Gandalf getting eval at U of IL tomorrow

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Vicky & Gandalf (GA) & Murrlin

Vicky & Gandalf (GA) & Murrlin

Member Since 2009
I haven't written much about this 'cause it's pretty upsetting, but Gandalf's parathyroid tumor has grown and I can now feel it. Last fall when he was eval'd there as part of a study on reoccurrence of parathyroid feline adenocarcinoma it was pretty small, .5cm I think.

The problem is that 1/2 his parathyroid has already been removed. Meaning if the other half is removed he would have to be on calcium supplements the rest of his life and there is a chance of him dying if his calcium level was to go low.

So I have to find out what are the chances first of him surviving another of this surgery, which knocked him for a loop in '08 when he was doing much better overall. He has the same problems now as then though, diabetes, arthritis, kidneys, possibly heart disease and he's 18 now. Seems like the deck was stacked against him then too, but he was 3 years younger.

I also need to find out what the prognosis is if we don't do surgery. Can it be aspirated periodically, but at what point does it affect his other systems? I'm pretty sure this one is also cancerous, one sign in a long term diabetic is that some cancers can lower their BG 'cause the cancer eats glucose. I don't know if his type can do that but his insulin needs have decreased fairly dramatically very recently.

I want to do the right thing for his welfare, but I can't imagine making him suffer through the progression itself if the surgery is the only obstacle. That and the calcium supplementation, I have to find out more about that.

And there's the small part of me which feels if anything about treating it could help another kitty at some point, I'd like to do that. The U of I is one of the top vet schools in the country and they do a lot of research, hence them wanting to see Gandalf last year, free of charge to me. This time it's all on me.

He laid on the couch with me watching Hulu this morning and I know he trusts me to do the right thing for him. So I just need more info at this point, to at least make an informed decision.
 
(((((Vicky and Gandalf))))

I worked with a woman who had to have her parathyroid removed. She has to watch her calcium levels like a hawk. Definitely research the side effects and how his calcium levels will be managed.
You'll make the right decision for Gandalf.

Let us know if we can help with research or anything else...
 
The unfortunate thing is it's so rare that I doubt there's much info on how much calcium is necessary, what affects the levels and what the best form is to give cats. Just knowing that people have the same thing happen helps, so thanks for informing me you knew someone. It's not as easy to test as BGs, it basically means a blood draw every time.
 
I freakin' love Google:

Postoperative Management

Hypocalcemia
•hypocalcemia is the most significant complication of thyroidectomy
•77% cats with hyperthyroidism are also hyperparathyroid and reversal of hyperthyroidism may predispose cats to hypoparathyroidism and hypocalcemia in postoperative period
•serum calcium levels should be monitored especially after bilateral thyroidectomy
•hypocalcemia occurs most commonly 2-5 days following surgery
•clinical signs occur when serum calcium concentration < 7.5 mg/dL
•clinical signs: restlessness, weakness, muscle tremors, twitching, tetany, and seizures
•treatment of hypocalcemia includes:
•10% calcium gluconate (0.5-1.5 mg/kg IV) at over 10-20 minutes initially
•10% calcium gluconate (10 ml added to 250 ml maintenance solution) at 60 ml/kg/day
•maintenance with oral calcium gluconate (3-4 ml diluted 1:1 with isotonic saline q 6-8 hrs or 0.2-0.5 g/cat)
•maintenance with vitamin D (0.02-0.03 mg/kg q 24 hr PO for 5-7 days)
•vitamin D supplementation can eventually be tapered and withdrawn in the majority of cats
•permanent hypoparathyroidism is likely if calcium does not return to normal within 14 days
•spontaneous resolution of hypoparathyroidism due to reversible damage or hypoxia resulting from thyroidectomy or compensation by accessory parathyroid tissue
Click to expand...

The worst part about researching medical things online is the publication of such documents usually aren't public and they are expensive just to get a PDF copy. I found one study in which a 17 yr old Persian was treated for parathyroid adenocarcinoma, but I can't read it!!

But the above is most helpful. Of course this is in cats which have their thyroids removed and assumes it's because the parathyroids were damaged during surgery. However it gives me hope that they know how to supplement for it properly and that it is manageable.
 
Thanks, Peggy.

I am kind of excited. This is the first time we make this trip in my new HHR and I was able to outfit it nicely for him. I was worried because he likes to climb in the backseat, well, now the whole back half of the vehicle is his! I put a litter box in the hidden storage area and a cardboard under the folded down seatbacks so he can get from the front seat to the back without getting a foot caught. I will try not to let him get in the front seat though. I can put the armrests up so they might block him from doing that.

here are pictures:
CIMG1798.jpg

CIMG1799.jpg

CIMG1800.jpg

CIMG1801.jpg


I figured out I can also hang a fluids bag, so I can give him sub-Q fluids before we head home. He gets very dehydrated on this trip for some reason. But yes, he will use the box in the vehicle. I learned to put a box in the car after having him pee once in the car after a dental!

I had him come outside and I showed him his traveling digs. He seemed to like it! He even jumped up on the platform which is above the litter box. I have put a blanket on that since I took the pic, since he got up on it. I know it's not cool to travel with an animal loose in the car, but I'm a very safe driver and don't anticipate a problem. I know you never know though, so it's a risk I'm willing to take so he's comfortable.
 
That is just PERFECT!! I wouldn't be afraid to have him roam free. This is less stressful.
Have a safe drive!
And did you pick that car just for Gandalf? I think you did,lol.

I learned about free roaming with Mickey after a couple of pees in the carrier too :mrgreen: One of them came out and shorted my friend's electric seats.
 
The set-up in the car looks great Vicky, Gandalf will be comfortable. He will be getting the best of care at the University vet clinic and you will get the information you need.
Sending positive thoughts your way.
Have a safe drive.
 
I have to give Yoyo "roaming" freedom in a car also. If I keep him in a carrier for a long trip, he will poop and pee all over himself and the carrier and I will have to wash him down with a garden hose when we get to our destination, something neither one of us enjoys.

I don't have a van. I have a Saturn and the back seats fold down, opening up the trunk to the car interior. I put a harness and a leash on Yoyo and a litter box in the back. He will poop in the litter box at least four times before I've gone 50 miles then he roams around the car, having intermittent panic attacks, while I continue to smell the litter box for the next three hours --- but he arrives at our destination smelling like a rose.

I would like to find a better harness than the one I have. Yoyo is an absolute Houdini, he is the Plastic Cat Shape Changer and is talented at wriggling out of it. The harness and leash limit his mobility enough to keep him safe but give him enough freedom so that he survives a four hour trip in better condition than he would in a carrier.

I was very sorry to hear about Gandalf's health set back. Surely it will turn out to be a manageable condition. Please keep us posted.

Lana
 
This really came up fast! I hope you get the answers to all your questions today Vicky and it helps you in making this very difficult decision. And I am glad he gets to make the trip in comfort. :) Please let us know.
 
We got home about 6PM. he enjoyed the trip, I have pictures I can upload later. I've spent so much time typing the past hour my index finger which I hurt while gardening earlier this year has gotten very sore! I wondered why it was hurting yesterday!

So I'm going to hold off on a full report till maybe tomorrow night. He's doing pretty well though for 18 yrs old with diabetes, arthritis, parathyroid enlargement, possible IBD, pretty much the whole 9 yards. The vet was pretty surprised he's maintained his bloodwork values so well over 9 months since she last saw him. I made sure to see the same resident vet. Am sad because apparently her residency is over soon.

Anyway, more tomorrow.
 
Vicky & Gandalf said:
So I'm going to hold off on a full report till maybe tomorrow night. He's doing pretty well though for 18 yrs old with diabetes, arthritis, parathyroid enlargement, possible IBD, pretty much the whole 9 yards. The vet was pretty surprised he's maintained his bloodwork values so well over 9 months since she last saw him. I made sure to see the same resident vet. Am sad because apparently her residency is over soon.
Click to expand...

I would think they are pretty happy to have this individual case study in Gandalf. Yes, it is too bad about the one vet ending her residency and moving on, but you know she will probably always remember Gandalf (that big grey cat!) in dealing with this condition. :)

Looking forward to the whole report.
 
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