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Veterinarian vs. Surgeon for amputation
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22 February 2017 - 4:29 am
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Back in September our cat, Bob, started hopping on 3 legs.  He wouldn't put any pressure on his right front foot.  Took him to the vet and the vet diagnosed him with a torn ligament in his toe.  He said to give it a few weeks and it should heal on its own.  It didn't.  It kept getting worse.  Took him back a few times and finally the vet said we should amputate the toe.  The day of that surgery  (December 29th) he called me while Bob was under sedation and said he felt a lump in his foot and thought we were dealing with cancer.  He removed the toe and the lump and sent it off for biopsy.  It came back as malignant, soft tissue sarcoma, nerve sheath tumor.  We had our fingers crossed he got it all and we'd be done with it.  Unfortunately, it has grown back and very rapidly.  Our choice now is to amputate the leg.

We got a quote from our vet.  I like him, but he's not my regular vet.  My regular vet owns the practice but is no longer practicing.  We were NOT impressed with the toe amputation.  He did the job, but it wasn't pretty.  So now we are faced with making a decision.  The quote we got from our vet was $1200.  We took Bob to a board certified surgeon yesterday (who we loved) but his quote is $3300.  OUCH.

I spoke with my vet (who owns the practice but no longer practices) and he suggested his wife do the surgery (she still practices there).  I just can't decide what to do.  My vet says his wife is a really good surgeon, better than him.

How did you decide WHO to have do the surgery?  Would you have a regular vet do it or go WAY above your budget and have the board certified surgeon do it?

My heart is telling me the surgeon, my head is telling me the vet.  I keep thinking this is major surgery.  Would I want my primary care physician to remove my leg or would I want a surgeon?

HELP! 

The Rainbow Bridge

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22 February 2017 - 10:02 am
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Hi Bob and family, welcome. Your future posts won't need approval and will appear right away.

We're sorry about the diagnosis and the situation you're in. It's definitely not an easy choice to decide between a vet surgeon and a primary care vet. Originally I was going to move your post to our "Treatment and Recovery" Forum because it's a choice that both dog and cat parents deal with. However I decided to leave it here, because there are unique things to keep in mind when a cat is undergoing such major surgery. I'm not a cat parent, but I'd want to know if either vet:

Not everyone can afford a specialist, that's totally understandable. If a general practice vet is all you have as a resource, then getting the surgery done is better than not doing it at all. But if the fee is something you can cover without going bankrupt or into major debt, then I feel that it would be preferable when it comes to cancer-related amputation.

Feline medicine hasn't really caught up to our canine friends' vet care, which is sad. I'd want to know that whoever performs this surgery has extensive experience handling cancer-related amputation surgery on cats.

Which leads me to another discussion. When the toe amputation was done, why was it 'not pretty'? What exactly happened?

Also, the fact that the original vet didn't 1) rule out cancer before your cat was on the table and 2) get clean margins for the amputation leads me to believe that he doesn't have a lot of experience in diagnosing and treating cancer, as well as cancer-related amputations. I'm assuming that the practice owner's wife doesn't either, as this is a primary-care practice? She could very well be an awesome surgeon, but I'd want to know what her experience is when it comes to cancer related surgeries. How often does she do cases like this? And what are the outcomes overall?

There is a good reason why any board certified practitioner charges what they do. Anesthesia and pain protocols are usually above average from a primary care practice, and they have far more experience in situations like this. As your gut instinct is telling you, this IS major surgery and the fact that cancer is involved complicates it further. You wouldn't want a family doctor to perform brain surgery, right? Same situation. I know, it's a shock. We're used to these choices for human medicine but it's still new when it comes to our animals. We're both blessed to have these choices, and cursed by the cost that it takes to make them happen. Yep, it ain't cheap.

I know our awesome feline members will chime in soon with their own experiences (and many did not go to a surgeon, so take my thoughts for what they're worth). Stay tuned.

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Michigan
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22 February 2017 - 10:53 am
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Hi and Welcome
Im sorry about Bob and your dealing with amputation and cancer.
Our cat Purrkins is 6 he had a soft tissue sarcoma on his front left carpus (wrist) He is 7 months post amp and doing fantastic!

I know this is scary and a lot of money ok! Truly get that ! We went with the surgeon. I agree with everything Jerry has stated above. If you can swing the Surgeon do the surgeon !

The first diagnosis and surgery was important and they did not get clean margins, which means this is going to be more even more aggressive. As you can see it already is .

If your proceeding with amputation this is not where you cut costs.  If at all possible.

You want what is best for Bob and Bob to have the best chance of getting rid of the cancer this time!

I would want to be sure I was getting the most qualified surgeon I could afford. You do get what you pay for.

Most places take care credit if that is a option. You charge it and make payments for the agreed amount time.
Whatever you decide we understand the costs and struggle we support you in whatever you do decide.

Just adding my opinion since you are asking for opinions.

Others will chime in, take all the information in and decide what is best for you and Bob.

I would do whatever possible to have the surgeon proceed.
Did they do X-rays bloodwork etc ?

Keep us posted please, give Bob a chin scratch from us
Hugs to you!
Holly & Purrkins

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22 February 2017 - 10:12 pm
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Ditto to all of the above. One thing to consider is the question of " did we do everything we could" so that you do not at a later point question yourselves. It seems you have done everything but the vets are taking a bit to catch up...so, all other things being equal, IF possible, go to a specialist for major surgery. My local vet is FANTASTIC and has been in practice for almost 30 years AND graduated from the Vet School I take my menagerie to. HE would recommend that I go to the Vet School for all of the above reasons. He wouldn't hesitate to make the recommendation. But we all certainly understand the dilemma...why are specialists so much more dang expensive...very best wishes to Bob ( LOVE his name:) and your family, hugs, and PyrPaws all around!

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22 February 2017 - 11:32 pm
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I live in a small community and there are no certified surgeons. My cat's tumour was growing so quickly that I wanted her leg off immediately and there was no time to search out others to do the surgery. I'm very comfortable with my vet and he phoned the big city surgeons to consult. Through them he found that it was best to remove the scapula when amputating the leg. I was also comfortable because he showed me the surgical suite with lots of equipment and I met the team of many who would be working with the vet during the surgery. The amputation cost $2,000 and Mona, my cat, went home with the vet the night after the surgery.

I have no opinion either way because I had such a great experience with the clinic and Mona continues to have a relationship with the vet and the team. She is very comfortable at that clinic and loves the attention they give her.

Jerry asks a lot of great questions. You might find what is best for you when answering those questions.

Hugs to both you and Bob,

Kerren and Tripawd Kitty Mona

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23 February 2017 - 5:12 am
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Thank you everyone for your replies!  They really have helped in my decision.  My vet IS a feline friendly practice.  I've been taking my critters there for over 10 years now.  I ADORE my vet, just wish he were still practicing.  I called my vet's office twice yesterday and was going to talk to the vet's wife and grill her about the procedure and make the appointment.  Both times I got put on hold at the initial contact (as in "thank you for calling, please hold") and was left on hold forever so I hung up.  I'm taking that as "my sign".

I'm probably going to have to sell a kidney or my soul to pay for it, but Bob is worth it.  Bob is a VERY special cat.  You can read how we got him here.

http://www.purr.....ry-of-bob/

I have a message into the surgeon's office (the surgery assistant who schedules everything was out sick yesterday) so I will be making the appointment today and surgery will probably be next week.

Virginia
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23 February 2017 - 8:40 am
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Awwww....just looked at the photos and the backstory of BOB!!!! Clearly Bob was sent to you by your dear friend! You have a very special Guardian watching over you 🙂

I hope your appointment goes well with the Surgeon and you get the answers you need. Perhaps you can work out some sort of payment plan. You can also discuss where some costs can be cut if something isn't absolutely necessary.

Thanks for sharing your precious Bob with us! He truly is adorable!

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!

Michigan
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24 February 2017 - 8:45 am
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Bob is adorable! There is something special about Orange kitties and the love bugs that they are😻 I agree with Sally Your dear friend gifted you with Bob. He has a special mission.

Always listen to you gut instinct , thats always the right choice! You were looking for signs to confirm you gut instinct. 

No selling souls or good body parts allowed ok😉 Payment plans can be worked out in some form I'm sure.

Let us know when surgery is scheduled, we will be here if you have questions or just for support.

Hugs,

Holly & Purrkins

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24 February 2017 - 11:40 am
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I am sending emissaries (DaBears) to come catnap the Bob. OOOOOOOOhhhhh myyyyyyyyyyy CAAAAAAAAAAAATTTTTTTTTT. Likely you could pay for the entire process just by sharing his adorable likeness as a screen saver...BOB!!!! (And we have had a Bob and a Buddy Bob Cat so we know just how purrrfect that name is). BOOOOOOOOOBBBBBBBBB! DaBears are on their way!!!(They will remain at home IF there are more Bob pictures posted...)

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24 February 2017 - 11:56 am
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Bob's surgery is scheduled for Monday.  I drop him off at 7:45am.  He'll have to stay overnight and I can hopefully pick him up Tuesday afternoon.  Right now he is drugged up and sleeping in the laundry basket.  He really is the strangest cat I have ever met.

Bob has his own Facebook page for more pictures!    

https://www.facebook.com/CrazyCatBob/

Michigan
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26 February 2017 - 9:32 am
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Sending Pawsitive energy for you and Bob tomorrow. We will be thinking of you .

Let us know when you can that Bob did great in surgery and is in recovery.

Hugs

Holly & Purrkins

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26 February 2017 - 2:15 pm
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Just been getting up to speed on Mr Bob Cat. What a treasure! Love the story of how your lives became entwined. Will be thinking of you and your boy tomorrow.

Sending every good wish,

Meg, Clare and Elsie Pie xxx

Meg, Mutt, aged around 8, adopted 31/12/2009. Sudden explosive right elbow fracture 06/12 (caused by IOHC), diagnosed with End Stage Arthritis 03/15, Total Elbow Replacement 08/15, problems with healing leading to skin graft & skin flap surgery, Chronic Infection leading to implant breakdown. Became a Tripawd 9th March 2016. 
Lives with Elsie Pie, & Mum, Clare, watched over by Angel Billie
My life as a MEG-A-STAR 


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27 February 2017 - 7:21 am
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Just dropped Bob off at the vet.  Surgery will be sometime between 1-3pm EST today.  I am a nervous freaking wreck.  He woke us up at 4am this morning crying because his foot hurt.  sad  I sure hope this solves his problems and we can move on with life with him back to his normal wacky self!

Michigan
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27 February 2017 - 7:51 am
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Today is one of the hardest days! Just remember this will help Bob ok! It stinks beyond belief we have to amputate the leg, but this is the best and only choice to help Bob! Hold on to that ! This will get rid of his pain long term. Hopefully get rid of the cancer long term that is the goal!

Make sure to have a good pain protocol in place before bringing Bob home. That will make a huge difference in Recovery for you both!

Stock up on some of his favorite foods, stinky wet foods worked best for us in recovery. Some kitties do not want to eat so kinda be prepared for that by having some favorite foods for him to entice if you need to. 

As far as recovery goes when Bob gets to come home. We always say block off under the bed before Bob gets home. You will want to be able to get to him for his medication and most times if allowed under the bed they will go. Its instinct to want to hide when they come home. You can stuff pillows, blankets etc under the bed or put mattress on the floor whichever works best for you. We had Purrkins recover in a spare room and put the bed on the floor. Purrkins chose the closet to recover in. 

Has Bob had a cone on before? We used baby onesies for Purrkins. We got permission from the surgeon to use those instead of the cone. 

I will put a video here for you to see Purrkins play! This will assure you Bob will be ok !This video is at 6 months post amp,

Hope this helps ease your worries some!

Hugs

Virginia
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27 February 2017 - 8:16 am
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And eat lots of junk food....it does wonders to help relieve stress, especially chocolate!

Bob will be high as a kite and seeing pink elephants today!

Update when you can.

Hugs

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

PS...Is that Purrkins adorable or what'

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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