mandibulectomy in a cat – Margaret's Corner

We brought Peekaboo home from the clinic almost a week ago, last Saturday evening to be exact. I thought that she’d slowly return to her usual self once she got home, but it has taken longer than expected. Reason: we ran into a few problems…

Problem number 1. Like most (all?) cats, Peekaboo was REALLY bothered by the Elizabethan collar, a cone-shaped torture device that prevents cats and dogs from licking or scratching or biting their wounds (Note: these three photos of Peekaboo are “post-Elizabethan-collar” photos. The white and red stuff around her neck is just a temporary bandage that doesn’t impede her movements and will come off next week).

Problem number 2. On Friday and Saturday, while she was still in the hospital, the vets had slowly weaned her off her pain medication. Too soon, evidently. By Sunday evening I knew she was in pain. She wasn’t purring or licking food off my finger anymore, so we had to feed her, and administer her meds (antibiotics, etc.), using the esophagostomy tube, which is a feeding tube that connects the esophagus directly to the stomach.

Furthermore, she was very lethargic and wasn’t moving at all, really. And she hadn’t used the litter box at all (even though we put one right on the bed).

I called the weekend vet who told me to give her more of the anti-inflammatory drug, which contains a painkiller, too. There wasn’t much else we could do on a Sunday evening, but first thing on Monday morning I took her back to the vet hospital, where they ran some tests and immediately gave her a shot containing a stronger painkiller. I gave her painkiller shots twice a day until Wednesday (at home). That at least got rid of the pain issue!

She peed inside the cat carrier in the car…so, er, that problem was solved, too! And in fact, as long as she wore the blasted cone, she peed only when we drove to the vet hospital. 🙄

On Wednesday afternoon the surgeon removed her feeding tube. Consequently, off came the cone!

Life was good again. Peekaboo was back to her old self–happy, relaxed, hungry, and curious. Since then, it’s been all uphill. JOY!!!

Without the awful collar, in fact, she began eating and drinking on her own…she started peeing (etc.) in the litter box, not in the car (!)…she’s grooming herself (as you can see in photo no. 3), and she purrs and talks a lot…

So she’s doing really well. One of my MAIN concerns, in fact, before agreeing to the surgery, was HOW she’d be able to eat without half a jaw…But she is indeed eating–wet food only, right now–and it is such a joy to behold…Cats are such amazing creatures…

More good news: we have some partial biopsy results (from her jaw, which of course was sent off to the lab for testing):

the cells aren’t dividing madly, as aggressive cancer cells do.
there are indications that this type of melanoma is NOT aggressive.

This means that, IF the surgeon was able to remove every bit of the tumor, and IF no cancer cells have migrated to another part of her body (the lungs, usually), from now on she will lead a normal, healthy life.

Of course, these are big “IFs,” and Peekaboo will have to be monitored for some time…with periodic X-rays of her lungs, for example.

But for now, at least, Stefano and I can sit back and relax…

All of Peekaboo’s test results are in (see my July 4 post; Peekaboo is one of our cats…11 years old…I took the above photo of her in 2015).

The biopsy confirmed the diagnosis of an aggressive malignant oral melanoma.

I won’t go on and on about all the discussions Stefano and I (and friends and family) have had in the past couple of weeks, especially this past weekend…all the going back and forth (surgery…or no surgery???), all the online research we’ve done, reading horrible stories on various cat forums, the heartbreak, the anxiety…”what should we DO???”…

You can imagine all that…

We haven’t been sitting around…doing nothing but talk, I mean. In addition to speaking with the oncologist and the vet surgeon at our own vet hospital, last week we sent her test results to a well-known oncology specialist vet( outside of Florence) who called us on Saturday, recommending we go ahead with the surgery.

Even with that second opinion, I still didn’t want to put her through all that misery…the pain…the risks of doing this surgery…etc. During the weekend, talking things over with Stefano’s aunt (also a cat lover) and his cousins, I decided to let Nature take its course: palliative care…curcumin…pain killers…But no surgery. Definitely absolutely NO SURGERY. How do you explain to a kitty that she’ll have to undergo such a painful procedure blablabla? You can’t. It’s not fair, I decided. She might never recover…never be able to eat properly again…and then she will die anyway, eventually…So WHY do it? Those were all the things rushing through my mind this past weekend.

But what happened today changed my mind. This morning I took Peekaboo to see another vet surgeon, highly recommended, at a clinic here in Florence. He went through her tests very carefully and calmly and told me that, if this were HIS cat, he’d go ahead with the surgery. I still wasn’t completely on board, though…

Until we looked into her mouth…

I’d seen the melanoma almost two weeks ago, when it was just a tiny oval on the side of her gum. Well, it’s not an oval now, and it’s not tiny, either. In just two weeks it has spread quite a bit. Now you can see the blasted thing clearly. It’s growing.

It freaked me out, I have to admit.

I took Peekaboo home and decided I needed to discuss this new bit of information with our vet and the main vet surgeon over at the vet hospital. I was there within a half hour. I told them both what I’d seen this morning in her mouth, and here’s what we agreed to do (we = all of us, Stefano included, of course…Oh my poor sweetheart, getting all this awful news while at work!):

I’ll take Peekaboo to the hospital day after tomorrow (which happens to be my birthday…I hope it brings her luck!). The vets will do another CAT scan to see how much the tumor has spread. Then we will decide what should be done.

If the blasted thing has spread TOO much, meaning that a manibulectomy would impair her QOL, then I’ll just take her home, and we’ll go with the palliative care option. Right now the tumor isn’t bothering her: she’s eating (even dry food), playing, purring, etc.
If, as we hope, something can be done to give her a good QOL for quite some time, we’ll go ahead with the surgery.

Whatever the choice, it’s going to be hard on all of us…first and foremost, on Peekaboo, of course, but also on Stefano and me. And I can’t help but still ask myself: are we doing the right thing? Or rather, are we doing the right thing FOR HER?

To be honest, right now I don’t have an answer…

Incidentally, I’d really appreciate hearing from anyone who might have had this sort of experience with their cat. Thank youuuuuuu!