A Consult with the Veterinary Oncologist and More Tests

The COVID has made receiving veterinary care so much more difficult. We  had to hand off Castiel to a technician who brought him into the SAGE Vet Hospital, while we waited in the car. All our contact with the doctors was through a telephone call.  We weren’t allowed to meet them in person – even masked.  How do you know if you can trust someone you can’t see.  Cancer is serious — life or death stuff — and we were talking to someone we couldn’t see – whose reactions we could not judge. It felt like an impossible situation. The oncologist did not inspire confidence. I’m sure she is probably well educated — much more than us — but she didn’t answer questions well on the phone.  She paused a lot. She sounded uncomfortable and as a result, we were uncomfortable. We didn’t know what to think, maybe if we could have seen her — but we couldn’t.

The medical oncologist conducted a CT scan (a CAT scan of our cat, ha ha!) and an ultrasound to try to determine if the cancer had spread. They didn’t see any signs of spread. However, the CT showed a cyst or lump in one of his thyroid glands. This might be cancer or it might not.  Malignant thyroid cysts in cats appear to be rare in the literature but in reality, we didn’t know. Fibrosarcomas are supposed to be 1 in 10,000 — we were already unlucky. Could we be unlucky again?  Worse, the oncologist didn’t mention this finding to us — a vet friend who we phoned one night out of the blue, probably breaking all protocols, pointed it out to us and recommended we check it.  Why hadn’t the oncologist mentioned it? We asked her… she didn’t think it was anything to worry about. It could be but maybe it wasn’t. Ugh! So much uncertainty! We didn’t want to remove his leg if the cancer had already spread but none of the tests claimed to be 100 percent. How could we make this decision? How could we even consider it… we could hardly bring ourselves to even say the word “amputation” never mind visualize it or consider doing it.

We saw our local vet to test the thyroid — it was normal. No hyperthyroidism. At 18.3 lbs he was still a big cat and well-groomed despite his now Frankenstein suture and funny haircut from all the tests and anesthesia monitoring.

The oncologist recommended we remove his left leg and scapula to give him the best chance of survival and a prolonged life. She said radiation and chemotherapy alone wouldn’t likely work. She thought the cancer would eventually spread, and that the cells on the edges might be more aggressive. She also recommended radiation and chemotherapy.

Our mostly retired veterinary friend (Castiel’s first doctor ) — the man we called out of the blue, offered to review the medical results and help us understand what it all meant. He has probably had more years as a practicing veterinarian than we’ve been  alive.  We wanted a second opinion from someone we trusted and who had no money in the game.  We trust our local vet but we didn’t know about these strangers at the vet hospital who we couldn’t see and whose reactions we couldn’t gauge over the phone.  Cancer treatment is expensive and while we believed everyone was telling us what they truly thought was best for Castiel, we weren’t sure. Family suggested vets were in the money making business, and this led to doubt.   And worse, family members voiced that we should do nothing and  “just let him go.” They told us we were being cruel. We felt like monsters.  Our vet friend helped calm us. He told us that he thought amputation was the best chance for a longer life. He assured us that he thought Castiel would adapt. He said he wasn’t sure if he would do radiation and that it would depend on if we got clean margins.  He said he didn’t think cats had the same psychological reaction as humans did to the loss of a limb. But how could we really know?  I think we were already grieving for Castiel’s affected limb. Our vet friend listened to us and we felt a little calmer. Another friend from church brought us a hot meal that night and a bag of groceries – easy to prepare things.  These things made the hard things a little easier.  People on this website reached out to us — they gave us tips and advice, they shared their stories, and they listened to our fears.  We were grateful and felt less alone.

 

 

2 thoughts on “A Consult with the Veterinary Oncologist and More Tests”

  1. ((((hugs))))

    You guys are so lucky to have that vet friend. Everyone needs someone like that at a time like this!

    You are NOT cruel, you are doing what needs to be done to give Castiel a better quality of life, and a longer one. Right now, stay away from anyone with a negative attitude. They don’t get it. And maybe they will once they see him fully recovered. But you don’t need that kind of energy during recovery.

    Sending lots of love & strength your way!

  2. Thank you Jerry. Yes, we are blessed to have two good vets guiding us. Our friend really went out of his way for us. He’s been so kind to us. Our local vet too. It’s just an awful thing to have happen to a little cat. We hope he will still have good quality of life. In all honesty, Castiel is not the most active cat. He’s a happy, lazy cat so maybe that will make the transition a little easier. Fingers crossed. We are making a decision based on the best science at the time and on love. We are trying not to think just emotionally –I don’t know that we are succeeding but we are trying to do what we think Castiel would want — and we think he would want to live and hang out with his hoomans and his silly siblings Clover and Aleksandr.

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