Progression of a feline uveal tumor?

January 16, 2006 11:06 AM

CatFilter: My 17 year-old cat has a uveal (ocular) tumor.

If she were younger, then she would probably have surgery to remove her eye. At this point, however, she is unable to tolerate the anaesthesia and general trauma attendant with surgery. Unfortunately, the veterinarian wasn't super helpful when it came to answering my questions regarding how quickly this will progress, and whether my cat is in discomfort. I figured I would google the condition and learn about it on my own, but everything I find is directed at veterinarians and fairly complex. Can anyone point me to an online resource that is directed more towards the pet owner, or at least possible for a layperson to follow? Also, personal anecdotes and/or information regarding feline uveal tumors (and brain tumors, since this is close to her brain) would be appreciated. Please, no comments telling me to put her to sleep - she seems to be comfortable at this point and that is a bridge I am not yet willing to cross.

posted by amro to Pets & Animals (11 answers total)

Hi Amro - I am very sorry to hear about your kitty. I hope you're able to find some good info to keep her comfortable as long as possible! My favorite resource for info on cats are the forums at snik-snak ... I got a lot of great advice when my cat was dealing with assorted medical problems, and you are likely to find someone who has gone through a similar issue there.
posted by catfood at 11:20 AM on January 16, 2006

Is it possible to just go to another vet? one who is more helpful and sympathetic.
It just bothers me that they weren't more helpful.
posted by TheLibrarian at 11:29 AM on January 16, 2006

I'd find another vet. Your vet is saying, cat's old, I don't want to risk an operation, just put her to sleep. That's not acceptable to you. You may well find another vet who is willing to risk the operation, assuming you accept the risk that your cat may not wake up. Or at least you may find a vet that can tell you more about the progression of this particular tumor and what to expect.

My experience with vets is that many of them are good at giving vaccinations and tapeworm medication and nothing else. You may really have to look around to find someone with firsthand knowledge in this area. Call multiple places and talk to the vet, not the receptionist, about this particular problem and see if they sound like they know what they're talking about.
posted by jellicle at 1:34 PM on January 16, 2006

Response by poster: jellicle, the vet and I are actually in agreement about not risking surgery. My cat had gall bladder surgery about 15 months ago, and really struggled to recover (she didn't eat for months following the surgery, and had to be fed via a feeding tube in her side; she lost 3 pounds that she's never gained back). The vet didn't suggest putting her to sleep, but there's not much to do barring surgery except see how the tumor progresses. I'd just like to get an idea of how quickly it will progress and whether it will cause her pain.

I do agree that I may need to find another vet - I've never really been happy with the place I've been taking her the last few years.

catfood, thanks for the link!
posted by amro at 2:28 PM on January 16, 2006

I would get a second opinion.

My 11 year old greyhound was diagnosed with thyroid cancer about a year ago (actually, three weeks after I rescued him), and there was some question as to whether it was worth putting him through surgery. Greyhound life expectancy is usually only about 10 years for one his size, and they are also a notorious breed for not doing as well under anesthesia, in fact there is a seperate protocol vets follow for putting sighthounds under.

After finding a confident, great vet, I elected to have the surgery, and chemotherapy for the next 6 months. He came through it all great- it's been six months since his last chemo dose, and he's still totally clear and free of any cancer. I could have lost him a year ago had I listened to the advice of some, and had him in my life for three weeks, instead of a year and still going strong, and missed him becoming my canine soulmate.

I don't know anything about feline uveal tumors, but unless you're absolutely sure that she would be unable to undergo surgery and recovery, I would at least seek another opinion. You don't have anything to lose by asking for another vet's advice at this point.

Good luck.
posted by Meredith at 4:13 PM on January 16, 2006

Here is a brief explanation of the process of diagnosis and treatment of ocular tumours in cats.

I would second TheLibrarian and jellicle in recommending that you find another vet, sooner rather than later. A good vet who specialises in the treatment of cats will be more than willing to answer your questions in easy to understand terms.

It may be that quality palliative care is the best option for your elderly cat A cat specialist will be able to provide this type of care and be supportive to you as well.

Wishing you and your cat all the best :)
posted by Arqa at 4:16 PM on January 16, 2006

Also zzcat.com has a page with support groups/fora for the owners of cats with cancer. The home page lists many clearly written articles about feline cancer.
posted by Arqa at 4:40 PM on January 16, 2006

At the risk of "me too"ing, I'd say you should get a second opinion even if you were generally happy with the first vet.
posted by winston at 6:41 PM on January 16, 2006

Wouldn't your cat tell you if she was in pain? Mine always did. She's old. She may have no more than an acceptable (to her) level of discomfort. 17 is quite old for a cat. Cherish her.
posted by Goofyy at 2:46 AM on January 17, 2006

Cats typically mask their pain, it's sort of an instinctive way of discouraging predators from coming after them. By the time you can tell a cat is in pain, it's pretty severe, in my opinion. Observant owners are going to be able to tell before a vet will, despite what vets will tell you. Changes in behavior and body language are the biggest clues. Have they stopped eating? Have their postures changed? My previous lady cat used to love to stretch out on her back and loll around, until she got intestinal lymphoma, and then she gradually stopped. Instead, she sort of crouched on all four legs or very gingerly lay down, folding one arm/leg at a time. And if you ask most vets if small cell intestinal lymphoma is painful to cats, they will tell you it is not. But they are simply ignorant, I'm afraid to say. At least most vets do acknowledge that tumors cause pain as they get large enough. They are generally not taught the finer points in pain in vet school, and many are not interested in pursuing further education in pain through seminars and conferences.

Anyway, I let a vet talk me into having a biopsy taken through abdominal surgery, and then the only pain meds they gave her were NSAIDs. I was so furious. She was already in pain from what they acknowledged was very, very advanced cancer, and then on top of that had abdominal surgery. She was a complete wreck, and the vet said defensively, "Well, she's standing up now!" like that was proof she wasn't in pain. Please spare me.

I found a vet in the yellow pages who specifically mentioned pain as a top priority, called him up, and got her on a fentanyl patch as soon as I could. I still feel really shitty that it took two days to accomplish. She was so much better, she even stretched out on her back again which she hadn't done in months.

There are some enlightened vets out there who are up to date on how to look for signs of pain and what pain meds are most effective. A lot of cats do really well on opiates like fentanyl and buprenorphine, but old school vets still think that cats don't need drugs that strong or can't handle opiates at all. Among vets like the one I have found and the one my mother has found, in a situation where it is reasonable to assume pain, like cancer or pancreatitis or surgery, it is also reasonable to try pain meds to see if the cat appears to improve.

Also, the best pain regimen will be an NSAID and opiate combo. (unless there are kidney problems, in which case an NSAID might be contra-indicated) Oh yeah, and don't let them tell you that Torbutrol is good enough (though you can try it). It is known by vet pain specialists in academia to be too short-lasting to be any good. I'll try to dig up the article if you're interested.
posted by overanxious ducksqueezer at 4:19 AM on January 19, 2006

Response by poster: Thanks for all of the thoughtful responses. I took my cat (Evie) to a new vet who was highly recommended by a friend. She has been extremely responsive to my questions, and her testing revealed that Evie is indeed in some pain, but it is treatable with eyedrops. She also gave me more info about the tumor and what signs to look for as it progresses. I probably wouldn't have switched vets if it hadn't been suggested here, but I'm glad I did.
posted by amro at 6:43 AM on January 19, 2006