Just Got Very Bad News

In December of 2022, my 7 year old cat Squeak had surgery to remove a tumor in his right ear.  My primary vet did a lumpectomy and pathology report said it was malignant melanoma. The excision was complete with narrow but clean margins. I was advised to monitor the area because melanoma can return. Everything went well until the end of September 2023. I noticed a swelling at the base of the same ear. I brought Squeak back to my vet and he suggested I go for a consultation with an oncologist. He examined my cat and told me that my cat needed to have a TECA-BO procedure. Surgery was done on Sept. 25. It was a complex and aggressive operation that was traumatic for my cat (and myself). I might add that this cost me over 10K that I had to take out of my retirement savings. Squeak recovered well and I was relieved but at the same time cautiously optimistic because of the nature of this cancer. Well, as you may have guessed, things took a turn in February of this year when I noticed that Squeak began shaking his head and scratching at the surgery site. I brought him in to see my regular vet (Squeak was due for chest x-rays and exam after the TECA) and I mentioned this. Vet showed no concern and said maybe he feels scar tissue. Looking back, I really wish I had been more insistent about it but I've always trusted this vet. Soon, the head shaking and scratching became more frequent and after seeing my cat again, he prescribed Baytril and prednisolone. This did not help at all and it was suggested that I schedule a CT scan at a specialty hospital to find out what we are dealing with. I immediately called and made an appointment. Squeak was examined by a surgeon and she did an aspirate and submitted it to cytology. The CT scan could not be done because the machine was down. This morning I received a call with the cytology results and it was not good news. I asked for a copy of the report. The pathologist interpretation was "Lymphocytic proliferation and many atypical multinucleated cells; suspicious for lymph node metastatic amelanotic melanoma."  I think I was in kind of a state of shock while on the phone with the surgeon but kept it together until I hung up. Then I had a meltdown...  She told me she would consult an oncologist and get back to me about "treatment" options. She mentioned surgery, radiation, or chemo as possibilities. Of course, I will do what I can to help my boy who I basically love more than life itself.  Squeak is essentially my emotional support and losing him would be beyond devastating. I am not mentally prepared to deal with this and hope there is some way to extend his time with me.  Any suggestions about what I should do next? I do realize that this is a horrible situation for Squeak but any bit of hope would be much appreciated at this time!

Hello there - and I'm so sorry to hear that you've had bad news.  I hear that Squeak is a very loved middle-aged cat with potenially years ahead, and that you would do anything to help him.  However, I trust that your vet and a cancer specialist between them, can help you with facts about Squeak's illness.  The oncologist is not only more qualified than me, but will have met Squeak or, at least, seen the lab reports and clinical notes and have much more experience in this field than I do.  So, trusting the cancer to them, let's address the subjective  side of this deelopment.

I hear that you love Squeak more than life itself and would put many resources into Squeak's ongoing survival and quality of life.  However, statements like this worry me because - and I know that you know this -  no-one can offer you infinite ongoing quality of life for any pet, for any price.  It is very common to go through a stage of greif known as 'bargaining.'  Thoughts that come up during this time are: 'what can I do that might possibly give a tiny chance of helping my cat live for just one month longer' and often a huge investment - emotional, stress or financial - can be placed down for extremely slim improvement in survival odds.  Therefore, I would urge you to have difficult questions ready for your vet - and I havent looked up the answers to these. 'What is a realistic expectation for length and QUALITY of life going forward,' and 'What is most likely to happen now?' and 'How can I prepare myself going forward if bad outcomes are expected?'   I hope that this helps a little.

In the even that Squeak may face a poor outcome, it is worth contacting a charity called The Ralph Site, who specialise in helping owners through losing a loved pet.

Thank you so much for your compassionate and empathetic reply to my post.  I do understand what you were trying to tell me about the part of grieving called "bargaining."  Yes, I have spent thousands of dollars on care for my animals throughout the years. I will be 71 soon and have had cats practically all my life.  I have had some live until 16 or 17 years of age and sadly, yes, I have had to take them to a vet to humanely help them to exit this physical realm when there is no hope to cure them.  I have had to deal with heart disease, intestinal cancer, kidney failure, megacolon, etc.   Of course, I know that it is an unfortunate fact that cats don't usually outlive us and the time will eventually come when you have to say goodbye. There are just some cats that formed a particularly strong bond with me.  A special relationship that makes me feel more loved than I've felt with a human being.  Squeak is one of those cats.  I admit it.  I like animals more than people. I suppose I fit the description of a "cat lady."  Never married, lived alone for over 20 years, few friends that don't live near me and I have a brother who I haven't seen in 12 years since our mother passed away.  I live a solitary life but my cats provide me with so much joy.  I currently have 7 in my home and there are 2 ferals that I have been feeding for many years.  They have their own insulated houses with heating pads that they use in the cold winter months!  Well, I guess you now have a clear picture what I'm about.  It is SO hard to accept that there is no cure for Squeak's disease.  I had been hoping that we beat this cancer after the very aggressive TECA surgery.  I was told by several veterinarians that this procedure was "curative" in many cases if caught early with no spread to distant organs. Now it is a major adjustment to have to switch my focus to palliative care for my boy.  Can you see where I am coming from?  I just wanted to get some advice from others that may have experience with this this cancer that is very rare in cats.  I want to make an informed decision going forward with Squeak's care. Wow...  I feel like I just had a therapy session!  Thank you for taking the time to read my very long post and reply to me.  Much appreciated!

Well, I may not be able to offer a second opinion on your cat, but we can witness your words and sadness and send best wishes.  I hope that find all the information that you seek.