liver mass - biopsy question (biopsy has been done)

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Michelle and Doodle

Michelle and Doodle

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My cat Angel had an ultrasound a month ago. She hadn't seemed unwell but because we had just adopted her a few months prior and she seemed to be struggling with persistent cystitis, we wanted to take a look at what was going on. During the ultrasound we saw what my vet thought was likely a dilated bile duct.
She prescribed antibiotics and Denamarin and a follow-up ultrasound a month later. Last evening she had her follow-up and the news was not good.
What we had hoped was a dilated bile duct is now a very obvious large mass on her liver. :(
She also has some thickening of the intestines and her kidney disease has progressed significantly.
She recommended we see an oncologist to do a biopsy and she mentioned something about a clotting profile.

I've googled but I'm not able to focus enough to comprehend what I'm reading at this point.
I'm hoping someone can tell me if the clotting thing has to be done and then there is a wait - or if it can be done just prior to a biopsy. ??
I'm also wondering if anyone can tell me if chemo drugs are cleared through the kidneys. ??
 
Re: liver mass - biopsy question

Michelle, I am so sorry you are going through this. When Minou had her biopsies, she had a pre-surgery checkup and they ran the clotting profile then. We got the results back at the end of the exam. If your vet/oncologist does in house blood work, the results should be available quickly. If not, it may take a day or so.
 
Re: liver mass - biopsy question

Oh Michelle, I didn't know this was going on, and you were supportive with Squeak!

I've no practical advice...we were thinking of doing the biopsy with Squeak but decided against it, so didn't have to figure out the prebiopsy tests...

Hugs

Jen
 
Re: liver mass - biopsy question

Thank you Karen. I was hoping it could be done the same day.
It was closing time when we were at the vets last night ( and my vet is off today) so I feel like I didnt have a chance to ask any questions.
 
Re: liver mass - biopsy question

Aww.. (((Jen)))
I didn't say anything because you've always been the one taking care of me. I thought maybe I could give a little back. :)
Seems like I'm back to needing the support though. :\
 
Re: liver mass - biopsy question

Michelle and Doodle said:
I'm hoping someone can tell me if the clotting thing has to be done and then there is a wait - or if it can be done just prior to a biopsy. ??
I'm also wondering if anyone can tell me if chemo drugs are cleared through the kidneys. ??
Click to expand...

Yes, definitely do the clotting profile prior to the biopsy, especially with a liver issue. Clotting factors are produced in the liver. It's just a blood test but most likely not done in the vet clinic so you may have to schedule it a couple of days prior to the biopsy.

I'm not sure on the the chemo drugs--not sure if that would be drug specific or not.
 
Re: liver mass - biopsy question

Thanks Deanie! I will definitely call first thing in the morning to see if I can get the clotting profile done right away.
I don't want to wait much longer to get the biopsy done and my vet is supposed to getting the referral worked out tomorrow.
 
Re: liver mass - biopsy question

Hi Michelle-

Gosh, I am so sorry to hear this. I have nothing to add other than to say I hope that the vet figures this out quickly and that her recovery is fast and easy. (((Michelle)))
 
Re: liver mass - biopsy question

Hi Michelle

I'm sorry to hear this. It might not be all bad news, though, as older cats sometimes get benign cystadenomas of the liver. There was someone on the board a few years ago who was told by the rDVM that all was lost, the cat had liver cancer and she went to a specialty hospital and had a biopsy and it was an adenoma. So I would wait before making chemo plans! Occasionally these benign tumors need to be removed because they are in the way (pressing on the stomach, etc.) but sometimes they can just hang out indefinitely. It's also possible that it's an abscess, or that it's not a mass on the liver at all but rather a gall bladder, and those things can be treated as well.

The specialty hospital can likely do a clotting profile in-house, and they like to do it as soon as possible before the biopsy. Cats can have a "Tru-Cut" biopsy with sedation and pain meds rather than general anesthesia, depending upon the location of the liver mass. But you can discuss that with the internist or oncologist. Since your regular vet confused a bile duct with a mass, I'm hoping the internist doesn't think things look as bad as your vet does. Please keep us posted.
 
Re: liver mass - biopsy question

Thanks Jess!!

Angel had her biopsies done on Friday. She ended up having biopsies done on both her liver and her kidney due to the fact that one of her kidneys was enlarged. The oncologist said she was concerned about that in conjunction with Angel's sudden spike in her creatinine and calcium.
The good news is that the "large mass" we saw on Tuesday's ultrasound turned out to be two benign cystadenomas! (just as you said Jess) I am, of course, incredibly happy about that!
However there was some inflamed tissue surrounding the cysts and the oncologist said that although she was hopeful... she couldn't rule out lymphoma in her liver.
I still don't have the results from the biopsies.
 
SO glad to hear about the cystadenomas. I think a lot of regular vets don't know about these because ultrasound wasn't as much in use -- so they probably have had older feline patients with these cysts but never knew it until everyone started getting ultrasounds!

Keep us posted on the biopsies please. Fingers crossed over here!
 
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