Breathing harder, drinking more, eating less.

We decided that it's time.

Trouble breathing

The tumor is now pushing to close off her second nasal passage, so Kitty is snorting and breathing very loudly now. She's back to drinking lots of water. I've also started to give her baths because it's very difficult for her grooming to keep up with the fluids that keep coming out. We know her time is coming up soon, yet it's hard to know exactly when because she still has so many social moments and purrs every night.

Still a trooper

Kitty cat is looking as beat up as our bathroom lately, but she's still hanging on in there. One nostril is completely closed up by the tumor, and the other one is getting pretty close also. The growth seems to be spreading at the bridge of her nose, to that area has been getting wider apart as well as lumpier. Left eye is a bit watery and squinty, and she continues to leak out her forehead. We're going to start giving her paw baths now because she's having trouble keeping them clean with her regular routine. On the eating end, she still has an appetite for hand-feed babyfood and has been holding steady at 5.4 lbs. She still sleeps with us and purrs and we're just taking it day by day.

From Bump to Bald spot

This photo shows kitty's head bump 1 week after it emerged.

The day before, I had taken her to the cat oncologist to get a second opinion on what it was. (Her normal vet thought it was inflammed tissue, but the antibiotics didn't seem to subside the bump.) The oncologist thought that it was her sinus fluids, built up from her nasal passage being clogged. There was really nothing the oncologist could do because she didn't want to risk infecting the lump by taking a sample.

Fast forward to the day of the photo. Nature took its own course when Cutie Cat popped the lump all on her own and drained the fluids through her forehead. I'll spare you the details.

Over the next days, the lump would build back up again, get drained, and the process would repeat. It's been surprisingly efficient, and short of a bald spot that formed around the drainage hole, kitty is doing well... social, alert, and eating regularly.

Current weight: 5.4 lbs
Medications: none

Antibiotics and Painkillers

The vet doesn't think the forehead lump is from fluids. She thinks might be infection of the tissue and prescribed some oral anitibiotics and painkillers. Both are stinky and makes kitty lose her appetite.

The lump grew pretty large by the end of yesterday and shrank a bit overnight, so she's kind of back the same lump size as yesterday, the first morning.

Current medications: .5ml Clavamox drops (Amoxicillin Trihydrate/Clavulanate Potassium) twice per day for the next 10 days. .25ml Oral Buprenorphine once per day, then dropping down to once every 2-3 days for a total of 8 syringefuls.

Weight: 5.8 lbs

Bump on the Head

Cutie cat woke up this morning with a big soft bump on her forehead and a little bit of blood at her left nostril, which is the same side as her tumor. The bump is soft and squishy so we suspect it's sinus fluids which can't drain out because of the growing tumor. I placed a call to the vet and am waiting to hear back on what to do. Bump aside, she's still purring, social, and eating well.

Eating like a little piggy

Last night I gave the last of the antibiotics to cutie cat by oral syringe and I'm sure she's happy not to have to go through that 3x a day anymore. She's been pretty much back to her old self prior to being sick. Her appetite picked up again and she's eating like a little piggy, snorting away and finishing whatever portions of milk with catfood I give her. I'm hoping at this rate, she'll be able to pack on some weight before any more complications from her tumor.

Current weight: 6.0 lbs
Medications: none
Currently eating: TJ's Turkey and Giblets watered down with lactose-free 2% milk

Feeling social again.

Things have been rough the past week with cutie cat in pain and getting weaker. Last night was a turning point for the better. When we got home after dinner, she was sitting up on the sofa (vs. hiding under the covers) and almost ready to scold us for being out. She seemed to have more energy, stayed awake, and purred quite a bit as she took turns between going from one lap to another over the course of the night. This morning her appetite was good and ate and drank without too much coaxing. She's also been sleeping in a more social position - one that stubbornly says "I want to be on you" instead of "I want to be curled up alone". We've gone through one full bottle of antibiotics now and have started a second.

Update

The antibiotics seem to be reducing some of the infection. She continues to have trouble eating and sometimes has trouble breathing also because of the growing tumor. Just a week ago, she would happily slurp away at her Trader Joe's Turkey and Giblets catfood and now just turns her head away at it because even that is too lumpy and gets stuck in her mouth. I've switched her to Gerber babyfood and lactose-free milk. Apparently babyfood must be a popular thing to feed pets because the cashier asked me if I was buying for a kitty or a doggy. At first I took a bit of offense that this stranger automatically assumed I wasn't a mother, but then I realized that real moms probably don't buy only the babyfood flavors that are all meat.

She also has blackish, liquidy poop, which is a sign of ulcers.

Infection and Antibiotics

We believe kitty's got an infection. She refused to eat, hid under the covers all day, and wasn't purring even when hugged. I managed to sneak a peek inside her mouth while she was grooming herself and saw that the entire left part of her mouth was red from where her teeth used to be, and swollen (not sure how much from the tumor and how much from an infection). She's definitely been having trouble eating and makes little snorty noises when trying to swallow her food. I got some liquid antibiotics yesterday from the vet which seems to be making her feel better.

Weight: 6.0 lbs
Medication: ClinDrops Clindamycin Hydrochloride Oral Liquid Antibiotic, 1 ml every 8 hours

Leaning Cat

You know how most cats are graceful and elegant? I don't think mine ever learned how to sit up straight.

Anatomy of a cat's tumor

I'm visual, so here's a diagram to explain what's happening...

PURPLE = the area of the tumor. Most of it is in the cheek and is gradually spreading towards the right side of this diagram, where the jaw and eye are.
PURPLE X's = teeth that have been extracted or loosened on their own. She may have lost some more upper teeth that we don't know about because when the vet looked in her mouth today, she didn't see any teeth that would create any sort of grinding with the bottom teeth.
ORANGE = the jawbone that the tumor is rubbing against. You'll notice from the arrows that the wider her mouth is open, the greater these two areas come into contact.

Oncologist Visit

Cutie cat's tumor has been growing and causing complications in her mouth. She's completely on canned catfood now and recently has been making a crunching noise when she opens her mouth wide. Crunching noises with soft food doesn't jive, so this morning we took her back to the oncologist for a checkup. My guess was that her teeth were grinding together from having their position shifted, but it turned out to be her jawbone. As she opens her mouth, the enlarged portion of her tumor rubs against part of her jaw. Believe it or not, this was actually good news because it mean that my cat 1) didn't need to be sedated for an x-ray, 2) did not have to have any teeth extracted, and 3) did not have to risk infection or weight loss from having teeth extracted.

All things considered, the vet was very impressed with how well kitty's been doing. (Remember that back in December, the prognosis was 1-2 months and it's now 7 months later.) Despite some gradual weight loss, cutie cat still has her appetite, grooms herself regularly, and is very content and interactive.

Current weight: 5.96 lbs
Current favorite food: Trader Joe's Turkey & Giblets

Struggling with the in's and out's.

Penny is still struggling with getting enough to eat. I've been trying to feed her 4x per day because she doesn't eat very much in any one sitting, and doesn't seem to like eating the dry food that's left out for her. She's also had some difficulty with constipation these past few days. The poor cat went and sat in her litterbox 3 times that I noticed on Sunday, before she was finally successful and got to bury something.

Current weight: 6.4 lbs.

What if...

I haven't posted in a long time, because everything has been holding steady. Aside from coughing up some yellow liquid this morning, Penny seems to still be happy and actually has been quite energetic since I started feeding her kitten food.

I do wonder whether I'm feeding her or her tumor though. Kitten food is higher in calories and I hoped that would help her gain weight back, but nope...she's still skinny. I hope that the extra calcium in the food is not fueling the tumor growth.

Here's a little photo experiment I tried to see how the tumor has affected her face:

Current weight fluctuates between 6.6 to 7.0 lbs.

Poop mystery solved.

Penny has always been a good communicator. "Pet me," "feed me," "let me in the closet." Whatever she wants, she finds a way to stubbornly let us know.

Awhile back, I discovered a piece of her poop in the middle of the kitchen floor and was convinced that my husband had somehow carelessly gotten it on his shoe and tracked it over there. When I accused him, he denied it and then accused me of doing it. Well, after some close scrutiny of his shoe and my sock, we determined that Penny did it all by herself. She never was very good at "making it" into her litter box, but it was highly uncharacteristic that something would end up so far away from the box. Turned out that she was trying to tell us to clean her litter box - very effective considering that the little present she left was in a location that could not have been missed.

There was a bit of mystery as to how she did it though. I mean, did she actually "go" in the middle of the floor, or move something over from her box? This week, the mystery was solved when David caught her in the act. She went to the bathroom as usual back at her box, and then dragged herself with her front paws, while in sitting position with her rear legs up! And what was left behind was, well, left behind. Mystery solved.

Current weight: 7.0 lbs.

Farewell, Tiny.

This past week I've been really thankful that Penny has been so stable. She's still a skinny little cat, but has been happy, energetic, and even seems to be better on the sneezes, lesions, and bothersome mouth pain from the tumor. No news is definitely good news for her.

On the other spectrum, the picture above is actually of cancer cousin Tiny, back when he was healthy. This is how I remember him. Tiny's intestinal lymphoma had made him very sick and weak in the 2 weeks since the family found out. He was in obvious pain and barely hanging on, so last Saturday, he was put to rest. Bye-bye, big guy. We'll miss you.

Eating in bed.

My husband asked a good question..."Is it still a 'surprise feeding' when she comes to expect it?"

Penny's been pretty stable this week. She eats 2-3 times a day in bed and supplements with visits to her bowl. The funny thing is that she will refuse to eat her canned food in the kitchen, but 5 minutes later will happily eat it all up if I give her the same bowl in bed. (Yes, she continues to be an unusual cat.) Her lesions seem to be healing and the sneezes have died down. At night her energy level is high, too.

As for cousin cat, Tiny, he's not doing quite so well. His weight has dropped another 2 pounds and the family is having him treated with steroids and other injections to keep him going a bit longer. I can't believe he's as small as Penny now. Just 2 weeks ago he was a big fat cat!

Penny's current weight: 6.8 lbs
Tiny's weight: 6.5 to 7.5 lbs, depending on the scale

How to Surprise Feed a Cat.

1) Start with a sleeping cat. Curled up and under the covers is good because she won't see it coming.
2) Water down some canned catfood and put into a little bowl.
3) Sneak up on the cat and shove the bowl right under her face. This step is especially easy when the kitty is deaf.

As cutie cat wakes up, she smells food and instantly starts to lick it up. No need to get up or even move her body. Is she lazy? Yes. Spoiled? Probably. Weak? Not anymore. This method has worked well for feeding Penny this past week.

Current weight: still 6.8 lbs, but with much more energy

Thinking of Tiny.

Today's post is less about Penny than it is for another cat named Tiny. Tiny is 12 years old and belongs to my sister-in-law's family. I guess that makes Penny and Tiny "cousins" in a way.

Tiny is also a tabby cat with white markings, however his normal weight is a hefty 12-13 lbs. Within the last week, he dropped 4 lbs. and suddenly lost strength to climb over anything, including the lip of his litter box. The vet discovered a mass and had Tiny sent over to the VMS, the same place that Penny went to see a cat oncologist. We were very sad to hear last night that Tiny was diagnosed with intestinal lymphoma. Without treatment, he only has a couple of weeks left. The family decided to give him one dose of chemotherapy plus steroids to hopefully prolong Tiny's life by another month or two. They'll know on Friday whether this was successful. In the meantime, Tiny is back home and still purring.

Two separate instances of cat cancer occurring at the same time in our extended family has truly been quite a shock. Our nephew Coby came up with a great idea when he said, "we should have lots of parties for Tiny and Penny so that they can be happy while they are alive." We'll be keeping Tiny in our thoughts.

In the meantime, Penny holds steady at 6.8 lbs. and she takes to supplemental feedings well using the "surprise method".

Big sneezes from a little cat.

Appetite has been mixed over the past few days. She's turning down some of her favorite foods again and not eating as much. When she does eat, it's very voracious, like she was starving and can't wait to get the food down fast enough. One of the things I've been doing is to bring a bowl of food over to her when she's napping. I stick the bowl right at her face, she wakes up, and starts eating without having to even move her body. It does seem to get her to eat when she won't go to her food bowl on her own.

Penny's also been sneezing a lot more now. She's really cute when she does it, but we know it's not a good thing. (Also not cute is when she does a big wet sneeze right at my face while I'm sleeping.) Based on past experience, if her sinus is clogged, she'll tend not to eat because she can't smell her food.

On other issues, her mouth is bothering her more (symptom: lip smacking). Lesions seem to be healing or decreasing, which makes us believe that they were caused by some sort of allergic reaction to the Piroxicam medication. Her hair is also thinning out.

Current weight: 6.8 lbs

Doing her thing.

Penny is more or less back to doing her thing: napping in various places throughout the house, following us around, and doing a very good imitiation of a paper weight on our laps. This picture was taken over the weekend - you can see the difference in size between her left and right cheek. She's back to eating hard foods and drinking water now, although not nearly at the quantities compared to just a month ago. For some reason, she doesn't like canned catfood anymore. She will eat a little of it I water it down to make it mushier.

Some recent anomalies we noticed include 1) small lesions all over her body and 2) a big-than-others vertebrae. I don't know when the lesions started because it's hard to notice under her fur. We noticed the first one last month when a scab came off (slightly smaller than the size of an eraser tip) and took off her hair with it. She has a little bald spot at her shoulder, which is growing back now. Could it be an allergic reaction to the Piroxicam? Or a rash somehow remotely related to the cancer? She does seem to be a bit itchier than normal so the marks could be caused by her biting at her skin.

As for the fat vertebrae in the middle of her back, David pointed it out to me last night. He thinks she may have had that for a long time and now it's just more noticeable with her weight loss and overall boniness.

Current weight: 7.0 lbs

Regaining appetite

Today was a good day. Penny's appetite has been regaining over the weekend and she's going to her food bowl multiple times a day now. For some reason, she's still not fond of canned food. But most of her old favorites are again tasty enough for a few licks or bites: corn chips, ice cream, milk, salmon...

Current weight: 7.0 lbs

Storms and syringes

I had hoped to talk with the oncologist about whether to bring Penny into their office this morning but could not get through to anyone all morning. The big storm today has been causing blackouts and downed phone lines, so their office is not really up and running. After the nurse finally called me back (on his cell phone), we decided to check in again on Monday. This was primarily because of Penny's slight improvement yesterday.

So far today, her appetite is still missing and even refused to eat the Alaskan salmon I tried feeding her. I syringe-fed her 2mL of mushed up salmon with half-and-half before I left, and need to go buy a bigger syringe so I can be more efficient with feeding. For reference, let's say that a slender cat on canned food, needs to eat 6 oz. per day. That 6 ounces coverts to 177mL (or 177 squirts with a 1 mL syringe), and that won't do.

Current weight: 6.8 lbs

Sleepy, shrinking kitty

Penny's been sleeping a lot more - probably due to a combination of aging, low energy, and lack of disturbances from her deafness. She used to come greet whoever entered the house or meow whenever the phone rang, but now I think she doesn't hear any of this go on.

Penny has always been a dainty eater and the past few days have been especially trying in terms of getting her to eat more. Her normal, healthy weight should be 9-10 lbs. During her annual check-up mid-November (before the tumor was discovered), she was 8.5 lbs. Right after Christmas, I weighed her at 7 lbs. 8 oz so I started her on canned catfood to try and get her to gain weight. She really loved it for a couple of days and then suddenly lost her appetite. We immediately stopped feeding her the Piroxicam that the oncologist had prescribed. New year's worried me because it didn't appear that she ate more than a few kibbles or drank all day. She's down to 7 lbs. 2 oz.

I tried everything from microwaving the catfood to handfeeding her (which she normally loves) and eventually ended up feeding her 4 mL of catfood mixed with half-and-half by syringe yesterday. Her appetite has been gradually picking up, and I'm encouraging her to eat whatever she will. Last night she licked up some leftover ice cream from my bowl and today she ate maybe 1/4 of what she normally would.

Aside from the loss of appetite and low energy, she's still a happy, purring, social cat.

Current weight: 7.2 lbs

The Background

November 2007
I took Penny to the vet for a routine teeth cleaning. She's had gingivitis ever since we've known her. (She doesn't chew her food.) To get her teeth cleaned, she had to under anasthesia and staying at the vet's office all day. While she was under, the doctor called to say that she found a lump at her upper left jawbone / cheek area and that 2 teeth needed to be extracted there. She didn't know if the lump was 1) an infection or 2) a tumor. An abscess was pretty much ruled out because whatever this lump was, it was pushing out the 2 teeth, which came out really easily. She recommended that an x-ray be taken (see photo below) and that I schedule a meeting with a cat oncologist and have a biopsy done as soon as possible.

Penny was pretty stressed out after having two teeth pulled and spending a day at the vet, so we decided to wait until she was back to normal before subjecting her to an oncologist's visit. We first had to get through 3 days worth of painkillers (liquid, which she happily took mixed with milk) and 14 days of antibiotics. The antibiotics were pills, which she HATED to take. Crushing them up to mix with tuna and stuffing them into Pill Pockets both didn't work because the smell was too strong. David had to do the unpleasant task of prying her mouth open and jamming a pill down her throat every morning. Not fun, considering her mouth was hurting already from the extractions.

If the lump was an infection, and not a tumor, then the antibiotics should have helped to reduce it. But the lump was now visible in her cheek, whereas 2 weeks earlier, the lump was only detectible from inside her mouth.

Despite all the recent trauma, Penny's behavior was finally back to normal. She was social, purring, playful, and swallowing her hard catfood whole (weird, I know, but she never did like chewing in the entire 6+ years we've had her).

We were fairly certain that IF the lump was cancerous, we would not put her through chemotherapy because she was back to being a happy, content cat -- minus 2 teeth and some progressive loss of hearing over the past few months that we attributed to her age.

December 2007
I schedule a meeting with the oncologist anyway to talk about treatment options and see if she has any better idea of what the lump might be. We're pretty sure it's not an infection by now and my vet's guess was that it could be osteosarcoma (bone tumor).

Without doing a biopsy, the oncologist thought the lump is likely to be one of 3 things:
1) A Benign Tumor: best case scenario, not cancerous, but would cause complications with her left eye if it continued to grow.
2) Osteosarcoma (bone tumor): cancerous, a 3-6 month prognosis, course of treatment would be chemotherapy
3) Squamous Cell Sarcoma: a very agressive cancer, 1-2 month prognosis, course of treatment would be chemotherapy. Not what I wanted to hear, but a possibility given how fast the lump went from being undetectible to a size that you could visibly see and feel.

Chemotherapy would involve 16-19 radiation treatments, each time requiring our cat to be driven to the oncologist (which she hates) and undergoing anasthesia for the day. Considering it took Penny 1.5-2 weeks to recover from her previous anasthesia experience, we already knew that we would not subject her to chemo. Since knowing the results were not going to affect our treatment, we opted to not even do a biopsy on Penny. (A biopsy would've meant another day under anasthesia and the possibility of bacteria infecting the tumor because of it's location in the mouth.)

For tumors in other locations, a treatment possibility would be to amputate or cut it out. This was not an option for us because the lump is in her face.

The only intervention we are doing is giving her Peroxicam every other day, which the oncologist thinks will help reduce inflammation and possibly slow growth if the tumor is squamous cell carcinoma.

In summary, we don't know which kind of tumor she has and we won't be subjecting her to chemotherapy. We're going to just focus on giving her the best quality of life possible while she's still with us.

My cat has a tumor.

The purpose of this blog is to record events relating to the discovery of a lump in my cat's left cheek. In the near term, this blog will help me keep track of what is happening to Penny. In the long term, I hope it will serve as useful research for others having to deal with cat cancer.