Charlie - DSH - Diagnosed with Colorectal Adenocarcinoma - Need Help.

miguel99nyc

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Hello,

I was not sure on how to combine or change the header of a past thread about my cat which I had labeled as initially Pancreatitis, but now since beginning of September up to this point - have gone through so many testing and imaging including the final step of surgical biopsy which has determined my cat Charlie has Colorectal Adenocarcinoma.

Unfortunately the only option/advice I've been given by oncologist is to either surgically remove it or try a very long shot at Chemotherapy medication called Palladia.

Long story short - I've tried doing my best on researching this cancer type and Palladia but its SO hard to find ANYTHING on it. Mostly I found was that surgical resection and Anastamosis is only way to get rid of it and best shot of long term survival, while Palladia may not even help it. I found that Palladia is mostly for dog however after speaking with primary vet earlier today, he said he wouldn't count on that medication because its used for Dogs mast cell tumors primarily and its still experimental stages. But I just can't seem to find other options for medication to possibly treat this and seems I'm at the end of the road here :(.

Surgery is the other option but he is still currently stitched from last Thursday's biopsy only surgery...so to have him go through it AGAIN is just seems so harsh on him. He is 15 yrs old , most would think he lived a long enough life...but the way this all came about back in early september was like this cancer came at the speed of light and just hit me so hard in the face. Prior to diminished appetite, hiding and wieght loss, Charlie was still acting like a kitten, so playful and jumping, everything. But that all changed within a week literally and was sort of downhill. Only thing is since early September, hes managed to maintain his weight and eat again though is very picky with his food. He even gained nearly half pound in the past week or so. I know it means nothing since the official diagnosis is this adenocarcinoma, but I'm not 100% on board doing another surgery, let alone primary vet while he recommends doing it with a board certified surgeon, he said he can do it as well which is few thousand dollars cheaper then at hospital with a surgeon, but if something goes wrong then he can die either way.

Both oncologist, surgeon and even primary vet have explained to me that even with surgery, it isn't guaranteed either for cure, esp if it has mestasized or spread to other areas which they can't see. A biopsy was taken of the lymph nodes but the only good news is that it hasn't spread there, not yet at least. And with surgery, it's a very complicated process and carries high risks as well which is what scares me the most. Just seems like a huge gamble to me and I've already invested since September - nearly $6k so far in testing and biopsy. I'd really hate to put him through hell again going surgery...but I would consider if it really meant to save his life...but its just such hard decision - wished there was some other medication than this expermiental dog medication of Palladin.

If anyone can please provide advice would greatly and sincerely appreciate it. I can post results of biopsy on here as well if needed.

Thank You everyone.
 

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Hello-thank you for allowing us to share in your situation and your furbaby's troubles.

Would a university medical veterinary department be a source of more information?
 
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miguel99nyc

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Sure! Any help would be greatly appreciated.

Again since we know now the diagnosis, its now the matter of what gamble to take considering the risks/complications. Either attempt the surgery or try the luck with the Palladia. I'm just in shock it comes down to that - basically a gamble :( with Charlie's life.
 

fionasmom

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All I can do is give you a comparison with my GSD who is going through something very similar with an anal gland tumor. He is 14, not in great shape as I have mentioned quite often here, possibly does not have a lot more time no matter what I do for him.

Last week we went to see a board certified surgeon in Los Angeles at a referral hospital. I trust this group as they have treated the dog before for melanoma. We did a needle aspiration of a gland on the same side as the melanoma was found, an xray of the abdomen and an ultrasound, all clear except for the fact that the spleen might be sketchy which I am not even thinking about right now as I don't plan to take the poor animal apart piece by piece in his last months.

Protocol was definitely surgery, above all surgery, no biopsy was done because the mass is still very small and they did not feel that they could get a decent piece; removing it would be more sensible as it eliminates one whole round of anesthesia and one whole incision and surgical procedure. They know how I feel about surgery and we went there in the first place three years ago because years before I lost an older, debilitated dog during surgery. They did not suggest doing radiation or chemo in place of surgery. They were offered as adjuvant treatments if I wanted to proceed. I did immunotherapy the first time and won't do anything else this time.

I don't believe, and you certainly don't have to agree, that Palladina will get rid of the tumor. Removal of any tumor is always the first step in treatment of any cancer that manifests itself in that form. Radiation and chemo basically try to get at "stray" cells that are running around and won't do much for a mass of any kind.

Yes, it will be several thousand less if your regular vet does this and that is up to you. My dog's vet won't do surgery on him because he is high risk and I would never leave him alone overnight in a vet clinic which does not have 24 hour care. A referral clinic with board certified doctors has all the emergency bells and whistles available like ventilators which are set up and ready to go along with 24 hour care...some of that for extra money. Even last week I was asked if I wanted code blue for my dog if he started to go down.

We are at the same place as you are with the exception of the fact that the dog did not have a surgical biopsy, so is not currently recovering from that. The pain and complications from the surgery concern me greatly; the dog is very sensitive to pain, reacts badly to some high powered pain meds like Fentanyl, and could well wonder what he did to deserve something like this being done to him. On the other hand, a growing tumor in the anal or colorectal area will not be bearable at some point. I am sorry that you are in this situation with Charlie.
 
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miguel99nyc

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Well
All I can do is give you a comparison with my GSD who is going through something very similar with an anal gland tumor. He is 14, not in great shape as I have mentioned quite often here, possibly does not have a lot more time no matter what I do for him.

Last week we went to see a board certified surgeon in Los Angeles at a referral hospital. I trust this group as they have treated the dog before for melanoma. We did a needle aspiration of a gland on the same side as the melanoma was found, an xray of the abdomen and an ultrasound, all clear except for the fact that the spleen might be sketchy which I am not even thinking about right now as I don't plan to take the poor animal apart piece by piece in his last months.

Protocol was definitely surgery, above all surgery, no biopsy was done because the mass is still very small and they did not feel that they could get a decent piece; removing it would be more sensible as it eliminates one whole round of anesthesia and one whole incision and surgical procedure. They know how I feel about surgery and we went there in the first place three years ago because years before I lost an older, debilitated dog during surgery. They did not suggest doing radiation or chemo in place of surgery. They were offered as adjuvant treatments if I wanted to proceed. I did immunotherapy the first time and won't do anything else this time.

I don't believe, and you certainly don't have to agree, that Palladina will get rid of the tumor. Removal of any tumor is always the first step in treatment of any cancer that manifests itself in that form. Radiation and chemo basically try to get at "stray" cells that are running around and won't do much for a mass of any kind.

Yes, it will be several thousand less if your regular vet does this and that is up to you. My dog's vet won't do surgery on him because he is high risk and I would never leave him alone overnight in a vet clinic which does not have 24 hour care. A referral clinic with board certified doctors has all the emergency bells and whistles available like ventilators which are set up and ready to go along with 24 hour care...some of that for extra money. Even last week I was asked if I wanted code blue for my dog if he started to go down.

We are at the same place as you are with the exception of the fact that the dog did not have a surgical biopsy, so is not currently recovering from that. The pain and complications from the surgery concern me greatly; the dog is very sensitive to pain, reacts badly to some high powered pain meds like Fentanyl, and could well wonder what he did to deserve something like this being done to him. On the other hand, a growing tumor in the anal or colorectal area will not be bearable at some point. I am sorry that you are in this situation with Charlie.
Thank you for that info.

Well the hard time Im currently having to think of that would sway my decision is that one, Palladia seemed like a dog mostly medication and after my vet said that it was experimental that it would most likely not work, I wonder why would an Oncologist suggest that? It upsets me, and as hard to believe, seems like finding a good Oncologist around here in NYC is impossible.

So that leaves me with only possible option of doing another surgery. I had the chance to just do the biopsy AND possible removal at the hospital...but it was a $4k difference from the vet. I too wasn't comfortable leaving Charlie in the clinic vet place for 2 nights all on his own unattended, but he turned out to be okay though. The oncologist initially after an ultrasound FNA, while it wasn't conclusive, it narrowed it down to either lymphoma, some other cancer, and carcinoma - which would ultimately need surgical removal. The other 2 cancers would be just solely medication. So I took that chance that Charlie would only need ONE surgery then medication - chemo. So I took that gamble and instead went with my primary vet for the biopsy. It was only 1/3 chance to be that surgical removal cancer, but turns out it that what it is which I already feel so upset about.

So now it leaves Charlie to any possible hope to recover somewhat with doing a 2nd surgery...and while I know the huge risks/complications from the surgery, I just really afraid of going further with it. My vet can do it at a lower cost...but then it becomes another gamble AGAIN whether he dies in surgery, or shortly after because of leakage, or even worse, the vet doesn't fully remove it completely thus cancer stays and its pretty much game over either way. I'm just very upset on how this boils down to literally gamble. I really hate it and almost borderline think this is some scam worked up by vet/oncologist/hospital because it shouldn't be a gamble at all. As if either way, Charlie will die regardless sometime soon. The only thing that makes me want to TRY the surgery is that the lymph nodes biopsy did not show that the cancer has spread, not yet at least. So maybe removing the tumor will cure him and hope it doesnt form again. But just all this seems like a gamble, and I already gambled by just doing solely the biopsy at vet, while the biopsy/surgery at hospital would have attempted either way to remove the mass just at higher price.;

Is that intestinal anastmosis that risky/dangerous? Thats primarly why im afraid of doing it....
 

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All I know is that Palladia is a palliative treatment that can give a few unwanted side effects.

My cat had an adenocarcinoma, which the vets at a very high end clinic surgically removed.
At the follow up visit a month later they told me that a palliative treatment with Palladia might have been advised.
I took my time and thought to ask the best oncologist in this country if this was a good idea. He said that considered my cat history and physical conditions, and considered it is a palliative drug, he would advise against it due to the side effects. He said "if the cat was mine I wouldn't do that".

If I were you, I'd go with the surgery and keep the Palladia as a successive resource just in case.
 

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Since it hasn't spread to his lymph nodes, I would do the surgery ASAP and get it done, with your regular vet. He knows the cat better than the specialist. I'm so sorry you and your sweet Charlie have to go through this, but my Burt had the same diagnosis and after seeing the suffering that he went through I would definitely have had the surgery instead of palliative care. Then you would know you had tried everything. I know it is terribly hard, but if he dies during surgery, he was under anesthesia and wouldn't suffer. My heart goes out to you, I'll pray for that sweet boy to come through the surgery with flying colors and to come home where he belongs.
 
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miguel99nyc

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Thank you guys for the reply!

Antonio65 Antonio65 , I hear you on the palliative part. And not just that but, well I don't have access to the best clinic nor best oncologist in the country unfortunately, in fact may be the opposite where I may have a very good primary care vet but oncologist - though seemed knowledgable, doesn't seem to really care as much when I speak to him on phone. The hard part nowadays also is that I don't even see their faces, its just all phone calls as Charlie goes in because of this stupid virus so I don't meet the vets/specialists 1 on 1.

But yes, my oncologist basically said the Palladia would just try to suppress the tumor and reduce in size as opposed to getting rid of it. I've read up the side effects and just seemed very intense for Charlie to go through. And since it is deemed as the worst possible cancer type, I mean why put him through further suffering with Palladia right?

Then came obvious the costs for this 2nd surgery, 2nd because he just went through the surgical biopsy on the Oct 15th. The problem that upsets me is that I HAD the opportunity to even to the possible removal with primary vet(lower cost) but all at once with that biopsy appointment. But problem was that he gave me obviously the risks and all, I just wasn't ready for it, let alone, the cancers boiled down to after ultrasound FNA was either Lymphoma, Mast Cell Cancers all treatable with medication, or worse case scenario Carcinoma which would require surgery. So 2 out of 3 were my odds so I said why risk surgery and instead just go for biopsy. Turned out to be the worse case scenario of not only being the adenocarinoma (mass in his colon), but also requiring a 2nd surgery. Just broke me apart last week to hear that.

But now as I await tomorrow confirmation as both Surgeon from hospital will talk to my primary vet at clinic to see what he saw during surgery for the biopsy - because my primary vet initially said it didnt seem it was removable. Whether that was true or if it is true because if it was on blood vessel or something else critical I dont know. I tried asking my vet Friday as to why he said it wasnt removable, he didnt really say then it wasnt, he would prefer a board certified surgeon to do so. But he understood my financial situation so he said he can provide an estimate which is half the costs of the Surgeon at hospital. Also, seemed like the Hospital would release Charlie the next day while my primary vet I assume for safety, would keep him for 2.5 - 3 day while on IV, Pain injections and Antibiotic Injections. It was bit hard knowign Charlie was on his own over night for 2 nights at clinic but again, he turned out to be ok so far. At the hospital they have overnight care obviously, but overall comes up to a much higher costs.

Attached I will post both estimates beacuse the hospital does list A LOT of things which I cant tell ifthey are necessary or unecessary, and then also result of latest ultrasound with FNA and the biopsy report. I am too leaning towards surgery as well, just questioning if I should trust my vet as he made it sound not guaranteed.

di and bob di and bob , yes per biopsy report and primary vet, the goodnews he said was that it hadn't spread yet to his lymph nodes so thats why i think if I eliminate the source - tumor mass, that will hopefully clear that cancer out? But then its back to relying on m vet. I do trust him with everything as he cared for all 3 of my cats including Charlie, so I know he'd try his best. But at same time I am somewhat ready to lose CHarlie in process of surgery or after if peritonitis occurs :(

If the estimates can be reviewed at least the hospital one - as again it seems to have much more of a breakdown but also more injections. I'd appreciate it. Thank you all.
 

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fionasmom

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My estimate for my dog is similar to the Blue Pearl....a high and low and they were the same for the melanoma. My estimate is between $4500 and $5500. I already paid $1500 for diagnostic tests mentioned. My experience has been, at least here, that they do try to come in closer to the lower estimate but want you to be prepared for the higher one. As for eliminating anything from the list, I am certainly no expert, but I did not see anything that might be removed but someone else might. In the case of my dog and his melanoma, the oncologist wanted a lot of xrays that the surgeon said where not necessary at the time, so we did eliminate those and it might have saved about $500.

There is nothing wrong with saying that the costs are very high. In this situation, pets become like uninsured children and most people are not sitting around with that much disposable income.

Neither of us is in the best place with our options. If I proceed, I will allow the surgery and brace myself for whatever the outcome is or where it takes us. As of right now, I would feel as if I gave him one more chance, but I might not feel that way tomorrow and may reverse my decision and just try to keep him comfortable for his remaining time.

Bowel resectioning is done all the time in colon surgery in people. My mother had it years ago for colon cancer and I don't know that it is any riskier than any other surgery procedure of its type. There can always be complications. Expertise of the surgeon probably plays a hand in it. Given it is the major part of the surgery for Charlie, I think that is why it is the lion's share of the expense.
 
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miguel99nyc

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My estimate for my dog is similar to the Blue Pearl....a high and low and they were the same for the melanoma. My estimate is between $4500 and $5500. I already paid $1500 for diagnostic tests mentioned. My experience has been, at least here, that they do try to come in closer to the lower estimate but want you to be prepared for the higher one. As for eliminating anything from the list, I am certainly no expert, but I did not see anything that might be removed but someone else might. In the case of my dog and his melanoma, the oncologist wanted a lot of xrays that the surgeon said where not necessary at the time, so we did eliminate those and it might have saved about $500.

There is nothing wrong with saying that the costs are very high. In this situation, pets become like uninsured children and most people are not sitting around with that much disposable income.

Neither of us is in the best place with our options. If I proceed, I will allow the surgery and brace myself for whatever the outcome is or where it takes us. As of right now, I would feel as if I gave him one more chance, but I might not feel that way tomorrow and may reverse my decision and just try to keep him comfortable for his remaining time.

Bowel resectioning is done all the time in colon surgery in people. My mother had it years ago for colon cancer and I don't know that it is any riskier than any other surgery procedure of its type. There can always be complications. Expertise of the surgeon probably plays a hand in it. Given it is the major part of the surgery for Charlie, I think that is why it is the lion's share of the expense.
Hi there.
I see. Yeah I mean I have him on insurance which was just renewed few days ago so I got $5,000 as potential reimbursment, but once I'm out of that, I'm empty and everything else going forward after surgery woudl be out of my pocket. So not only i want to salvage a little of that newer reimbursemnt money, I want to make sure I have left over for the next 360 days as Im sure this won't be the last of diagnostics/imaging needed on Charlie- I highly doubt it. However, the other thing is that the hospital was willing to release him and have him eat the following day which I didnt feel comfortable. There was a possiblity they said he can stay one more night, but then the cost would nearly double the either lower or higher end which is insane.But again this is because of the hospital stay and care.

While my vet has no one to watch him overnight, that was the only thing that scared me initially doing the surgical biopsy, but thankfull Charlie was fine and my vet would call me each day make sure Charlie is doing okayor if something was wrong. I can definitely trust my vet for sure, but this stitching god forbid something happens to him overnight is what scares me again with this intestinal stitching, but the cost is sooo much more, its just a very hard decision to make.

Another thing I was wondering was - since today Ive been rethinking of possibly going forward with the surgery solely because the lymph nodes doesn't seem to have that cancer, it almost gives me hopes this one time surgery will do the trick at least to buy Charlie some time, probably some medication after, not sure. But oncologist did mention there's still possibility cancer might haave spread to his lungs/heart/stomach, etc other organs but he wouldn't be able to tell. So my question would be, would Xrays give any hints on that? Because Charlie did have Xrays back in Early September when this whole weight loss and diminished appetite started, but primary vet said there was no findings everything looked completely normal. It was only the following week we had to do an ultrasound which found the mass but that was an abdominal ultrasound. So I mention this because if it had spread to other organs by now, either A he would be acting more sick? Or B if it hasn't (check via Xray?) it would make me think I should act on that surgery ASAP rather than later. Am I correct thinking that way? Im no expert , just kind of seems logical sense.
 

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I am glad to hear that you had insurance for some of this. My dog is not insured, but after the melanoma episode, I insured my three youngest cats.

You are thinking very clearly and asking good questions. The problem is that there are no clear answers or guarantees.

I share your concern about any problem with the resection if Charlie is alone. Would he be sedated enough to prevent movement? I mean, I don't know. Has the vet answered that question because it is a good one. Maybe there is almost no chance of that happening given how the surgery is done.

I agree that in theory removing a tumor which has not metastasized would give Charlie more time. That is one very good reason for doing the surgery, both for you and for my dog, Orlando. As for distant disease, as they say in the world of cancers, x rays would show some of them, as would other imaging such as PET scans, etc. Normally, even for people, if a cancer would normally move into the lymph glands and they are clear, that is usually the end of the investigation as cancers move along certain pathways in the body and doctors know what those are. When my dog was dxed with melanoma, they immediately xrayed his lungs to see if it had gotten there. They were less concerned about doing the abdomen as the pathway would have been in the lungs first.
 

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So my question would be, would Xrays give any hints on that? Because Charlie did have Xrays back in Early September when this whole weight loss and diminished appetite started, but primary vet said there was no findings everything looked completely normal. It was only the following week we had to do an ultrasound which found the mass but that was an abdominal ultrasound. So I mention this because if it had spread to other organs by now, either A he would be acting more sick? Or B if it hasn't (check via Xray?) it would make me think I should act on that surgery ASAP rather than later. Am I correct thinking that way? Im no expert , just kind of seems logical sense.
From what my experience with a number of carcinomas is, Xrays or ultrasound aren't the golden choice to diagnose a tumor in the body, especially when it has a small size.
I was told by a vet that an Xray or ultrasound scan aren't able to reveal masses smaller than 0.5 cm in diameter (0.2" in diameter), so they prefer a CT scan instead.
A CT scan is much more sensitive to very small masses, and because of its 3D nature, the position of the possible mass can be assessed much more precisely.
I do not have experience with MRI, but I think it's pretty much the same.

If the mass that Charlie has in his bowel is confined to that department, the surgery, to be performed as soon as possible, is the way to go, provided that the surgery remove it with wide margins.

As for the estimates, I don't think anything can be removed from them, and even if something can be removed, it might be something that impacts very little on the total, like an IV item or a drug (if any), but the major costs are the surgery and the anesthesia and they are absolutely necessary.
Though the cost of the surgery alone might be comparable to what I'm used to see here (I'm based in Italy, when my cat had a carcinoma removed in her abdomen the surgery cost alone was €2,500), all the other costs are frightening to our standards, for example, a chemistry panel at $275 is at least 3 times what I would pay for it over here.
 
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miguel99nyc

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Thank you all.

fionasmom fionasmom Yes I believe for the surgical biopsy 2 weeks ago, they told me he would be kept in warm blanket over night and would be sleeping primarily (whether or not that meant he was sedated Im not sure didnt ask that specifically) but I had asked about what would happen over night.Assistant told me they would solely keep him in that warm blanket so he can rest and not move around. The other remarkable thing I guess was that the vet himself would call me each day and said he wasn't going to need that elizabethean collar as he wasn't licking his stitches off. I guess it didnt affect him as much as the vet thought. Even to this point with his stitches on, he doesn't really try to lick it off, just maybe once or twice but we'd stop him. The only thing was that during his stay he was given antibiotics (per estimate shown) plus given Clavamox drops to take twice daily. But as soon he got home and the following 2-3days he had diarrhea and was doing all over the apartment. Sure enough I spoke to vet and he said to take him off the antibiotic as it was most likely side effect. After taking him off his stool became normal and no sign of infection on his incision area. So overall I'd trust him with the surgery and his overnight stay even though no one is around. It's just that gamble of that leakage which I read can show up anywhere from 24 hours after to up to 5 days after. I jsut don't see how or why it's harder for any vet to do - Id assume its that complicated that they would fear it. But then I see other normal clinics around my area that have vets and they do offer mass removals as well but I just never took Charlie there so I wouldn't know how they are. Plus they also close normal business hours so they don't have anyone overnight either. Again, just wasn't so sure of Blue Pearl releasing him the next day after, that itself seemed risky as well.

And yeah I would want to consider doing surgery solely because well as of 2 weeks ago biopsy, the lymph node wasn't affected yet so chances are that this surgery would be it and he would be okay.

The only other part was that I wasn't sure is how physically and directly is this mass affecting his eating habit? I mean oddly enough he has been eating more normal amounts in the past recent weeks than back in early September (and he isnt on any medication now). I know the weight isnt bouncing back because Cancer is Cancer. however, Charlie did manage to gain half pound 2 weeks ago. So that prior to the biopsy surgery made me assume it wasn't cancerous because he wasn't contiously losing weight either. Not since beginning of September which seemed somewhat of good news to me as well, let alone Charlie regaining his eating little by little again all despite not on medication.

I'm thinking of scheduling this final attempt/surgery by this Thursday after one last consulting with my vet and Surgeon to see if they got the confidence of doing this then make that final call. Just so nervous on this.
 

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It is very likely that Charlie would sleep off the effects of the anesthesia the first night and be sedated for any further nights over. And let's look at the bright side for a minute...it is unlikely that stitches are tearing and complications are arising on any regular basis and it is unlikely that Charlie will have complications of that sort.

Your vet sounds very competent and I would not shop around for another one just for the heck of it. It sounds as if this doctor has been conscientious and while the others will all probably tell you that they can do the surgery you would then be turning Charlie over to an unproven vet.

I do agree that if you are going to do the surgery, it is best to do it as soon as possible. It sounds as if Charlie is in a good place with his slight weight gain, probably the best place right now to do the surgery.
 
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miguel99nyc

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So I have scheduled the appointment for this final surgery this Thursday at my primary vet.

Seems like he will take care of him, again still quite scared that either Thursday morning coudl be the last time I see him sadly or within a week as the surgeon spoke to me yesterday - Said regardless if vet or surgeon does the surgery by the book and everything is correct/perfect, the growth/adaptation of the colon anastomosis has the chance to grow incorrectly which would lead to that leakage - thus at that point another surgery is needed but in all likely hood will just be to put him to sleep. I hate that this is all a risk/gamble/chance with luck that he pulls through just the surgery/recovery. Then from there, it will still be in the air if he makes it through this 1st week, how long after he would be without the cancer.

They mentioned that there's the possibility that if entire mass is removed, plus based of the biopsy report they will determind whether or not if he will need further medication/treatment after. If not, then it would just be removal and nothing else after but recovery and perhaps just imaging down the road to see if it regrows? It still strikes me...that this mass could have been growing since lord knows when - June, July? Earlier? And yet only show symptoms until September...Ultrasound finding that mass in Mid September, mass still there in early October FNA Ultrasound - mid october with biopsy surgery but not yet have metastasized to his lymph nodes. While I am so thankful it hasn't, surely with this Adenocarcinoma being the aggressive form, I thought he would have been finished by now...It seems remarkable a bit. Unless of course, either biopsy is incorrect or false...or something else going on. But overall I am just so scared.

I appreciate though everyone's input and help, its really appreciated. I will definitely post as the vet updates me on his recovery at the clinic.
 

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I will be thinking of you on Thursday. This is so hard but I want to restate that whatever the outcome, you have completely thought this through and are making the most logical decision that you can. You gathered information, considered it, spoke to your doctor and now the rest is to wait for the outcome of the surgery. I agree with your decision, and while I have not made one for my dog yet, I completely understand that if he has any chance to beat the cancer, it all lies with having the surgery.

I am guessing that this is a surgery where they have a good chance of getting a clean margin at least. No one knows how cancer develops or grows in most cases, especially animals. It isn't like your cat smoked a pack of cigarettes every day. It is an unpredictable disease and if it were not so unpredictable there might be a cure for at least some types of it. All cancers start out as individual cells which are completely unnoticeable until something becomes more serious or obvious. Don't drive yourself crazy thinking that there was some magic way that you could have found the original microscopic cancer and done something about it. You are taking excellent care of Charlie with the information that you have now.

Please do post even a brief update on Thursday.
 

Pouncecat1

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I went through cancer with one of my cats and despite the poor prognosis I proceeded with surgery. The first surgery worked (removed the tumor), but it came back within 8 months. The second surgery did nothing and in hindsight I should not have done it. The cancer jumped to the incision site (grew around the incision site, then moved internally. Yes this was a different type of cancer, but after the second surgery we only had 3 months before I had her euthanized because she had a golf ball sized tumor at the incision site.

The problem with cancer is that while you can remove the mass, you cannot remove the individual cancer cells that are seeded throughout the body. If you catch the cancer really really early, you might get lucky in that you can have a successful removal. It is hard to stay unemotional and make a logical decision, but no one would fault you for considering euthanasia rather than surgery.

This is according to google: "the median disease-free interval was 251 days (range, 37-528 days) and the median survival time was 269 days (range, 40-533 days) Subtotal colectomy and adjuvant carboplatin is a safe and potentially effective treatment for cats with colonic adenocarcinoma.

It sounds similar to my cat in that you might get another 8-12 months of life. I would want to have a conversation with the vet about possible survival times and how long will the recovery take- how long til the cat can eat and go to the bathroom normally? As I would be very hesitant to recommend surgery if the prognosis is that poor.

If he has cancer, you will not be saving his life, but you will be buying him time. The question is what his quality of life will be like after the surgery?

Our beloved animals have a shorter lifespan then us and they will die at some point. 15 years is a good age for a cat. Please do not think you have to go to the ends of the earth. I know this cat means everything to you, but you must consider what the cat's quality of life will be like after surgery.
 
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miguel99nyc

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I went through cancer with one of my cats and despite the poor prognosis I proceeded with surgery. The first surgery worked (removed the tumor), but it came back within 8 months. The second surgery did nothing and in hindsight I should not have done it. The cancer jumped to the incision site (grew around the incision site, then moved internally. Yes this was a different type of cancer, but after the second surgery we only had 3 months before I had her euthanized because she had a golf ball sized tumor at the incision site.

The problem with cancer is that while you can remove the mass, you cannot remove the individual cancer cells that are seeded throughout the body. If you catch the cancer really really early, you might get lucky in that you can have a successful removal. It is hard to stay unemotional and make a logical decision, but no one would fault you for considering euthanasia rather than surgery.

This is according to google: "the median disease-free interval was 251 days (range, 37-528 days) and the median survival time was 269 days (range, 40-533 days) Subtotal colectomy and adjuvant carboplatin is a safe and potentially effective treatment for cats with colonic adenocarcinoma.

It sounds similar to my cat in that you might get another 8-12 months of life. I would want to have a conversation with the vet about possible survival times and how long will the recovery take- how long til the cat can eat and go to the bathroom normally? As I would be very hesitant to recommend surgery if the prognosis is that poor.

If he has cancer, you will not be saving his life, but you will be buying him time. The question is what his quality of life will be like after the surgery?

Our beloved animals have a shorter lifespan then us and they will die at some point. 15 years is a good age for a cat. Please do not think you have to go to the ends of the earth. I know this cat means everything to you, but you must consider what the cat's quality of life will be like after surgery.
If I may ask, what kind of cancer did your cat have? Did you have to follow up with medication(s) after to try to keep it from coming back? While I do appreciate your feedback as well sincerely, this kinda seems like a 180, but with respect totally understand your point because afterall, it is cancer and as the oncologist and vet said, there's no way with the human eye anyone can see the other cancer cells - thus removing the mass may or may not work.

Ive spoken to the surgeon about the prognosis and oncologist assistant just yesterday whom made it so assuring in a way regardless if I did it at their hospital or at my vet. The one thing they all agreed on that the mere fact it hadn't so far as of 2 weeks ago spread to lymph nodes, it COULD be in the early stages. Of course, it can be masking and hiding itself throughout the body sure, we all agreed on that, but to NOT have gone through the surgery would guarantee his death sooner than later. The thing is also, which I wondered and asked but none of them know other than it could be just a matter of luck so far, is that since it hasn't spread yet based of biopsy and xrays, how come it took this long? Only medication he been on for just about 2-3 weeks back in September was Prenisolone, and after that until now, nothing other than few times with MIrtazapine to help him eat. He didnt seem like he was getting worse...just instead becoming rathr picky with his food and sleep alot.

So the oncologist and surgeon and vet said unfortunately only way to give him a long shot would be to attempt and remove the mass, even if it all wasn't removed, the prognosis is better then just leaving it there entirely. Then to follow up with medication. Of course - the sole medication at first the oncologist suggested was Palladia - which mind you he said he'd order it on chewy??, like Im new to this, i thought the hospital would carry such medication? But besides that, my primary vet said he would caution against it as its experimental and not known to really cure or help much with adecarcinoma but instead he uses it for mast cell tumors in dogs. Plus I read the worse side effects of that medicatino so I wasn't going to go with that. So what were my options, either put him to sleep/let him pass away or at least try the surgery. IF i didnt have him on insurance, i would only attempt medication then put him sleep, but since I got him on it i figured Id try one last time.

All said its hard to tell the survival time after, can be from several months to up to 2-3 years or more, depending how sucessful the removal is, and if it hasn't mestastized then evne better of not coming back esp if follwed up with medication. Recovery time mentinoed by surgeon said - he'd be able to eat in about 24 hours after surgery...(which is why i was hesitant because hosptial was willing to release him next day while primary vet was 2-3 days stay), and crucial timing was 1st week after surgery for that leakage probem. if that happens then its also game over unfortunately. But after that, then just monitoring him but he would pass soft stools maybe 2-4 weeks max out from post surgery but then would be fine after.

So the only real hurdle is getting through surgery, and then that 1st week approx after for that possible leakage. I am scared to death, knowing the real possibilty that this may be CHarlies final days if it doesnt go well, but at the same time I know by that point Ive tried my best. Ive cried alot back a month ago from first ultarsound report about a mass being in his bowel, vet was confident it was cancerous, I thought maybe slim chance was benign tumor but after ultarsound FNA and surgical biopsy, it confirmed it was probably worst form of cancer. I accepted, i accepted partial defeat but to see Charlie still walk around almost be his normal self, kind and affectionate, he didnt seem like he was giving up , nor continue to lose further weight as he maintained for a month and gained a little weeks ago despite eating less then his normal amount. So i figured let me try this one last time. If it worsk out then great, if it only buys few months, yes will still be sad but then I know Ive done the max I could for him, sure maybe he suffered being alone in clinich overnight for 2 nights but, he had at least 15 great years with me and my family. Sadder part is that I thought he would outlive my 18yr old cat who has CKD currently, but boy SHE is putting up more of a fight as she still acts like a kitten and demands for SO much attention , i love her so much! I love Charlie so much too, but when it comes to cancer, its all just bad luck and you can only try and hope for remission or possibly even cancer not coming back, but i know its a long shot.
 

Antonio65

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The problem with cancer is that while you can remove the mass, you cannot remove the individual cancer cells that are seeded throughout the body. If you catch the cancer really really early, you might get lucky in that you can have a successful removal. It is hard to stay unemotional and make a logical decision, but no one would fault you for considering euthanasia rather than surgery.
[...]
If he has cancer, you will not be saving his life, but you will be buying him time. The question is what his quality of life will be like after the surgery?
Our beloved animals have a shorter lifespan then us and they will die at some point. 15 years is a good age for a cat. Please do not think you have to go to the ends of the earth. I know this cat means everything to you, but you must consider what the cat's quality of life will be like after surgery.
This is what the vets and specialists told me about my cat, both on the occasion of her first carcinoma, and when she had her second carcinoma (unrelated between them, 5 years apart).
They told me that I would have put my cat through hell on earth, that I would have been through the same nightmare myself, and that the outcome would have been poor anyway. According to them, it would have been way better to put her to sleep.
Well, it turned out that my cat survived both carcinomas, against all odds, surprising all the doctors who had the chance to help her. They even told me, on both occasions (two different clinics, different bunches of doctors), that my cat would have ended up into some medical book due to her wonderful and unexpected recovery.

She died 6 years later to a third carcinoma.
You might say that I bought her 6 years from the first carcinoma, but it isn't like this. I saved her from the devils she had in her tiny body. And her quality of life was very good. Eventually she died to the third demon, she was nearly 17 yo.
I saved her and gave her 6 more years, I didn't bought her 6 years, it's totally different.
 
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