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Deciding on Amputation for 15-yr old cat Squamous Cell Carcinoma
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17 January 2018 - 12:10 am
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Hello, I'm a new member here and found your site upon researching feline leg amputation topics. Looks like a great group! 

Ahhh... this is probably going to become a long, drawn out story, as I imagine cancer sagas can easily become, whether we want them to or not! But, maybe you can bear with me, (and pardon my grammar), I'll try to be brief! As some of you can probably relate, the past couple of months have been a rollercoaster of emotions... I'm "servant to" ^_^ the greatest 15-year old lilac lynx point siamese, Spirit, the love of my life! <3 He's essentially my "therapy cat" and has been with me longer than any human I've ever lived with, and he's just the sweetest, best little guy I could imagine! Everyone comments on his calm, gentle, cooperative nature. He's a perfect angel, just amazing how well behaved and innocent he really is! He's already had a digit removed on his front right paw that had a squamous cell carcinoma tumor overtaking it, and now, an month after surgery, another tumor has formed, so a full leg amputation is something I need to decide about asap.

At first we were unsure if the first tumor was just an infection, so they treated it as such, with antibiotics... but thankfully, my vet recommended doing an aspirate on it within the first week and a half of his being on the antibx, because they were not shrinking the growth. It came back as squamous cell carcinoma. Then it was clear that the digit needed amputating... so off he went to have x-rays and bloodwork pre-op, and in the x-rays, an unidentified "blur" /mass was shown in his lung area. However, no conclusion could be drawn about it with clarity, as two board-certified radiologists were unable to say that it was or was not a tumor, so they recommended a CAT scan.

In the meantime, while I was trying to raise $ to do the CAT scan, a new growth started to form in the area where the digit was removed. I was diligent in checking it, and let the surgeon know right away my suspicion, sending pics of the area when he asked me to do so - once, and then again a few days later when it was already growing slightly larger. He looked at them & dismissed me as being paranoid... However, within a week, I went to see my regular vet with Spirit, at which point it had grown even larger, and she validated my concern & did an aspirate on the bump. Once again, it turned out to be squamous cell c. 

I was all too aware that time was of the essence if the tumor was already growing at this rate. I'd already found out how fast the first one went from bad to worse and had to deal with the bleeding, bandaging, soaking, treating, medicating, and seeing my poor little guy in pain for too long at home between the initial discovery, then finding out it was squamous cell, and getting the digit actually removed. Motherly instincts sure kick in when what needs to be done to expedite things feels like life-and-death every step of the way... The whole backpack of emotions and dealings that come with that first cancer diagnosis, seeking out a surgeon, having the consult, researching every possible thing I could about the diagnosis, prognosis, alternative therapies, etc., x-rays, bloodwork, more research, questions, answers, and waiting to get in to have the digit removed. Some of you know!

So, since it had been aggressive the first time around, I knew this time, to nip this in the bud asap. I didn't know if any changes had taken place in the lungs yet - but if they were looking ok for surgery, I wanted - hoped - that there was a chance to take just another digit, even just to buy some time. I think we all wish to have to do the least amount of surgery we can and still keep our furbabies comfortable/quality of life up. And although the surgeon had originally considered taking two digits, (the second being the one that's now infected), and said that Spirit would be able to walk ok with the two gone, he only ended up needing to take the one. I knew there was a chance of the s.c.c. returning, and we'd also briefly discussed the potential of taking the whole leg if things got much worse. I wanted to focus on the best possible outcome, hopeful with the digit removed, he would be in remission.

Unfortunately, while trying to set up an appt to have the original surgeon see about taking digit #2, (the same one who took the digit and I was hoping would be able to do any subsequent surgeries), we had a big falling out over the phone, where I hung up crying and feeling disrespected. I already was feeling distraught and awful that the cancer had come back so soon, fearing the worst, not wanting my little guy to be in pain and unsure of what the best course of action would be, with the lung in question as well. I was even more disappointed after that call, feeling back at square one, not comfortable now to return the original surgeon, and having to find someone new and unfamiliar with Spirit - and again, time is of the essence! 

So, I called up all the vets in the area who do surgery, and found most would be unable to even get Spirit in for weeks or months! Then finally I found a vet who might be able to perform the surgery as quickly as possible, and was able to consult with me that day (today!). He examined the tumor, and had been willing to take another digit if it was feasible, but concluded that the best option for surgery, if I wanted to go that route and the lungs & bloodwork checked out, would be full leg amputation. Now it was real. We talked about the alternative - pain management and no surgery, and that doesn't feel like what Spirit would be happiest with. I do wish there were more options/alternatives. I'd heard of cryotherapy and photodynamic therapy, but no one in the area seems to offer those.

New x-rays were taken, and the lung "mass" has not changed or worsened, thank goodness! Still... there's "something" unknown there and I'm trying to have a radiologist weigh in on the lastest images. The uncertainty of the lung thing is my one major hesitation... because I would feel so awful to go through with the amputation only for the lung to "go viral" and do him in, living out his last days unnecessarily sans a leg. Doing a CAT scan to be sure at this point is not in my budget, and because the x-ray was clear enough to give the surgery a thumbs-up at this point, I'd rather tackle what we know is causing problems and is a threat.

I almost forgot to mention, as has been noted to all vets, Spirit had developed a concerning cough, around the time of the digit amputation, which made me really worry about the lung issue. It was a dry cough lasting up to 30 seconds at a time, starting every other day and then increased to a few times a day. It peaked last week, but in the past few days he has not coughed at all! I'm glad of it, but wonder what changed? I run a humidifier, and took him in the bathroom while I showered, as regular vet advised, in case the steam might help and perhaps it was the cold, dry winter air? He also stopped having hairballs though, which he would get up at least once a week or every other week throughout his life... but regular vet said maybe it was because he didn't groom as much with the arm bandaged for weeks post-op. (Makes sense, but still... it's been out of the bandage and grooming regularly with hair regrowth now for a couple of weeks).

His eating habits have changed a bit since the new tumor started forming - less interest in finishing meals, and for the course of the disease, his eating time has slowed (not his appetite, just the actual time he takes him to finish a meal) which seems to have something to do with his sense of smell or sight, as he sniffs around the bowl for a long time, then determines nothing is left and walks away, but if you put something new down (especially fish! though I try to limit his intake of fish) he'll gladly start up trying to eat again.

There are some other variables I have to consider as well - the new vet's practice does not offer overnight care, so I would need to take Spirit home the night after surgery... slightly risky imo, as the other place kept him overnight with 24-hour care. He also wants to have me come in the day before to give Spirit a Fenatyl patch to put on in order to get the pain meds flowing through him before his surgery the next day... I wonder if any member have had this experience & what your thoughts are on this if so? After some research on that, I'm going to ask if there is another alternative, because it left me feeling uncomfortable with that option for a number of reasons.

There is a definite plus if I go with this vet - he can do it soon (this Friday even!) and the operation itself is almost half the cost that it would be at the first surgeon's office. I feel fairly confident about this doctor from what I could ascertain from his demeanor and answers to my qs, reviews of the practice, etc.

My regular vet (she doesn't perform surgeries like this, and she's only at the office in my area a few times a month, unfortunately), who's been a god-send through all of this - her hunches being right each time, ended up conversing with surgeon #1 and getting him to "step back" and see that we were really all on the same page, but the communication got really out of hand. She said he was willing to still do surgery on Spirit if I wanted, and the plus to that is he is a bit more experienced, a board-certified specialist, who already knows Spirit, whereas the new vet/surgeon I'm going to is not board-certified, but has done a number of amputations and seems to know his stuff without being cocky (not so for surgeon #1 :P). The Fentayl patch recommendation from the new vet though - to have it put on the day before surgery, would have to be discussed more/work out an alternative and I wonder how wise of a recommendation that is in the first place. If I went back to surgeon #1, it would be more $, a longer wait to actually do the surgery, and I'm not sure how cool I am with that intermediary tech who is also the hospital manager, and would surely be there at some point if Spirit was there overnight. I would really, really have to trust that none of the personal issues we had would be brought negatively into Spirit's surgery or care. 

So... I'm planning to consult with my regular vet again tomorrow after she sees copies of the latest x-rays, and try to decide 100% for or against amputation, ask her thoughts on the Fentayl patch as well... Then if it's 100% for amputation of his leg, I have to figure out which vet/surgeon to go with... I burst into tears a lot mulling over the decisions, what's best to do, what would Spirit want... Up until the initial tumor growth, he had been so active and overall in great health with a nice coat and build. He has a young Bengal brother who loves to play with him (maybe more than he loves to be played with sometimes, as a 15-year-old "older man" 😉 ), he loves to do laps around the table and lay in the sun and purr under the covers with me at night. He loves his wheatgrass, yowling/talking and playing with the laser pointer. How much would change, and how long do we have? Ahhh, the human longing for certainty! 😛 Anyway, I've rambled on enough I suppose... I appreciate this group existing and anyone who's gotten through this extended talking story of my dear Spirit's disease progression and where we're at right now - holidays were definitely hard this year. If you have any tips or advice, I'm open to hearing it, thanks in advance! smiley

Diet / Supplement Log FYI:
 
Mostly organic wet food, if I can afford it, or Bravo chicken with liver, I try to avoid anything with fillers, "meals" etc... mostly chicken or turkey, seafood or sardines 1-2x a week. I've been lucky enough to get multiple free bags of Organix dry food by being a Pet Smart member! Dry food 1 meal a day, wet 1/2 can split between 2-3 meals. He weighs only 9 lbs, healthy weight per regular vet, though he has lost some weight during the course of the disease. He drinks spring water, and dishes are ceramic or stainless steel, pine pellet litter.

Ubiquinol ~25mg daily for years now, along with a sprinkling of d-Mannose for urinary health (had a blockage a few years back due to stress from another cat) in morning meal

Prob not worth mentioning, but after initial diagnosis, I briefly tried some modified-Hoxsey (Harry Hoxsey, see "When Healing Becomes A Crime") tincture that I got from an herbalist and animal chiropractor at the recommended dosage added to wet meals but stopped a few days prior to his surgery for fear of the herbs being in his system and contradictions with the heavy meds.

Post-op, and after he was off the pain meds, instead of going back to the Hoxsey tincture (I didn't want to try too many things at once) I began giving Spirit 20 mg THC-free CBD capsules with organic coconut oil, from a friend in CO who runs a non-profit helping to heal people and animals, at about 1/2 a capsule, liquified and added to his wet food per day, sometimes up to a whole capsule a day. The problem with this form is that the coconut oil solidifies easily in this winter weather and then he refuses to eat it. :/ I'm looking into getting the liquid form instead of capsules when these run out. He's only had this for 2.5-3 weeks, but perhaps this is partially responsible for why nothing has gotten worse in his lungs? who can say for sure? 

Every other day, small sprinkling of spirulina in wet meal before bed

I also have added small amounts of - echinacea, parsley, thyme, and astragalus to his meals variably, as each of those has reference to positive effects on cancer, inflammation, increasing immunity, etc... but have not been too successful at getting him to eat much of this - he doesn't seem to like having these in his meals unless I coax him by adding sardines :P. I may try grinding them finer. 

Slippery elm 2-3 times in past week added to wet meal with a little water, skipping a day or two between... cough subsided around the same time of first dose - link?

I'm considering adding turmeric to the mix, but need to do more research on it. I know in humans, adding black pepper is necessary to make the compound bioavailable, but cats aren't supposed to have pepper, eh? Not sure if the curcumin would be bioavailable for them without it, def need to look into that more.

Wheatgrass set out to graze on once every month or two, or whenever I pick some up or grow it!

I also received Pet Wellbeing Life Gold Cancer Immunity Support liquid blend that seemed to have great reviews and a combo of ingredients I had read good things about separately - have yet to try this & won't begin this treatment if he goes on meds for surgery until he's off of those first.

The Rainbow Bridge

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17 January 2018 - 6:18 am
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Hi and welcome! I have some thoughts about all this but am on my phone now so I’ll write later from my laptop. Just wanted to get your post approved so others can chime in ASAP. Stay tuned for feedback!

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17 January 2018 - 8:30 am
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Hi Spirit and Mum

i am having to Split this reply into different sections if I may....

i am not in any way suggesting that Spirit has the same cancer as my Mojo had. But the fact that there are multiple tumours in the toes, along with the mass in the lungs, it sounds all too familiar...  My fingers want to start typing madly, but I’m not sure where to start so bear with me please. This is going to be a bit difficult because my Mojo was my spirit baby and we lost him all too soon!

Mojo had a rare cancer called Lung/Digit Syndrome... my vet had only seen it once before and I was fortunate that she caught it in time! Otherwise, we would have put Mojo through some most difficult surgeries, as I can see you are doing with Spirit! Again, I can not say that this is the same kind of Cancer, this is just my experience. Please take the time to read through Mojo’s story. I Will be back after I have been able to put some more conclusive thoughts together for you... is it possible for you to X-ray Spirits other limbs to ensure that there are no more masses showing up elsewhere?

http://stewie20.....ne-cancer/

Please keep us informed as to how Spirit is doing, you are on my mind now and I will answer any questions, regarding my own experience, that you may have. Good luck with your Spirit baby, this is tough, we know!!

hugs from Petra and her gang. heart

On July 10/17 I became a Super Tripawd! You can find out more about my Pawrents Allensong but first Check out my 🎗 journey Super Stu Remember...“live in the moment!“  

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17 January 2018 - 9:44 am
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Dear little Spirit and loving mom - there is a lot to think about in your story. I'm sorry to hear of your cat's diagnosis and the mass on his lung.

First, I'd like to thank Petra for her story of Mojo. It sounds like the lung-digit-syndrome is worth exploring with your vet. Is there an oncologist in your community? Pet oncologists are very experienced in different types of animal cancers.

Regarding your personal challenge with the first surgeon. My family doctor once told me that we go to specialists for their expertise, not for their bedside manner. I'm not sure if that holds for the animal medical community but it may be something worth considering.

I noticed that you are giving your cat a lot of supplements. I would suggest limiting these unless you get advice from a holistic vet who is experienced in alternative supplements and any contraindications. If you go ahead with the amputation you don't want your cat turned off eating because of hidden supplements. They are smart and start learning our medication/supplement hiding techniques!

My cat Mona had a rapidly growing tumour on her front leg. Her lungs were clear and had her leg amputated immediately. My vet would not have amputated her leg if there was a mass on her lungs. What does your vet think about the mass on your cat's lungs?

I don't think it's unusual for a fentynal patch to be applied in advance of an amputation surgery. 

It looks like you have a lot of things to consider and I know it's not easy. I'm glad you came to the site where you'll find a lot of information and support.

Remember to take good care of yourself.

Kerren and Tripawd Kitty Mona

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17 January 2018 - 10:43 am
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Welcome and we are sorry you have to join us!

We all understand too well what that a cancer diagnosis is like and all the decisions that need to be made. Our cat Purrkins had his left front leg and scapula removed from cancer a Soft Tissue Sarcoma a year and 7 months ago.

I agree with Kerren you need a oncologist on this do you have access to one? Maybe we Tripawds can help you find one? I believe you need expert eyes on what you have.

We have specialist for this reason to get to bottom of what is the main issue. Same with the board certified surgeons they are more expensive because they specialize in a area. More education and we do get what we pay for.

I am hesitant to say anything other then I agree with Petra & Kerren ask about X-rays of the other digits and the very least rule out the Lung Digit Syndrome before proceeding. 

I am a fan of supplements with cats but we have assistance with our holistic Vet. Cats are so sensitive to so many supplements cat metabolize everything differently then dogs and humans. When your giving multiples it’s best to have guidance.

You are dedicated and clearly you love your Spirit! He sounds a lot like Purrkins a real sweetheart.

I would not take the shadow on X-ray of the lungs lightly, I think that is key to your diagnosis .

We want you & Spirit to have the best quality of life you can that may be amputating the leg and it may not be. We will support you thru this whichever way you chose to proceed.

Please keep us updated

Hugs
Holly & Purrkins ❤️

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17 January 2018 - 11:07 am
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OK a few thoughts.

First, regarding supplements and things. I would honestly wait to pursue any new supplements until you know what you are dealing with, and what kind of treatment you will pursue. 

Next, it sounds like a complicated situation. If you are able to get to a veterinary oncologist (I assume so, since you have already found a board-certified surgeon?), do that. Get a consult and find out the best course of action. As Purrkins said, we can help you locate one if your vet doesn't know of any.

while trying to set up an appt to have the original surgeon see about taking digit #2, (the same one who took the digit and I was hoping would be able to do any subsequent surgeries), we had a big falling out over the phone, where I hung up crying and feeling disrespected.

Your relationship with your veterinary team is so important. If you don't like the way this person works with you, move on.

 He also wants to have me come in the day before to give Spirit a Fenatyl patch to put on in order to get the pain meds flowing through him before his surgery the next day... I wonder if any member have had this experience & what your thoughts are on this if so? 

This is standard protocol according to the latest pain management guidelines for cats and dogs.

the new vet's practice does not offer overnight care, so I would need to take Spirit home the night after surgery... slightly risky imo, as the other place kept him overnight with 24-hour care.

Can you transfer Spirit to the ER for overnight care? If not, that first night can be hard but it's not impossible, Many people here have done it and lived to tell about it!

There is a definite plus if I go with this vet - he can do it soon (this Friday even!) and the operation itself is almost half the cost that it would be at the first surgeon's office. I feel fairly confident about this doctor from what I could ascertain from his demeanor and answers to my qs, reviews of the practice, etc.

Price is important but please keep in mind that it's also about the surgeon's experience, hospital team, their equipment and protocols. Here are some links that explain what to look for:

Why Your Pet Should See an AAHA Accredited Vet

Why Pre-Surgery and Pre-Amputation Diagnostic Tests Matter

Considerations When Price Shopping for Veterinary Care

I know this is a lot of information to digest but I hope it helps.

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17 January 2018 - 11:38 am
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Hi again

I had asked our vet what the condition was that Mojo suffered from… It was Lung Digit Syndrome. Mojo had a primary lung tumor (probably bronchogenic carcinoma) which spread to his digits.

Best wishes and hugs on whatever you decide!

Petra and her Spirit Angel Mojo! xxx

On July 10/17 I became a Super Tripawd! You can find out more about my Pawrents Allensong but first Check out my 🎗 journey Super Stu Remember...“live in the moment!“  

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17 January 2018 - 12:53 pm
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If you proceed with amputation on Friday and have questions please ask, I hope you know we are just looking out for you both and want the best outcome for you both!

I was going to address the fentanyl patch and had a cat get on the laptop! I think that is FANTASTIC the more we can manage pain before during and after amputation surgery is great no matter who does the surgery!

If your Vet does the surgery you can bring Spirit home that night, it’s not easy by any means and it would be better to have supervised care but it’s doable! Supervised by you is better then no 24 hour care.

The coconut oil that you give have you tried just putting on your fingers Spirit might just lick that off your hands! Our guys love coconut oil and will readily lick it off our hand, it melts so easily in your hand. I would not put supplements in Spirits food he will refuse to eat at some point!

What I do is syringe the supplements, pulverize solids with a mortar and pestle and add liquid to syringe. You can add sardine or tuna juice too he wont mind being syringed. I use little liquid so I don’t aspirate them. 

I would discuss all these supplements with your Vet prior to surgery if you didn’t already just to be safe. They will tell you which to stop prior to surgery if needed. I use Dr Mercola’s Curcumin for Pets -Cats get a tiny scoop and it has no flavor.

Let us what you hear on the X-ray’s please we are hoping for a definitive solution that you can move forward with & give Spirit extra quality time. 

Hugs
Holly & Purrkins❤️

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17 January 2018 - 4:26 pm
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Thank you all for your replies! <3 I read them all and really appreciate the help, it's invaluable to hear from others who know the ropes!

Petra, I was in tears reading your story of Mojo, thank you for sharing it - what a beautiful, big boy! I can feel the love between you. __/|\__ He was surely your spirit baby and so I know you know what it's like! <3 Such heart-stealers cats are! I can't overlook that I just recently was told by my friend that his grandma Petra's birthday was the other day & he was sending her a card - makes me pause to wonder if there is more to the synch, with such an uncommon name...

Yes, the lung-digit-disease is something that we've been concerned about too - precisely what has me second-guessing amputation - not wanting to put him through that if there is more underlying that will crop up. But with no solid answers from x-rays/radiologists, and nothing in the lung x-rays changing over the past month with the new x-ray, it's so hard to know without a CAT scan. We had been prepping for CAT scan, as I mentioned, to determine if the lung mass was in fact a tumor or not, and considering lung surgery before the new paw tumor cropped up/ came back. It's such an "immediate threat" and affects his (and our) life, as you probably know with Mojo's multiple tumors - poor guy! 🙁 - that taking care of the paw before it does spread/takes over more toes has been the pressing issue. Unfortunately, there is only one place that does CAT scans in my state, (same hospital associated with surgeon #1, but diff location), and it's more expensive than the amputation surgery quoted for the new vet. It worries me to put him under for the CAT scan, and then put him under again for a major surgery not long after... He is 15. The alternative/original plan is trusting surgeon #1 again as he could do the CAT scan and potential surgery same-day, I just found out the earliest he could do surgery is the 25th or 26th... 

I wonder if the x-rays for Mojos lungs had defined mass? More than one? Were they able to take a needle sample to know it was cancer/type? The big prob I have been having is no consensus on what is going on with Spirit's lung - radiologist who thinks it's nothing, one who thinks it's something! 😕 I just requested the new x-rays be looked at by a radiologist, so hoping there is some kind of conclusion that can be drawn. I should know more tomorrow about that. These were the clearest x-rays thusfar.

In addition to the 3-view of the chest, they took a paw x-ray with the recurring tumor and I was able to see that. I'm no expert by any means, I could see the outline of the mass, and where the other digit was removed (which concerned me to see as I had thought surgeon #1 was supposed to have taken 3rd phalange as well, but it was still there - maybe why it spread???), but no bone issues. And the new doc did not mention nor point out that the bones were looking affected - yet... just where the mass was and what might be affected/risk area and why it was large enough to be concerned & consider full scapula/leg amputation. (I don't know much about full scapula vs. other options??? Holly? Purrkins? Kerren? Mona?) My regular vet has pointed out that the disease is always ahead of what we're seeing too... which is why I wonder what the tumors appeared like in the x-rays for Mojo? Were tumors present on the outside too? I will strongly consider x-raying his other paws, but so far it seems like the only x-rays showing actual bone damage were of the first affected digit at the time of surgery.

There was a bit about Mojo that stuck out to me especially - that he was a mouser... because the initial issue with Spirit was discovered shortly after he had caught a mouse (he doesn't ever kill them - he's a gentle soul... he just alerts me & I get a box, angle it in front of him, and tell him to put the mouse down, and he does - always, unharmed! And I take the mouse far away & release! Crazy, but true!), and I had noticed what looked like blood around his nail bed... and from there it was suspected as an infection, discovered it was scc, the x-ray with unidentified blur/mass in lung, etc... So it makes me kind-of scratch my head - if these are both cases of the lung-digit, which of course, I hope not - whether there is something carried by mice that might spread this? Just a thought... 

Spirit is definitely showing signs of discomfort last night & today, wanting to sleep more and purring less, as the paw tumor continues to grow and affect his mobility and pain levels. He had stopped purring altogether before the first digit amputation, and he's like a purring machine, so I knew he wasn't happy then. It was the greatest thing to have him back to his old self post-op... even if for only a short time! Regular doc suggested by phone yesterday starting him on oral Clavamox, and Buprenex if pain is obvious. I had a week's worth of Clav left so gave him one this morning, but am holding off on Buprenex for now. He had his first coughing spell in days this morning. sad

I was hoping to hear back again today from my awesome regular vet. She said she'd touch base after she was emailed the x-ray results yesterday, but nothing yet - looks like new vet forgot to email them over to her, so they're doing so now. She's not in the other office she works out of today, but has called me from home before, so may again - I hope! I had called in to new vet about the Fentayl patch and alternatives, and the answer was they could give him pain meds (non-patch) the day of surgery. That was reassuring, though I wonder why the patch was suggested at all, unless it's a matter of timing and getting pain meds flowing through him prior. 

Unfortunately, there's no oncologist in the whole state! The closest oncologist is a bit too far for me to travel to it looks like. Not even at the big specialists 24-hour hospital in my state that's AAHA accredited (the one where surgeon #1 would do CAT scan, it's the sister hospital to his usual practice which is over border in another state, but where Spirit had the digit off & where the problematic tech/hospital manager is as well). They do have a very knowledgeable liaison in the surgical dept at said specialist hospital who I spoke to today to get more of an idea of time frame and cost if we happen to decide to go back to surgeon #1. He was quick to say that they don't change doctors so I'd still have to see/go through surgeon #1 to do anything at the closer/ in state location, even though he is only there a few times a month, mostly for CAT scans. I was kind of hoping I could see another doctor at the in-state hospital who I don't have this "bad blood" with, but I guess not. This liaison is the one who referred me to the over-the-border sister hospital & surgeon #1 in the first place (he was new at the practice and seeking to build up clients at the time, so had faster availability to do surgery/get us in than elsewhere). 

I totally understand about supplements and the concern for effecting meds, and will take him off everything once surgery date is set a few days prior (have only given him the Ubiquinol today & don't plan on giving him anything else, if we decide Fri will be surgery), and won't be giving him any post-op while on meds, the same as I did before for the digit amputation. Listing them out like that probably looked like a lot, but a couple are just listed as ones I want to try (the new Pet Wellbeing blend, turmeric), and one I tried very briefly (modified Hoxsey) prior to digit amputation. Considering his actual intake of most of them, it's very small... Ubiqunol, spirulina, astragalus every other day, and as much CBD out of 20 mg he will take daily depending on his appetite/food temperature, are the main ones he actually consumes. Spirit ate this morning and later at lunch, but not a whole lot. Nothing was added to those meals, except CBD in the morning. I know it's important to seek professional guidance - I'd been running things by an herbalist friend of mine out of state and already had an appt set up with a holistic practitioner/herbalist/acupuncturist who specifically treats animals, but had to cancel as the tumor & potential lung matters have taken precedence. I hope to get back there as things improve to get a handle on long-term treatment/prevention. 

Jerry - thanks to your helpful suggestion, I ended up ask my regular vet about overnight care, and they don't have that option, unfortunately. But I also asked the liaison in surgical at the big AAHA specialist hospital in-state if overnight/ post-op care from the new vet for Spirit is doable, and new vet might be able to get a quote on how much it would be by calling doctor there tomorrow. It may turn out to be the same cost as having Spirit just go to surgeon #1 for surgery over the border at sister hospital where he was before (liaison quoted $2000-2500 for consult and amputation), depending on what they charge for the overnight at the AAHA in-state place - the liaison said it would have to be through emergency $$ + cost of surgery with new vet ~$1200 (big price difference from surgeon #1!). If I did the surgery with #1 (again, earliest the 25th or 26th and having to trust the Dr. I had falling out with and at the location where the problematic hospital manager/tech is), he could stay overnight there. And of course, this all depends on final say from radiologist on lungs/x-rays and/or if CAT scan is really necessary.
 
I know quality over price is huge for such important work, but these two sister hospitals are known to be the most expensive, (I can attest from the first amputation bill) and essentially, they can charge what they want being the only specialist hospital open 24 hours in this state. way-confusedUnfortunately, it seems that some options are limited as I live in a small state, with an apparent high demand on vet services - so many of the places I've called are booked months in advance or they have to call the same independent board-certified surgeon in to do major operations. I'd gladly have moved on from the "incident" with surgeon #1 and not looked back, (although again, my regular vet stepped in and seemed to try to smooth things over/get us back on the same page and he said he's willing to do the surgery via the liaison, but I have yet to hear from him myself since our phone call that went bad), which is why I did seek out the new vet / call a bunch of other places, and found this decent (but not AAHA Accredited) one who could see me/do surgery asap... I'm worried now about the lack of overnight care... and have some concern about AAHA accreditation now that you've brought my attention to it... How bad is the first night if he comes home, I wonder? question In a way, I feel like I'm kind-of at the mercy of surgeon #1 if I want the best "set up" for Spirit... 

I will say, that the "new vet" while his facility is not AAHA accredited (at least as far as I could tell from their site), interned at that AAHA specialist hospital and his wife is a doctor there currently. There are a few others on the AAHA list that I have spoken to, who have said they could not do any surgery for weeks or months, but a few I hadn't checked out that I'll call - and will be sure to ask if they offer any overnight care by chance too... Although to bring another new hand in to stir the soup, might not be a good idea at this time... hard to say! 

What do you think about waiting to do a CAT scan (which would have to be with surgeon #1, at only place in state that does them), Friday the 26th (earliest avail)? I'm so afraid if I wait too long things will get worse, but I also want to be sure it's not going to get worse despite amputation if there is something in the lung. The cost of CAT scan is a little more than the surgery at the new vet ~$1200-1400. I'm trying to be wise about funds as well, as my resources are limited. I probably said it before, but I worry too about putting him under for CAT scan and then again for surgery. It is a possibility to do it all at once with surgeon #1... but so much trust, I just wish we never had the big falling out. I'm anxious to hear what the radiologist says about latest x-rays so maybe she'll say "all clear" - but will that be enough to go forth and amputate, not do a CAT scan, especially if he is coughing? Will I be able to decide the best course of action in time!? I just feel like the clock is ticking and I still don't have the right answers or a clear path to move towards yet. Leg amputation surgery Fri with new vet & take Spirit home? transfer him to in-state specialist over night post-op? Wait till early next week with new vet? Wait till end of next week 25/26th & go back to surgeon #1 and trust him and the instigator tech? Do CAT scan with him first w/possibility of same day surgery if lung is clear? Seek out a diff vet if any are avail to see him in the next week/do surgery from the AAHA list of ones I haven't already called? How bad will it be by then? I feel like it's growing rapidly... crying

I've had this open & re-written in a number of times as calls were made and came in with more info/quotes/options, so hopefully all info is updated/concise. I truly do appreciate your support, suggestions, experiences, links to info! You guys are great! I hope I can be more of a help to others as I gain more understanding as time goes on - instead of a needy, worried cat mom! I definitely need to get some sleep tonight, sleepy I've started to come down with the sinus cold that's been going around.

Hoping Spirit eats well tonight! <3 He's such a dear heart...

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17 January 2018 - 4:49 pm
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Purrkins said
If you proceed with amputation on Friday and have questions please ask, I hope you know we are just looking out for you both and want the best outcome for you both!

I was going to address the fentanyl patch and had a cat get on the laptop! I think that is FANTASTIC the more we can manage pain before during and after amputation surgery is great no matter who does the surgery!

If your Vet does the surgery you can bring Spirit home that night, it’s not easy by any means and it would be better to have supervised care but it’s doable! Supervised by you is better then no 24 hour care.

The coconut oil that you give have you tried just putting on your fingers Spirit might just lick that off your hands! Our guys love coconut oil and will readily lick it off our hand, it melts so easily in your hand. I would not put supplements in Spirits food he will refuse to eat at some point!

What I do is syringe the supplements, pulverize solids with a mortar and pestle and add liquid to syringe. You can add sardine or tuna juice too he wont mind being syringed. I use little liquid so I don’t aspirate them. 

I would discuss all these supplements with your Vet prior to surgery if you didn’t already just to be safe. They will tell you which to stop prior to surgery if needed. I use Dr Mercola’s Curcumin for Pets -Cats get a tiny scoop and it has no flavor.

Let us what you hear on the X-ray’s please we are hoping for a definitive solution that you can move forward with & give Spirit extra quality time. 

Hugs
Holly & Purrkins❤️  

Missed this one! Hi Holly & Purrkins 🙂 Thank you so much for your support!
Yes, I have given both my boys coconut oil like that too & they usually LOVE heart it! Especially the bengal, he's a coconut fiend! I have to ration it in teensy amounts to him.... what a kid! I can def try giving the CBD/coconut oil to Spirit that way, and I think I did at first and he was disinterested... maybe the scent is different? But I'll try again. Kiko (the bengal) would gladly eat it all! laughing I have to lock him away from Spirit's food because of course he races to finish his quickly, on the chance that he can have seconds - knowing his brother eats slow, Kiko zips over to try to eat "Whitey's" meal (one of Spirit's nicknames winker), and since Spirit has been really picky the past few days, and eating slower than ever, I've had to lock the bengie in the bedroom till his brother is through.

I've also found myself having to use the sardine juice to get him to eat regular canned food the past few days - it is a great trick, eh? I've been thinking of the syringe thing too, (though will stop supplements pre-op once I know when/if we're set on surgery date), he reeeeeally despises taking meds (on the Clavamox today) and having things put in his mouth, but I had to give him the buprenex by syringe and clav pills and something else... maybe Onsior? for previous surgery/post op so it's doable. I haven't yet tried syringing supplements, but have considered it - though I hadn't thought of doing the fish juice in the syringe, that's a good idea!

I am a Mercola fan, so will look into that supplement, thanks! Unfortunately, I have told my vets about the supplements I give the boys and they do not have much knowledge of them/ opinion other than "be careful," and obv to stop around surgery time... like I said, I plan to stop once I have surgery date, as I did before. Especially Ubiquinol, pretty sure it can have effects on blood/bleeding... He did well before with the stopping/restarting of supplements, and bounced back from surgery quickly.

I'll check back in when I know what the radiologist has to say. *thumbs up*

Thanks again for the love & support! *hugs all around* heart 

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17 January 2018 - 4:56 pm
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edit: Realized I said I'd given him Ubiquinol today, but I meant CBD.

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17 January 2018 - 6:13 pm
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Hi Spirit and Mum and certainly not forgetting about a beautiful treat such as a Bengal named Kiko!

You have brought me to tears in your acknowledgment of my Munchkin, Mojo. Thank you!

There is so much that I want to answer to in your post that I am going to have to write offline, so that I don’t go over our internet data quota. I won’t have a book to write, but it is going to take me a while to compose... Please know though that you and Spirit have been on my mind all day and I will be getting back to you to answer your questions. 

Thank you as well for giving me the chance to offer you my experience with this Lung Digit Syndrome. Sadly my experience was in dealing with an extremely aggressive type of lung cancer that spread to Mojo’s digits. In my vets experience, and what Paul and I witnessed was that the tumours in the toes were a bigger problem than the lungs. The X-rays of the lungs showed one single mass, I’m sorry but I don’t know how large. I didn’t ask to see his X-ray. I will get back to you in more detail later. I sincerely hope that this is NOT what you are having to deal with!!! 

Your friend’s Grandmother Petra... she has a good strong name! Happy Birthday to her from a fello namesake! It means rock in Greek! So maybe my role in your life right now is to send a little more strength and love your way! With your friends Grandmother on one side of you and me on the other, the ‘Petra rocks’ are with you!aw-shucks

Take care of yourself and your Spirit boy and love each other to pieces. I know how hard this is for you!! I’m Sorry that you aren’t getting any straight answers. Sometimes, you just have to follow your heart and just do the very best that you can for your fur baby, he is going to love you to the end of the earth and more, no matter what you choose! You are doing all that you can for your boy, he knows it!

All the very best and more to youheart

Petra and her Clan xxx

On July 10/17 I became a Super Tripawd! You can find out more about my Pawrents Allensong but first Check out my 🎗 journey Super Stu Remember...“live in the moment!“  

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17 January 2018 - 6:27 pm
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Hello-

Spirit sounds like such a lovely cat. I do not have any relevant info to relay in order to help you, as my cat (although he was 14 at time of amputation) had cartilage cancer, and not what you are facing. I just wanted to say I know all these decisions are hard to make, almost impossible it seems, but you clearly care so much about your cat and will do what is best for him and you.

I hope Spirit is doing well this evening and look forward to reading an update soon.

Hattie

Hugs,

Hattie and Jerry Cat (right front leg and scapula amputation due to chondrosarcoma at age 14, lived 2 1/2 years post amputation, succumbed suddenly to suspected lymphoma at age 16)

10/2001 - 10/9/2017 R.I.P ~ Love you always

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17 January 2018 - 7:58 pm
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just where the mass was and what might be affected/risk area and why it was large enough to be concerned & consider full scapula/leg amputation. (I don't know much about full scapula vs. other options??? Holly? Purrkins? Kerren? Mona?.

We discussed this prior to surgery and were told the scapula would go with the leg, that was the way this surgeon did these surgeries we were told Purrkins would be more comfortable without the scapula and we didn’t question more because there was no choices to be made. The majority of what I have seen here are done the same way.

I did some digging on this and I will provide some links I'm sure you have looked into this but if for some odd chance there is info in here you did not know or find great. The sage journals (first link) goes into great detail on what tests should be ran to rule this in or out! The other is from the Winn Feline Foundation 

I personally would need to know before taking the leg, by taking the leg are you going to make Spirit comfortable? It comes down to quality of life and how can we get to one? What is doable within our power?

We take the leg to take away pain and in hopes of taking off the cancer or take away the pain for extended quality of life.

Since this has been brought up before then I am even more suspicious. Get your radiographs read and lets go from there.

I would NOT hold off on the pain meds! Why hold off on pain meds that can help Spirit now? I would give the Buprenex and get him comfortable while your trying to figure out the best route & get your questions answered.

We are saying some prayers for you & Spirit for some answers and clarity on all of this!

Will watch for a update tomorrow and I do hope you can get some rest tonight things are always clearer when we get some sleep!

Hugs,
Holly & Purrkins❤️

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18 January 2018 - 12:13 am
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Mona also had her scapula removed with her leg. Initially the vet was going to leave the scapula until he consulted with the big city surgeons who advised him to take the scapula to get the largest margins possible. I don't think it would have been useful for anything if left behind.

As Holly says, get a good sleep, it'll help with your decision-making.

Kerren and Tripawd Kitty Mona

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