Mali's Ultrasound

[RG & Mali (GA)]

Mali had her abdominal ultrasound yesterday and she's got multiple issues going on including her pancreatitis is still active, a gob of medical terminology that boils down to she may or may not have some cancerous lesions in the liver, kidneys, bile ducts and gall bladder along with what they call thickening of the intestinal loops and submucosal layer. This was done to see why she wasn't reacting to the insulin as they felt she should. Ultrasound, Xrays, PLI, Hyperthyroid recheck profile, urine culture=$700 plus.

They want to do exploratory surgery, renal pelvic and GB cultures to confirm or disavow their findings...still wating on estimate for those procedures.
Now I think we are mostly lay people on this board, but I'm just looking for your thoughts and opinions, if any, on this situtation.
As always, thanks for your input.

 

[jt and trouble (GA)]

I'm sorry I dont have any advice but you must be so worried. Sending prayers for Mali. I hope she feels better soon and wishing for the best possible outcome for you both.
Good luck and best wishes,
jeanne

 

[Larry and Kitties]

I feel for your for having to make the decision of what to do. One thing that I do is ask what are you going to do with the results. How would they change what actions one would do.

 

[RG & Mali (GA)]

I feel for your for having to make the decision of what to do. One thing that I do is ask what are you going to do with the results. How would they change what actions one would do.

Great question, Larry. Just got estimate for exploratory surgery and that will probably make the decision much easier..it is a BIG number!
She is a great comfort to both my wife and I, but she is 17 and has had really good health until the last few months. After her initial couple of lbs. weight loss, she has pretty much maintained, is eating pretty well, moving about without any obvious pain and continues to be a great cat. I will continue to monitor her BG and insulin with the excellent help and advice that I have gotten here and hope that we can keep her in as good shape as possible.
Thanks for your thoughts.

 

[RG & Mali (GA)]

I'm sorry I dont have any advice but you must be so worried. Sending prayers for Mali. I hope she feels better soon and wishing for the best possible outcome for you both.
Good luck and best wishes,
jeanne

Thank you very much for your thoughts and prayers. I will keep you updated on her progress.

 

[Deb & Wink]

Sorry to hear the ultrasound was not good news. Love Mali with all your heart. She doesn't know that anything is different.

Keep us posted on how you are doing.

 

[Hillary & Maui (GA)]

I will share Buster's story with you. Buster was born to a feral mom on my porch, she had two sibs (one didn't survive, the other had palsy and lived to 18 months - my friend took him). The sib started to have convulsions and epilepsy and that is how he died. When Buster turned 2, she started to have the same epilepsy convulsions and needless to say, I freaked out. I took her to a specialist as these episodes continued and because there was no pattern to the episodes, he didn't want to prescribe anything, instead he wanted to do exploratory surgery in her head to see if there was a tumor or something there causing it.

When I asked the question that Larry posed - if you do this, what happens next - the answer was well then we know and she may not have long to live.

I then asked about the invasiviness of the procedure and recovery and he said well it is opening up the skull and exploring, but it doesn't hurt and recovery he couldn't say.

Forget the expense which was another concern.

I said, if all you are doing is seeing if there is a tumor and not doing anything else, like solving the problem, then NO THANK YOU - I will not put Buster through that. The vet wasn't pleased and wrote a nasty letter to my primary vet about my not accepting his recommendations and going against medical advice blah, blah blah.

For the next year to two years, Buster continued to have intermittent seizures and then the time between them got longer and longer and longer and today Buster is 10 years, still alive, hasn't had a seizure in years and is just fine.

Now that isn't to say that she couldn't have died like her sib and I was even prepared to come home one day and find her dead or comatose. I look at each day, each year with her as a blessing and have never regretted not allowing the vet to do exploratory skull surgery.

And yes, Buster was young, but there was no way I could put her through that, just to satisfy the vet's curiosity and not change anything - only tell me that she may have a tumor and die. Well I was prepared for that anyway.

Now, you are in a similar situation and I suggest you write down all your questions, weigh the pros and cons and decide what is in the best interest of Mali and would she even survive such a procedure......and if money is a concern at all, well that is something else you need to factor in. And yes, you do, because you will put out money and for what? You won't have fixed anything and still may not have answers and/or find that you can't fix her or doing so will be painful and cost prohibitive......

 

[RG & Mali (GA)]

Thanks, Deb...will keep her cloaked in love, because she is a great little girl.

 

[RG & Mali (GA)]

Hilliary, that is a great story on what may happen, what can happen and what does happen...love it when they turn out that way!
I talked to my vet this afternoon and we discussed the alternatives in addition to the exploratory surgery.
Second option is less invasive, little less expensive, but still surgery and still under anesthesia which is also a great concern because of her age and her grade 3/6 heart murmur.
The third option is continuing with some of the same meds and changing to others which one is considered a type of chemotherapy. I'm relatively sure this is the route we will take and just try to keep as much as we can under control and hope for an outcome as great as Buster's.
Thanks for your thoughts.

 

[Hillary & Maui (GA)]

RG - you know your cat's history/medical conditions and age and the risks associated with each procedure. There are some risks that you may not be willing to take with your cat and given that, then you do what makes sense for you, Mali and your wallet and if pallative care is the answer, then it is easy to adjust the insulin for example to work with the other issues.

the more informed you are, the better you can make a decision. I do hope you get a positive outcome for Mali.

 

[BJM]

Chemo in cats is generally aimed at control, not cure. Because of that, they say that cats won't experience many side effects from chemo. In Pepper's case (GA), they were wrong. She got sick at both ends a couple hours after every chemo treatment. I had to give meds to stop vomiting, to stop diarrhea, to calm upset stomach, to increase appetite, etc. I don't think I'd do that to a cat again, what with the stress of going to the vet, and the possible effects of the treatment. And for a few thousand dollars, she lived maybe another 3 months.

If you want to go ahead with the biopsy, first find out how well the blood is clotting and if there is any kind of murmur. If there's a murmur (possible dilated heart chamber) or fast clotting, I wouldn't do it. Spitzer's saddle thrombus may have been a complication of the GI biopsy (a dislodged clot), and/or a slightly dilated heart chamber which allowed the blood to slow down and clot. He was in agony from the thrombus blocking the blood supply to both hind legs. I'd never heard him cry out like that before, and I never want to hear a cat cry like that again. I wouldn't let him suffer and helped him go.

 

[RG & Mali (GA)]

She definitely has a grade 3/6 murmur and we have already decided not to put her through the biopsy (second option) because that still involves sedation and we just don't think she would tolerate it well and the vet absolutely understood. Regarding the the chemotherapy, the drug suggested is Lukeran in pill form that, thanks to the raping and pillaging of big pharma, it's cost has doubled from about 6 bucks to little over 11 bucks each and the dosage is every other day and like you say, it's really a control not a cure....maybe if she was younger. Now we've added a couple more meds to her stash including Orbax, Metronidazole, both broad spectrum antibiotics, one pill form, the other liquid added her present meds of Ursodiol, Atopica, B12 shots and Cerenia. I can tell you it's no small task getting her to take all of that in additon to testing and shooting.