4/30 - Noodle AMPS 82 +5.5 50 +10 116 PMPS 115- Hello from a stranger! (cytology results included)

Patricia & Noodle

Member Since 2015
Hello LL! It has been quite a while since I was last active on the board. I see a lot of new faces and a lot of old friends.

To reintroduce Noodle and myself: Noodle was diagnosed with diabetes in January 2015 at ~8 y/o during a severe bout of DKA. She was hospitalized for a time and recovered better than any of us expected she would. We started our dance on Lantus and experienced a roller coaster of high highs and low lows that seemed to have no rhyme or reason. After quite a bit of frustration, we made the switch to Levemir at the end of 2015 and it was the correct choice for her. She is much more stable and her dose has been teeny tiny (we hover around .51mm using calipers) for the past few years. It's definitely still needed, but she gets very little.

Her bean (:waves:) has not been great about following TR or even SLGS for quite a while. I was struggling quite a bit personally and because she was doing so well, I stopped tracking so diligently. We still test at every preshot, but spot checks in between are few and far between and my SS has long been ignored. It is certainly not an ideal situation - I cannot recommend it to others! - but her bloodwork has been great, she gets a full senior blood panel 1-2x a year, she rarely has glucose in her urine, and we are happy with how she is doing overall. It was the best choice for us at the time, I could barely keep my head above water and treating her diabetes more aggressively was just not in the cards for me. If I had to generalize, she is typically in the blues, with regular greens and occasional yellows. I will drop her dose accordingly if she goes too low more than once and rarely raise it since I am not tracking closely enough to feel it's safe to do so. We've had a couple issues with UTIs when she's been over stressed - both have been when we moved. The one in 2019 was terrible due to a reaction she had to clavamox that lead to 2+ months of digestive issues.

She is doing very well otherwise, still gets the zoomies at her age, and terrorizes her drooler brother regularly! Her beans got married last year and she even graciously sits with her father to watch a movie now, it only took 7 years of warming up to him. :)

Of course, there is a new story to tell, sadly. On Tuesday night, I felt a new lump on her lower abdomen. She has always had some fatty deposits in that area that her vet was aware of and has had 2 ultrasounds of her abdomen in the past that weren't concerning (one in 2015, one in September/October 2019). It was more solid and larger than the ones I was used to and seems to have appeared quickly. I like to think I keep a close eye on her and she is in my lap every day for her BG tests (I test on her back paws, so her belly is exposed). I've also had to pick her up off my laptop about 867x a day since I've been working from home the past 6 weeks and only noticed the mass Tuesday, but who knows. I may have not noticed it growing because of the others she has in the area. We went to the vet Wednesday afternoon and are waiting for the cytology to come back. The vet thinks it is most likely a cyst or a mammary tumor. It is the push I've needed to stop being complacent about her diabetes and start tracking it more closely. I can't control the test results, but I can approach whatever treatment she needs more informed about her diabetes and keep that as well managed as I can.

So, if anyone remembers us, hi old friends and a warm hello to all our new friends, too! I do check in even if I haven't posted in ages and have said many a prayer for the GA kitties who helped us so much when our journey was new and scary. Here's to turning over a new leaf.
 
Thought I'd update the post here with the cytology that came back sooner than expected. Inconclusive, of course. The vet who took the sample and sent the results suggested two options: "1) sedation and biopsy of the mass (taking a small section), or 2) anesthesia and removal of the mass for pathology (excisional biopsy)." I asked if there is value in treating the mass as if it was malignant and taking an aggressive approach towards option 2.

I also plan to ask about redoing the cytology after looking at the results - does anyone have insight as to if that would be worthwhile?
 

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Thanks @Sue and Luci ! Nice to meet you!

That does sound reasonable. I think there is part of me that wonders if it would be better to just knock it out right away and be pleasantly surprised if it is not malignant? Definitely need to consider the cost of each option too (and of steps 2, 3, 4...). She's the million dollar cat at this point!
 
Thanks @Sue and Luci ! Nice to meet you!

That does sound reasonable. I think there is part of me that wonders if it would be better to just knock it out right away and be pleasantly surprised if it is not malignant? Definitely need to consider the cost of each option too (and of steps 2, 3, 4...). She's the million dollar cat at this point!

I hear you...I guess I'd ask how large they think it is and knowing what it is and if follow up is needed, just in case...

Nice to meet you too!
 
Hi Patricia - long time no "see". :bighug: Pass on some scritches to Noodle from me. We do have a bean who dealt with a mammary tumour a while ago. Tagging @AliceMeowliss&Cassandra to see if Cassandra is around. Or you can search her posts. Alice did well with the removal of the mass.
Hi Wendy!! :bighug: Noodle appreciates the scritches and says hello. Hope you are doing well and have had some quality time on the water lately! Thank you for tagging Cassandra. I'd already stumbled across several of her posts and am now taking a look at the posts about Alice's surgery! I do think I need to talk to my regular vet about the pros and cons of each option. I cc'ed her on my response to the doctor with the results so hopefully she has some time to take a look.
 
I’m not sure what active post you have up so I’m just going to comment here...

Alice and I went through a mammary tumor. I wish I had had it out ASAP—it was cancerous and while it didn’t grow during her emaciated time on Novolin N, when we got her on a good insulin (Lantus) it grew just as quickly as she did. Once she was back up to around 6lbs we had it out.

We didn’t bother to biopsy. Personally I wish my veterinarian had removed the whole mammary chain as is advised in the research I did, but she removed the tumor with good margins and it was still grade 2 with lymphovascular invasion and a chance of metastasis. By then it was the size on the outside of a small fingertip maybe.

It has, however, been nearly 11 months since removal, and she’s doing okay and her bloodwork checks out generally alright. We did not have access to a veterinary oncologist for follow up.

My opinion is that any of the tissue around the tumor that isn’t needed would be better off going rather than playing guess the cat symptom games later just to find out there is a cancer that has spread.


I believe I also read that 85% of mammary tumors are malignant. Source was Cornell vet website I think but I would have to go digging for it. I think this is why I kind of just wanted it out of her.
She had another factor to consider though, which is that she had not been spayed. Until that point I had never wanted her to have to be cut on, not realizing the risk I had put her at. Having her spay done at the same time as having the tumor removed was useful and it was suspected hormones played a role in tumor growth.


My best to you and Noodles, and don’t feel bad about SS and testing, just get back up and get on the horse! I’ve been behind on Alice’s more than once. Sometimes we simply do our best. :)
 
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