A Turkish Angora cat with leiomyosarcoma

[ipek]

Our cat is a 15-year-old Turkish Angora tom. He was well until 15 days ago, when we recognized a mass in the interior part of his left leg. We called a vet and he drained some 20 ml of clear liquid by puncture. Then he referred him to a pet center where he was diagnosed with a tumoral mass in his left leg. His CBC and biochemistry including blood glucose, liver and kidney function tests were all normal, an ultrasonogram and plain film disclosed a 5x5x4 cm tumor. They resected the tumor and a part of muscle without complication. He is now well with good appetite, no weight loss and reasonably mobile. However, pathologic examination of the tumor disclosed leiomyosarcoma of soft tissue. They advised chemotherapy for three repetetive cycles. We are now trying to find the best answer for our cat:
1. Is he too old for chemotherapy? I am an hematologist/oncologist and I know that chemotherapy is not recommended for human beings over 80 year of age. Is there any age limit for chemotherapy in cats?
2. Which drugs are the best for cats with this disorder? Is it the same with humans? Is there any chance for chemotherapy-related deaths? What kind of complications can happen? In which sites metastases occur? Is it liver and lung like in humans?
3. If we decide "no treatment" what would happen in future? I know there is no standard answer, however, I would like to learn the common answer.

[Savas]

Glad to help. I've dealt with older animals with cancer and unfortunately this is almost always the decision you have to make. It's painful to do, but usually for the best.

[CatMom87]

My 17 y.o. male tabby cat had leiomyosarcoma on his left forepaw area. It was hard to aspirated to even get an idea as to what kind of tumor it was. It took 3 different clinics before we got a diagnosis, & then my vet was surprised, as he said leiomyosarcoma is rare in felines. He did a wide-margin excision surgery. But even with that, it returned within 3 months. The vet then decided that amputation at the shoulder was probably Jasper's best bet in buying us some time together with relatively little pain post-surgery. It didn't quite turn out that way. The surgery itself was successful & who's to say whether or not my cat felt much pain after recuperation or not, or if he experienced phantom pain syndrome. All I know is that he quickly went downhill. He wouldn't ever sleep in bed with us anymore or get up on furniture, even his kitty hammock that was less than a foot off the floor & tethered on all 4 corners, so it's not like it was an unstable thing. He started hiding under the computer desk in a dark room & wouldn't socialize much. Then his appetite waned. He later moved into a walk-in closet I had accidentally left open one day. I took to laying down with him for hours at a time in the closet for about 5 months before he was kindly & gently euthanized. About 3 months before then, I noticed he was rarely using the litter box, too. We started I.v. Hydration every other day & carrying him to the litter box & holding him while he took care of business. Yet, he was constipated continuously. He gave up the fight quickly, & I feel he was depressed after his surgery. He lost his independence, something we all know cats highly value. I would take him outside to "sniff the wind, the shrubs, plants, etc., but he didn't ever want to stay out more than 10 minutes at a time, & would get skittish at the slightest increase in the rustling of leaves, as if he felt vulnerable out there, even though I feel he must have felt safe in knowing I would never let anything bad happen to him (although maybe he felt I had already let him down in that department by having such radical surgery). Once he moved into the closet, things went down so rapidly. He had absolutely no interest in food whatsoever, yet, when I took him to the vet, his blood chemistry was perfectly normal & there were no new masses. I almost didn't have him put to sleep when I did, as on the way to the vet's he seemed to perk up & wanted to look around over the top of his crate (one that had an optional grate on top that opened up). When we got to the vet's, he didn't even complain when inserting the I.v. In his paw, & just payed down on the oil surgical table top, absolutely as if telling us he was ready to go. That was the absolute worse day of my life. It's been 13.5 years since his passing & I still mourn him & wonder if I & our vet did everything we should have or shouldn't have done.
God bless you & your family & your beloved kitty. I pray you make your decisions with prayer & discernment. You probably have a much clearer idea than I ever had, as you are an oncologist yourself. I would only caution that depression can kill as quickly as cancer in our pets. Praying for the best outcome for all concerned.

[ipek]

Savas, thank you for your kind interest. We talked to a human oncologist who also has 3 cats and a son in his home. He is an expert in solid tumors. He told us that leiomyosarcoma can spread into lung and liver. Ipek's radiograms and ultrasonogram were normal without a mass. He therefore said that if there is no metastasis, there is no need for chemotherapy. If there is metastasis, no chemotherapy is successful in human of this age (we assumed ipek was above 70 years of human age). therefore, we decided to "wait and see".

[ipek]

Savas, thank you for your kind interest. We talked to a human oncologist who also has 3 cats and a son in his home. He is an expert in solid tumors. He told us that leiomyosarcoma can spread into lung and liver. Ipek's radiograms and ultrasonogram were normal without a mass. He therefore said that if there is no metastasis, there is no need for chemotherapy. If there is metastasis, no chemotherapy is successful in human of this age (we assumed ipek was above 70 years of human age). therefore, we decided to "wait and see".

[Savas]

To clarify; I meant- understanding that the treatment that makes them feel worse is for their own good and will lead to a healthy outcome.

[Savas]

These are very specific medical questions I wouldn't feel comfortable answering for a number of reasons, a main one being I'm no expert on cancerous issues with felines (perhaps another here has more experience?)

I will say from a behavioral standpoint that animals aren't like people. They don't have the understanding of the situation that gives them that "Will to fight through and survive".

With any radical invasive treatment that will cause pain and convalescence, I warn folks that a main issue is length of treatment/recovery. Animals will only suffer so long before they just "give up" and lay down and decide to die. So the shortest time possible for recovery is crucial.

With an older animal...it's tricky. Their abilty to heal successfully and quickly is a huge issue. I would try to get an estimated time of treatment/recovery (realistic) and decide to go with whichever has the least physical/psychological impact and the shortest potential recovery time. This may not be considered the best treatment option in terms of statistical medical success, but in terms of a successful outcome it may be the better route.