how long?

[Shan]

Is she still eating okay? If not you could get a appetite stimulate like mirtazapine. What kind of cancer ?

[todd]

she eats normally as she always has. what kind of cancer? can’t answer as i didn’t follow up with vets advice to see a specialist. what first alerted me was a small open wound on her left side the size of a pea. vet removed it and sent it to a lab and it just came back as cancerous. it initially healed then grew to the size of approximately a golf ball. it’s still there and doesn’t seem to hinder or bother her. she exhibits no pain when i touch it. it’s been this way for around 6-8 months now.

[Chris]

Hi Todd, first, if your vet sent the whole original mass out to the lab, there would be a specific histopathologic tissue identification report that would at least explain what type of cancer/tumor category it falls under (sarcoma, carcinoma, etc.). I would expect there would be a report from the lab sent to your vet, which you could request a copy of, along with any other part of your cat’s records.

Second, if you don’t trust your vet (for whatever reason, I’m not here to judge that), I would encourage you to seek out another, because ultimately, a good vet you can develop a good relationship with should be honest about helping you to assess your cat’s quality of life. There’s nothing more important than assisting with quality of life decisions and end of life care.

It really depends on the type of cancer, but some medications can be used without affecting a pet’s quality of life significantly, while slowing down tumor growth, etc. I have found in my experience, that fear of side effects and comparing cancer and cancer treatment to what some humans go through often immediately turns some pet owners off to even exploring those options.

I do have my own 18yo cat with nasal adenocarcinoma and I can certainly identify with the difficulty of assessing quality of life. In my own cat’s case, my dilemma has been somewhat similar to yours. Though it is a different cancer, he has a tumor in his nasal passage that continues to grow slowly, and he is losing weight but he continues to eat, use the litterbox, spend time with us, and he receives an anti-inflammatory medication (via an oncologist’s advice).

While I can’t tell you what to do, I can provide you with the four quality of life criteria that I use to counsel pet owners on whether it’s time to consider euthanasia. I also use the same four when assessing my own cat Bart’s quality of life on a regular basis. The four of them are: appetite, mobility, pain management, and nursing care.

For appetite, this is regular intake of food. My Bart still eats twice a day main meals with his snacks in between. When we’re considering a cat just licking gravy or eating a couple of treats here and there and it’s not just a “one off” day, this is not a good appetite. To me, at least three days in a row of very poor appetite when we have an idea of what the cause is and treatment options being limited is enough to fail this criteria. I think an appetite stimulant is appropriate still to use when it makes a significant difference without providing any additional stress to administer (for the cat or the owner).

For mobility, this is being able to get around to food/water, use the litterbox properly, and reach favorite places as well. Bart is able to do all of these things with regularity for now. He sleeps much of the day, but what 18yo cat doesn’t? He comes down to the kitchen in the morning to get his food, uses both litterboxes we have on his own, and seeks us out for companionship.

For pain management, this is whether we feel that pain or discomfort that is present is being addressed adequately. If we feel there is pain or discomfort present and we cannot manage it effectively with reasonable medical approaches, then we have to consider quality of life, especially if pain may be impacting one or both of the other two factors above. In my cat’s case, I think he feels mostly congested at times, but oddly enough, many tumor tissues don’t cause pain so much as their negative effects are caused by space occupation and sometimes secondary inflammation. For a cat with a tumor of the skin or subcutaneous tissue, this might mostly appear as scratching, biting, licking, chewing, etc., of the site. Other secondary effects that might suggest discomfort would impact appetite and/or mobility/activity.

For nursing care, this is unique to the relationship between pet and pet owner. My cat is also diabetic and I am more than willing to continue his morning routine with insulin and medication. However, I would not necessarily expect another cat owner to involve themselves to the same level. Essentially, if caring for a cat’s condition is causing undue stress to either the cat, the pet owner, or both, this can be considered a failure of this quality of life factor.

Overall, if a pet is failing any combination of two of these quality of life factors, euthanasia is appropriate to consider. I also think if one factor is being failed to a significant level (such as a cat not eating at all or a cat being unable to move or get around), that can also warrant a euthanasia consult.

I can’t advise you specifically, but it sounds from your description that your cat is at least passing appetite and mobility and as you have not chosen to pursue further medical treatment (not a judgement) the nursing care part is also not impacted. For determining pain, I would consider changes in other aspects (like mobility and appetite) or what I mentioned above.

Continued weight loss can be expected, as any kind of tumor can consume calories. Cats are remarkably adaptable I think to muscle loss compared to dogs, but weakness and mobility problems will eventually develop. That brings you back to assessing mobility (which can in turn develop into nursing care concerns, etc.)

But as I mentioned at the beginning, I do think finding a vet you are comfortable with who can provide you with an in-person quality of life assessment with a physical exam and perhaps providing some more info with the histopath report from the tumor’s removal could go a long way. It is also entirely possible that there is another contribution to your cat’s weight loss, especially if your cat is elderly. Not that a golf-ball sized tumor couldn’t be the only cause, but given the length of time you’ve mentioned without it growing, a concurrent illness would just be something to consider, and knowing more of what’s going on could change prognosis and/or what to expect and what to look for. Understanding what to expect for quality of life does require having the fullest picture of health possible.

[todd]

thank you much for this thoughtful response. it was the kind of reply i was hoping for. hoping to have the report in my hands soon. never thought to ask for it in the first place. i just heard ‘cancer’ and my brain just sort of stopped. i will take her someplace for the kind of inspection you talk about.

thanks again

[todd]

turns out it was more than a year december ’24!

this following report doesn’t mean much to me. again, thanks for your thoughts.

***************** ADDENDUM COMMENTS – 12/10/2024 *********************

MICROSCOPIC FINDINGS: Lymph node: Metastatic malignant melanoma

MARGINS:

Tumor cells abut multiple surgical margins such that complete excision

cannot be histologically confirmed. Close monitoring for recurrence is

recommended.

COMMENTS:

This specimen is a lymph node. Within the lymph node there is a

metastatic malignant neoplasm. The neoplastic cells contain dark

brown/black cytoplasmic pigment that is positive on fontana masson

stain, consistent with melanin. Thus, this tumor is most consistent

with metastatic malignant melanoma. The behavior of feline melanocytic

neoplasms is not fully characterized. Most are considered a malignant

neoplasm that have the potential to be locally aggressive as well as

metastatic. Evaluation for a primary mass is advised.

MICROSCOPIC DESCRIPTION:

The specimen is a lymph node that is largely effaced by a poorly

demarcated, unencapsulated, and moderately cellular mass composed of

neoplastic polygonal to round to spindle cells arranged in sheets.

Neoplastic cells have variably discrete cell borders, scant to

abundant eosinophilic to pigment-laden cytoplasm, a round to ovoid

nucleus with vesiculate to stippled chromatin, and one prominent

nucleolus. Anisocytosis and anisokaryosis are marked with karyomegaly,

binucleation, and multinucleation. The mitotic count is >20 in 10 hpf

(2.37mm2).