Friday Cat Blogging: CAT Scan

(Updates/notes in green.)  I blogged recently about Smudgie's right eye being all squinty and not responding to ABs and topical treatment.  This picture isn't very good, but it shows what his eye looks like these days.

Kevin took Smudge to see Dr. Ringle the opthamologist at Animal Emergency and Referral Center.  The doctor did some tactile stuff and some gadget stuff and concluded that there's something behind Smudge's eye.  It could be inflammation or a tumor. The something is pushing on his eye, causing the symptoms we saw.  It's also causing glaucoma; normal glaucoma readings are 15-20; his is 27.  The doctor doesn't think Smudge is in pain at the moment(and he doesn't act like he's in pain).  And his glaucoma number isn't severe.

Iot get a better idea of what's behind the eye, the next step was...wait for it...a CAT scan (I think the kids call them CT scans nowadays, but I couldn't resist).   I took him down to Red Bank Veterinary Hospital earlier this week.  That's the closest place that does the scans.  Fortunately, Dr. Ringle is there, too.  He called today with the results: Smudgie has a growth back there.  Based on certain characteristics the radiologist saw in the scans, it's a malignant tumor.  It's most likely lymphoma or carcinoma, although other types of cancer are possible.  A surgically-obtained biopsy is necessary to definitively identify the type of cancer.  The cancer originated in his frontal sinus area and destroyed some bone on its way to the tissues surrounding the eye.

Our next steps are:

• ask Dr. Ringle and/perhaps an oncologist at RBVH some questions that have come up since I spoke w/Ringle earlier today
  • What would we do if we wanted to provide Smudge with palliative care?  And how long could we expect him to live in this scenario?  We'll meet w/Dr. Risbon the oncologist next week and go over this stuff.
  • If we did a biopsy:
    • Would they be able to ID the cancer type right away?  No. Or would it be sent out and take a couple of days to hear back? Yes.
    • If they could ID it right away and it turned out to be a cancer best treated w/surgery, would they do it while he's under for the biopsy?  No.  Or would that be another surgery?  Yes.
    • If it's lymphoma: what are treatment/management options, statistics (e.g., survival rates w/ and w/o treatment), etc.?  Talk w/the oncologist.
    • If it's carcinoma: same questions  Talk w/the oncologist.
    • If it's some other cancer: same questions  Talk w/the oncologist.
    • If they can't ID the cancer right away, does it make any sense at all (would there be any benefit) for the surgeons to remove the tumor and possibly his eye while they're in there for the biopsy?  We're not looking at the benefit of saving time, but rather possible benefits of avoiding a second surgery complete w/a second dose of anesthesia, of an aggressive approach to the tumor, etc.  Forgot to ask; ask oncologist.
  • How much would the different options cost?  Ask the oncologist.
• then decide what to do

Our choices are:

• do minimal care from this point on, i.e., w/o knowing exactly what kind of cancer it is; one doesn't really 'do nothing'; we'd make Smudge as comfortable as possible
• do the biopsy and pursue treatment for whatever kind of cancer it is, based on specifics of Smudgie's case and general statistics/prognosis for his kind of cancer
• do the biopsy and not pursue further treatment for whatever kind of cancer it is, based on specifics of Smudgie's case and general statistics/prognosis for his kind of cancer

Personally, I like to know exactly what I'm dealing with, i.e., I want to know what kind of cancer he has.  Of course, his future may look bleak no matter what kind of cancer he has.  Awwwww, here he is right now, jumping up on the table, hanging out while I blog about him.  Through all of this doctoring and prodding and poking and travelling (he's quite the homebody) and whatnot, he's remained his sweet, mushball self.

Comments

[Babeth]

All we can say is... hang in on there ! Hopefully he will be able to recover from this. If not, well, enjoy his company as long as you can in good comfort. We all have our time on this mortal rock, the only thing we can do really is try to enjoy it and each other's loving company.

[Megan & Bad Kitty Cats]

Oh We are praying and purring for Smudgie. We hate to here this news. I would agree, we would want to know all options and possible scenarios. But love is the key. Poor Baby our eyes are leaking. Sending Lots of Love and Purrs and Hugs

[HotMBC]

Oh poor Smudgie. All that pokin and proddin isn't much fun. But V-E-Ts help lots (even if it's just with bein comfy). We're gonna send lotsa purrs and purrayers for Smudgie.
PURRRRRRRRRRRRRRRS
purrrrrrrrrrs
purrrrrrrrrrrrrrrrrs
purrrrrrrrrrrrrrs
purrrrrrrrrrrrrrrrs
Sanjee, Boni Maroni, Mini, Gree and Pepi

[Zippy, Sadie and Speedy]

Aw no, this sucks. I'd want to know what kinda and what can be done. When our Punkin was diagnosed we went with the aggresive treatment and got another 19 months before it came back. It was another 19 months for us to love her, when it came back the only option was pain management. We owe a lot to our oncology vet, he did a mighty job keeping her quality of life up. We'll say prayers for little Smudge...

[KC]

We's purraying fur u's, Smudge. an purrs an purrayers fur tha whole fambly.
KC & Missy

[Samantha, Tigger and Mom]

Oh poor Smudge, we are so sorry about the tumor. We will be purrring and purrayering for
Smudge. Please keep us informed!

[Annie]

Gosh, everyone, thanks for stopping by and wishing Smudgie well. That's very thoughtful of all of you! I will definitely post updates about Smudgie. Thanks again. Our family very much appreciates your kinds thoughts.

[Hendrix]

Hi, we're very sorry to hear about Smudgie. It is so hard when we aren't sure of the answers. We'll be purrng and praying for Smudgie and all of you. Knowing that you love him so much means you'll make the right decisions for him.
Take care, we'll be thinking of you.

[Radcliff, Allie, Luna, & Ozzie]

We heard from the Cat Blogosphere about Smudge's cancer. We're hoping for the best.

Sending healing purrss to Smudge from all of us.

[Daisy the Curly Cat]

I am very sorry to learn this about Smudgie. He is such a cutie! I am going to purr for him, and wish him the very best.

[Bad Kitty cats]

ust stopping in to say we are thinking about you all and Smudgie... Sending purrs and Prayers and Love! Hugs to you too

[Parker]

We will pray for Smudgie too - Lots of prayers and love!

[the zoo]

Poor Smudgie we hope and purr for the best.

Not to be morbid but would removing the eye and closing the lid permanatly be an answer. Our last experience with eye problems was about 15 years ago with our cat Thomas and he had to have that done to his eye. The Vet said it was best. Of course that was so long ago but thought we'd offer it up.

All the best,
The Zoo

[China Cat & Willow]

We are certainly sending purrs and prayers over for Smudge!

[Annie]

Megan, Thanks so much for sharing Smudgie's woes w/other cats and cat lovers in the blogosphere. We're received a crazy lot of support!

Zoo, that's a question we'll ask the oncologist when we meet w/her in a few days. We'll discuss his case and Smudgie will have a biopsy done. His eye isn't the main problem; it is, however, affected by the tumor behind his eye, the tumor being the main problem. We do wonder if it would be radical, yet best to take out the tumor and the eye. The two most likely cancer types are carcinoma and lymphoma. If I understand correctly: If it's the former and we proceed with treatment (as opposed to palliative care), surgically removing the tumor is the thing to do and the eye just has to come out, too. If it's the latter and we proceed w/treatment, chemo is the thing to do. I'll post more after we see the oncologist and Smudgie's biopsy is done.

[plum]

Best wishes for a good outcome for Smudgie.

[Cassie]

Oh no I'm so sorry about poor Smudgie. You're in my thoughts and prayers, you've got some hard questions to ask and decisions to make.