Caring for a Three Legged Dog or Cat

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! 

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.