Cat mammary tumour - to treat or not?

RE: Cat mammary tumour - to treat or not?

jane alexander — Wed, 15 Apr 2020 14:44:31 GMT

yes, but generally spayed ex-breeding queens.

RE: Cat mammary tumour - to treat or not?

Anthony Todd — Wed, 15 Apr 2020 13:04:03 GMT

[quote userid="4080" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/29032/cat-mammary-tumour---to-treat-or-not/221760"](i/m triple combo[/quote]

Not around in my day. Sounds much easier as cats I/V are not so, and needs two trained operators. Are there ever "complications" with the modern triple combo for cats?

[tangent??]

RE: Cat mammary tumour - to treat or not?

joanne mcallister — Wed, 15 Apr 2020 12:30:42 GMT

yes, I'm not worried about anaesthetic complications due to age but wondered if the different GA induction I would use to maintain social distancing as far as possible (i/m triple combo rather than i/v propfol) might increase risk - not in itself maybe but more because I am less used to this - and should the owner be made aware

RE: Cat mammary tumour - to treat or not?

Anthony Todd — Wed, 15 Apr 2020 12:27:23 GMT

[quote userid="5012" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/29032/cat-mammary-tumour---to-treat-or-not/221729"] weigh up the risks vs benefits of anaesthetising a 14 year old cat that may well have other[/quote]

Is there any evidence that "old" cats & dogs have more anaesthetic complications, even with pathologies, than young, apparently normal animals??

Invariably they seemed to sail through??

RE: Cat mammary tumour - to treat or not?

Dagmar Steele — Tue, 14 Apr 2020 20:09:29 GMT

I would love a bit more of history. If the cat has been spayed at 6 months or younger it is very likely something else than mammary cancer. Having said that, if the cat is otherwise fit and healthy I wouldn't want to wait for it to grow, regardless what it is. I'd make an appointment to remove and stage beforehand in one go. Mammary cancer in cats has a fairly grave prognosis, catching it early might be the only chance to get rid of it. 14 isn't really that old any more, I've seen plenty 18,19 and 20yo last week.

RE: Cat mammary tumour - to treat or not?

Michael Woodhouse — Tue, 14 Apr 2020 19:53:51 GMT

[quote userid="4080" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/29032/cat-mammary-tumour---to-treat-or-not/221714"]thanks for this. What are people doing for other new lumps that may or may not be malignant based on anatomical site? [/quote]

Unless I suspect something really nasty (like MCT) then remove and send for histo.

This cat, I would get to come one morning starved, examine and if appropriate keep in for Sx. I wouldn't delay.

RE: Cat mammary tumour - to treat or not?

Clive Ansell — Tue, 14 Apr 2020 19:47:27 GMT

[quote userid="2235" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/29032/cat-mammary-tumour---to-treat-or-not/221727"]Why create an extra journey? I was under the impression that FNAs from mammary tumours were fairly useless for differentiating benign from malignant[/quote]

At this stage we don't know if it is a mammary mass or not.

I think I would start with a full history and examination, and weigh up the risks vs benefits of anaesthetising a 14 year old cat that may well have other pathologies due to age. (The last day of the last locum in March we had an "emergency" appointment for a mass that the owner was very concerned about and couldn't possibly wait. Suspect lipoma been there for > 6 months! - I told her to come back when things were back to normal))

If I was fairly certain it was a mammary mass, and the cat was otherwise healthy, I would likely go ahead with ga and removal.

I agree about the extra journey, try and avoid if at all possible

RE: Cat mammary tumour - to treat or not?

Rob Davis — Tue, 14 Apr 2020 18:18:40 GMT

[quote userid="5012" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/29032/cat-mammary-tumour---to-treat-or-not/221724"]14 year old cat, maybe examination and conscious fna first? [/quote]

Why create an extra journey? I was under the impression that FNAs from mammary tumours were fairly useless for differentiating benign from malignant, so I would say either leave it until after lockdown restrictions are reduced or get on and remove it now.

RE: Cat mammary tumour - to treat or not?

Clive Ansell — Tue, 14 Apr 2020 15:55:56 GMT

Individual risk assessment on a case by case basis of course.

If the owners are not unwell, and the cat can be hospitalised without owner contact then isolated the risk from C19 would be minimal.

If mass is benign waiting 2-3 months will make no difference, and if malignant likely to be metastasising already.

14 year old cat, maybe examination and conscious fna first?

RE: Cat mammary tumour - to treat or not?

Anthony Todd — Tue, 14 Apr 2020 14:58:52 GMT

The only mammary tumour in a cat I remember was in a very mature breeding queen. Removed it, [extensive!!] and removed the small regrowth later.

Does it ever occur in spayed queens? I can't recall any others??

RE: Cat mammary tumour - to treat or not?

Allison Gleadhill — Tue, 14 Apr 2020 13:30:48 GMT

I’m pretty sure I’ve read a paper where feline MGT prognosis was much better if less than 4cm when removed & a lot worse if > 4cm. I would deal with it now as it’s prognosis will get worse the longer it’s left.

RE: Cat mammary tumour - to treat or not?

joanne mcallister — Tue, 14 Apr 2020 12:06:28 GMT

thanks for this. What are people doing for other new lumps that may or may not be malignant based on anatomical site?

RE: Cat mammary tumour - to treat or not?

David Mills — Tue, 14 Apr 2020 11:19:15 GMT

The evidence around cat mammary tumours isn't great, as the numbers are small. IME the oft quoted 90pc malignant isn't the case in the primary practice world, but a significant percentage are still malignant, and many don't have signs or sequelae of metastasis at or after removal.

What is certain is the longer it is left, the more chance it has of metastasing. And who's to say in 1 to 2 months the covid situation will be any different?

RE: Cat mammary tumour - to treat or not?

joanne mcallister — Tue, 14 Apr 2020 11:15:09 GMT

but there is a high chance it will have already metastasised and timing of surgery will not affect if but when metastatic disease shows up. is that enugh justification for surgery now rather than 1-2 months?

RE: Cat mammary tumour - to treat or not?

Thomas Johnson — Tue, 14 Apr 2020 11:05:37 GMT

[quote userid="8991" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/29032/cat-mammary-tumour---to-treat-or-not/221700"]Personally, would get on and do it. Cats, being in a basket, are fairly easy to treat with minimal distancing.[/quote]

I agree. I also feel that treatment of a mass that has a reasonably high chance of being cancerous, with a high risk of metastasis, is urgent and I wouldn't delay it.

RE: Cat mammary tumour - to treat or not?

David Mills — Tue, 14 Apr 2020 11:00:45 GMT

Personally, would get on and do it. Cats, being in a basket, are fairly easy to treat with minimal contact.

RE: Cat mammary tumour - to treat or not?

joanne mcallister — Tue, 14 Apr 2020 10:51:30 GMT

thanks, those are my thoughts too, but finding it challenging to stand my ground with an insistent owner!

RE: Cat mammary tumour - to treat or not?

Jill Butterworth — Tue, 14 Apr 2020 10:10:24 GMT

If I had willing and able staff I would offer to be scheduling it within in the month. That will give time to see how lockdown is progressing, and it's an ideal case that can be managed remotely before and after. Maybe offer to fit the op in at short notice, depending how you are fixed? Kitty could even be left the night before for fasting and to reduce fomites.