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Dr. B.
Dr. B., Cat Veterinarian
Category: Cat
Satisfied Customers: 18307
Experience:  I am a small animal veterinarian with a special interest in cats and am happy to discuss any questions you have.
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My cat is 16.5 years old. He had a bite from a rat and it didn't

Customer Question

My cat is 16.5 years old. He had a bite from a rat and it didn't heal well. It turned into a lump on his eye . He has had this for four or five years. It opened up recently and I took him for treatment.
I took him for treatment . It was ulcerated. The vet took tests and now tells me he has a mastocytic (?) tumor. This may or may not be benign. I cant quite get the est. but I was told the options are
a) further tests under general anesthetic to determine if its cancerous / and or if it has spread.
b) to go ahead with chemotherapy regardless
c) do nothing and wait to see if it is aggressive ,use remedial care / have him euthanized.
He has a grade 2 heart murmur, so I am worried about whether the anaesthetic would kill him. Ditto therapy.
He is old( ish).
I would like to know what risk he has if I get the further tests.
He is apparently healthy, no symptoms of any illness ( like weight loss, vomiting etc.) not in pain, the mass doesn't seem to bother him ( except for the flare up recently). He does tend to sleep a lot but I thought this might be age anyway.
What is his prognosis if I leave things and see if it becomes worse?
What are his chances if he has surgery or an general anesthetic for further exploration?
Is it better to leave it or get it treated given his age?
I don't want to lose him prematurely if he is likely to less time than it takes the tumor to spread. I couldn't even find out if it was benign or not without further tests it seems.
Wonder if you could offer more advice really? I have been left with the decision. I feel ill equipped.
Or are there other questions I can ask the vet to get the information I need?
Submitted: 1 year ago.
Category: Cat
Expert:  Dr. B. replied 1 year ago.

Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you with your wee one today.


Is this on his eye lid, eyeball or just near the eye?
Was his examination otherwise healthy?
Has any blood work been tested?
Customer: replied 1 year ago.

No bloodwork just a aspiration on the lump.

Lump is above his eye ( eye is fine and he can see). It looks like a sty .

He has a grade 2 heart murmur. This was found when I took him with the eye problem.

Expert:  Dr. B. replied 1 year ago.

Thank you Lynda,

I can understand your distress, as this is a challenging situation. Without knowing whether this is a sinister or benign mast cell tumor, one cannot make a fully informed decision. And I have to say that this is quite common with this type of tumor since the small aspiration sample size can make interpreting these tricky cells difficult. Especially since mast cells are a normal part of the immune system and can normally be present anywhere there is infection or inflammation (which would go along with the current ulceration).

So, with this complication in diagnostics, your vet’s options are reasonable ones. Of course, it does depend on what they are referring to when they say “chemotherapy.” This is because this is not a tumor type that has really shown much response to chemo (plus it's less then ideal to use chemo without a diagnosis). Though if they meant palliation with steroids, then that would be a different situation (as it could reduce any swelling associated with the mass and reduce discomfort) and could be an option to consider as opposed to just leaving the mass to do what it will.

Now the first option you noted was anesthesia for further testing. Now before we even consider any anesthesia, his organ health is the most important consideration. Therefore, if you were to consider this option, it would be highly advisable to have a blood sample tested. This would let you confirm that his organs are healthy and that he is a good candidate for anesthesia. If anything was found (ie struggling kidneys, liver disease), then this option would be off the table for Mickey right off the bat. If it was clear, then it would be a viable option for him (and the murmur isn't a major issue if he doesn't have clinical heart disease signs, but would only mean the vet would potentially alter their anesthesia plan for him).

Otherwise, if he was confirmed to be an anesthesia candidate, then this option could be realistically considered. Though if this mass is small (at least as small as it will ever be), then realistically it would be better for them to rule out tumor spread and then just remove as much of the mass as possible. This is better then taking a biopsy (since that actually would have increased risk of tumor spread in the area). And as this location isn't one where clean margins are likely (since the cancerous concern we have is a tumor that snakes out tentacles into the tissues as opposed to just growing as a mass), the surgical approach would be the same for either.

Finally, there is the option of benign neglect. If this hasn't caused him bother until now, this is very tempting. Especially if the flare up was potentially traumatic as opposed to this growing in size. If it were, then one could hope there was scope for this to settle and resume its innocuous existence. The trouble though is that at this stage, we just cannot predict the masses future actions and if grows any bigger such that the skin cannot stay whole over it, then we could be stuck with a permanent festering wound. Therefore, this isn't an ideal option for Mickey if we can avoid it. As I noted before, it'd be better to use palliation (and treat any infection that may be present currently since it is ulcerated) then nothing at all. And if we did and the mass responded to steroids, then we could see him manage with this for a good wee while (likely months to years as opposed to weeks...but again without being able to confirm if this is cancerous and what grade we cannot truly give a prognosis.

Overall, it is not an easy decision for anyone. If you are considering surgery/anesthesia, then I would say that the first step is to check bloods. Because if he has any age old issues with his organs, that may not really be an option for him. If that is all good, then we'd be in a position of hedging our bets. We can remove it as it is to give him the best chance of having no further issue or at least prevent this from growing/festering as long as he is with us. Or if you don't feel that is the option for him, then we'd want to consider further discussion on your vet's chemo thoughts and the use of steroids to reduce tissue inflammation and at least try to keep this as small and comfortable as possible for as long as possible.

Now I will pause there since I did type quite a bit to you. Please let me know if there are any more questions you have or anything I have missed (as your history was quite verbose as well;)).
Dr. B.
Dr. B., Cat Veterinarian
Category: Cat
Satisfied Customers: 18307
Experience: I am a small animal veterinarian with a special interest in cats and am happy to discuss any questions you have.
Dr. B. and other Cat Specialists are ready to help you
Customer: replied 1 year ago.

Thank you. Your explanation has been very thorough and clear and now I know what the situation is . I didnt really understand before. I had options . I was not fully informed.

I am very grateful for your help.

I think I will goand ask for afull examination of Mickey priorto deciding if he should have the anaesthesia. If it is at all possible I want him to have treatement.

Otherwise I willfollow your suggestions on steroids.

Thank you again for the explanation. You have been most clear and informative. I have a way forward now.

Lynda

Expert:  Dr. B. replied 1 year ago.
You are very welcome, Lynda.
I am glad that I could shed some light on this situation and give you some direction.
Best wishes for you both,
Dr. B.

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