6 yo cat humerus sarcoma

RE: 6 yo cat humerus sarcoma

Judith Archbold — Thu, 12 Jul 2018 07:25:52 GMT

This is Hobie..... my 18 year old diabetic cat. I amputated her left hind leg two years ago: osteosarcoma in distal femur. She’s still going strong and just enjoyed her breakfast on the deck.

nb. Sadly my IPad photography skills are less than my surgical skills .... and she is about to slide off the decking :)

RE: 6 yo cat humerus sarcoma

Judith Archbold — Thu, 12 Jul 2018 07:23:25 GMT

RE: 6 yo cat humerus sarcoma

Mark Naguib — Wed, 11 Jul 2018 19:47:44 GMT

Probably a bit late now! I have one (humeral osteosarcoma, forequarter amputation) that is 5 years post op and still doing well.

RE: 6 yo cat humerus sarcoma

Martin McDowell — Tue, 10 Jul 2018 11:35:31 GMT

Cool. I was going to +1 for amputation.

All you can do is monitor and if any problems show up repeat the chest rads.

RE: 6 yo cat humerus sarcoma

Iain McAllister — Mon, 09 Jul 2018 13:37:54 GMT

He's had the forelimb amputated today - thanks for the advice - will look out for the post op issues mentioned - many thanks

RE: 6 yo cat humerus sarcoma

Laurence Webb — Sat, 07 Jul 2018 20:55:50 GMT

I have only encountered one osteosarcoma in a cat, and that was in the distal femur. Embarrassingly it came in with a fracture and I put an external fixator on it (iffy radiograph quality and hindsight) which failed most spectacularly when the cat panicked at discharge and got the fixator stuck in the cat box door mesh.

Amputation and histo showed the tumour to be an osteosarcoma but the cat went on to live happily after.

Limited experience of forelimb amputations in cats but those that I have seen generally seem to do well.

Given the choice of euthanasia or amputation I'd recommend the latter.

RE: 6 yo cat humerus sarcoma

Thomas Johnson — Wed, 04 Jul 2018 16:23:02 GMT

[quote user="Gerry Polton"]I have seen poor outcomes with forequarter amputation. I don't know but I speculate that patients can suffer a muscle strain in the suspensory apparatus of the remaining limb. Sometimes these patients can exhibit signs of significant pain on ambulation at some point in the two to three weeks following surgery. Affected patients can behave as though they have neuropathic pain and it will persist for a few weeks as there is no way the patient can rest it. We try very hard to restrict the heavier patients prior to discharge and then try to be very overbearing and emphatic about the importance of continued rest once patients have returned home. One of the reasons that I suspect this is a muscle injury is that you can predict the patients that are going to be at risk from a complex relationship between the patient's weight and stature and the attentiveness of the owner when discussing post-operative care instructions.[/quote]

I saw something similar in a cat earlier this year, 12yo M(N) Ragdoll that had a forequarter amputation to remove a fibrosarcoma that was attached to his distal scapula. He was fine for the first few days after the surgery, but after that was very subdued, reluctant to move, and would cry in pain and then quickly look round. The wound was healing very well and I couldn't elicit a pain response on examination. He was already on Metacam and I added in gabapentin thinking it might be neuropathic pain. It took about 4 weeks for him to get back to normal.

However in this case I would recommend amputation.

RE: 6 yo cat humerus sarcoma

Sarah Keir — Wed, 04 Jul 2018 16:07:49 GMT

My n=1 for the cases is a nurse's cat. Humeral osteosarcoma, forelimb amputation, did very well after it but euthanased due to mets in chest about 6 months post surgery even though chest xrays clear at the time. Perhaps time for a case series if we have multiple cases with outcomes not as good as previous studies.

RE: 6 yo cat humerus sarcoma

Gerry Polton — Wed, 04 Jul 2018 15:31:27 GMT

[quote user="Anthony Todd"]I doubt if there is anyone on here who has ever had an unsatisfactory outcome from a fore-limb amputation??[/quote]

I have seen poor outcomes with forequarter amputation. I don't know but I speculate that patients can suffer a muscle strain in the suspensory apparatus of the remaining limb. Sometimes these patients can exhibit signs of significant pain on ambulation at some point in the two to three weeks following surgery. Affected patients can behave as though they have neuropathic pain and it will persist for a few weeks as there is no way the patient can rest it. We try very hard to restrict the heavier patients prior to discharge and then try to be very overbearing and emphatic about the importance of continued rest once patients have returned home. One of the reasons that I suspect this is a muscle injury is that you can predict the patients that are going to be at risk from a complex relationship between the patient's weight and stature and the attentiveness of the owner when discussing post-operative care instructions.

To put some context on this, I can think of one case this year, a golden doodle, and one case from a few years ago that was a rottweiler.

Great discussion

Always consider plasma cell tumour in monostotic lytic bone lesions in cats; I suspect it is under-reported

Gerry

RE: 6 yo cat humerus sarcoma

Julie Innes — Wed, 04 Jul 2018 15:22:37 GMT

Another for amputation. Cats do so well with 3 legs, and this guy is young.

RE: 6 yo cat humerus sarcoma

Anthony Todd — Wed, 04 Jul 2018 15:15:31 GMT

I can't remember a cat but I've done a few dogs and, embarrassingly, as one bounced in [Dalmatian of course] I thought it was walking funny, not noticing the amputation of the front limb.......

I doubt if there is anyone on here who has ever had an unsatisfactory outcome from a fore-limb amputation??

The patients never even notice, ever!! [weird?]

RE: 6 yo cat humerus sarcoma

Jill Butterworth — Tue, 03 Jul 2018 19:11:57 GMT

Lots of things in it's favour, it's pretty straightforward surgery, I'd want to go for it.

There must be a 3 legged cat on line which has done well that might help their decision.

RE: 6 yo cat humerus sarcoma

Clive Ansell — Tue, 03 Jul 2018 18:05:33 GMT

+1 for forequarter amputation

RE: 6 yo cat humerus sarcoma

Neil Wheadon — Tue, 03 Jul 2018 18:01:17 GMT

From 'Feline Orthopaedic surgery and Musculoskeletal Disease' Montavon,Voss and Langley-Hobbs

Primary tumours are uncommon in cats 4.9 per 100.000

Osteosarcoma are the commonest - 70%

Appendicular Skeleton is affected more than axial, hindlimb more than forelimbs (so yours is a rarity)

Regardless of primary site, osteosarcoma are considered locally invasive. Low metastatic potential of only 5-10% (dogs 90%)

Limb Amputation is the treatment of choice, often curative

Median survival rate 24-44 months. No adjuvant chemotherapy recommended due to low metastatic potential.

Neil