Castiel, parlor panther

Castiel is an awesome panther. He is strong and brave, and loved beyond measure. We got some terrible news this past week. Castiel has not one but two new cancers – a thyroid carcinoma and a very slow growing lymphoma in his intestines. No one is worried about the lymphoma. He could live out his life with it and it is treatable but the thyroid carcinoma is a nightmare. His oncologist does not think it is related to the fibrosarcoma that led to the amputation of his front left leg. The cancer is big. Egg shaped. It measures 4 x 4 cm and it encapsulates the right thyroid and then some. It extends forward and back. It’s like an iceberg, with only a smaller portion sticking out front. He has now had an ultrasound, a CAT scan, numerous fine needle aspirates, and blood panels.

His oncologist thinks surgery is his best option. Today, we had a surgical consult at SAGE Dublin with a board-certified surgeon. The surgeon thought a high dose radioiodine therapy might be a good option. She called around to U.C. Davis, SAGE in Redwood City, and a place in Chino, CA. The first two don’t do the high dose radiotherapy and we haven’t heard back from the last. The literature seems to suggest the high dose radioiodine therapy is a good option, but we can’t find it anywhere — and Castiel does not travel well.

We don’t know how fast this tumor is growing. The oncologist didn’t want to do a biopsy for fear of a bleed, so we don’t know how aggressive it is or what stage it is at. We just know it has cells indicative of thyroid cancer. We could wait and watch it for a few weeks but the risk of spread increases, as does the risk that it grows and becomes inoperable. We can keep searching for a place that does the high dose radioiodine therapy, but the surgeon thinks cats might need to stop the thyroid medicine for a week before proceeding with therapy and Castiel might have to be there weeks afterward to reduce the radiation. And could we even get him to a place that has this therapy if we could find it? Castiel panics on all forms of transit except his three feet, so that in itself is risky.

The other option is surgery. The surgeon says it would be a complicated surgery with serious risks. The biggest risk is hemorrhage. The tumor is in a very vascular area, and it is fixed. It is adjacent to carotid artery and jugular vein. One millimeter the wrong way or a tear during detachment, and it could go very badly fast. There is also a small nerve that runs alongside the larynx that would need to be lifted and that could be damaged. If damaged, it would limit the opening and closing of the larynx. There is a second nerve that works with this nerve on the opposite side of the larynx, but he could potentially be down to one –and we don’t know how difficult this might be for him. The surgeon estimates that the surgery has a 25 percent risk of a serious complication. We don’t know what to do.

We talked with the surgeon again tonight and we have agreed to surgery tomorrow with ground rules. The first rule is keep Castiel alive. The second is if the surgeon goes in there and it’s a nope, she closes him up again and we are fine with that. We don’t try to scrape the tumor off the side of dangerous vasculature. We accept that clean margins are not a possibility. We debulk, especially around the trachea, as possible and we remove only what is possible. No excessive risks. The whole thing is risky, but we remember that Castiel is an awesome, strong cat and we do what we can. We keep positive. He is going to survive this surgery. We look to regular radioiodine/chemotherapy afterward to help with what the surgeon cannot do. We hope and pray that we buy time. With surgery and adjunct treatment, he could live up to three years. We are optimistic and that is okay. We know that there are lots of reasons not to be, but we choose to be anyway. It is not fair for one little panther to have two rare cancers, and a third cancer to boot. No one should have to endure this and certainly not a sweet little black cat.

Please, please keep Castiel in your thoughts and prayers. Employ whatever kind of luck you believe in. We need it all. We are so scared. We need you to help us be brave.

Castiel had been cancer free for over two years and he was doing great and then Thursday we found a lump under his chin in his neck area. We brought him to his vet on Friday and she did a fine needle aspiration and X-rays. We got the results Monday – there were abnormal cells. I called SAGE Veterinary Hospital and made an appointment with his oncologist. They got us in today – Wednesday morning. The news is bad, bad, and bad. The oncologist thinks it is one of three things (1) a reoccurrence of the fibrosarcoma (2) a new cancer — possibly a thyroid carcinoma, or (3) a new cancer — possibly a soft tissue sarcoma. She thinks a fibrosarcoma is less likely because it doesn’t usually spread this way, but a new cancer, either a thyroid carcinoma or soft tissue sarcoma seem more likely, with a thyroid carcinoma being the best guess.

What we do know is that there is a 4x 4 cm mass on the ventral cervical subcutaneous tissue on the right side of the thyroid. It is firm and attached. The left thyroid is normal. The doctor couldn’t see the right side of the thyroid so it may be obscured by or part of the mass. The doctor did an ultrasound of his abdomen and neck area and needle aspirate (via ultrasound) and cytology of the cervical mass and abdominal lymph node. The abdominal ultrasound noted some thickness in the intestinal tract and a mild increase in lymph nodes around the abdominal tract. The doctor did an aspirate from that lymph node also, but she doesn’t think it is related to what else is going on but is checking just in case there is a metastasis. His organs looked good with just mild age-related kidney changes. His lungs looked clear on X-ray. He hasn’t lost any weight, and his blood work is good. He does have hyperthyroidism, but it is well-controlled with medication and his levels are normal.

We need more information. We know none of the news is good, but we need to know what we are doing battle with. We have always known that a reoccurrence was a possibility, so I guess in some way we are prepared but we were hoping that it was gone forever. Gone forever was not what the statistics said but we were hopeful because we wanted it to be gone forever. And when you love someone, you are always hopeful. When we get the cytology results on 1-2 days we will know more. The doctor has scheduled him for a CT and biopsy next Wednesday. We are really nervous because the doctor mentioned everything that can go wrong – hemorrhages and thyroid storms and the usual risks of anesthesia — and Castiel is a big cat, chonky for a tripod. He is 13.6 years old. That said he is a strong, happy, silly cat who likes to lie with his belly in the air, play in boxes, tackle catnip toys, follow the sun throughout the house, and snuggle with his fluffy sister Clover. He sleeps on our bed ever night. We can’t bear the thought of him sick again.

Sorry, it’s been so long since our last update. The fact is everything has been going so well that there was very little to report. Castiel has remained cancer-free since his amputation surgery in October 2021. And not only did he remain cancer-free he has remained his same goofy self –rolling around with his belly in the air, playing feather toy, smothering his humans with love in the morning, snuggling with his sis Clover, and hanging out on the window perches with his bro Aleksander.

It’s been quite an ordeal going to oncology check-ups every three months. His oncologist relocated from the SAGE cat hospital that was less than 30 minutes from us to one that is an hour from us when traffic is good. Castiel HATES car rides. He gets so scared and poos and pees and it is truly awful for all of us. We feel terrible bringing him that distance and wish we could explain our reasoning to him.

The oncology office was also not as understanding as his home veterinarian about him arriving in a smelly, messy state (“code brown,” we call it). We tried various vet recommended medications to calm him but all we got was drugged cat who still pooed and peed when scared. He is also a difficult patient — he hisses, flattens his ears, and threatens to end the veterinarian and her staff. His local vet knows this is a bluff, but the oncologist doesn’t. We hate bringing him the extra distance, but we want to make sure during this period (the first 1.5 years) where cancers are more likely to re-occur that he had a trained oncologist and radiologist looking him over carefully to ensure that if the cancer did re-occur that we could get treatment started early. Thankfully, there have been no signs of cancer.

He did develop hyperthyroidism last year but we are told that is not unusual in cats over 10 years old. His local vet checks his thyroid regularly and so far, it seems controlled. He takes a flavored chewy pill daily that we order special from a pharmacy to help maintain his thyroid — doesn’t even know it’s medicine. He thinks it’s a yummy treat. It’s much more expensive to have it made into a treat but not fighting with him to take a pill is priceless.

Castiel had a thyroid check-up two weeks ago, his bloodwork and urine were all normal and everything is looking good, except he lost a few ounces of weight. His thyroid number is right where it should be. The doctor didn’t feel any lumps or bumps and Castiel is eating well. We have been trying to watch his weight and slim him down a bit. He is 18 lbs. and some ounces, but we hadn’t been terribly successful. He still regularly tries to steal his sibling’s food and frequently succeeds if I turn my back on him in the early morning hours. It isn’t a lot of weight, but our vet weighed him twice just to rule out wiggling. We don’t know why he has had a slight weight fluctuation or if it is anything at all to be concerned about. Castiel is getting older, so it’s possible he is just thinning out a bit as he ages, or our weight control efforts are working better than we thought. But his previous cancer diagnosis has taught us to be hyperalert for any changes in weight or behavior. His behavior is more-or-less unchanged, although he has been napping downstairs more lately but it is summer and it’s hotter upstairs and he’s big black cat so he gets hot easier, so that may be why he is napping downstairs more often. Or it could be arthritis that has him sleeping downstairs more, although his mobility hasn’t changed since his surgery. He gets around just fine on all three, although he can be lazy and does like to be held and carried — but he has always liked that.

Tomorrow, he has what we hope will be his final check-up with the oncologist, if everything looks good. After that he will follow-up regularly with his local vet, no more special oncology checks every three months. We are hoping everything goes well, and aside from the weight issue have no reason to believe anything is going on. It would be nice for him to not have to travel so far in the truck for care, and if I am being honest, it would be easier on us too. These oncology visits cost close to $1,000 every 3 months. A similar check-up at the regular vet is about one-third of the cost. And the one-hour drive each way to and from the oncologist is stressful for us all and it requires a few hours off work — and while employers are good about allowing time off for childcare or eldercare, they are not so understanding about cat care — even though we consider Castiel to be like any other family member.

If you are reading this, please keep our sweet parlor panther (Castiel) in your thoughts and prayers or whatever kind of luck you believe in, and let’s all hope that there is no cancer re-occurrence. It’s going to be a nerve-wracking few days while we wait for test results. In the interim, none of us are looking forward to the drive tomorrow. Hopefully, the oncology office is readying the freshener spray.

Yay! We are very happy to share that it has officially been one year since Castiel’s diagnosis and amputation surgery and there is no sign of cancer reoccurrence. He has check-ups with his oncologist at SAGE every three months where X-rays and blood work are taken, and he is subject to much poking and prodding to check for any lumps. At his last check-up his X-rays were clear, blood work looked good, (the albumin abnormalities seen before are gone), and there were no lumps or bumps. I cannot say Castiel was on his best behavior. Apparently, he was a little testy with his caregivers; he was scared. Thankfully his care team is used to flattened ears, biting, and bathroom issues from scared kitties and take such things in stride. We do a lot of apologizing.

The only new health development is that Castiel has developed hypothyroidism, but this is not related to the cancer. His veterinarians tell us hypothyroidism is common in middle aged and older cats and may be due to the fire-retardant materials used on furniture and carpets and the like. Apparently, cats are more sensitive to these chemicals being smaller beings that spend much time lounging. He takes a chicken flavored pill twice a day. He thinks it’s a treat.

We will continue with 3-month check-ups this next year as we know it is always possible that this kind of cancer can come back, and the first year and a half isa time for extra vigilance. Castiel has a great medical team though with his hometown vet, Dr. Rau at Benicia Cat Clinic and his oncologist and radiologist at SAGE. We hope he will continue to remain cancer-free but if cancer does rear its head again, we are determined to catch it early. We are thankful we chose to go through with the amputation. I cannot begin to tell you how incredibly difficult that decision was — the hardest decision we have ever made. We have had a wonderful year together filled with lots of love – a year that likely wouldn’t have occurred without the surgery. Castiel got to enjoy all the things he loves – playing feather toy with his humans; supervising puzzle completion; napping in his human’s desk drawer on work from home days; playing with his tiger siblings Clover and Aleksandr; eating pumpkin goo while the humans carve pumpkins; and lying around in the sun with his belly in the air.

Castiel remains our ridiculous parlor panther. Surgery didn’t change his purrsonality and he proved wrong those family members who voiced their disapproval for surgery and predicted Castiel would be depressed and never move. He continues to amaze (or should I say thwart) us with his ability to get up on things, usually in the process of stealing food — ours or his siblings. He will leap from chair to hamper to desk in an effort to snarf down his sister’s remaining food. We place his sibling’s food in high places to try to prevent him snacking up their leftovers, but Castiel is like a very awkward supersized squirrel in his acrobatic attempts to access food. As a result, his weight is still not where we or his veterinarians would like it. We will all have to try harder. We want to protect his joints as best we can and reducing his weight will help. Castiel, however, remains the most food motivated and obstinate cat on the planet, possibly a leftover from his kittenhood as a wild catty (before rescue).

As we pass the one-year anniversary, my husband Brian and I want to again express our gratitude and thanks to all the people on this website and the Facebook page who have reached out to us and/or whose stories of their pet’s journey has helped us along our path. Thank you so much! We are so very grateful for your support.

For those beginning this path, please know that you can always reach out to us. Some of the products we have found useful are ramps (adjustable and nonadjustable) and wide steps. Castiel, as a front leg amputee, can get up places easily but getting down has proved trickier. We have come to learn the “Hooman, I require assistance” meow usually when Castiel has got himself up somewhere and is in a pickle about getting back down. Castiel took to his ramps and steps immediately. The ramps/steps are carpeted which makes them especially easy to maneuver on. We have them leading to the bed, the desk drawer he likes to nap in, his favorite chair, the sofa, and the cat tree. We tell folks our house is Cat ADA. His siblings like to use them too, although his sister Clover has a bad habit of napping halfway up the ramp creating a fluffy obstacle. The ramps make is easier for him to get around and are also easier on his joints, something we are concerned about because he is a big tripawd cat and is now 11 years old. I have also found raised dishes helpful and have placed carpets over a faux marble entryway, which frankly the humans found slippery too. Our home is about practicality for all its residents. Castiel is a love, our handsome parlor panther. We love him so much and are so happy to be celebrating another Christmas holiday season with him. Below are some pictures of him.

Castiel had his third check-up post amputation.  He had a physical exam, X-rays, and blood work done.  Poor guy was so nervous, and truth be told, so was I.  He meowed up a storm at the vet.  I think folks heard him a block away.  His vet didn’t see anything on the X-rays, and she didn’t feel any lumps or bumps during the exam.  His weight is still a whopping 18 lbs…we’re still working on that slimming plan.  You’d be amazed at how fast a three-legged cat can move when he wants to steal his siblings left over food.  I blink and he is  chowing down his sister’s supper.

The bloodwork was mostly normal, except for a raised albumin level. It is double what it was pre-amputation. The vet said this could be a sign of inflammation. Now I’m wondering if this is a sign of the cancer returning or that he is in discomfort or maybe has worsening arthritis.  The vet said it could be a sign of a lot of things and/or not much at all. It’s 4 when the top normal is 3.9 but it was 2.0 before his cancer surgery. She said we should monitor it but didn’t recommend any additional tests at this time.  The only other slightly abnormal result was his thyroid.  The doctor said it was in a “grey area,” which means we probably need to watch for hypothyroidism in the future. Castiel is 10 so he is getting to be that age when hypothyroidism can show up.

The vet said Castiel looked good and she was pleased to hear he was using his ramps and steps. Castiel took to them right away and they really help him to get wherever he wants to be. He can get up most places, it’s the getting down that is the harder part. Castiel seems happy and healthy.  He loves playing feather toy and wrestling with his baby sister Clover.  He is doing everything he did before and is the same silly parlor panther he has always been. We love him so much.  We hope and pray every day that he stays healthy and well.