Our 15 year old cat most likely has squamous cell carcinoma in his jaw. The biopsy result won’t be in until next week, but the vet is pretty sure this is cancer. Our options are to drive an hour and 40 minutes to a vet hospital, have surgery, and hope to buy him time, or to simply treat for pain and infections and let the cancer run its course until it is clear he needs to be put down. The prognosis is poor, even with surgery.
I’ll be in a better position to decide once we know the biopsy results, but I’m wondering if you’ve faced a similar situation and how you decided what to do.
I’m so sorry to hear that your beloved pet is so ill.
We lost a cat to cancer and it was very difficult.
That being said, one thing that made it that much harder was the bill at the animal hospital. We signed a waiver that allowed treatment and the waiver asked us to acknowledge that the bill would be “more than” $750. That seemed reasonable considering how ill she was. Our cat was only 8 years old at the time and we expected that she would have several years ahead of her.
The process took all day – 8 hours about – and the bill was $3000. That cost produced only a diagnosis, not the treatment. They also informed me that we needed to put her to sleep. That was our best option.
The experience was devastating for us emotionally and economically.
A friend of mine at work calls this The Veterinary Industrial Complex. In which it is made to seem that you have one option to treat your animal, and that option is pricey and not always effective. Guilt ensues if you don’t do this expensive thing
I am here to relieve you of the guilt of not pursuing these expensive and often useless options.
It’s terrible and sad to lose your pet. It’s okay to treat her for pain and ease her out of this world in a gentle way.
Physician here, past dog owner. Your cat sounds elderly. I’ll put it in human terms. If it were me as an elderly human, or an elderly relative, I would not have the surgery. No matter how alert et al I was. Bodies wear out and I wouldn’t want to be miserable just to gain a few extra months. btw, physicians and other health care professionals are less likely than the general population to go for treatments and more willing to do palliation instead. We have seen much and evaluate the supposed benefits with more knowledge.
Even if not metastatic the surgery to get a clear margin likely would be disfiguring, require painful healing, inability to eat normally for some time et al. It is not only the financial cost and initial surgical pain but the healing process and needing to deal with a new jaw configuration. Do you think your cat wants to deal with all of that, at his age? Removing a part of the jaw would mean a real difference in how his mouth feels to him. Would he resume good eating habits, be uncomfortable with the change even after a successful tumor removal and healing?
Then there is the cost. Is it worth thousands of dollars to extend his life by a little bit given his age? Will the gained months offset the misery months in time? We all eventually die of something. Any surgery will not give him a younger body.
PS- I purposely did not define elderly, put a number on it.
I would focus on keeping your fur baby comfortable and not put him through the trauma of a painful surgery. Quality of life vs quantity. That’s what I would want for myself!
We had a dog who developed a tumor at an advanced age. He had been relatively healthy up to that point, just taking joint supplements so we were sure our vet would want to operate. She kindly told us that the stress of the operation and risks were not advisable at his age. It was really about his quality of life. In the end we were thankful that we had some warning and were able to say goodbye to him as a family. It was still the hardest thing I have ever had to do.
One year ago today, my 10-year-old Australian shepherd was at the nearby university-affiliated veterinary school to have a growth in her mouth evaluated. It turned out to be a fibrosarcoma, a type of cancer that doesn’t spread to other parts of the body but does grow.
The veterinary resident decided to not even tell me during the follow-up appointment about the only type of treatment that would have possibly eliminated the cancer, because of how extreme it would have been: removal of half of my dog’s face. He did tell me about other treatments and said the only one likely to stop the cancer from growing was 20 radiation applications, each one under general anesthesia.
I chose to not have her undergo any intense treatment; we just treated symptoms (e.g., providing softer food eventually). I had her euthanized at home five months later. I have no regrets about how I dealt with the final illness, but I am very mad at cancer!
I just spoke with the vet again when I picked up the kitty. She showed me the photos and x-rays, and it’s pretty clear that whatever this is has affected the soft tissue as well as the bone. Surgery would not do much good, so we’re just going to treat with pain meds and antibiotics (his mouth has an open sore). Won’t get the biopsy result anytime soon, but even if by some miracle, it’s just an infection, the treatment would be the same. The vet says the cancer progresses quickly, so I’m hoping we have a few good weeks before we have to put him down.
@wis75 , I completely agree with you about palliative care often being the best course of action in elderly or hopeless cases. I watched my father go through hellish treatments that did absolutely nothing to aid his quality of life. Quality matters, for people and pets.
I’m super sad about this and need to figure out how to inform the kids. My son won’t be home until the end of October, and my daughter has just suffered a loss, so I need to tread carefully. Thanks for your support!
@Dustyfeathers , I am so sorry about your awful experience. That sounds really unethical. The vet should have called before proceeding with a $3000 surgery to get your consent!
I was given a guilt trip once before about not pursuing chemo for a 17 year old cat (yes, chemo!), and it made me realize how ridiculous some vets (and people doctors) can be about aggressive treatment. I think our current vet is much more reasonable. She said she wouldn’t pursue anything other than palliation at this point.
I’m SO SORRY you are facing this decision. Many HUGS.
My cat was a victim of the chinese melamine food poisoning of pet food years ago. We did pull her out of kidney crisis (with a very expensive vet bill) at the time but it was a long haul. I hand fed her treats for months (all she would eat). She was pretty young and I think we bought a couple years.
My sister’s cat had cancer (tumors) and it was pretty bad. My sister wouldn’t accept the fact that her precious pet was going to die pretty much no matter what she did. It was an expensive and emotional process. Her cat was older than mine and while we can never determine life span of an individual pet I don’t think she would make the same decisions today with 20-20 hindsight to treat her cat.
We faced this decision almost exactly a year ago with our 14-year-old cat (advanced kidney disease, not cancer) and “The Veterinary Industrial Complex” (thanks, @Dustyfeathers) made us feel terribly guilty about not choosing to prolong his life with surgery, daily injections, and painkillers with no reasonable estimate on how much longer he could live. I will never forgive them for that.
We chose to give him a painkiller so his boy could have one last Skype with him from college before he was put down. It was a short call because our soldier started to cry.
I think you’re doing the right thing, @Massmomm, and you should feel no guilt. You are loving your cat through to the best, most peaceful end. Hugs to your whole family and especially your kids as you go through this.
I am also sorry for you and your family. I have been down that road several times. I have never regretted not pursuing treatments for a severely ill pet. As much as I have loved each animal, I would rather put them down rather than put them through painful procedures with low success rates. I feel it is part of the deal I have with my animals not to let them suffer needlessly. It is a horrible decision but I feel that you are thinking of your cat instead of yourself which is how it should be. Hugs to all.
So sorry - I know how hard this is. I do think you are making the right decision. I had a black lab, Bonny, gosh I loved that girl. She got cancer at 9. My Mum was looking after her for me after I got divorced and Mum worked at the Royal Veterinary college. Everyone loved Bonny and they treated her for free and tried so hard to save her. In the end she died anyway and she suffered with the treatment (not for long as we all quickly realized it was not going to work). I regret to this day putting her through it and wish we’d just kept her comfortable and lavished her with love and treats.
Gosh, crying now and it’s been 34 years. Big hugs to you.
My sweet girl Kira (see avatar) was diagnosed with a tumor in her neck in January last year at age 14. Our vet, thankfully, didn’t recommend heavy-duty treatment – we treated her with some non-steroidal meds and antibiotics til she started struggling with her breathing at night. At that point, I knew it was time. The vet told us we could go spend 5-6k at the specialty vet, but that it would not change the course of the disease. We loved her to pieces in those last three months. We discussed the treatment options as a protocol and my position was that she wouldn’t understand the invasive treatment or why she felt miserable. The treatment (in her case, IMO) was not humane.
@Massmomm, I’m so sorry and I know how hard the decision can be. I was gutted.
Totally right on the Veterinary Industrial Complex. Great phrase! What a timely post. My cat is in surgery this am, and I think is a bit insane. She has an open lesion from a mammary tumor, which I am learning is surprisingly common in elderly and especially Siamese cats. The tumors, not necessarily open ones. This is probably cancerous, and maybe there are metastases. Both my home vet and the one at the specialty clinic are saying removing the tumor is crucial as it is open. My vet is lower intervention than many, which is why I go to him. But…given her age, her renal disease…really? If I did not have a trip planned with my elderly mom coming up, and not wanting to perhaps leave the final decisions to others, I’d let nature take its course over the next few months.
They asked if I wanted to talk to oncology, to send the tumor to pathology, check the lymph nodes, to have further imaging done to check for possible metastasis. No, no no…Meanwhile her quality of life is ok right now, so it would be hard to put her down. My impression from the vet is that she probably will develop other tumors in the next year. We shall see. She is really old, 19 and very much my sweetie. Though that does not influence my feelings about the ethics of the situation.
What bothered me in the process, is the lack discussion of palliative care, which I’d expect with the any very elderly human getting into multi system failure.
@great lakes mom-- I think that’s what my sister ran into. It’s a combination of caring vets who have expensive options for short term measures but no one really giving the facts about survival probabilities/recurrence stats of CA and options of palliative measures.
Or they did and she didn’t hear it.
OP, hugs. I probably would not have bothered with a biopsy. But we are fortunate to have a vet that would have explained that whether this is cancer or not, either way the prognosis is not great, and any additional options that involve chemo or surgery are both expensive and may not be in the best interests of a 15 year old animal with a typical 15 year lifespan. Our vet would have presented these options, but would focus the discussion on making sure we understand the next steps in pain management, and what to expect as the end of life is inevitable.
This is difficult, for sure. I, for one, would prefer to use whatever comparable funds are considered, toward adopting/rescuing another animal in need.
My heart goes out to you, and to your kids - having to give them that sad news when they are away from home is difficult.
With my Aussie, I think all the vets agreed that palliative care was fine. No one pushed me to have her be treated more aggressively. But in the final few weeks of her life, one of the vets did seem to hesitate supporting me in making the euthanasia decision. She said that I should wait until my dog couldn’t eat anymore because that would mean the dog was about to die. I did not want to wait until the dog was in such bad condition. I decided that this vet’s advice perhaps reflected that she still hasn’t become comfortable with euthanasia in practice, even if she accepts it in theory.
My current dog (pictured) also has cancer. I did decide to have him undergo amputation of the diseased leg because it was causing him severe pain and because it could have fractured at any time; if it had broken, I probably would have had to have him euthanized immediately. He has survived six months since then (amputation but no other anti-cancer treatment) so I’m glad I chose the surgery.
