Help with a differential for my own cat

Re: Help with a differential for my own cat

Jenny Prebble — Sun, 10 Nov 2013 18:42:40 GMT

the findings would suggest you are right. Cells in the fluid consistent with chondrosarcoma. Currently waiting to hear back from an oncologist. Thank you all for your input

Re: Help with a differential for my own cat

Laurence Webb — Thu, 07 Nov 2013 23:27:47 GMT

Fluid of some sort makes sense - tumours that double in size in 36 hours are pretty rare. Might it be synovial fluid? May still be from a chondrocytoma though. :(

Re: Help with a differential for my own cat

Yantha Smyth — Thu, 07 Nov 2013 19:53:02 GMT

.? Synovial cell sarcoma?? Good luck, I hope you get some answers and puss is comfortable Yantha

Re: Help with a differential for my own cat

Jenny Prebble — Wed, 06 Nov 2013 21:21:12 GMT

Thank you all for your comments. I will keep those names in mind. We stuck a needle in today (while I had my fingers crossed for pus) and what came out was not expected!

About 5 mls of thick clear sticky fluid was taken from the mass. I was quite salivary in appearance. Have sent for cytology etc

Any one any ideas...she shouldnt have any salivary glands in her shoulder.

Jen

Re: Help with a differential for my own cat

Martin Atkinson — Wed, 06 Nov 2013 14:33:31 GMT

[quote user="Nicola M"]Similar to my thoughts-which were get Gerry Polton's advice! Masivet king, lovely man and will give you fantastic, honest, user friendly advice.

[/quote] Gerry Polton walks on water.

Re: Help with a differential for my own cat

Nicola Cole — Wed, 06 Nov 2013 14:05:11 GMT

Similar to my thoughts-which were get Gerry Polton's advice! Masivet king, lovely man and will give you fantastic, honest, user friendly advice.

Re: Help with a differential for my own cat

Rob Loxley — Wed, 06 Nov 2013 13:51:47 GMT

Was it Merial who were working on a 'vaccine' for injection around the site of soft tissue sarcoma removal in cats?

Re: Help with a differential for my own cat

Martin Atkinson — Wed, 06 Nov 2013 12:22:08 GMT

If it were my cat I would just give palliative treatment now and PTS when the time came. Interesting thoughts from David though, I wasn't aware that Masivet had any action on this type of tumour especially as Gerry Polton who helped pioneer its use in this country wasn't using it for this purpose last time I had contact with him. He was however using Doxorubicin with great success in feline vaccine site sarcomas. Maybe have a word with him: gpolton@ndsr.co.uk. he's my 'go to' oncologist at present - don't have huge faith in Cambridge from past experience - sorry.

Re: Help with a differential for my own cat

Michael Woodhouse — Tue, 05 Nov 2013 23:35:23 GMT

I think if I was going to do anything (and not doing anything is perfectly reasonable) I would go in, see what is happening, debulk and send excised tissue for histology. Possibly as David says.

Fingers crossed you get up in the morning and the CBA has burst,,,,,,,,,,,,,,,,

Re: Help with a differential for my own cat

Utlendigur — Tue, 05 Nov 2013 22:10:55 GMT

Sorry you are facing such a horrible situation, I think it's sometimes worse as a vet because we tend to go into overdrive trying to figure out the problem aswell as the emotional turmoil of being a worried owner.

[quote user="Jenny Prebble"]I am leaning towards palliative care but am considering biopsy but only if there is reason to think this mass could be something else[/quote]

I suppose another way of looking at it would be that until you do a biopsy, you can only think/imagine what it is - if you biopsy it you will know and can decide what to do with the facts in front of you. A small incision biopsy isn't major surgery, and at least then you won't be playing out all sorts of "what if" scenarios in your head. I doubt a FNA would be diagnostic though if it's a sarcoma as many don't shed cells very easily.

Re: Help with a differential for my own cat

David Mills — Tue, 05 Nov 2013 22:08:36 GMT

My sympathies.

There are a couple of options, which I suppose depend on your frame of mind.

If you're going to sample it then get some tissue. ST sarcomas exfoliate (usually) poorly and so a punch biopsy under sedation + local is going to give you far more information than an FNA (and I'm a big FNA fan).

Surgery is very unlikely to be curative, but it may not need to be. Certainly I've had success (anecdote alert) with cytoreduction (i.e. debulking surgery) and TKIs for other soft tissue sarcomas (fibrosarcs mainly), so it may work in this case.

Masivet appears to be the easiest to use in cats (I believe it's being put through safety trials at the moment) and there is pharmacokinetic data out there on its use. 50mg q24-48h PO appears to be efficacious and well tolerated. Main side effects are neutropaenia and proteinuria which need monitoring for, which, according to the Cambridge oncologists (whom I trust), occur in 10-15% of cats. It also targets the PDGF in fibrosarcs so may be more efficacious in these with double action but I would say definitely worth a go in this case.

I think you're going to increase your chances of success massively with another surgery though. I know she is 15 but if she's otherwise healthy, it surely isn't too much to put her through? There'll be plenty of spare tissue in the area I'd assume, and you don't have to get it all, just as much as you can.

Re: Help with a differential for my own cat

shanley barber — Tue, 05 Nov 2013 21:52:22 GMT

I really feel for you, Jenny! I am incapable of being rational and objective when it comes to my own animals, I usually hand the animal over to a colleague and get them to take over the case. Could you do an aspirate of the lump, instead of a full biopsy? Might give you enough information to help you make a decision.

Re: Help with a differential for my own cat

Jenny Prebble — Tue, 05 Nov 2013 21:40:07 GMT

Thanks for your reply. Unless it was something where surgery was curative I don't intend to put her though major surgery. My vet brain knows it is probably bad news but my owner brain is looking for all the treatable it will go away (and she will live on for years to come) conditions because I don't want to lose her.

Re: Help with a differential for my own cat

Dagmar Steele — Tue, 05 Nov 2013 21:21:45 GMT

To be honest I don't think this sounds very good. I'm sorry. But also I must say I would take a biopsy, just to make sure I know what I'm dealing with. With my own animals I tend to be very critical with myself and to be very much in doubt with everything I decide. I would need to know. But that's just me, and others may be different. What I wouldn't do is put her through another surgery.