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One week till surgery!
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23 August 2017 - 7:24 pm
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Hi everyone,

We are just one short week away from our front left + scapula amputation surgery for little Maceo! He has been the bravest and most patient patient, through 20 sessions of radiation therapy (including 2 days when the machine was broken but he still had to fast till the afternoon just in case), daily supplement dosing, and living away from home in a hotel in Davis, CA for a month of our summer. 

We are pretty nervous. The surgeon we are seeing is Dr. James Farese, and he is very well regarded around here, but he is a free agent and doesn't work full time at the clinic. Therefore, it's very hard to get ahold of him and get any information (it's all via his email, which he doesn't seem to check every day). 

I'm so thankful for Tripawds and all the resources around pain management, onesies, the right kind of litter and everything else. 

Poor Maceo is clearly in pain, according to the IVAPM guidelines, and yet he still manages to be his sensitive and curious and (way too!) intelligent self. We were told by our radiation oncologist at UC Davis that the fibrosarcoma cancer had eaten away at the bone of his scapula, so even though the textbooks say that "fibrosarcoma doesn't cause pain," it certainly does if the bone is being destroyed by cancer cells. We have Tramadol as a transdermal, but I've been concerned about using it unnecessarily given that it could affect his appetite, and we need all the pounds and ounces we can keep on his little body.

I am very concerned about pain management because I haven't heard a word from the surgeon or the clinic on pre-operative medication, or what they plan to do post-op. I called and emailed today and hope to hear more by tomorrow. I've asked about the Gabapentin and Fentanyl as pre-operative measures, since I read about that here on Tripawds in this extremely useful article about pain.

With all this going on, we have our jobs and random other stuff too 🙁 I wish I could tell the world to stop since my baby is having a big procedure next week, but it's hard to explain how much care he needs (already! and the amp hasn't even happened yet).

Anyway, I had a couple more questions and was hoping folks here would have some thoughts:

1. Eating and appetite

I am super concerned about this as poor Maceo is already exhibiting a significant loss of appetite, possibly from pain.

What can I expect from his eating and appetite after such a major procedure?

2. Pre-operative state

He is not doing so great right now, as defined by his eating, weight and general activity level. Mostly I'm worried about his eating, and the fact that he has gotten quite skinny (might look normal to a bystander, but he is naturally dense and round -- we are pretty sure he has some Bombay or Burmese based on his density and his features). He is just 11.2 pounds now, down from 12.5 back in March and (a somewhat overweight) 14 in January. 

Normally we would want to be at our strongest for such a monumental recovery task, and so I'm very worried -- especially since I know eating will go further downhill post-op.

Is this weakened state an ok state for him to be in, entering into such a major operation?

3. Litter

I know Tripawds has previously recommend an antibacterial clay litter for senior kitties. The only issue is that Maceo has an unfortunate habit of EATING that brand of litter, and I've read that the clumping nature can cause major intestinal problems. It's very hard to stop him from nibbling it.

Would our regular litter be ok?

We use a tofu-corn litter that's incredible (brand is called Greenenqi on Amazon), but it's not specifically antibacterial. We also have World's Best but it smells awful. The tofu one is completely odor free -- magical. 

4. Cat brother

We also have a kitten named Charlie who is about to turn 1 year old. Charlie and Maceo are not a bonded pair, as Charlie was only adopted and introduced 4 months ago, but they get along decently. Charlie tries to play with Maceo, and also stalks him quite a bit, and Maceo hisses or growls, but they don't fight otherwise. Whenever we notice Charlie engaging in stalking behaviors, or otherwise tormenting Maceo, we separate them by putting Charlie in a time-out, or distract him with play. Still, we are concerned about what to do post-op.

Should we separate them for several days / weeks? Do we need to reintroduce them if they've been separated, almost as if they were strangers again? How can we make sure Charlie does not torment Maceo while he is recovering?

When Maceo was a kitten, he had to have emergency intestinal surgery after eating a toy that ended up scratching his small intestine and creating an absess inside. It was Christmas 2007, and we had to take him to emergency up in Seattle where I was visiting my family. It was so stressful, but the main thing I remember is how incredible his recovery was. Well, there was no "recovery" really -- it seemed like he went from pre-op to recovered just like that, instantaneously. He was totally normal afterward, and very happy and hungry. Those were the kitten days, and that wasn't cancer.

I am hoping that what people say about cats recovering well from amputations is true... and can be true even for cancer kitties who have been through the lion's share of suffering already. He has been so brave. All those car rides to the radiation clinic. All those pokes for anesthesia. All those hours and days and weeks with the catheter and the cone! Now he is finally home, but soon we'll have the surgery phase in our lives.

Needless to say, I love Maceo more than I can describe or even understand, and just want him to be happy and pain free!

If anyone is reading this and can offer advice, I would greatly appreciate that! Also, if anyone is reading this and NEEDS guidance on radiation, I'm happy to tell all I know. It was an interesting process and I learned a lot about the different types and how they work, plus side effects etc. His fur has fallen out in the radiation site, and the skin is a bit flaky, but nothing extreme and he is still incredibly handsome.

Anyway, thank you very much in advance for all the info and all the support. 

Oh! PS. I started a blog for Maceo. It needs a LOT of work (have been quite busy with my job), but I'll piece it together little by little

http://maceo.tr.....pawds.com/

Thank you again! 

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23 August 2017 - 10:19 pm
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I’m happy to answer your questions based on my experience. Congratulations for making it through the radiation treatment.  Macao is very brave.

I imagine Maceo has pain since the fibrosarcoma has affected his bone. Could you try the Tramadol just to see if it does affect his appetite? If so, you can stop. Although food isn’t Mona’s main focus the vet put her on canned kitten food and she devoured it. Kitten food is high in calories, protein and fat.

What can I expect from his eating and appetite after such a major procedure? Mona loved the canned kitten food. After 4 days or so I slowly started her on her regular food.

 Is this weakened state an ok state for him to be in, entering into such a major operation?  The surgeon would not do the surgery if he doesn’t believe it’s safe for Macao.

 Would our regular litter be ok? I believe its okay, just so it’s not dusty. I was told to use Yesterday’s News but Mona wouldn’t use it so I had to go back to her regular litter.

 Should we separate them for several days / weeks? Do we need to reintroduce them if they've been separated, almost as if they were strangers again? How can we make sure Charlie does not torment Maceo while he is recovering?  Since Charlie is still a pesky youngster you might want to have a safe, quiet space for Maceo and only bring Charlie in for supervised visits. Eli is 2 years older than Mona and he was very sweet to her and acted like a protector but this may be unusual for many cats. I hear some don’t like the hospital smell.

 I hope he’s pain-free, happy and will be able to chase Charlie soon.

 Kerren and Tripawd Kitty Mona

Livermore, CA
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23 August 2017 - 10:37 pm
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Hello and a belated welcome to you and Maceo.

I'll leave it to our wonderful kitty parents like Kerren to answer your cat specific questions.  I've had cats in my life, but not for many years, and never went through a major surgery.

I wanted to let you know that we have a Nor-Cal Tripawd group that gets together at a dog park in Mill Valley a couple times a year.  Not expecting Maceo and Charlie to attend, but if you wanted to get together with some Tripawd folks and pups we would love to meet you! I haven't posted anything official yet but the next gathering will be November 4th.

Best of luck with the surgery.

Karen and the Spirit Pug Girls

Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.

1999 to 2010

 

              Maggie's Story                  Amputation and Chemo

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24 August 2017 - 6:52 am
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Thank you so much for the info about the group, Karen -- I would definitely love to join, and November is the perfect time 🙂 Do let me know.

We've been longing to adopt a dog but have been waiting for all the surgery stuff to blow over till we do. Maybe by then! 

Kerren and Mona -- thank you for the info about your experience! I've loved your blog, and Mona is simply amazing. I really hope Maceo can be a Mona! 

The kitties got along fine during Maceo's 4.5 weeks of daily radiation, where he would leave and come back with a weird cone and catheter attached to his arm, but we are definitely going to give him his own separate space that Charlie can't access. If we have to do reintroduction, so be it -- been there, done that.

Yes, we will try the Tramadol again starting this morning. We have a transdermal to make it easy, but he still seems to hate it! It's definitely a 2 person job to get it in his ear.

Thank you all again, now it's just a countdown till the Big Day! 

The Rainbow Bridge

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24 August 2017 - 10:43 am
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Hey Susan, I know the build up to the amputation must be making you nervous, it's been a long time leading up to this. So I'll ty to help answer your questions:

What can I expect from his eating and appetite after such a major procedure?

Most animals do lose their appetite because of the pain meds. Have the stinkiest, most favorite foods of Maceo's on hand and whatever you do, don't mix the meds with his food. Tramadol is so bitter tasting, it can really ruin a pet's appetite for a long time afterward. Feed off different plates and bowls to keep things interesting for him. Also, these Tripawds Nutrition blog tips can help:

Amputation Recovery Supplement Helps Tripawds Get Healthy

Easy Fish and Meatballs Recipes for Cats and Dogs

Is this weakened state an ok state for him to be in, entering into such a major operation?

Ditto what Kerren said.

Would our regular litter be ok?

I would think so if he hasn't had any issues with it.

Should we separate them for several days / weeks? Do we need to reintroduce them if they've been separated, almost as if they were strangers again? 

This Forums discussion can give you some insight on how others have coped.

How Did You Prepare Your Other Cats for the New TriKitty?

I hope this helps. Let us know what else has ya worried and we'll try to ease your fears. Hang in there, you're doing GREAT.

It's better to hop on three legs than to limp on four.™
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27 August 2017 - 7:05 pm
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Thank you so much for the resources index. By the way, we spoke to the vet at the surgery clinic (different person than the surgeon) and she strongly recommend TRIPLING the dose of Tramadol, since we're giving a transdermal and it's weaker. She said it was most likely pain that was causing his inappetence, not the medicine, especially since transdermals shouldn't do that. She was pretty adamant! 

I was worried about further side effects, but decided to try it one night. In the night, he snuggled with us (hasn't done that for months since the cancer) and the next morning, he woke up loudly demanding breakfast. Then proceeded to scarf down his whole breakfast and then a second breakfast, then lunch, then a second lunch, then dinner, then treats!

They also gave us Buprenorphine, which really sedated him, and now we're just restricting that to nighttime use. 

The surgeon finally spoke with us and encouraged us to separate the cats, but wasn't necessary to make other accommodations. He said he even front-amputated his own cat, and they are remarkable at recovery. I hope he's right! 

We do have one set of pet stairs for the bed, and we'll probably get another set just in case. 

Tomorrow, we will start the Gabapentin (three days prior to surgery). 

Other than that, it's all about fattening him up before the surgery! Thank you all so much for the support and especially the tips.

Virginia
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27 August 2017 - 8:39 pm
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Really interesting  about the pain meds and how the Vet had you tweak them. Sooo glad Maceo started feeling better.

Have the Vet prepare you for the way Maceo  may  react to Gaba in conjunction with the other meds.  In dogs, sometimes it can have a sedation effect.

Keep eating Maceo!  You need to chunk up, okay?

Hugs

Sally and  Alumni Happy Hannah and Merry Myrtle and Frankie too! 

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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31 August 2017 - 8:02 am
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Today is Maceo's big day! We just gave him his Gabapentin (it has been fine for him, a little sedating but not much) and will leave for the hospital in 20 minutes.

His last CT was the day before yesterday and everything looked the same as back in early July. 

We are extra anxious! I guess that's normal. A lot of the anxiety is because of the tumor location (on his shoulder blade / neck) and how much 'cat' the surgeon is going to have to excise in order to get that giant tumor off.

I know everyone says tripawds do great, especially cats, but I can't help but wonder to myself -- what about when the tumor is right against the torso almost to the midline? This is not a tumor on his paw or leg, but really right against his torso. That's so much cat! 

Anyway, I guess the surgeon wouldn't agree to it if he thought it were impossible or risky. I'm glad he's been relaxed at all of our interactions, because I sure don't feel that way inside.

Here he is being extra snuggly on his last night as a quad (yes he has put on weight :O !!

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Here's hoping for the best, let's see what the surgeon says in a few hours...

The Rainbow Bridge

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31 August 2017 - 9:29 am
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All paws, tails, fingers and toes crossed here for you guys! Of course you are nervous but that's OK. Once you see Maceo's sparkle come back you'll be amazed at his resiliency. You will be inspired!

He's in great paws, try to remember that and stay strong. Keep us posted oK?

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Virginia
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31 August 2017 - 10:46 am
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We're all here cheering for Maceo!!!    

  Anxious??? Oh heah, we all understand "anxious"   I was sooooo scared I even cancelled my Happy Hannah's first scheduled appointment!!      Recovery was no picnic, that's for sure!   It took me three weeks before I could finally say I did this FOR her and not TO her! 🙂  

STAY CONNECTED!!!   We'll halp you navicw theough all this and we'll celebrate with you wihen Maceo's sparkle comes back!

Hugs

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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31 August 2017 - 8:59 pm
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Black, short-haired male cats are the best! I had a male that cuddled just like Maceo did in the photo. You may have many cuddle days ahead...

Yes, he will have a massive incision. I'm sure much larger than Mona's because his will go across the upper back. Not to worry, it will be neat and tidy. The surgeon will do a great job.

Ultimately I doubt that the location will affect him any differently than Mona who also had the scapula removed. 

I hope the anxiety has lessened for you. It will be better when he gets home.

Hugs,

Kerren and Tripawd Kitty Mona

Livermore, CA
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31 August 2017 - 9:08 pm
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I hope everything went well today, please update when you can.

Karen and the Spirit Pug Girls

Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.

1999 to 2010

 

              Maggie's Story                  Amputation and Chemo

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2 September 2017 - 11:56 am
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Hi everyone,

Thanks for all the kind support, makes a huge difference -- one of my favorite moments is logging in to Tripawds!! 🙂 

Well, Maceo is doing GREAT. His surgery started much later than expected on Thursday, due to a mixup with the surgeon's schedule, but they got it done. 

We actually visited him on Thurs night, about 6 hours post-op, unfortunately because our other cat had to go to emergency for inhaling some water (thank goodness for insurance for that kitty!). Maceo was waaaay excited to see us and began thrashing around and trying to walk, obviously high as a kite and not aware that his arm isn't there anymore. We kept it short, but it was great to see him.

Yesterday, Friday, we went to visit him again and drop off some extra Gabapentin. He looked amazing! Thanks to the pain meds I guess 😀 

The best part was that there was an empty food tray, indicating he had eaten about half a can of wet food, and then he gorged himself on the special Origen kibble and treats we brought with us. He definitely ate a full sized meal, if not more, and was so excited that he overturned the dish multiple times. 

The surgeon had told us that they often won't want to eat for several days, and especially while in the hospital, so we took this as a very positive sign that he is doing well.

His incision is enormous, because the tumor was so spread out, but the surgeon felt that it was a good excision. There was a part of the tumor that was up on his neck, and fortunately, the surgeon said there was some fascia or something else protecting his neck, so he was able to just "peel" off the tumor without carving into the neck muscles. Sounds like it was a fairly standard removal, except that the surgeon worked really hard to carve it up precisely (this guys is really in demand -- performed a surgery in Nevada that morning before coming back into San Francisco!).

Maceo still looks absolutely adorable:

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Also, I think they probably cleaned and fluffed up his fur as part of the surgery! 😀

We've missed him so much, and we are very excited to pick him up in about an hour and bring him home finally! They've already weaned him off the morphine drip, and his Fentanyl patch will be good through tomorrow. 

The surgeon said the first night is the most painful, so I guess we've passed through the toughest part of the pain and it'll be up and up from here.

We are very concerned about tumor recurrence, so we are starting him back on his supplements TONIGHT. Poor guy, back to mushrooms and fish oil. 

East Tennessee
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2 September 2017 - 3:33 pm
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Excellent news!  Sounds like he is in excellent hands.  Love his big, bright eyes.  What a handsome fellow!

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2 September 2017 - 4:02 pm
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He looks so little! And, of course, so adorable!

This is wonderful news. Keep it up Maceo. You've been through so much that it's time to go back to just being a cat who doesn't have to go to smelly animal hospitals anymore. Well, maybe one more time to get the stitches out.

I'm sure you'll get a lot of attention and cuddles when you get home.

Kerren and Tripawd Kitty Mona

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