Feline Injection Site Sarcoma

Hi. New to this group. My 9 yo Furball was diagnosed with Feline Injection Site Sarcoma after a lump formed last August between his shoulders. Lump was removed and we were told that treatment would be Chemotherapy followed by regular Radiotherapy and surgery to remove any further lumps. This could extend his life expectancy between 1 - 2 years. He does not react well to being kept inside after surgery or treatment and becomes very anxious and miserable. We have another cat who comes and goes as she pleases so Furball can’t understand why he’s not being allowed out. Because of his middle age and the need for constant surgery, we chose to just give palliative care and not go down the chemo path. And apart from the above, the cost of treatment could be approximately £15k. He is currently on daily steroids to try to reduce the growth of a 2nd lump, which cannot be removed as he does not have sufficient skin to close the wound. However this lump seems to be growing more rapidly than the first. So my question is, should we wait until he is failing, unable to groom, not eating and vomiting to put him to sleep or is it kinder to do this before he becomes miserable and in pain?

Hello.  I'm sorry to hear about the problems that your cat is facing; it must be stressful and upsetting.  It sounds as though a second lump has been found and diagnosed to be an extension / regrowth / metastasis of the first.  If this is not the case, it is a matter to clear up with your vet.   Sticking with your question however - should we wait or euthanase now - noone but you can answer that and it is never an easy question. There are some things that you and your vet might consider, which might help.

There is no objective point at which a deterioration of quality of life balances perfectly against the value of being alive; no objective tipping point at which vets should call 'time'.  All humans and animals perceive and cope with pain subjectively - and differently.  There are tools for scoring pain in animals (ask your vet about this), but there is also a discussion to be had over the significance of the results; all animals feel some pain, sometimes - at what moment does pain become untenable?  I have heard people say 'more bad hours than good hours / more bad days than good days.'  However, this is rarely a convenient linear progression.  I have heard people say they 'just know,' but I think that this mostly suggests that some people are more binary thinkers in this matter than others, or that some pets exhibit a sudden, marked drop in quality of life - which cannot be taken for granted by the owners of other pets.  I have met people who have wanted to make decisions relatively early, just to be free of the burden of the decision; I have seen people wait a very long time.   A few articles have been written on this subject in the blog; search for 'put to sleep' and 'euthanasia.'  The Ralph Site, a charity set up to help people around the time of loss of a pet, may also be very helpful.   However, I think the bottom line is that everyone's answers and outlook will be different, that you know your pet the best but that your vet may have seen similar situations many more times than you.  Therefore, the best way forward may be to talk to one another about these issues as early as is possible.   For my part, i think that we can all expect some decline in comfort and capability as we get older. To some extent, this can be controlled.  However, pinpointing the exact moment for euthanasia is an impossible task and we need to be kind, open and deliberate about how we go about it in each case.   'Euthanasia' means a 'good death,' but as with life, it may be possible that there is no such thing as a perfect one.

Oh dear, I have rambled.  In summary 1) please check out the objective facts of this case and your cats' time scales with your vets;  I do not know this case and am in no position to understand them.    2) Ask a lot of questions that start, what will it look like if we go down path X?   3)  life is perfectly imperfect - communicate with your vet to do the best that you can.   Best of luck.