Oral Tumor in our 16-year-old

[__caitlin]

Thanks in advance for reading this I hope all of you & your babies are doing well. I posted here awhile back when my other cat was dying of gastrointestinal lymphoma -- the support I got from you all here was invaluable and I'm grateful this community exists.

We have a 16-year-old cat, Jelly, who was recently diagnosed with what is potentially an oral tumor. We originally noticed swelling and what looked like an abscess in her mouth, took her to her primary vet, who thought it was just an infection + potential dental cleaning needed, put her on antibiotics. The antibiotics helped the swelling go down, but now it looks like she potentially has an oral tumor that they're recommending biopsy for.

I'm now in the process of looking for some place (we're based in NYC) that can get a biopsy or cytology done in the quickest timeframe. So far, I have an appointment today for some place that can hopefully do a cytology -- but even those take 5-7 business days to receive a result. I understand that removing the mass and biopsying is a more involved procedure and most places are giving me dates 2-3 weeks out.

Does anyone have any advice for us while we're in this early stage? It seems like the prognosis for oral tumors isn't good, especially at 16 years old (both in terms of likelihood of cancer + treatment options once it's confirmed cancerous). Any recommendations for procedures or treatments I should consider? Thank you

 

[white shadow]

Hi C __caitlin !

Most oral tumors seem to be squamous cell types. While you wait for replies here, you might want to post the same question to the Facebook community formed just for this: Feline Squamous Cell Carcinoma.

Hope that may help.

 

[marshmallow2013]

My cat passed away from oral cancer, squamous cell carcinoma under the tongue. From noticing his first symptom of little saliva by his mouth, to not being able to eat, was just six days. It was a terrible shock how he became so sick in such a short time.

 

[silent meowlook]

Hi. Unfortunately, if it is a tumor, they usually are not very treatable. I have seen some cats get some extra time with Prednisolone. But it isn’t all that long. Usually months. That’s just in my experience. I have used Metronidazole successfully for oral bacterial problems.

 

[Antonio65]

My cat passed away from oral cancer, squamous cell carcinoma under the tongue. From noticing his first symptom of little saliva by his mouth, to not being able to eat, was just six days. It was a terrible shock how he became so sick in such a short time.

My Lola (my avatar) had the same kind of cancer, under her tongue.
I noticed that she would drop some kibbles every now and then, the vets said it was a gingivitis, but after a couple of weeks I found a drop of blood on the floor and noticed that mass under her tongue. The diagnosis was a shock to me.
She was treated with radiotherapy and chemotherapy, but that monster was untreatable, and Lola left me 8 months later.

 

[__caitlin]

Thanks everyone for your replies. As it turns out, we never did end up getting to do an official biopsy -- her FNA came back inconclusive, and given other internal conditions (CKD, hyperthyroid, heart murmur), we ultimately decided not to risk anesthesia + a surgery as major as trying to remove a piece of the jawbone. We did move forward with Palladia under the presumption that it is most likely SCC. But as you all have noted, this cancer is so aggressive -- I guess we won't ever know for sure if the Palladia helped in slowing the growth at all.

This is a really difficult position to be in, because her mouth is inevitably losing function -- but the rest of her body is honestly not so bad. Her CKD isn't late stage; her thyroid issues are controlled. And she's not in pain because her monthly pain medication works really well for her. It's really hard to make the decision of when to euthanize when she's currently still enjoying life in so many ways -- she still acts normal, plays, cuddles, etc. Considered a feeding tube, but it seems not worth the risk of undergoing anesthesia for what would probably only extend her life by a couple months at most. And on the other hand, obviously we don't want to wait too long for her to essentially starve to death.

If anyone has input / experiences with making these kinds of decisions, anything is welcome. We've had a lot of cats but all of them passed away of chronic illnesses; this would be the first cat we may have to make that decision for when the rest of her body still seems relatively "healthy."

 

[silent meowlook]

Hi. I think I may have mentioned before, I have seen one cat that had their mandible removed due to oral cancer. I would not do that type of surgery on my cat. The cat I am mentioning did have chemotherapy and did recover, but it was very short lived. She lasted maybe another month. She didn’t survive long enough to have radiation.

It’s a horrible cancer and a terrible location. I understand your hesitation for a feeding tube.

As much as I don’t want to say it, I have to. Cancer hurts.

I have always heard that it is better to euthanize a day early than a day late. With my horse, I euthanized a day early as she was still escaping from her pasture to eat other horses food and still mugging me for carrots. From the mid section foward, she looked great,I thought. Unfortunately her back legs were breaking down and the vet explained that soon she wouldn’t want to get up and that would be bad. It was so hard for me to do, but I did and second guessed myself and went through tons of internal stress over my choice.

Then 4 years later, while at work ( with horses) I witnessed and stayed with an aged mare in while she died before the vet could make it there. It was horrible and since then, I know I did the “right” thing. I would not wish that tragic agonizing “natural” death on anyone.

I have known cats where the owners waited to long and the cat had a miserable death. Very few die quietly in their sleep. Some, but not as many that die horrible deaths.

I waited too long with my own cat, Rusty. I just couldn’t see how bad he had become because, maybe I didn’t want to, or it happened so gradual. I don’t know. When I did suddenly make the decision, I could see the shock in the vets eyes as I pulled my once 17 lb cat, who was then 6 lbs, out of the carrier.

No matter what you do, it always feels like the “wrong” decision, and that is because it is a decision we should never have to make.

When I look back at pictures now, it took me years to be able to, I can see how far my cat, Rusty had deteriorated. I just couldn’t see it then. When I look back at pictures of my mare, Penelope, I can readily see the pain in her eyes. I see that pain in photos taken years before I euthanized her. Why couldn’t I see that then? I don’t know. Maybe I just didn’t want to.

I have found pictures to be useful, for me to be a little more objective. I would consider taking at least weekly photos and then comparing them to previous photos from the week before. It may help. It is what I do with my cat, Cheetah, who has lymphoma. It helps me, it might help you as well.

I am truly sorry about everything going on. I know it is so hard.

 

[fionasmom]

There have been members of TCS who have had mandible removal surgery and I respect them for the amount of effort that they put toward helping their cat. Of the ones of which I was aware or in contact, the cat did not live for very long after the procedure. My own cat vet completely refuses to consider that surgery.

I lost a cat, Matilde, to SCC several years ago. We did do the biopsy after I noticed a facial swelling and even that was hard on her and she never returned to anything like normal so I made the decision to euthanize her.

Can you hand or syringe feed Jelly? That, along with feeding anything that is acceptable including Gerber's meat baby food may help you to continue to give her a good quality of life. A feeding tube would help but I understand your point about anesthesia risk. If Jelly reaches a point where no food is taken in, you will see a decline in the other positive behaviors more than likely and you will know that it might be time to make a decision.