7/27 Jessi, SCC tumor, time sensitive questions

[Stefania S]

https://www.felinediabetes.com/FDMB...osting-in-the-main-forum.278910/#post-3083298

Hi all,

I have gotten a recent diagnosis of Squamous cell carcinoma for Jessi. They did follow up tests to make sure it hadn't spread to other organs. Although I don't have the official reply from the specialists yet, the intake Vets were optimistic.

Can you tell me any and all experience you personally have had with SCC and/ or point me to information about this that could be helpful?

Unfortunately, we are in a small city in Italy and the options aren't many. But there is a good University clinic as well as a private clinic that specializes in Oncology and various therapies.

I am hopeful surgery will be enough since it is on her lower neck area and even though it will obviously be painful it wouldn't be too bad as far as locations go. I would like to avoid radiation and other harsh treatments if possible.

The two best options for surgery are Anicura and Clinica Veterinaria Università di Bologna. Anicura is the only Vet clinic with high tech radiation facilities in Italy, from what I see, but I would probably leave that for in case the Vets believe surgery isn't enough or isn't the best option.

The University clinic is where I have been taking Jessi for sensor application and monitoring. That is where the tests were done.
https://site.unibo.it/ospedale-veterinario/it/piccoli-animali/endocrinologia

Anicura has the only linear accelerator (?) for radiation therapy (I am translating literally from their website so this term might not be accurate) If you know anything about this specific kind of treatment please share.
https://www.anicura.it/cliniche/centro-oncologico-veterinario/la-clinica/

I welcome all your opinions and feedback. My only request is that they be positively focused. I'm super sensitive, especially right now, and I can easily spiral down about this topic so please tread lightly and share only what you feel would be supportive of the best possible outcome right now.

Thank you for kindness and help during this crucial time for us. If nothing else, please send lots of wishes, prayers and good thoughts. I know they will help Jessi immensely.

 

[Veronica & Babu-chiri]

Hi sorry about his diagnose, but carcinoma treatment has advanced a lot recently, there are options for local quimo treatments, that are applied in the affected area only and are having very good results.

What they usually do is when they surgically remove the tumor they give the quimo therapy in the affected area with the help of advanced equipment, while the wound is still open and the cat is still under the anesthesia so he literally doesn't even feel anything is a one time treatment and since is done only in the affected area the cat does not get side effects in other organs , appetite or anything else.

A year ago Babu had an apocrine quistic carcinoma, it was in his forehead, they removed the tumor, an as much as possible of the surrounding tissue, because of the location there wasn't really much to work with, and the oncologist applied the chemotherapy in the wound, he really did not had any after effects other than the fact that the skin did got a bit stretched and we had to be very careful to avoid any extra stretching but it only left a scar, hair grew back and now you can't even see it, this was a year ago and we have been monitoring him and so far everything is ok

I suggest you talk to the vets in the clinics to look for this kind of treatments since they do need to have the right equipment but it is not so hard to find, it was even available here in Mexico so I'm pretty sure you will be able to find it

 

[Stefania S]

Thanks for your reply Veronica. It's good to know that that there are gentler treatments available. That's great that Babu is doing well and that there were no side effects from the treatment.

I'll have to do some investigating here, hoping that the terminology is the same. Do you know if that type of local chemo has a specific name, or maybe the name of the equipment used? That would make it easier for me to find it in Italian and communicate about it to the Vets here. Maybe it won't be necessary if they already know exactly what it is.

It seems like what you're talking about is different from what's mentioned on the Anicura website, this linear accelerator for radiation therapy. Chemo refers to chemicals that are used to destroy cancer cells, and these vary according to the type of cancer, location, etc....is that right?

Do you have a sense of the pros and cons of chemo vs radiation?

 

[Suzanne & Darcy]

I believe that Veronica is talking about the Electro-Chemotherapy that I mentioned in a previous post of yours. It is chemotherapy that stays in the local area where it is needed and so does not cause systemic side effects. Let me find the report from my consultation with an oncologist about this procedure and see if it describes the treatment better.

 

[Suzanne & Darcy]

Here are some notes from the oncologist that saw Marcus (before we decided to go to University of Georgia Veterinary Teaching Hospital.). There is some general information and some more specific to the radiation and the electrochemotherapy. I hope you won’t need any of this and that it can be removed with surgery. My poor Marcus has had two surgeries already and that is why we chose to pursue Strontium 90 radiation- because I don’t want any more cutting!

 

[Stefania S]

Here are some notes from the oncologist that saw Marcus (before we decided to go to University of Georgia Veterinary Teaching Hospital.). There is some general information and some more specific to the radiation and the electrochemotherapy. I hope you won’t need any of this and that it can be removed with surgery. My poor Marcus has had two surgeries already and that is why we chose to pursue Strontium 90 radiation- because I don’t want any more cutting!

Thanks Suzanne! Now I know the names of these two types of treatments, that will help me when discussing with vets here, hopefully they'll understand the terms.

I don't see a linked or attached document or page. Were you planning to include one in your reply above?

 

[Veronica & Babu-chiri]

Do you have a sense of the pros and cons of chemo vs radiation?

Actually I don't think is like one or the other they have different purposes and scopes, sometimes both are used it all depends on the tumor and type of cancer

I hope you won’t need any of this and that it can be removed with surgery.

I hope so too but very often some additional treatment is required after removal of the tumor with surgery to ensure all cancer cells are removed or eliminated, to avoid it coming back or spreading to other areas or tissue since even if the surgeon can do a very good extraction it is almost impossible to be totally sure every single cancerous cell was removed so it is highly recomendad some extra treatment but now luckly specially for skin related tumors there are some non or almost non invasive options

I do think that knowing that are some not so invasive options will allow you to discuss it with your oncologist since he is the one that has actually looked at the tumor and tell him you do want some treatment but you want or need it to be the least aggressive and invasive possible

 

[Stefania S]

Actually I don't think is like one or the other they have different purposes and scopes, sometimes both are used it all depends on the tumor and type of cancer


I hope so too but very often some additional treatment is required after removal of the tumor with surgery to ensure all cancer cells are removed or eliminated, to avoid it coming back or spreading to other areas or tissue since even if the surgeon can do a very good extraction it is almost impossible to be totally sure every single cancerous cell was removed so it is highly recomendad some extra treatment but now luckly specially for skin related tumors there are some non or almost non invasive options

I do think that knowing that are some not so invasive options will allow you to discuss it with your oncologist since he is the one that has actually looked at the tumor and tell him you do want some treatment but you want or need it to be the least aggressive and invasive possible

Thanks Veronica, I will keep all this in mind as we move forward. I'm still waiting to hear back from them. Hopefully that will be very soon.

 

[Suzanne & Darcy]

I hope so!

 

[Suzanne & Darcy]

I’m going to try again! Here is some information from our visit with the oncologist:

“General disease information
Cutaneous squamous cell carcinoma (SCC) is a malignant cancer affecting skin. They are usually found in areas of unpigmented or lightly pigmented skin typically around the face (tips of ears, eyelids, around nose & lips) particularly in outdoor cats with high sun exposure. Solar radiation damages the skin over time leading to cancer formation. Clinically the lesion may appear proliferative or erosive. Future sun exposure should be minimized. Surgical removal is recommended if possible however there are anatomical limitations. Prognosis is good with complete excision for each spot however They are locally invasive but usually do not spread (metastasize) and most cats eventually develop multiple lesions. Although lesions may occur at different times, this is typically a result of cumulative damage to the skin from years prior and not spreading from one skin site to another. Once the damage has been done to underlying skin, there is no way to reverse this. Other treatment options for non-surgical lesions can include strontium90 localized radiation therapy to minimize side effects to surrounding areas and/or electrochemotherapy (typically carboplatin or other drugs).

Therapy/Treatment Plan:
None at this time (no active lesions). Monitor closely for any new skin spots especially on tips of ears, around eyelids, nose, and lips. If possible, any new lesions should be surgically removed. Other treatments can include:

1) We are currently in the process of obtaining licensing for a radiation treatment called Strontium90. This is a handheld instrument that can direct a focused beam of radiation to a skin site without causing internal damage like "regular" radiation. Response are usually very good and can even have a "curative" effect on individual lesions and can treat multiple spots. Does typically require a short anesthesia for treatment and depending on severity of lesion, may take one or more treatments. Cost estimate currently not available and timeframe of when we will have this onsite is unknown but anticipated in the next few months. For updates on this, you can contact the radiation oncology team. To schedule an appointment for consultation regarding this option, you can schedule with Dr. Fout (radiation oncology). There may be other regional facilities that have this availability, but this type of radiation is NOT available at all veterinary radiation facilitates.

2) We are currently in the process of obtaining equipment for electochemotherapy. This is a method by which an electrical field is applied to diseased tissues and localized chemo administered to improve penetrations of chemo into cancer tissue. Response are usually very good and can even have a "curative" effect on individual lesions and can treat multiple spots. Does typically require a short anesthesia for treatment and depending on severity of lesion, may take several treatments. Cost estimate currently not available and timeframe of when we will have this onsite is unknown but anticipated in the next few months. For updates on this, you can contact the oncology team. To schedule an appointment for consultation regarding this option, you can schedule with Dr. Ayers (medical oncology) as Dr Wypij is not currently trained in this technique. There may be other regional facilities that have this availability - I believe the closest are University of Florida and Charleston SC but there are no "lists" of facilities with the capability.”

 

[Stefania S]

I’m going to try again! Here is some information from our visit with the oncologist:

“General disease information
Cutaneous squamous cell carcinoma (SCC) is a malignant cancer affecting skin. They are usually found in areas of unpigmented or lightly pigmented skin typically around the face (tips of ears, eyelids, around nose & lips) particularly in outdoor cats with high sun exposure. Solar radiation damages the skin over time leading to cancer formation. Clinically the lesion may appear proliferative or erosive. Future sun exposure should be minimized. Surgical removal is recommended if possible however there are anatomical limitations. Prognosis is good with complete excision for each spot however They are locally invasive but usually do not spread (metastasize) and most cats eventually develop multiple lesions. Although lesions may occur at different times, this is typically a result of cumulative damage to the skin from years prior and not spreading from one skin site to another. Once the damage has been done to underlying skin, there is no way to reverse this. Other treatment options for non-surgical lesions can include strontium90 localized radiation therapy to minimize side effects to surrounding areas and/or electrochemotherapy (typically carboplatin or other drugs).

Therapy/Treatment Plan:
None at this time (no active lesions). Monitor closely for any new skin spots especially on tips of ears, around eyelids, nose, and lips. If possible, any new lesions should be surgically removed. Other treatments can include:

1) We are currently in the process of obtaining licensing for a radiation treatment called Strontium90. This is a handheld instrument that can direct a focused beam of radiation to a skin site without causing internal damage like "regular" radiation. Response are usually very good and can even have a "curative" effect on individual lesions and can treat multiple spots. Does typically require a short anesthesia for treatment and depending on severity of lesion, may take one or more treatments. Cost estimate currently not available and timeframe of when we will have this onsite is unknown but anticipated in the next few months. For updates on this, you can contact the radiation oncology team. To schedule an appointment for consultation regarding this option, you can schedule with Dr. Fout (radiation oncology). There may be other regional facilities that have this availability, but this type of radiation is NOT available at all veterinary radiation facilitates.

2) We are currently in the process of obtaining equipment for electochemotherapy. This is a method by which an electrical field is applied to diseased tissues and localized chemo administered to improve penetrations of chemo into cancer tissue. Response are usually very good and can even have a "curative" effect on individual lesions and can treat multiple spots. Does typically require a short anesthesia for treatment and depending on severity of lesion, may take several treatments. Cost estimate currently not available and timeframe of when we will have this onsite is unknown but anticipated in the next few months. For updates on this, you can contact the oncology team. To schedule an appointment for consultation regarding this option, you can schedule with Dr. Ayers (medical oncology) as Dr Wypij is not currently trained in this technique. There may be other regional facilities that have this availability - I believe the closest are University of Florida and Charleston SC but there are no "lists" of facilities with the capability.”

Thanks Suzanne, this is great!

From what I’m finding so far, it looks like the strontium90 might not be available yet here, while localized electro chemotherapy is.

Still waiting to hear back from the Clinic. It’s a slow system here unfortunately. They made me rush to take her for follow up tests but they’re making me wait a week, so far, for the final word on the results.

sorry, just having a little frustration moment

As soon as I talk to them I’ll check back in here to run it by you all.

 

[Veronica & Babu-chiri]

while localized electro chemotherapy is.

I'm glad it could be a good option

Still waiting to hear back from the Clinic. It’s a slow system here unfortunately. They made me rush to take her for follow up tests but they’re making me wait a week, so far, for the final word on the results.

The studies they run usually takes a few days so hang in there and let us know how's everything going

 

[Stefania S]

So here is the latest update: No to Strontium90 at least from what the Vets at the Bologna University clinic and at the Anicura Radiation treatment center told me.

The latest tests, x ray and ultrasound are showing that cancer cells have not spread to other organs, however they are concerned about some lymph nodes in the area of the SCCs. They are suggesting surgery, but when I asked about doing local electrochemotherapy they said this is not something they do there. They would take a wide margin out and remove the lymph nodes in two places near the SCC to be safe.

Tomorrow we have an appointment to do a biopsy of the lymph nodes, but I was told that even if it shows negative they will remove the ones near the site to be safe. They will also do some more blood tests to check her current state before surgery. I will speak with the oncologist and other related doctors tomorrow to get more specifics on their suggested approach.

If they won't do the localized electrochemotherapy during surgery, can it be done after, some place else, or does it have to be before they stitch up the area?

@Suzanne & Darcy
@Veronica & Babu-chiri

would love your opinions on this

 

[Suzanne & Darcy]

So here is the latest update: No to Strontium90 at least from what the Vets at the Bologna University clinic and at the Anicura Radiation treatment center told me.

The latest tests, x ray and ultrasound are showing that cancer cells have not spread to other organs, however they are concerned about some lymph nodes in the area of the SCCs. They are suggesting surgery, but when I asked about doing local electrochemotherapy they said this is not something they do there. They would take a wide margin out and remove the lymph nodes in two places near the SCC to be safe.

Tomorrow we have an appointment to do a biopsy of the lymph nodes, but I was told that even if it shows negative they will remove the ones near the site to be safe. They will also do some more blood tests to check her current state before surgery. I will speak with the oncologist and other related doctors tomorrow to get more specifics on their suggested approach.

If they won't do the localized electrochemotherapy during surgery, can it be done after, some place else, or does it have to be before they stitch up the area?

@Suzanne & Darcy
@Veronica & Babu-chiri

would love your opinions on this

Oh my! I’m afraid I don’t know. I feel terrible that you are under such pressure right now to make decisions when you don’t have all the information. So tomorrow they are removing two lymph nodes and trying to get a wide margin? I don’t know if I am understanding correctly?

 

[Suzanne & Darcy]

And they plan to remove all lymph nodes near the site of the SCC? Tomorrow? Have they explained what the implications of removing the lymph nodes are? I only know that - in human medicine- removing lymph nodes can result in swelling due to lack of proper drainage when the lymph nodes are no longer there. I don’t know which lymph nodes they are removing though.

 

[Veronica & Babu-chiri]

If they won't do the localized electrochemotherapy during surgery, can it be done after, some place else, or does it have to be before they stitch up the area?

I'm not sure but for what I remember when I talked to the oncologist for Babu, it has to be done on the adjacent tissue to where they removed the tumor it is actually an extra mesure to make sure all the cancerous cells are eliminated so I don't think it can be done later. But if the tumor is really very well localized well it may not matter if they don't apply it hopefully they will remove enough of the near by tissue to avoid any future problems

As far as the lymph nodes I'm with Suzanne, If it is not really necessary I would question the real reason to removing them before they do it

 

[Stefania S]

I’m sorry I wasn’t clear in my message. Today we are going just to have another biopsy and some bloodwork done and then discuss the treatment plan (and options hopefully). Surgery hasn’t been scheduled yet.

Please tell m everything you know about lymph nodes and possible consequences of removing them. They seem decided that these will be removed regardless of the outcome of the biopsy.

I don’t know what to do anymore. I don’t feel good about taking her there but almost every vet I have spoken to and plenty of pet owners refer to the University clinic as the best especially for Endocrinology which is how we ended up there in the first place.

There may be a private clinic tucked away somewhere that is much better, but I haven’t found it yet.

 

[Veronica & Babu-chiri]

Well first of all they do have a function to fulfill in the body and I for one am of the idea that we should not try and take out anything that does not need to be taken out , lymph nodes are after all part of the body's defence mechanisms against viruses and bacterias and it can make his recovery from the main surgery more difficult since removing them can cause irritation, more swelling and that can make his recovery a bit more complicated.

I'm not saying they should not remove them if they are affected or enlarged or are somehow not normal, and they think the problem can not be dealt with antibiotics or some meds then removal may be a good approach but if they are not they maybe ask the vet what the reason for removing them is.

 

[Stefania S]

I'm not sure but for what I remember when I talked to the oncologist for Babu, it has to be done on the adjacent tissue to where they removed the tumor it is actually an extra mesure to make sure all the cancerous cells are eliminated so I don't think it can be done later. But if the tumor is really very well localized well it may not matter if they don't apply it hopefully they will remove enough of the near by tissue to avoid any future problems

As far as the lymph nodes I'm with Suzanne, If it is not really necessary I would question the real reason to removing them before they do it

And they plan to remove all lymph nodes near the site of the SCC? Tomorrow? Have they explained what the implications of removing the lymph nodes are? I only know that - in human medicine- removing lymph nodes can result in swelling due to lack of proper drainage when the lymph nodes are no longer there. I don’t know which lymph nodes they are removing though.

Hi Suzanne and Veronica,

So here is the latest update. During a grueling afternoon at the clinic, which Jessi is still recovering from, I did get to speak with the surgeon. They did biopsies on surrounding lymph nodes so I will have those results next week some time, hopefully it won't take as long as last time to move the next step. They did more bloodwork and, if I understood right, they also did a scraping of this other scabby spot in the area of the SCC to see if that also needs to be removed. If the results are negative for the lymph nodes they would still remove the lymph nodes near the tumor site as a precaution because he is saying that is how SCC cells typically spread in the body. I asked about drainage and possible swelling, he said, yes, that could occur but only for a few days and then other pathways for drainage would be formed. You can tell me what you think about that.

Hopefully the other skin abnormality near the tumor is benign in which case they would do surgery on the SCC only taking a wide enough margin to be safe without taking too much skin. It does go below the surface a little so they have to include some depth as well, if I understood right. If the other needs to be removed as well I'm not sure if they'll do them at the same time.

I asked about local electrochemo and he said that was an available option but only if it seemed necessary. He seemed inclined not to do it, but we will wait for the test results for deciding that as well.

I could try to get a second opinion, but I would have to take her to yet another clinic with all new people, and probably more tests, more stress...to say nothing of the huge expense, so I may not do that. I don't think the opinion would be very different and I don't think it would be any better. I got a pretty good feeling from this surgeon, although he is on the young side, but that can be a good thing. He was very communicative, kind and respectful. He seemed to genuinely care about Jessi and although I can't evaluate his skill level and technical competence, I felt I could be ok about putting her in his hands. The worries and doubts probably will always be there and there are obviously risks, but I know we can't leave her in this condition and I don't have any better options at this time.

What we need right now is for Jessi to get strong and ready for a surgery, which seems inevitable at this point. This isn't easy considering how weakened she is by the stress of these visits and also by having the tumor touched, bandaged, cleaned, etc... which I now have to do several times a day, aside from the obvious challenges of her FD condition. Her BGs go super high after these visits, with some help from the wonky sensor, and then after a few cycles they often dip quite low.

I guess that's all for now, I'm going to try to get a nap in.

So much learning, studying, implementing new practices, adapting to new challenges coming up, trying to integrate it all while managing her health....along with all the usual stuff of life...I know lots of people on the forum are going through similar experiences or have in the past, at least it helps to know it's not just me.

Thanks so much for your insights and support, feel free to share anything you think might be helpful!

 

[Stefania S]

Well first of all they do have a function to fulfill in the body and I for one am of the idea that we should not try and take out anything that does not need to be taken out , lymph nodes are after all part of the body's defence mechanisms against viruses and bacterias and it can make his recovery from the main surgery more difficult since removing them can cause irritation, more swelling and that can make his recovery a bit more complicated.

I'm not saying they should not remove them if they are affected or enlarged or are somehow not normal, and they think the problem can not be dealt with antibiotics or some meds then removal may be a good approach but if they are not they maybe ask the vet what the reason for removing them is.

I just saw this other reply, Veronica. Yes, thanks, I totally agree that nothing should be removed unless truly necessary. Once we get the results from the last tests, I will insist more to see just how important he thinks it is to remove them and why. As you know, it can be hard to have a dialogue with doctors as they tend to see you as ignorant and themselves as having all the knowledge and authority. The surgeon seemed particularly kind and willing to talk to me, but he also seemed quite sure about removing those nodes.

First I will wait to hear from them about the results, then I will ask to speak with him again before any decisions are made.

He told me after surgery they will have to keep her there 1-3 days depending on her condition. I figured as much, but it is going to be so hard for her to be in a cage in a room full of other scared cats, lots of people, noises, lights, smells...I so hate putting her through this...but what can I do? I waited too long as it is.

I know she is stronger than she seems and if she has a will to keep living and be well, we'll get through this. On the other side is a much better quality of life......right?

 

[Stefania S]

Hi Suzanne, Veronica, and anyone else who is has knowledge to share or is interested in this topic. I will post a little update next about the next phase of SCC diagnosis and treatment.

First, can you tell me to your knowledge can an SCC tumor affect BG levels and insulin uptake and in what ways?

Thanks so much!

@Veronica & Babu-chiri
@Suzanne & Darcy

 

[Stefania S]

Hi all,

I started to write the other day and then my message didn't get uploaded.

So here is the latest news, I will try to control my emotions:

They are really dragging this out. I had to wait another week for test results because one of the doctors was away on vacation. And now two of the doctors are on vacation. They gave me an appointment for more testing and a 'colloquio' as they call it which is more like a classroom for vets who gather all around terrified Jessi and make it look like they're taking care of her when they're actually studying her and practicing their very newly learned skills on her. Enough said.

I was told on the phone by the only Vet who ever contacts me, that the next time we go they will fix a surgery date. She also mentioned, about a week after the visit, that they weren't able to get a biopsy of the lymph nodes because they were too small, so they don't know if there are neoplastic cells there or not. They still want to remove them because they say this is the usual way for it to spread to other parts of the body and this is standard practice. You tell me what you think.

As far as I am understanding, the SCC remains contained in the immediate region of where it's located, but they are dragging this out so long that who knows if it will stay that way. The tumor is worsening visibly at least, making Jessi pretty uncomfortable and unhappy, stressing me out too. But I have to wait until it's convenient to them and until they have used Jessi to teach enough burgeoning vets something new and interesting.

Yup, I'm a little angry and frustrated because I feel powerless about the whole thing. Jessi hates having the dressing changed so she is avoiding me more and more these days. Today she went way too long without eating during the critical hours of the cycle because she was afraid to come out. I finally fed her under the bed where she was hiding.

She kicks at the bandage and manages to get the moistened gauze out from underneath them which is terrible for the tumor. But then again, so is being covered with ten layers of synthetic wrapping and self adhesive bandaging.

The skin near the tumor on one side is peeling off, I mean, a chunk of skin came off with the bandage when I removed it this last time, and there is like a indentation where it used to be.

I'm losing my stamina for this and getting more and more nervous. I try to do other things, get my mind off of it, but it feels very pressing.

I just hope they decide to make this 'case' important and urgent enough to take care of before August.

Also, they don't seem to be equipped to do electrochemo, but instead of referring me to a place that is they are telling me it 'probably isn't necessary' (the surgeon said) and 'there isn't enough evidence to support that this is actually effective (the Endocrinologist team vet said). Soooo...I have no idea.

 

[Dyana]

I've been following your post, but have no experience.
I'm just sending you hugs, patients vines, and The Best Of Luck in getting this taken care of.

 

[Stefania S]

I nixed the neck wrappings and put a kitty shirt on her with my own invention of a moistened inner liner to cover the tumor loosely and keep it moist. Guess what I used as a liner? pretty brilliant actually although the vets probably will think I'm insane! and they'll say it isn't sterile, but I don't care. Want me to tell you?

It's true it's not sterile, but neither is a sterile gauze after a few seconds of being on her so....I use colloidal silver spray to disinfect it and saline to moisten the liner.

so far it's working, and it seems to be much more comfortable, although she hates having a shirt on...It has a high neck, turtle neck style. I'm able to cover the tumor and keep it moist without wrapping her neck tight to the point of almost strangling her. She is still kicking it but not as much. Not so easy to change the inner dressing without taking the shirt off, but I managed today. I could do this while she was eating down on the ground without restraining her at all and without putting her up on a counter where she can't get down on her own. I managed to give insulin without taking the shirt off too although it was a little tricky and definitely not ideal.

I just need to take the sleeves off and shorten the back which is way too long. They're made for Sphynx cats. I'll get around to that one day....

I don't like seeing her in a shirt, it's so un-catlike and it covers her beautiful fur. I can't even pet her properly. But right now, it's a big improvement for her quality of life and mine.

I feel some relief now that we have a better system. But the tension and suspense is still there. As if there isn't enough of that with the FD regulation alone!

Oh, the things we do for our beloved kitty friends...ey?

 

[Stefania S]

I've been following your post, but have no experience.
I'm just sending you hugs, patients vines, and The Best Of Luck in getting this taken care of.

Thanks so much Dyana! I truly appreciate your support and positive energy!

 

[Nimi S]

They are really dragging this out. I had to wait another week for test results because one of the doctors was away on vacation. And now two of the doctors are on vacation

Hi Stefania and Jessi
I’m following your and Jessi’s journey and your updates about the vets make me so mad. Can a doctor really be so nonchalant when dealing with a cancer diagnosis in a being so tiny? I do get that maybe if a cancer (or any other disease, for that matter) is caught in the early stages there may be some leeway with respect to the timeline for action, but I can’t wrap my head around how unbothered (for lack of a better word) they seem to be. My nerves would be shot if I had to wait so long for updates

It just sucks how difficult it is to find good vets for cats. I’m currently in the middle of dropping my 3rd vet, who added pretty much nothing of value to Shen’s life, just bills.

they weren't able to get a biopsy of the lymph nodes because they were too small, so they don't know if there are neoplastic cells there or not. They still want to remove them because they say this is the usual way for it to spread to other parts of the body and this is standard practice. You tell me what you think

If this is standard practice they should be able to provide you with some evidence or resources that point to it being so. I think you should ask. At least you can read up on some literature while they’re making you wait. It’s not a crime to want to be well-informed about the choices you need to make for Jessi. I was reading up a bit a couple of days back. I’ll post something here for you if I find anything relevant

It’s pretty sad that there’s such a low tolerance amongst doctors for queries about stuff relevant to a disease’s prognosis which isn’t always linked to their skills. They nearly always take so much affront

I nixed the neck wrappings and put a kitty shirt on her with my own invention of a moistened inner liner to cover the tumor loosely and keep it moist. Guess what I used as a liner?

I think I know what it is but only because I’ve spent a little too much time on the FDMB in the early days looking up things I didn’t need to.
Is it something us ladies need every month?

Btw, I had a paraplegic cat who was prone to pressure sores and one time he had terrible open wounds on his legs. I’d used this foam dressing that I could keep on for a few days at a time, while keeping the wound moist. I don’t know if it’s available where you live but it was really great for the healing since it’s non-adhesive, although a bit expensive. The normal cotton and gauze dressing would stick to the wet wound and pull back parts of it while changing the dressing. It was really horrible.
I don’t know if the foam dressing will work for the area where Jessi’s ulcer is. I think it should, so long as her fur over there is shaved.

With regard to Jessi’s SCC, there was something I thought I’d highlight. I recently read that vitamin B12 sort of helps with helping some cancers grow (some evidence found only in human studies though). Since B12 basically helps with cell growth, the cancer could use it for growing too (I’m dumbing it down too much).

I’m not sure if Jessi gets any Vit B12 (I assume she does since a lot of FD kitties have neuropathy and I was giving it to Shen too even though he doesn’t need it) but here are some posts about B12 and cancer:
https://www.felinediabetes.com/FDMB/posts/3011835/
https://www.felinediabetes.com/FDMB/posts/2746486/
Tanya's page on the B Vitamins only says not to give it to cats who have cancer:
Vitamin B12 and Cancer

Don’t mean to alarm you with this info. Just thought that you can err on the side of caution

Hope you can get back on the BG train soon with a new sensor

All the best for all the dressing changes and vet visits. Keep venting and updating us here

 

[Nimi S]

can you tell me to your knowledge can an SCC tumor affect BG levels and insulin uptake and in what ways?

I obviously don’t have any experience with feline cancer but came across something that might answer your question partially. It’s from a book - Canine and Feline Geriatric Oncology. (Pages 75-76)

Posting a snapshot below of the relevant page for easy reference:

 

[Veronica & Babu-chiri]

I'm glad you've found some sort of solution for the ulcer, to be honest I stopped putting anything on Babu's lesion while we waited for the surgery. I hope they do realize that to keep waiting is not a good idea and move the surgery. In the mean time keep us posted on how he's doing

Regarding his BG even though the cancer itself may not do anything directly to his blood glucose levels, at least as as far as I know there is no evidence especially in skin cancer, him feeling bad and uncomfortable and of course stressed by everything could raise his numbers a bit so yes I think all this ordeal could affect his diabetes a bit.

 

[Stefania S]

Hi all,

I have to make some important decisions really fast. We went to a different clinic yesterday for the SCC, and I am going to go with them for the surgery, just better facilities, more organized, cleaner, quieter, one-on-one attention, and other things that make it a better experience overall. Very expensive too.

The wanted to do a CAT scan on the spot but I waited. Can you tell me if you did CAT scans for your cats before the surgeries? If that seems necessary? I prefer to avoid it especially since it requires anesthesia. I’ll leave aside the cost.

They say it’s important for deciding what kind of surgery to do, from purely palliative to removing a huge area and pulling a flap to cover.

Without the CAT they believe you can’t accurately choose which surgery to do.

I have to decide fast.

A couple of weeks have already past since her last x ray so if I opt out of the CAT scan they want to repeat the x Ray. Personally, I want to get on with the surgery, taking a moderate margin. Then there are the 2 lymph nodes which they are insisting should be removed as a precaution same as the other clinic. Another decision for me to make quickly.

There is no hard evidence that the lymph nodes are infiltrated but the belief is that they are the most common way for it to spread so better to remove them preemptively.

They can give me a surgery date this coming week. I just have to decide on these crucial things.

Your perspectives and experience could be very helpful in deciding.

It has to be today, or tomorrow morning latest so if you could reply right away that would be awesome!

Thank you!

 

[Suzanne & Darcy]

Hi all,

I have to make some important decisions really fast. We went to a different clinic yesterday for the SCC, and I am going to go with them for the surgery, just better facilities, more organized, cleaner, quieter, one-on-one attention, and other things that make it a better experience overall. Very expensive too.

The wanted to do a CAT scan on the spot but I waited. Can you tell me if you did CAT scans for your cats before the surgeries? If that seems necessary? I prefer to avoid it especially since it requires anesthesia. I’ll leave aside the cost.

They say it’s important for deciding what kind of surgery to do, from purely palliative to removing a huge area and pulling a flap to cover.

Without the CAT they believe you can’t accurately choose which surgery to do.

I have to decide fast.

A couple of weeks have already past since her last x ray so if I opt out of the CAT scan they want to repeat the x Ray. Personally, I want to get on with the surgery, taking a moderate margin. Then there are the 2 lymph nodes which they are insisting should be removed as a precaution same as the other clinic. Another decision for me to make quickly.

There is no hard evidence that the lymph nodes are infiltrated but the belief is that they are the most common way for it to spread so better to remove them preemptively.

They can give me a surgery date this coming week. I just have to decide on these crucial things.

Your perspectives and experience could be very helpful in deciding.

It has to be today, or tomorrow morning latest so if you could reply right away that would be awesome!

Thank you!

Would the CAT scan include the lymph nodes? So they could see for sure if there’s anything going on there?

 

[Suzanne & Darcy]

Hi Stefania and Jessi
I’m following your and Jessi’s journey and your updates about the vets make me so mad. Can a doctor really be so nonchalant when dealing with a cancer diagnosis in a being so tiny? I do get that maybe if a cancer (or any other disease, for that matter) is caught in the early stages there may be some leeway with respect to the timeline for action, but I can’t wrap my head around how unbothered (for lack of a better word) they seem to be. My nerves would be shot if I had to wait so long for updates

It just sucks how difficult it is to find good vets for cats. I’m currently in the middle of dropping my 3rd vet, who added pretty much nothing of value to Shen’s life, just bills.



If this is standard practice they should be able to provide you with some evidence or resources that point to it being so. I think you should ask. At least you can read up on some literature while they’re making you wait. It’s not a crime to want to be well-informed about the choices you need to make for Jessi. I was reading up a bit a couple of days back. I’ll post something here for you if I find anything relevant

It’s pretty sad that there’s such a low tolerance amongst doctors for queries about stuff relevant to a disease’s prognosis which isn’t always linked to their skills. They nearly always take so much affront



I think I know what it is but only because I’ve spent a little too much time on the FDMB in the early days looking up things I didn’t need to.
Is it something us ladies need every month?

Btw, I had a paraplegic cat who was prone to pressure sores and one time he had terrible open wounds on his legs. I’d used this foam dressing that I could keep on for a few days at a time, while keeping the wound moist. I don’t know if it’s available where you live but it was really great for the healing since it’s non-adhesive, although a bit expensive. The normal cotton and gauze dressing would stick to the wet wound and pull back parts of it while changing the dressing. It was really horrible.
I don’t know if the foam dressing will work for the area where Jessi’s ulcer is. I think it should, so long as her fur over there is shaved.

With regard to Jessi’s SCC, there was something I thought I’d highlight. I recently read that vitamin B12 sort of helps with helping some cancers grow (some evidence found only in human studies though). Since B12 basically helps with cell growth, the cancer could use it for growing too (I’m dumbing it down too much).

I’m not sure if Jessi gets any Vit B12 (I assume she does since a lot of FD kitties have neuropathy and I was giving it to Shen too even though he doesn’t need it) but here are some posts about B12 and cancer:
https://www.felinediabetes.com/FDMB/posts/3011835/
https://www.felinediabetes.com/FDMB/posts/2746486/
Tanya's page on the B Vitamins only says not to give it to cats who have cancer:
Vitamin B12 and Cancer

Don’t mean to alarm you with this info. Just thought that you can err on the side of caution

Hope you can get back on the BG train soon with a new sensor

All the best for all the dressing changes and vet visits. Keep venting and updating us here

I agree with this about the B-12 injections. I have read the human information about B-12 and cancer growth.

 

[Suzanne & Darcy]

Can they do a CT scan on the day of the surgery- prior to the surgery? I suppose they can’t because they need a radiologist to read it and they don’t have one on staff. I’m just thinking.

 

[Suzanne & Darcy]

Also, they don't seem to be equipped to do electrochemo, but instead of referring me to a place that is they are telling me it 'probably isn't necessary' (the surgeon said) and 'there isn't enough evidence to support that this is actually effective (the Endocrinologist team vet said). Soooo...I have no idea.

This is a shame. A surgeon cuts. It’s what they do so they can’t seem to think of any other resolution to a problem.

 

[Suzanne & Darcy]

You know, the CT scan could really be helpful for the surgeon. I just don’t have any experience with having one done. How many minutes does it take - how long would she need to be under anesthesia? What kind of anesthesia will they have for her - to protect her - will they monitor her blood pressure during the anesthesia? How? This is important. It’s okay to ask a few more questions isn’t it? So it sounds like you have found a better place? If they wanted to do the scan right away they are at least taking her case very seriously.

 

[Stefania S]

Would the CAT scan include the lymph nodes? So they could see for sure if there’s anything going on there?

It would include everything I think.

 

[Suzanne & Darcy]

I would lean toward doing the CT scan because I would want them to be able to know exactly how much they will need to remove and if there is any lymph node involvement -- although I think they're saying that removing those nodes is "standard of care" for this surgery -- it's a "just in case" kind of thing. I'm not really comfortable with that, but if there is lymph node involvement, that's another story. Oh, I feel so sad/hurt/terrible for you ... having to make these decisions. Have they ever told you what the ramifications are for Jessi if the lymph nodes are removed. What will the effects be in her body afterwards -- long term? Has anyone ever answered this question?

 

[Suzanne & Darcy]

So because of the location of Jessi's tumor, I would probably go with the CT scan, but that is just me. We don't really know how deep the tumor is, do we? I didn't read any posts about the x-ray. I will go look for them now. I was thinking about you and wondering why I had not heard anything lately about Jessi because I had not seen any posts lately -- but it may be just me because I have been away and/or super busy off the Board.

 

[Stefania S]

I would lean toward doing the CT scan because I would want them to be able to know exactly how much they will need to remove and if there is any lymph node involvement -- although I think they're saying that removing those nodes is "standard of care" for this surgery -- it's a "just in case" kind of thing. I'm not really comfortable with that, but if there is lymph node involvement, that's another story. Oh, I feel so sad/hurt/terrible for you ... having to make these decisions. Have they ever told you what the ramifications are for Jessi if the lymph nodes are removed. What will the effects be in her body afterwards -- long term? Has anyone ever answered this question?

I have asked the doctors in both clinics about the role the lymph nodes play and the possible effects of removing them, and they said the same thing, that the body would compensate by creating other channels for drainage and it wasn’t a big deal, something like that. When I mentioned their role in immune defense they basically denied or downplayed it. Today I confirmed that for myself with a quick online search. But it might also be true that if/when the immune system is not able to defend properly against cancer cells, it becomes a kind of catalyst or vehicle for it to spread. So they see the removal of the lymph nodes as taking away a potential pathway for spreading.

Yes, the burden of choosing is huge. Thank you for your empathy. I have no idea what is the right way. So ultimately I’ll have to choose what feels best.

A CAT scan requires full anaesthesia. Doing that twice in a short period to Jessi’s body doesn’t feel right to me. If it weren’t for that I probably would have agreed. Surgery will get postponed more if I do the CAT scan because I will have to let her fully recover from that.

She is weak from so much ongoing stress, from the Diabetes, neuropathy, digestive difficulties, and probably other hidden issues. I’m afraid to put her under twice in a short time.

My feeling is to have them remove the tumor with a safe but moderate margin, but I’m not sure about the lymph nodes.

This is all unknown territory to me, and it’s hard to know who or what to trust.

They don’t seem to do the combination of surgery and electrochemo here. The approach here is to do the surgery then test the area and decide if electrochemo is necessary after surgery.

The oncologist said that the chemo could make healing from surgery longer and harder on her body. I guess I believe that, they are pretty harsh chemicals after all. If she were young and otherwise healthy and strong it would be a different matter.

 

[Stefania S]

So because of the location of Jessi's tumor, I would probably go with the CT scan, but that is just me. We don't really know how deep the tumor is, do we? I didn't read any posts about the x-ray. I will go look for them now. I was thinking about you and wondering why I had not heard anything lately about Jessi because I had not seen any posts lately -- but it may be just me because I have been away and/or super busy off the Board.

The x Ray done at the previous clinic (University) was not conclusive as far as the lymph nodes go. They could only see that they looked not completely normal but that could be just from the immune response to the presence of a tumor. They saw no evidence of neoplastiche cells in other organs.

At the new clinic (Anicura) the oncologist said that a CAT scan is more revealing than an x ray as it would show finer details. It might find cells the X Ray didn’t. It might show metastasis in the lymph nodes, but it might not, which is why they would remove them in any case. So doing the CAT scan won't necessarily be conclusive either. I think for them the main reason to do it is that if they saw it had spread to other organs than there would be no point in taking bigger margins, they would just do a palliative surgery to remove the discomfort of the external mass.

But to put her through that seems worse right now than taking wider margins. Maybe I'm wrong. There is plenty I don't know.

 

[Suzanne & Darcy]

I have asked the doctors in both clinics about the role the lymph nodes play and the possible effects of removing them, and they said the same thing, that the body would compensate by creating other channels for drainage and it wasn’t a big deal, something like that. When I mentioned their role in immune defense they basically denied or downplayed it. Today I confirmed that for myself with a quick online search. But it might also be true that if/when the immune system is not able to defend properly against cancer cells, it becomes a kind of catalyst or vehicle for it to spread. So they see the removal of the lymph nodes as taking away a potential pathway for spreading.

Yes, the burden of choosing is huge. Thank you for your empathy. I have no idea what is the right way. So ultimately I’ll have to choose what feels best.

A CAT scan requires full anaesthesia. Doing that twice in a short period to Jessi’s body doesn’t feel right to me. If it weren’t for that I probably would have agreed. Surgery will get postponed more if I do the CAT scan because I will have to let her fully recover from that.

She is weak from so much ongoing stress, from the Diabetes, neuropathy, digestive difficulties, and probably other hidden issues. I’m afraid to put her under twice in a short time.

My feeling is to have them remove the tumor with a safe but moderate margin, but I’m not sure about the lymph nodes.

This is all unknown territory to me, and it’s hard to know who or what to trust.

They don’t seem to do the combination of surgery and electrochemo here. The approach here is to do the surgery then test the area and decide if electrochemo is necessary after surgery.

The oncologist said that the chemo could make healing from surgery longer and harder on her body. I guess I believe that, they are pretty harsh chemicals after all. If she were young and otherwise healthy and strong it would be a different matter.

I do agree that you would not want to allow any kind of chemo (electro or otherwise) or radiation for that matter, until she was fully healthy. Hopefully it will not be necessary. You see, we can’t see Jessi or know exactly what kind of condition she is in. That is a very important piece of the whole situation. You know her best. You will make the right decisions for her. It is a burden though. I understand.

 

[Suzanne & Darcy]

They could only see that they looked not completely normal but that could be just from the immune response to the presence of a tumor.

I understand this. That could be just inflammation from the immune response. I agree. With my Marcus, they wanted to do a fine needle aspiration of his lymph nodes for the same reason, but they couldn’t get anything because the lymph nodes were too small. We did not pursue anything further with the lymph nodes after this attempt.

 

[Suzanne & Darcy]

The x Ray done at the previous clinic (University) was not conclusive as far as the lymph nodes go. They could only see that they looked not completely normal but that could be just from the immune response to the presence of a tumor. They saw no evidence of neoplastiche cells in other organs.

At the new clinic (Anicura) the oncologist said that a CAT scan is more revealing than an x ray as it would show finer details. It might find cells the X Ray didn’t. It might show metastasis in the lymph nodes, but it might not, which is why they would remove them in any case. So doing the CAT scan won't necessarily be conclusive either. I think for them the main reason to do it is that if they saw it had spread to other organs than there would be no point in taking bigger margins, they would just do a palliative surgery to remove the discomfort of the external mass.

But to put her through that seems worse right now than taking wider margins. Maybe I'm wrong. There is plenty I don't know.

I think you are on the right path. You know her best. You have thought deeply about this and researched it and you will make the right choices. Please keep us notified about what happens and the schedule for her surgery. I will be praying for Jessi.

 

[.:. in.active .:.]

My feeling is to have them remove the tumor with a safe but moderate margin, but I’m not sure about the lymph nodes.

So doing the CAT scan won't necessarily be conclusive either. I think for them the main reason to do it is that if they saw it had spread to other organs than there would be no point in taking bigger margins, they would just do a palliative surgery to remove the discomfort of the external mass.

My observation is that thinking aloud perhaps allowed you to give yourself the answer you sought help with at the first place, but gotten lost in the overwhelming emotional fog you're currently navigating through.
A moderate margin tumor removal, without lymph nodes included. Then after full recovery (and hopefully better controlled diabetes and other issues) perhaps committing to a CT scan when she's more stable to re-evaluate said lymph nodes and/or other organs, then go from there.
What do you think?

 

[Suzanne & Darcy]

The oncologist said that the chemo could make healing from surgery longer and harder on her body. I guess I believe that, they are pretty harsh chemicals after all. If she were young and otherwise healthy and strong it would be a different matter.

I just have been thinking more about this. These treatments do take a toll on their little bodies. You are right to be cautious about everything. When Marcus had his Strontium 90 radiation therapy, it was successful, but it really depressed him and his immune system in general (even though the radiation was very localized.). We have been battling other issues since then due to the toll that the whole experience has taken on his body. Of course, he has FIV so that also played into it, but I am glad that you are aware of the stress that the surgery and other possible therapies can have on her and that you are planning to be cautious. Hugs! I will be thinking of you both!

 

[Stefania S]

I understand this. That could be just inflammation from the immune response. I agree. With my Marcus, they wanted to do a fine needle aspiration of his lymph nodes for the same reason, but they couldn’t get anything because the lymph nodes were too small. We did not pursue anything further with the lymph nodes after this attempt.

Same happened for us. Too small.

 

[Stefania S]

Hi Stefania and Jessi
I’m following your and Jessi’s journey and your updates about the vets make me so mad. Can a doctor really be so nonchalant when dealing with a cancer diagnosis in a being so tiny? I do get that maybe if a cancer (or any other disease, for that matter) is caught in the early stages there may be some leeway with respect to the timeline for action, but I can’t wrap my head around how unbothered (for lack of a better word) they seem to be. My nerves would be shot if I had to wait so long for updates

It just sucks how difficult it is to find good vets for cats. I’m currently in the middle of dropping my 3rd vet, who added pretty much nothing of value to Shen’s life, just bills.



If this is standard practice they should be able to provide you with some evidence or resources that point to it being so. I think you should ask. At least you can read up on some literature while they’re making you wait. It’s not a crime to want to be well-informed about the choices you need to make for Jessi. I was reading up a bit a couple of days back. I’ll post something here for you if I find anything relevant

It’s pretty sad that there’s such a low tolerance amongst doctors for queries about stuff relevant to a disease’s prognosis which isn’t always linked to their skills. They nearly always take so much affront



I think I know what it is but only because I’ve spent a little too much time on the FDMB in the early days looking up things I didn’t need to.
Is it something us ladies need every month?

Btw, I had a paraplegic cat who was prone to pressure sores and one time he had terrible open wounds on his legs. I’d used this foam dressing that I could keep on for a few days at a time, while keeping the wound moist. I don’t know if it’s available where you live but it was really great for the healing since it’s non-adhesive, although a bit expensive. The normal cotton and gauze dressing would stick to the wet wound and pull back parts of it while changing the dressing. It was really horrible.
I don’t know if the foam dressing will work for the area where Jessi’s ulcer is. I think it should, so long as her fur over there is shaved.

With regard to Jessi’s SCC, there was something I thought I’d highlight. I recently read that vitamin B12 sort of helps with helping some cancers grow (some evidence found only in human studies though). Since B12 basically helps with cell growth, the cancer could use it for growing too (I’m dumbing it down too much).

I’m not sure if Jessi gets any Vit B12 (I assume she does since a lot of FD kitties have neuropathy and I was giving it to Shen too even though he doesn’t need it) but here are some posts about B12 and cancer:
https://www.felinediabetes.com/FDMB/posts/3011835/
https://www.felinediabetes.com/FDMB/posts/2746486/
Tanya's page on the B Vitamins only says not to give it to cats who have cancer:
Vitamin B12 and Cancer

Don’t mean to alarm you with this info. Just thought that you can err on the side of caution

Hope you can get back on the BG train soon with a new sensor

All the best for all the dressing changes and vet visits. Keep venting and updating us here

Freakin horrible! You think you're giving them something to make them better and it turns out it's feeding cancer cells! It's a good thing I don't have a lot of time to feel the anguish of this! It isn't the first time I have found out that something I was doing to support her health turned out to be undermining it. But this tops them all! I stopped giving it to her, but it makes me sad knowing I can't do something for the neuropathy that is moderate to severe. And it gets worse instantly with stress, poor love.

I found the foam dressing you suggested. Pricey, but I think I will buy some for using after surgery.

Excuse me for not doing the embedded quote phrases, I just don't have time right now, so it's one big chunk.

I switched clinics and I'm much happier with this one. They are moving fast and they are super organized and efficient. They are still vets with their limited views, but at least these ones listen to me and consider what I am saying. They still insist on what they believe is the right course and there is always that touch of arrogance and patronizing, with a nice helping of manipulation to get you to do what they want, but all things considered it's a much better experience than where we went before.

I made the mistake of asking the oncologist to do a BG test. Of course she went right for the lateral vein! When I said something about it she brushed it aside with a 'oh, it's totally fine'. Right, sure, it's totally fine. It isn't your ear, that's why it's totally fine!!!!

Anyway...I have to keep the main goal in sight and see it as using them for what I need. I made my decisions and we are moving forward now.

Surgery will likely be next week.

BTW, yep, you were right about what I used as a liner. I guess that word was a good hint. And you are so clever! Or maybe we just think alike!

Sensor use is on pause. I will wait until after surgery, when the wound is at least partially healed. I am aware the sensor is a burden for her body as well. And I can't be bandaging two different areas and having to control her behavior towards both of these. If only she would let me do some ear pricks...but that will have to wait too.

She is on the same dose, about .5 which I will hold as long as I don't notice any hypo symptoms. So far so good. I am home a LOT watching her a LOT, feeding her often, so I know I can do this fairly safely, but obviously it is far from ideal and we are not doing any kind of real regulation. More like maintenance.

Oh, don't get me started on the ignorant things that came out of that oncologist's mouth regarding FD! Stick to your area of expertise, my dear, you are way out of your element! That's what I wanted to say!

Oh, you're so fun to vent with.

Thanks for all your support Nimi! You're such a good forum friend!

 

[Stefania S]

I just have been thinking more about this. These treatments do take a toll on their little bodies. You are right to be cautious about everything. When Marcus had his Strontium 90 radiation therapy, it was successful, but it really depressed him and his immune system in general (even though the radiation was very localized.). We have been battling other issues since then due to the toll that the whole experience has taken on his body. Of course, he has FIV so that also played into it, but I am glad that you are aware of the stress that the surgery and other possible therapies can have on her and that you are planning to be cautious. Hugs! I will be thinking of you both!

Thank you, Suzanne! Your intelligence and understanding combined are super helpful right now. You share your thoughts but also consider mine deeply and you are willing to change your mind when you can see and appreciate a different perspective. That is a precious gift! I guess I just needed to hear it was ok to do what I feel is right. I am terrified to do the wrong thing, but I also know ultimately there is no way to know what is the right thing. Maybe there is no right way, just doing our best to follow what seems right in the moment.

I have no idea how this will go and the thought of that little delicate body and sensitive mind going through all of this is agonizing. I just take the next step, ask for support, set my intention for the best possible outcome, remember to breath, try to sleep enough and stay sane...and take another step....

Everything is possible. I keep saying to her and to me 'we will get through this, on the other side is a much healthier, happier, fuller life'.

Precious, sweet Jessi, we are rooting for you and your stronger-than-it-seems body!

You can do this! We can do this!

Love you so much!

 

[Stefania S]

My observation is that thinking aloud perhaps allowed you to give yourself the answer you sought help with at the first place, but gotten lost in the overwhelming emotional fog you're currently navigating through.
A moderate margin tumor removal, without lymph nodes included. Then after full recovery (and hopefully better controlled diabetes and other issues) perhaps committing to a CT scan when she's more stable to re-evaluate said lymph nodes and/or other organs, then go from there.
What do you think?

Yes, that’s what I’m inclined towards. I am still considering the lymph nodes but I sent a message to the oncologist asking to proceed with setting a surgery date without a cat scan.

I’ll have to decide now if I let them do another X Ray, or just ask them to go ahead without it. We already had one done at the other clinic but a few weeks have passed so they want to repeat this if no CAT scan.

It’s a good point that we can re evaluate after she is recovered. They will do a histological exam right after surgery to check the area and based on that we can decide if local chemo would be important. But in any case I would wait to let her get her strength back.

I am much more clear now. I was definitely foggy before. It has been so helpful to bounce things off of you all.

Thank you

 

[.:. in.active .:.]

Could the X-ray be done right prior to surgery, straight after she's put under GA?
I had a similar conversation on another thread, where I found out in the US for example they don't sedate pets for scans/ultrasounds. Where I'm at, they do put pets under for these types of procedures, so they stay still. If that's the case in Italy too, I'd definitely request the X-ray immediately pre-op, killing two birds with one stone, if possible. It can 100% be done - while one of mine was under for a dental, they did a full body X-ray on my request, to confirm her arthritis.

Am I correct that Jessi's lump is on/around her neck and that's the area where you usually get the CGM placed too?
I understand how stressed she is (both mentally and physically) but you could always consider a different Libre placement? I pop it on mine's thorax, alternating sides. The one time the vet placed it, it was more on his shoulder/scapula in the hope it'd last longer on him... He peeled it off after 3 days When I apply it on his thorax at home it stays in-tact for at least 10 days and we only use SkinTac and a CGM patch on top, because he renders dead if there's any sort of clothing or bandage touches/"restricts" him. Dramatic much
Edit: I just wanted to add here, that I personally have some negative experience with the Libre constantly giving incredibly inaccurate readings in the higher numbers (as in +200 discrepancies!!!), but I understand it is not the case for everyone.

I also believe, once the tumor is off, her diabetes will be easier to control, which will lead her neuropathy easing tremendously.
Although we had gone through a whole different, non-tumor-related surgery a few days ago, my boy is stable now regarding his BG levels, and he isn't even fully recovered yet from the op! You too are fully aware of how much pain and discomfort affects BG levels. I have to admit I was a little sceptical on this matter, but seeing constant flat numbers for the past three days -for the very first time ever, since his diagnosis- was a real eye-opener for me.

By the way I wanted to say well done to colloidal silver. Not many know about its benefits.
Jessi is very lucky to have you going over and beyond for her

 

[Suzanne & Darcy]

By the way I wanted to say well done to colloidal silver. Not many know about its benefits.

Me too. Love colloidal silver.