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!