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18 y/o Strummer amputation advice pretty please
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Member Since:
11 August 2020
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16 August 2020 - 1:53 am
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Hi all!

Ok, Jackie & Jerry - I'm doing my post! Thanks for the encouragement. smiley4

My kitty, 18 year old Strummer, broke his leg six months ago, had surgery at SAGE in Redwood City, CA (Bay Area). Healing seemed to be going slowly, but we were not super alarmed. His surgeon seemed a little frustrated, but also NOT alarmed. Every month we would take him in, she would examine/xray him, send him back with advice to bring him in again in another month. 

June was different. His surgeon said she felt that he was still healing slowly, and this time she wanted us to wait two months to bring him back in. We did just that, and this brings us to about a week ago. She called us after his visit to give us the bad news that between June and August, his entire femur was basically demolished by some kind of cancer. We could end his life, or do the very intensive testing required to determine if amputating his right hind leg was an option.

After a week of devastation and tears (I won't even tell you about the nightmare I had last night!) I have a determination to take decisive action, one step at a time. Here are some facts:

- Strummer is an "elderly" cat, but ridiculously healthy. No medical issues before/during all this, except a slight heart murmur, and as his surgeon says "He's SO fat!" (Personally I think she's a fat-shamer, I'll just leave my one dig at that, hahaha! He does weight 14 lbs, which I'm sure it's pure muscle LOL)

- We know that Strumbum has lived a most excellent life. We do love him just about as much as a cat could be loved! He has a meow for everything: some highlights: "Question-meow", "Goat-meow", "Underwater Meow" and "Jewish Grandma Meow" are some of the classics.

- Because he's so damn healthy, it does seem wrong to let him go without at least some kind of investigation. 

Without getting further testing done, nobody at SAGE knows what type of cancer he has. In fact one dr. says she thinks Osteosarcoma, the others thinks it's Fibrosarcoma! We haven't been thrilled with the way SAGE does business, and we are ready to consider making a switch to another care facility.  I have a phone consultation scheduled with Dr. Kennedy at AMC in NYC next Friday, which I totally owe to Sumi! Mad props, girl! Thank you...xoxxoxo!

However, since I'm in CA, we'd have to quarantine for 14 days to actually receive treatment from Dr. Kennedy, etc. so I think this is solely for a second opinion and her expert input re: a path to choose. (unless that quarantine gets lifted this week, sigh.)

QUESTIONS:

1. Obviously UC Davis would be a fantastic choice if they will take Strummer on. We live about 2 hours away, but I can make it work. Go for it? Any other Bay Area ortho surgeons that anyone knows about it before I take the kitty to cow-town?! 🙂 

2. Does anyone have any thoughts about what the hell happened with my cat's leg?? The whole thing is just so disturbing for us. We would have done the amputation to begin with if our surgeon hadn't pushed with surgery! Her rationale was "he's too fat to have three legs." And why did she pick June to tell us "Oh, yeah, just, you know...come back in a couple months." WTF? We looked back at his xray from June and his femur looks like it's just starting to give way... icon_cry

3. If we go through with the "staging" (that's what it's called, right?) what is reasonable testing for Strummer. We don't want him to have to go through any more procedures than is really necessary, but want to do the right thing for our boy. Also, his lower leg is now starting to swell up, so we've really got to act quickly on this.

Ok, I think that's probably enough for now. Thank you all for being here, and supporting all the peeps that love their pets so, and the pets who love their peeps! 

Warm wishes,

Jen



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16 August 2020 - 6:40 am
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Wow, what a story. To see it all clear cut in it's proper storyline... man. I feel awful that you have gone through this, and honestly I would be pretty mad right now at the way this has been handled. 

I am glad you came here, I hope we are able to help you sort things out. First, for us, Huck did not have cancer. He had a traumatic leg injury (?) that broke his femur clear into 2 pieces. We were given the option to try and wire it and get it to heal (hahah, feral kitty), amputate, or euthanasia. In my honest opinion, there was only one choice. Even if we had to release him after he healed, I could not put a young, otherwise healthy cat to sleep for that injury. 

So, from what I have learned by people in here, are just a few things. Some cats have gotten prognosis of "probable" osteo, and knew amputation was the only way to go. Biopsy for this, from what I hear, is quite painful and the leg goes away anyways. A few people have just opted for amputation and had the limb sent post op for biopsy. 

One thing I am fearful of here is the amount of time that has passed. It would be good to be able to see if a clean amputation can even be performed. Does the doc you will be consulting with have access to the rads taken of Strummer? If you haven't already, I would try to make sure Dr. Kennedy has all rads taken, bloodwork results, visits, etc.. so that she can get the clearest picture possible of what is going on. 

I know others will be in to share experiences and advice. I am glad you posted your story!

Hugs,

Jackie and Huck sp_hearticon2

Hugs,

Jackie, David, Bo, Andy, Oscar, Phoebe, and the coolest feral tripawd kitty Huckleberry

Huckleberry's Blog

New York, NY
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16 August 2020 - 9:06 am
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Hi Jen!  I'm chiming in about AMC.  Griffin had his amputation surgery performed there, and continues to see doctors in the rehab and oncology departments.  They are fantastic!  While I haven't worked with Dr. Kennedy, folks I've spoken to at AMC speak very highly of her - so I'm really glad that you are able to have a consult with her.  If you decide to go the amputation route, I hope UC Davis is an option for you just in terms of the logistics and follow up care being so much easier.  However, if a trip to NYC is part of your plan, please let me know if there is anything I can do to help while you are here (I live a few miles from AMC in Manhattan).  Good luck!  sp_hearticon2 Stacy (Griffin's Journey)

Griffin lived an amazing life for 11 years! Diagnosed with osteosarcoma on March 17, 2020, Griffin's right forelimb was amputated on April 2, 2020. Ten days later he was running and playing fetch! Lung metastasis discovered in July 2020 did not slow down Griffin and he lived joyfully for the next 7 months, passing peacefully at home on February 11, 2021. https://griffin.tripawds.com

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16 August 2020 - 9:35 am
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Hi Jen

Im soooooo happy you are going to speak with Dr.Kennedy. 

I think seeing an oncologist surgeon was so clutch for me. She had an eye to see Pittens had a swollen lymph node yesterday and remove it...because she is also an oncologist. I am so damn grateful. If you come to NY, I will help you also! I live deep in BK which is about an hour and change away from AMC. I will help you! 

You got this. I stand with you. You are doing the right research amd going deep into understanding the whys and routes. It is what is needed. 

I am with you lady! 



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16 August 2020 - 10:59 am
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Hi Strummer’s family,

Sorry you have been going through this for 6 months. I feel your frustration that you have been going through this for six months ago. My biggest frustration is that sometimes vets do fancy bone surgeries on cats only to find they don’t heal or that there is cancer. I think part of the problem is that there is such little research done on cats so they diagnostics and treatments are limited (compared to dogs).

I’m sure you will be able to find an excellent surgeon in your area and Jerry might have some suggestions. Otherwise, UC Davis has a good reputation. Here is a forum with posts that may help: https://tripawd.....referrals/

What really concerns me is the delay in the proper treatment. The lump on Mona’s leg grew rapidly to golf ball size in less than a week. The vet did an xray on her leg to determine if she had osteosarcoma and since that wasn’t evident he assumed it was a fibrosarcoma because it was aggressive. We did not biopsy first. After xraying her lungs to ensure they were clear they did the amputation which was necessary to save her life. They also took lymph nodes along with the leg for the pathology. The pathology report indicated the lymph nodes were clear, the lump was a high-grade fibrosarcoma from a vaccine injection and the margins were huge and no other treatment was required.

Most cats need to lose some weight with an amputation so they aren’t stressing their remaining legs. If Strummer is a bit heavy you can start the weight reduction today. I found the easiest way is to weigh the amount of food allowed for the day. No treats but use some of the weighed kibble as a snack throughout the day. If Strummer is your only pet then you could put his food in various bowls through your home (don't hide it). My heavy-weight is fed twice a day. I have to feed my tripawd privately so the heavy-weight doesn’t clean up her bowl for her. Please note that rapid weight loss for a cat is not good. Slow and steady is best.

You have great questions. You might also want to ask what further testing is needed before an amputation.

Please find another vet as soon as possible. I don’t see how staging is important and should not make any difference as to whether you should amputate or not. These are the actions I would take:

  • Start Strummer on a weight loss program at this very moment. No treats! If he thinks he’s hungry distract him by playing, brushing, etc.
  • Find a vet near you or phone UC Davis. Have the records sent over and schedule a surgery date if the new clinic agrees it makes sense.
  • A consultation with the vet in New York is fine but it would be safer to have the amputation done closer to home.

Strummer sounds like he’s very healthy and very delightful with his range of MEOWs. Phone in to the hotline here if you need immediate support or want to brainstorm some ideas and plans.

Hugs to you and Strummer,

Kerren, Tripawd Kitty Mona and Heavy-Weight Sweetheart Eli sp_hearticon2sp_hearticon2sp_hearticon2

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16 August 2020 - 11:39 am
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Hi Jen and Strummer,

Nice to meet you, even though it is not under the best of circumstances.  It sure sounds like you both have been through a lot already.  While I have no experience with cancer in pets, I do have an adorable tripawd cat Tuxedo who lost a leg and partial pelvis from trauma.  So unfortunately I do have experience from that aspect.  A couple of things came to mind upon reading your post.  I wonder if the initial bone weakness leading to the break was cancer or just bad luck.  No matter I suppose, we just go forward from here as the past is already ... Past (gawd that just sounds weird).

Anyway, first off, I would find a new vet no matter what you elect to do.  It will give you some peace of mind, not to mention an unbiased second opinion.  I am in Kansas, so I have no clue who has good reputations out in your area, but I am sure many on here may have suggestions.

Next, I would get a body/lung scan before I considered any surgery (including a biopsy) because if it has spread beyond the leg, best to know the situation going in.  It might change your options or impact how you and Strummer move forward.   If the original break was partially due to bone cancer, it might have spread in the six months.   Maybe see an onocologist as well as a general vet/surgeon.

As to a biopsy, I have heard they are very painful.  Before I would go that route, I would ask the vet, how the results might impact going forward.  Is there any advantage in knowing the cancer type/grade if you plan to amputate anyway?  If you plan palative care, again does it really matter?  Would it make you feel more secure in your choice?

As to Strummer's weight ... Well guess what my Tuxedo is a huge 15# chunk of love that is constantly on a diet.  He was overweight before he lost his leg and still is overweight.  But he manages pretty darn well.  As others have said, you can slowly cut back on his food and/or switch to a lower calorie version to address this.  No matter how you elect to go forward, this will help him get around easier.

Speaking of getting around, how has he been doing over the past six months?  Sounds like he might have a bit of a head start on adapting to a three legged life already if you do decide to go with amputation.

I am not on here too often, but please do not hesitate to drop me a private message should you wish to talk further.

Warmest wishes and hugs to you and Strummer!

-Dawna, Tuxedo, Lilly, and Angel Dazzle

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16 August 2020 - 3:07 pm
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Jen.... I just got home with Pittens. I am feeling this was the right decision for her. She is doing remarkably well in 24 hours and she is 18 also. 

I have no regrets at all. Obviously I have a road ahead I have read about and yet to experience. But she has no pain, infection, or the growing mass. I decided even if this comes back as something aggressive the biopsy ... I will not do chemo...I just wanted her pain free and her end of life not to be in crisis. 

message me any time. serious. and by the way.... I have been doing this for 5 months too. Its ok. I only found AMC this month. 

We are here for you. I am in the process now too, so its raw for sure. So pick my head any which way you want. and by the way.... this week on monday I  had canceled the surgery. 

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16 August 2020 - 3:30 pm
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Thank you Jackie, Stacy, Sumi, Kerren & Dawna!

Special thanks to Sumi & Stacy for your incredibly kind offer to help if we were to come to NYC. Unfortunately because I live in CA, I can't travel to NY without having to quarantine for 14 days. So I think that option is out. AMC truly does sound amazing though.

Dawna: Yes, Strummer's lungs were x-rayed a week ago, and looked clear.  Also, I do think if we went the surgery route, he would possibly do well, since he literally puts zero weight on his right hind leg as-is. 

We also have radiographs from last week that include the pelvis. Can a good oncologist tell from radiographs if the disease has spread to the pelvis?

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16 August 2020 - 3:52 pm
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I met a lady whose dog has  tumour growing in his lungs.  They performed a CT scan for definitive answers. 

I think any university affiliated and accredetid hospital will be top notch. Theybare up to date with latest treatments and procedures then.

This is a very tough decison and so many said this to me and I will say it to you...

neither is wrong...and everyone was right that there will be a moment when you have done your due diligence and researched everything that nothing is left and talked to many professionals and then see Strummer and know.

You still will waiver as I did. But you will walk through this process and how you got to your decison to rebalance and ground yourself again. So this stage you are in is important and responsible. 

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16 August 2020 - 3:53 pm
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Write a comprehensive list of questions for Dr. Kennedy. and ask her for referrals in your area. 

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16 August 2020 - 4:05 pm
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Thanks Sumi. I'm just worried that waiting all the way til Friday for my consult with Dr. Kennedy will delay things too much...

Sounds correct about the CT scan being the best way to get many important definitives. 

We're going to call UC Davis tomorrow morning first things to see what they can do...

ALSO - SO HAPPY that Pittens is home and doing so well!! I got a good feeling about the kitty of yours!!

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16 August 2020 - 4:19 pm
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You have a good solid plan. 

The Ct scan requires anesthesia, so ask what is the best course. Also, think about just Strummers current state and what to alleviate that. Even if you get the definitive answer, will it change your course of action? 

On The Road


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16 August 2020 - 4:43 pm
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Jen,

I'm so hoppy you started a topic! I see you've gotten some fantastic, insightful and compassionate advice by this amazing community! I'll chime in with some tips for ya too:

QUESTIONS:

1. Obviously UC Davis would be a fantastic choice if they will take Strummer on. We live about 2 hours away, but I can make it work. Go for it? Any other Bay Area ortho surgeons that anyone knows about it before I take the kitty to cow-town?! 🙂 

I wouldn't hesitate to work with UCD. They're rated the #1 vet teaching institution in the world currently, you have the most brilliant minds within reach. Go for it. Check out our most recent interviews with UCD vets for some insight on the team. We sp_hearticon2Dr. Marcellin-Little's orthopedic department and I believe that is who you would be working with. If you do, Dr. Kapatkin is amazing and you may even want to ask her about the bone regeneration technique she pioneered to see if it's an option for Strummer. I know they have done it on cats.

2. Does anyone have any thoughts about what the hell happened with my cat’s leg?? The whole thing is just so disturbing for us. We would have done the amputation to begin with if our surgeon hadn’t pushed with surgery! Her rationale was “he’s too fat to have three legs.” And why did she pick June to tell us “Oh, yeah, just, you know…come back in a couple months.” WTF? We looked back at his xray from June and his femur looks like it’s just starting to give way…

What a totally awful situation, I was disturbed just reading about it. Aside from the surgeon's judgement about his candidacy for a Tripawd, I guess what it comes down to is 1) she never considered osteosarc as a possibility because cats just don't get diagnosed with it very often and 2) surgeons like to fix things, it's what they do. The fact that it was such a weird way for a cat's leg to break just never factored in to her thinking about his situation, and that is just really tragic. Does it make her a terrible vet? No. Even great vets miss things sometimes. Only thing is that if Strummer were a dog, I'm almost certain that osteosarcoma would have been on her radar because it happens so often with canines. I'm so sorry that this all happened to you guys and to Strummer.

3. If we go through with the “staging” (that’s what it’s called, right?) what is reasonable testing for Strummer. We don’t want him to have to go through any more procedures than is really necessary, but want to do the right thing for our boy. Also, his lower leg is now starting to swell up, so we’ve really got to act quickly on this.

Right now, getting rid of the pain is the most critical issue. The staging (yes, that's what it's called when they take samples to find out the type and aggressiveness of the cancer) can happen after the leg is removed. If the leg is beyond salvage, amputation is likely the only option besides euthanasia. If you and Strummer are not ready for that, which it doesn't sound like, then moving on to surgery is the priority.

I know this is a lot to deal with, I'm so very, very sorry you are but as you can see you have us to lean on. I hope this helps.

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

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16 August 2020 - 9:55 pm
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Jerry,

Thank you from the bottom of my heart. I will echo what Sumi says - you are an AMAZING person to have put together so much help for folks like us! Thank you for your compassion. 🙂

Steve (Strummer's Dad) and I are working every minute we can to figure out a game plan. We are 100% aware that the clock is ticking. There simply seem to be so many variables to all of this, and we're trying to laser-beam focus and work through it step by step, while not losing track of the big picture. It's proving difficult.

We are willing to consider traveling to any state (WITHOUT a 14 day COVID-19 quarantine for Californians) that we might be able to get high quality testing (and possible treatment) for Strummie, at a more reasonable price than the continued insane quotes we are getting. It's very, very discouraging, and I look at that little cute fuzzy Strummie-face and I feel like a failure as a kitty-Mama that we can't afford all this. 🙁

Do you (or anyone reading this) have any recommendations of specific orthopedic surgeons (anywhere in the country) that can do not just amputations, but hemipelvectomies? I'm pretty convinced, based on what I've read, that this would/could be the best surgery for him, since his tumor affects his femur. Of course even this may not be warranted if the find via CT scan that the tumor had crept into his pelvis. 

I'm willing to go to the ends of the Earth for Strumbum (or at the very least, Arizona, lol). Just kidding, my sister lives there. Still. 

Again, thank you, thank you! You are a kind, good person. 🙂

- J

On The Road


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16 August 2020 - 10:17 pm
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Awww you are very sweet. It's everyone here that makes Tripawds so special, really!

Hemipelvectomies are not all that uncommon so I imagine that a credentialed surgeon will do it, like the ones at UCD.

Yes, the vet care in CA is maddenly pricey. Our Wyatt Ray was once hospitalized for 48 hours at a VCA in Southern CA and the bill came out to $4500! My guess is that the prices you are seeing are inline with everywhere in the state, or any major metro area.

Have you seen our Forum topic about costs of amputation for cats?
https://tripawd.....d-you-pay/

UCD won't be cheaper than a private practice, unfortunately. But when it comes to a cat Strummer's age, and with all he's been through, I would be very selective about the practice you choose for the surgery and not just rely on price alone. I know you're not saying that you are, but just want to throw that out there so you can make sure you're comparing apples to apples. Also, remember that any follow up care like chemo is optional so when you get estimates make sure you are breaking the amputation price out separate from any follow up treatment.

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

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