in advance for the length of this. Looking back I have to say over the course of many years, Ricky’s off and on vomiting, and diarrhea was never really addressed and I am so mad at myself. Back in 2018 he was given metronidazole for a bought of diarrhea. I think around then he was diagnosed with constipation and he has been getting ¼ teaspoon of Miralax daily, he was not really given a special diet, we tried the Royal Canin GI high energy food, Ricky’s favorite food is Fancy Feast Medley’s and Friskies wet food. In May of this year my Mom mentioned Ricky’s hips looked thin so I addressed this with his primary and he was at 15.14 pounds (he was 15.12 on 3/19/20). Also maybe during this time, Ricky stopped waking me up during the night for a snack, he Always woke me up and I thought maybe it was because our 3rd feline Pepper was spending time in the bedroom and Ricky and Pepper do not get along and I keep them separated. He also chose a new spot to sleep (under a desk) and I thought is he hiding but he often finds different places to sleep (currently his new spot is under the fish tank) During his 6 month wellness exam on 7/8/20 he was at 15.04. I mentioned he vomited 6 times from 6/8-7/2/20 and nothing was really said. He was never diagnosed with IBD. On 8/31/20 he had some diarrhea and on 9/1/20 he was supposed to get his leukemia vaccine and he weighed 14.20, so the primary said maybe we should see an internal medicine doctor, we agreed to not give him the vaccine. I found an IM doctor an hour away that saw Ricky on 9/3/20. The results of the ultrasound were: 1) moderately large cystic structure associated with the liver adjacent to the stomach – rule out biliary cyst adenoma versus other 2) Bilaterally hyperechoic renal cortices with decreased corticomedullary definition – rule out age related renal degeneration versus other 3) Diffusely mildly thickened small intestinal wall with prominent muscularis layer – rule out inflammatory bowel disease (IBD) versus small cell intestinal lymphoma versus other 4) Mesenteric lymphadenopathy – rule out reactive lymphadenopathy versus metastatic neoplasia versus other.
Ricky was scheduled to meet with his Cardiologist on 9/10 and the Hospital kindly squeezed in a surgery consultation after that appointment so we did not have to take two 40 minute (one way) drives. (The cardiologist said there was no change from last year and he could have surgery – Side note in 2018 I thought he looked lethargic and rushed him to the ER, they said he was OK and his primary care doctor recommended we do a proBNP test which shown a high number, she recommended he see a cardiologist who did not see anything wrong in 2018, she recommended a follow up in 2019 and a new cardiologist also did not see anything and said Ricky should not be tested for proBNP anymore and if nothing changed in 2020 he would not need to be seen again)
It was pouring rain out when I spoke to the surgeon after the consultation and I could not hear her that well but my understanding was Ricky is a good candidate for the removal of the cyst and the biopsy of his intestines, liver and lymph nodes. She said due to there being multiple lesions to address Ricky could not have aspirations or endoscopes done. She said there is a risk of a serious complication of leakage of intestinal contents that can occur at the biopsy site. She said this is reported up to 20% but her experience was lower. She said if this happened a 2nd surgery would be needed and after the 2nd surgery the outcome was favorable. She said surgery is not needed right away but that surgery should be done within the next couple of weeks. I asked about the #2 item on the ultrasound (she did not even mention it) and said this could be early kidney disease. She said that Anesthesia can stress out the kidney’s and that a chronic kidney disease could become acute kidney disease. I asked her about Rickey’s age and she said age is Not a disease. She said I would receive her notes over the next few days and I received them on Saturday which I enclosed. She did not even mention the anesthesia potential problem in the notes which makes me wonder if there are other potential problems that I failed to ask about and she failed to mention thinking I knew about. Also Ricky has not ever been away from home before, it is my understanding he would be away the night before the surgery and the night of the surgery and maybe another day or more. Ricky is very nervous going to the Vet his palms get sweaty.
Our primary care doctors have said the decision to do the surgery is up to me they have not advised me either way, they just said to weigh the options and they will help with any decision. Their only advice was to not let Ricky eat any grass when outside or that we have grown inside (He loves to eat grass but then will vomit it up sometimes, it has been so hard to stop him from eating grass outside)
I want to do what is right for Ricky, what Ricky would want and not want I want. I play these mind games, if Ricky wakes me up then that means he wants the surgery. Also health care should not be about the cost but the cost for the surgery low end is $5k and high end $5,700.00, we are located in Connecticut.
So right now we are in limbo as I have been unable to decide if Ricky should get the cyst removed with the 3 biopsy’s done. It is my understanding that we should not start any therapy now and then decide to do the biopsy later as the results could be inclusive. After the 3 visits Ricky had diarrhea and vomiting and our primary care said environmental factors could contribute to IBD symptoms. (after fasting for the ultra sound on 9/3, on the night of 9/4 I heard his stomach gurgling for hours and finally he projectile vomited across the futon, and floor it was liquid and a little hair, I have never seen anything like that, it was very scary) I feel very pressured to make a decision right away so Ricky can start some kind of therapy and also the surgeon said a decision should be made within a few weeks while Ricky is doing well.
I have been reading and saving a lot of your posts to refer again to later. I would appreciate anyone’s input on why they decided to do the biopsy, risk factors they were advised of, age of their kitty, and if cancer was found did you do chemotherapy and how did your kitty handle Chemo and anyone that did not do the biopsies and why they did not and if they regretted either decision. And what your cost was. Also hoping to hear from anyone that had a liver mass removed and the outcome. (the liver lobectomy is $1,800 so that is why the cost is so high). Also, In reading some posts, it is my understanding that some of you did not do a biopsy but that your kitties’ treatment could involve chemotherapy drugs. The surgeon said chemotherapy drugs are not given if a cancer diagnosis is not proven, so I confused on how some kitties may be getting chemo drugs without having a cancer diagnosis. Any information on this topic would also be greatly appreciated.
Healthy Regards
Ricky and Maria
Thank you for accepting us! Ricky will be 15 on November 12th. I apologize in advance for the length of this. Looking back I have to say over the course of many years, Ricky’s off and on vomiting, and diarrhea was never really addressed and I am so mad at myself. Back in 2018 he was given metronidazole for a bought of diarrhea. I think around then he was diagnosed with constipation and he has been getting ¼ teaspoon of Miralax daily, he was not really given a special diet, we tried the Royal Canin GI high energy food, Ricky’s favorite food is Fancy Feast Medley’s and Friskies wet food. In May of this year my Mom mentioned Ricky’s hips looked thin so I addressed this with his primary and he was at 15.14 pounds (he was 15.12 on 3/19/20). Also maybe during this time, Ricky stopped waking me up during the night for a snack, he Always woke me up and I thought maybe it was because our 3rd feline Pepper was spending time in the bedroom and Ricky and Pepper do not get along and I keep them separated. He also chose a new spot to sleep (under a desk) and I thought is he hiding but he often finds different places to sleep (currently his new spot is under the fish tank) During his 6 month wellness exam on 7/8/20 he was at 15.04. I mentioned he vomited 6 times from 6/8-7/2/20 and nothing was really said. He was never diagnosed with IBD. On 8/31/20 he had some diarrhea and on 9/1/20 he was supposed to get his leukemia vaccine and he weighed 14.20, so the primary said maybe we should see an internal medicine doctor, we agreed to not give him the vaccine. I found an IM doctor an hour away that saw Ricky on 9/3/20. The results of the ultrasound were: 1) moderately large cystic structure associated with the liver adjacent to the stomach – rule out biliary cyst adenoma versus other 2) Bilaterally hyperechoic renal cortices with decreased corticomedullary definition – rule out age related renal degeneration versus other 3) Diffusely mildly thickened small intestinal wall with prominent muscularis layer – rule out inflammatory bowel disease (IBD) versus small cell intestinal lymphoma versus other 4) Mesenteric lymphadenopathy – rule out reactive lymphadenopathy versus metastatic neoplasia versus other.
Ricky was scheduled to meet with his Cardiologist on 9/10 and the Hospital kindly squeezed in a surgery consultation after that appointment so we did not have to take two 40 minute (one way) drives. (The cardiologist said there was no change from last year and he could have surgery – Side note in 2018 I thought he looked lethargic and rushed him to the ER, they said he was OK and his primary care doctor recommended we do a proBNP test which shown a high number, she recommended he see a cardiologist who did not see anything wrong in 2018, she recommended a follow up in 2019 and a new cardiologist also did not see anything and said Ricky should not be tested for proBNP anymore and if nothing changed in 2020 he would not need to be seen again)
It was pouring rain out when I spoke to the surgeon after the consultation and I could not hear her that well but my understanding was Ricky is a good candidate for the removal of the cyst and the biopsy of his intestines, liver and lymph nodes. She said due to there being multiple lesions to address Ricky could not have aspirations or endoscopes done. She said there is a risk of a serious complication of leakage of intestinal contents that can occur at the biopsy site. She said this is reported up to 20% but her experience was lower. She said if this happened a 2nd surgery would be needed and after the 2nd surgery the outcome was favorable. She said surgery is not needed right away but that surgery should be done within the next couple of weeks. I asked about the #2 item on the ultrasound (she did not even mention it) and said this could be early kidney disease. She said that Anesthesia can stress out the kidney’s and that a chronic kidney disease could become acute kidney disease. I asked her about Rickey’s age and she said age is Not a disease. She said I would receive her notes over the next few days and I received them on Saturday which I enclosed. She did not even mention the anesthesia potential problem in the notes which makes me wonder if there are other potential problems that I failed to ask about and she failed to mention thinking I knew about. Also Ricky has not ever been away from home before, it is my understanding he would be away the night before the surgery and the night of the surgery and maybe another day or more. Ricky is very nervous going to the Vet his palms get sweaty.
Our primary care doctors have said the decision to do the surgery is up to me they have not advised me either way, they just said to weigh the options and they will help with any decision. Their only advice was to not let Ricky eat any grass when outside or that we have grown inside (He loves to eat grass but then will vomit it up sometimes, it has been so hard to stop him from eating grass outside)
I want to do what is right for Ricky, what Ricky would want and not want I want. I play these mind games, if Ricky wakes me up then that means he wants the surgery. Also health care should not be about the cost but the cost for the surgery low end is $5k and high end $5,700.00, we are located in Connecticut.
So right now we are in limbo as I have been unable to decide if Ricky should get the cyst removed with the 3 biopsy’s done. It is my understanding that we should not start any therapy now and then decide to do the biopsy later as the results could be inclusive. After the 3 visits Ricky had diarrhea and vomiting and our primary care said environmental factors could contribute to IBD symptoms. (after fasting for the ultra sound on 9/3, on the night of 9/4 I heard his stomach gurgling for hours and finally he projectile vomited across the futon, and floor it was liquid and a little hair, I have never seen anything like that, it was very scary) I feel very pressured to make a decision right away so Ricky can start some kind of therapy and also the surgeon said a decision should be made within a few weeks while Ricky is doing well.
I have been reading and saving a lot of your posts to refer again to later. I would appreciate anyone’s input on why they decided to do the biopsy, risk factors they were advised of, age of their kitty, and if cancer was found did you do chemotherapy and how did your kitty handle Chemo and anyone that did not do the biopsies and why they did not and if they regretted either decision. And what your cost was. Also hoping to hear from anyone that had a liver mass removed and the outcome. (the liver lobectomy is $1,800 so that is why the cost is so high). Also, In reading some posts, it is my understanding that some of you did not do a biopsy but that your kitties’ treatment could involve chemotherapy drugs. The surgeon said chemotherapy drugs are not given if a cancer diagnosis is not proven, so I confused on how some kitties may be getting chemo drugs without having a cancer diagnosis. Any information on this topic would also be greatly appreciated.
Healthy Regards
Ricky and Maria
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