Fibrosarcoma

[FarrahFawcettsFlick]

Flick Cat had a lump removed from her ear about 3 1/2 yrs ago. Results were abnormal but not cancerous. Margin around lump was clear of abnormal cells.

Christmas 2011 lump was back and ulcerating. Ear was removed. Results again were abnormal but not cancerous. Margin again clear.

Christmas 2012 stump of ear became very swollen very quickly. Vet initially tried different types of antibiotics. Took samples of fluid by needle. Not a bacterial infection. Ear still swelling. Vet then thought it could be an auto-immune problem, tried steroids, ear still swelling.

Vet did a punch biopsy, results came back as fibrosarcoma. I feel so guilty. Back when the lump was first discovered on her ear the vet did offer me the option of removing her ear. Then the operating vet said he could remove lump and retain (odd shaped) ear. Vet said the other lumps were not necessarily a pre-curser to the FS. That Flick Cat could just have been very very unlucky on the same ear. I just think it's a bit odd she's had all the problems on the one ear.

So, my options are now an operation. This means removing the ear stump completely with at least a 2cm margin around the stump. This would entail a massive skin graft and reconstructive surgery. She doesn't have a 2cm margin available. Surgery can't guarentee the FS doesn't return. The other option is pts.

Flick Cat is 17+ yrs old. With an undiagnosed mass behind one of her kidneys. X-ray and ultra-sound couldn't reveal what mass is. Surgery is looking unlikely with unreliable outcomes. I just feel cheated. She's in reasonable health for an old lady. She still gets out and about, snoozes a lot and talks to me all the time. Who else is going to sleep on my pillow, mither me for roast pork, cuddle and groom my hand? Whine to go out and knock at the door a micron later to come back in - moaning at me that I took too long, and take me to bed in the evenings.

Just feel sad. How long do I give her? Feels awfull the wait, knowing I'm
weighing up everyday looking to see how she is.

[cozietoesie]

Oh Dear. That's not good.

Does she seem in any discomfort ? (I know cats are good at covering up but you can often tell.) Did the vet put her on any meds and what sort of prognosis did he give her?

[FarrahFawcettsFlick]

No, she seems in good sorts and I did ask the vet about pain relief but he didn't think she needed it (at the moment). I'm waiting to hear back from the vet. He has been speaking to an oncologist specialist, but from what my vet has said and not said (he hasn't gone down the route of discussing alternatives) the standard treatment is surgery, which is not looking promising.

When I asked about how much time to give her, the vet said there was a high rate of cell replication - ie the cancer is growing rapidly. Althought the cancer won't in itself kill her (spread to other places/organs) it will become so large as become its own problem. Basically it only going to get bigger and bigger quite quickly. And it is getting noticeably bigger from when I first took her to the vet's in November.

I know she's old and with age comes a whole host of medical problems but you (I) just push it to the back and hope one day you wake up to find them gone. I think I'm finding it hard to deal with because it's her ear. If she had been found to be riddled with cancer I could see the kindest option would be pts. But it's an ear!

If there was the margin I would definitely go for the op if the vet found her in good health. She coped very well last year when her ear was removed. I don't know, even if the ear was removed she would gain what, a year or so? Death by a thousand cuts! Do you say enough, quality of life, this is a good point to go or see how much longer you can gain. If it were my DM and she said, "Farrah, I've had enough" I'd have no qualms about a one way trip to Switzerland! I know my DM well enough to respect and understand her. But with Flick cat, I don't speak much cat. It's all down to my ability (or not) to let go.

[cozietoesie]

So difficult. I'd go for surgery at that age but not heroic surgery. I hope she remains comfortable and pain free for a good bit anyway.

All the best to you both.

[dikkertjedap]

How long does the vet expects it takes her to recover (skin graft and reconstructive surgery)? What does the vet advise?

If she seems happy and if the vet can reassure you re the above I would go for surgery.

[PK1975]

Hi. My cat had this kind of tumour. It was on his back. He was only 7 at the time. We left it until it really needed removing as it wasn't bothering him but 6 months later there were 3 more lumps. As he'd recovered so well from the first surgery and was a happy, well cat we decided to have the other lumps removed. Almost straight away another appeared and then a few more. He also started to become unwell. 6 months later, the tumours were big and he was very unwell so we put him to sleep. It's an awful condition and it robbed us of our gorgeous cat.

I remember our vet saying that if he'd had it anywhere they could take a decent margin (like a leg or ear) he would have had a different outcome.

Good luck x

[jasmine31]

I would want to get the opinion of a soft tissue surgeon to find out what they feel the chances are of the surgery being curative. This is major surgery and IMO would only be justified, particularly in an elderly cat, if there was a high chance of complete cure. It would seem a shame for the cat to undergo such major surgery if the tumour was going to recur again, putting you in the same position a few weeks/months down the line.
You could ask for referral to a specialist surgeon to discuss the options after they have examined your cat as it might be difficult to assess the available margins just by your vet's description or even with photos. Before contemplating surgery, the vet would probably want to check bloods and urine, particularly for kidney function, as the presence of kidney disease might affect your decision re surgery and would also limit the pain meds that could be safely given.
I have amputated the leg of a 16yr old cat with a fibrosarcoma (I'm a vet btw) and it recovered very well, the tumour didn't recur (and the cat died a year later of something else). Before operating I did ask the opinion of colleagues as to whether surgery was really a fair option, given the cat's age but on balance it seemed worth it in the end. I have to agree that removing an ear stump with adequate margins would be much more difficult though and I'm not sure I would go down that route if it was my own cat. Very difficult decision though. Good luck.

[FarrahFawcettsFlick]

Thanks for all your responses. We've decided not to go forward with surgery.

• the specialist quoted £4.5k for the op, including scans to check the spread of the tumour.
  
• the tumour could reoccur.
  
• difficulty with the position of tumour and available margins.
  
• Flick Cat is at least 17yrs, how much longer, even if the tumour was successfully removed would she have in good/reasonable health.
  
  I don't want to spoil whatever time she has left with a big op, recovery and potential reoccurrence of the tumour.
  
  My vet thinks that given the rapid growth of the tumour Flick Cat will have till Easter-ish before it becomes too uncomfortable for her. We've decided that her last few weeks will be comfy and filled with delicious treats, before pts.