Cat just diagnosed with end stage cancer.

[Ivy12345]

Bare with me as this will be a long post... Looking for some input/advice/other experiences.
My cat Ivy had a front L 5th digit toe amputation in mid February due to anulceration that persisted since August. The biopsy showed she had a sarcoma but they could not pinpoint the specific kind. They did a chest xray that revealed no metastatic disease.
In late March she had a follow up with an oncologist with a chest xray and abdominal ultrasound that revealed all normal findings. Chemo was not suggested as vet said not likely to do much and she showed no metastasis.
Fast forward to last week. A new growth on her front L paw, 4th digit, and she had another consult with the surgeon who confirmed it was a recurring sarcoma. She did a CT scan with contrast and that's when everything came crashing down..
Ivy has "too numerous to count" lung nodules as well as a few enlarged lymph nodes in her front left paw and left armpit.
The radiologist/surgeon/oncologist all spoke and agreed this is late stage cancer. They can't really saywhat kind but they said if they had to guess it originated in her foot and spread.
A few things I'm confused about..
Did Ivy have these lymph nodes and nodules for months and they just went unnoticed because an xray was done instead of a CT scan? And if that is the case, aside from xrays being a cheaper and less invasive option, why use them at all?
Also, if my cat has sarcoma with mets to the lungs how could she have survived this long? It has been 9 months now since her first toe tumor was noticed. How is she even alive with NO symptoms if she has advanced lung cancer? Could the nodules be from something else? She has chronic asthma, history of pneumonia and bronchitis, immune disorder, horrible allergies..
My last question is, the surgeon estimated she has 2-3 months to live. I want to keep her comfortable for as long as possible. Should I still amputate the 4th toe so it isn't an ulcerated painful mess for her in these last few months of life? Other than the toe, at this time, there is no noticeable changes in her.
Sorry for the novel...just have so many questions and feel pretty lost. Thanks, in advance.

 

[Furballsmom]

Hello - I'm so sorry to hear you and your baby are going through this.

Have you had a chance to talk with your vet more? Can the vet confirm whether the nodules would have been visible in the xrays?

Should I still amputate the 4th toe so it isn't an ulcerated painful mess for her in these last few months of life?

There have been suggestions that sometimes a question to ask a vet is if this were their cat, what would they do.

 

[moxiewild]

I am so sorry you and Ivy are going through this. My heart breaks for you both.

As Furballsmom said, the first course of action would be to discuss all of this with her vet(s).

If for some reason you are not comfortable enough, most of your questions are generic enough that they may be able to answer them on Reddit’s AskVets subreddit/subforum - r/AskVet

They won’t answer any questions about your cat’s specific case, or make recommendations, but they might be able to answer your general questions about the diagnostics, how they work, how vets choose when to use what and why, along with progression of the cancer (I.e. “how could she have survived this long?”).

Be sure to include the information they require to post (species, age, medical conditions, spayed, symptoms, and general location, as in “Texas”).

They are usually very sympathetic with terminal cases like these.

 

[jefferd18]

I am so sorry for what you and Ivy are going through. My prayers are with you both.

Unfortunately cancer is insidious and be in the body for a long time before it makes itself known. The surgery that your baby went through several months ago can sometimes cause the cancer to spread like wildfire. However, having said that, I too don't know why she has survived so long. When my cat developed tumors throughout his whole body he was given a matter of a few days to live- not months. Also, my cat acted like he was really sick.

Is there anyway you could get a second opinion?

 

[FeebysOwner]

Hi. So sorry for what you and Ivy are going through. My heart goes out to you. I, too, would want a thorough dialog, especially with the oncologist about the logic with the x-ray vs. CT scan. And, some sort of validation that the nodules aren't connected to her respiratory issues.

And, in support of the proposed second opinion, I would ask your vet to consult with a vet university - or any vet that would be willing to do so. Copies of all of Ivy's tests would be an absolute must/asset. Another set of experts eyes - not related to your current vet's practice always helps, as they are less likely to support/substantiate one another's opinions.

It doesn't mean that the cancer is not spreading, but it does seem odd that Ivy is not experiencing more issues. If this 4th toe is causing pain, and she can tolerate having it removed to lessen pain/suffering, I would hope one these vets/specialists would support that.

Please keep us posted.

 

[fionasmom]

I am so sorry about this. Speaking from experience with dogs, if the toe is painful it should be removed. Having said that, with a dog it would bring up issues of weight bearing digits being removed, but to me pain would be worse than an adjusted gait.

I am assuming that with the amputation of a toe, they had plenty of room to get a clean margin. Was that mentioned to you at all or did they just check for mets? In some cancers, clean margin carries more weight than in others, but it was an important point of my dog's melanoma surgery. If they did not get a clean margin, that is probably the source of this next occurrence. Soft tissue sarcomas can be staged and graded just like human cancers can and it does not sound like that was done?

Definitely get a second opinion from another independent oncologist or vet who can facilitate contact with an oncologist; I don't know if this is an issue of location because of where you live or not. All of your questions need to be answered including what is going on now. All of the questions you put in the post need to be brought up to an oncologist.

 

[Ivy12345]

Sorry for the delay, I did not get an alert that anyone responded to my post and thought it went unnoticed. Thank you so much to everyone who responded. It always makes a person feel better to know other people understand where they are coming from and want to help!

A small development: Ivy's 4th digit was ulcerated and bleeding and so I had her surgeon amputate it this morning. She is left with 2 toes and her "thumb" toe. She just got home a little while ago from the hospital and she is doing great, eating up a storm, and very alert. She does have a major limp and a bit of difficulty getting around right now. We shall see how she does once she adapts and her bulky bandage comes off next week.

The undifferentiated sarcoma on her 5th toe that she initially had amputated in February was stage negative with clear margins and an extremely low chance of recurrence. The mitotic index was high, I believe 34, which I know can be a bad sign.

She does have an oncologist who works at a different location than her surgeon. The surgeon spoke with the radiologist and oncologist and all three agreed she is end stage cancer with mets to the lungs. She had no effusion which is also quite rare in end stage lung cancer. It just confuses me because like I said, she shows no signs of illness. I know cats are really good at hiding discomfort but I've had half a dozen cats growing up and when they were very sick without much time left it was very obvious. It's just hard for me to see her as sick which I guess is what is so frustrating. There is always the chance she will make a quick turn and go downhill. I hope that doesn't happen but if she has as aggressive cancer as they think, I imagine it would be only a matter of weeks at most.

 

[FeebysOwner]

Thanks for the update! I am so glad she got through the toe surgery and is doing well! I honestly don't know how she can be in end stage lung cancer and not show signs. Cats aren't that great in hiding discomfort - especially with the mets to the lungs. It is miraculous that there is still no effusion. But I guess one never knows. Still, she can be rid of the pain from that toe for now. Please continue to keep us updated. Ivy is a trooper!!!!

 

[Furballsmom]

 

[Oysterbay]

She sounds like a fighter. Animals are forces of nature so their bodies have no confusion about fighting to survive and thrive. Since lung mets are untreatable by vets, I'm wondering whether you're open to a non-traditional course of action. If you are, follow the fenbendazole protocol for cancer. It seems to work by breaking up cancerous growth. You'll find more information from Vitality Science, which is an animal care company that doesn't even sell the protocol, they are just the first to publicize its success in animals. All the best to you, from me and my kitty Chairman Meow. She was diagnosed with cancer earlier this year as well.