Cat GI adenocarcinoma, could stenting help?

Our cat, a 14 year old male ragdoll recently went through an abdominal ultrasound scan that revealed circumferential, focal large intestinal wall thickening with loss of normal layering, most consistent with a colonic mass, and proximal constipation. The GI tract was otherwise normal. Small volume echogenic ascites, moderate hypoechoic enlargement of the left limb of the pancreas, and ill-defined hypoechoic mesenteric nodules were observed with otherwise normal surrounding abdominal organs. We then did FNA and pathology and ruled out lymphoma. So the diagnosis was GI adenocarcinoma. I am wondering for palliative care, if putting a stent in the narrowed portion of the GI track can help him feel better? But are we running the risk of rupture the tumor? We wanted to extend his life and improve the quality of life. Thank you so much!

Hello and thankyou for this excellent question.  Please note in this case I cannot give a second opinion, because between myself and your vet, I have less knowledge of your cats individual case and I am not specialist - or even an operating surgeon - in this area.  The upshot is that your vet is in a better position to give you advice about any specific case than I am. . That understood, my own understanding is that placing a stent is quite a serious undertaking, involving cutting into the bowel ie weakening the barrier between sterile and unsterile areas.  If there was any significant risk that the tumour had spread around the body along the bowel (as happens in lymphoma), I would be very concerned about this because the tissue might be more inclined to break down, which would likely be fatal.  I am unsure as to the chances that this has happened in a single adenocarcinoma lump, but your vet should be able to give you this information, possibly enlisting the help of a laboratory pathologist.   If there are no likely mets, this raises concern as to what is happening with the pancreas and how both that and the surgery are likely to affect the length and quality of life moving forward.  Your surgeon will want to consider a) what is to be gained and b) the cost of the surgery and the stent to the patient (I don't mean financial, although I'd be lying if I didn't acknowledge that that comes into it too). I hope that you can find the information that you need in order to make this complex decision.

In short, stents can be very useful and a skilled surgeon can apply them; however, the appropriateness needs to be reviewed for each specific patient and because your cat is already advanced in years and has concurrent pancreatic disease that I don't know the nature of, this is a decision to be taken carefully with someone who is familiar with the case, I.e.  your vet.  Wishing you the gentlest of outcomes in whatever you decide; please will you let us know what happens?