PDA

View Full Version : Vaccine-related fibrosarcoma


News Reader
September 19th 05, 06:45 AM
Hi,

My otherwise healthy 8 year old cat was recently diagnosed with
vaccine-related fibrosarcoma (the vet believes it was the 3 year rabies
vaccination).

He has an appointment with the oncologist on Tuesday.

Can anyone give me some advice as to what questions to ask, what things
I should read up on, what I can expect in terms of treatment and
prognosis, etc.? Any pointers would be helpful.

Thanks

Phil P.
September 19th 05, 09:11 AM
"News Reader" > wrote in message
ups.com...
> Hi,
>
> My otherwise healthy 8 year old cat was recently diagnosed with
> vaccine-related fibrosarcoma (the vet believes it was the 3 year rabies
> vaccination).
>
> He has an appointment with the oncologist on Tuesday.
>
> Can anyone give me some advice as to what questions to ask, what things
> I should read up on, what I can expect in terms of treatment and
> prognosis, etc.? Any pointers would be helpful.

I'm sorry to hear about your cat.

If there's no evidence of metastasis, about the only suggestions I can offer
is to speak to your vet about calling in an ultrasound specialist.
Ultrasounds can determine the limits of the tumor. This will increase the
chances of getting the entire tumor out on the first surgery. The first
surgery has the best chance of producing a cure. Also, by defining the
limits of the tumor, the margins may not have to be as wide as the vet might
have estimated.


Best of luck.

Phil

Betsy
September 19th 05, 03:50 PM
My cat Aggie also had a fibrosarcoma, and rabies vaccine was the only one
she got.

Where is it located?

Aggie unfortunately had to have her whole leg amputated, even the hip. She
did very well for almost a year (missing a leg did not limit her activity
level) and then died of something unrelated. She was a real trooper, and I
miss her.

My regular vet at the time tried to operate, and only made the problem far
worse, and cost me tons of money. I took her to U Penn after that, and
because they couldn't get the surgery scheduled immediately she had a round
or two of chemo. I believe she had an ultrasound, as Phil mentioned.

The tumor itself rarely metastasizes, if I remember correctly. But it is
very locally aggressive, and must be completely removed, with quite wide
margins, which is why Aggie lost her hip.

I wish you the best. Surgery can be a complete cure, depending on where the
tumor was located and the skill of the surgeon.


"News Reader" > wrote in message
ups.com...
> Hi,
>
> My otherwise healthy 8 year old cat was recently diagnosed with
> vaccine-related fibrosarcoma (the vet believes it was the 3 year rabies
> vaccination).
>
> He has an appointment with the oncologist on Tuesday.
>
> Can anyone give me some advice as to what questions to ask, what things
> I should read up on, what I can expect in terms of treatment and
> prognosis, etc.? Any pointers would be helpful.
>
> Thanks
>

Steph
September 19th 05, 04:12 PM
Sorry to hear about that. My friend's cat just went though this but his was
between the shoulder blades. He had to have most of the muscle and I think
about eight dorsal spinal process removed...and some of each scapula as well
I think. He recoved just fine. Had some problems with the incision
dehissing and had to have it redone about three times. But everything is
great now. He has a "caved in" look, and feels odd when you pet him, but
still super lovable and his attitude never changed. Best of luck with
everything!

News Reader
September 20th 05, 12:35 AM
Yeah, unfortunately, my cat's tumor is not entirely on his leg, in
which case I understand they can simply amputate. It is kind of on his
rear leg "shoulder." The vet said that location makes it more difficult
to treat.

Mostly I just want to know if it is worth trying to treat or if the
treatment is just going to make the cat miserable and not even work.
I'd hate to put him through that for nothing.

Betsy
September 20th 05, 02:54 AM
I don't think it will make him miserable. You really need to talk to a
surgeon and see if adequate margins can be achieved. I think when you say
"shoulder" you mean his hip?

I've had cats treated for so many things, some serious involving surgery,
some just painful. They tolerate it well. They are very forgiving.

If you can afford it, I'd suggest going through with surgery.

"News Reader" > wrote in message
ups.com...
> Yeah, unfortunately, my cat's tumor is not entirely on his leg, in
> which case I understand they can simply amputate. It is kind of on his
> rear leg "shoulder." The vet said that location makes it more difficult
> to treat.
>
> Mostly I just want to know if it is worth trying to treat or if the
> treatment is just going to make the cat miserable and not even work.
> I'd hate to put him through that for nothing.
>

News Reader
September 21st 05, 12:33 AM
Yes, hip. Sorry. I knew there was a better word for that!

News Reader
September 21st 05, 12:39 AM
I had the appointment with the oncologist today.

She said she was "cautiously optimistic" and said that she thinks there
is a good chance of helping my cat. Apparently his tumor is relatively
small and hasn't been growing very quickly and is in a good location
for surgical treatment. She said that based on the lab reports, the
tumor doesn't have all of the classic signs of being vaccine-related,
but based on the location, she thinks it must be.

She outlined two options:

One option spares his limb but there is a good chance the tumor will
recur. This approach involves a more conservative surgery and then 3
weeks of radiation. The cat is often disease free for about 18 months.
I think she said that this approach isn't generally curative.

The other option is the radical option and it involves amputation of
the leg. This has a good chance of being curative as they will get the
entire tumor. There is then no need for radiation. They often recommend
several chemo treatments (maybe they do that with either option?)
because there is always a chance that an undetectable number of cancer
cells have spread to another part of the body and the chemo gives them
a decent chance of killing those cells before they really start to grow
into something big.

So I think the chemo is something they might do in either case -- she
explained that about 25% of the time the cancer can spread, so they
might be doing it unnecessarily, but there's no way of knowing if
you're one of the 25%, so they often do it anyway.

Her recommendation was the more aggressive approach. This also seems to
be the recommendation of non-professionals (cat owners) here on the
forums and newsgroups. Many of you have said that the cat does
remarkably well and often lives many additional years. Her feeling was
that the best chance of a cure is to take an aggressive approach early
-- your first shot is always your best shot at getting it.

Given his age (he's 8 and could have many more years), she felt this
was a good approach as it is often curative. As opposed to the smaller
surgery and radiation and repeated treatments and being disease free
for only maybe 18 months, this treatment may be all you ever need to
do. Her feeling was that as awful as it sounds, the best recourse is to
sacrifice the limb. She explained that this is the reason they give the
vaccine there -- so that they have some recourse if this happens. I
guess they used to give them in the scruffy part of the neck between
the shoulder blades.

My mom, who has had (and lost) several cats and has regretted keeping
them alive longer than she should have for HER benefit, suggested I
also ask the vet about the "do nothing" approach (asking how long he is
likely to live and then just letting him go as long as he seems happy
and healthy) and also asking what the benefits would be to non-surgical
approaches (radiation and/or chemo only). I have a call in to the vet
and I will ask about those things as well -- I guess it is better to
have all the information. It is hard for me to imagine simply doing
nothing, though, as awful as the treatment sounds. I would feel like I
wasn't even trying. And I would have a hard time taking the next step
when he did get sick. If there's something that may prevent him from
getting sick at all, isn't that a good option? Or is that being
selfish?

We're going to do a CT scan next to see exactly where the tumor is just
in case it has gone farther than we think, and then depending on what I
decide, I will talk to the surgeon. We did a chest xray today and it
didn't show any problems elsewhere.

So now I need to decide what's best for him (and what's best for me?)
-- giving him the best chance of being cured and living several(?) more
years, but with a disability (although one that people say is really
not so terrible for the cat), or living some period of time (unknown)
the way he is now but knowing that he'll get sick at some point in the
future. The cost doesn't matter to me. I just want to do what's best
and it is really hard to figure out whether trying to treat him would
really be for me and not for him.

Well, that's the update for now. Thanks to everyone who has responded!

Topaz
September 21st 05, 12:53 AM
"News Reader" > wrote in message
oups.com...
> I had the appointment with the oncologist today.
>
> She said she was "cautiously optimistic" and said that she thinks there
> is a good chance of helping my cat. Apparently his tumor is relatively
> small and hasn't been growing very quickly and is in a good location
> for surgical treatment.

Oh I'm so glad for you and your kitty!


[..]

>
> So now I need to decide what's best for him (and what's best for me?)
> -- giving him the best chance of being cured and living several(?) more
> years, but with a disability (although one that people say is really
> not so terrible for the cat), or living some period of time (unknown)
> the way he is now but knowing that he'll get sick at some point in the
> future. The cost doesn't matter to me. I just want to do what's best
> and it is really hard to figure out whether trying to treat him would
> really be for me and not for him.
>
> Well, that's the update for now. Thanks to everyone who has responded!
>

I read your post carefully, and have read of many cats that lived very
happily with three legs. Eight is young, and he has a chance to be
cancer free. I can tell that you love this cat. I hope you will go for the
more radical surgery that your vet thinks has the better chance of
curing the cancer. If your cat was 17 years old and there was no
chance for a cure I could see your Mom's point, but that is not
the case with your cat. I wish you both the best and appreciate your
sharing your experience here so that we may benefit from it.

Candace
September 21st 05, 05:55 AM
News Reader wrote:

> My mom, who has had (and lost) several cats and has regretted keeping
> them alive longer than she should have for HER benefit, suggested I
> also ask the vet about the "do nothing" approach (asking how long he is
> likely to live and then just letting him go as long as he seems happy
> and healthy) and also asking what the benefits would be to non-surgical
> approaches (radiation and/or chemo only). I have a call in to the vet
> and I will ask about those things as well -- I guess it is better to
> have all the information. It is hard for me to imagine simply doing
> nothing, though, as awful as the treatment sounds. I would feel like I
> wasn't even trying. And I would have a hard time taking the next step
> when he did get sick. If there's something that may prevent him from
> getting sick at all, isn't that a good option? Or is that being
> selfish?

No, it's not being selfish at all. If your cat had a grave prognosis
and was suffering, then you might be selfish for continuing treatment.
But that is not the case here. Your cat has a very good prognosis.
It's a horrible shock for a human to lose a limb but it's not the same
for a cat. They don't have the same emotional attachment we do and
they don't feel "disfigured." It might be a little shock to *you* but,
from what I have read, cats adjust very well to losing a limb. (I know
someone who has a cat who lost a back leg due to a car accident.
They're morons and still let her outside, which I think is unwise, but
she has adapted very well, runs, jumps, plays.)

Let us know your decision. I know it's hard to choose amputation but
it probably would be the best thing for your cat.

Candace

Phil P.
September 21st 05, 12:07 PM
"News Reader" > wrote in message
oups.com...

> We're going to do a CT scan next to see exactly where the tumor is just
> in case it has gone farther than we think, and then depending on what I
> decide, I will talk to the surgeon. We did a chest xray today and it
> didn't show any problems elsewhere.

Don't make any decisions before you see the results of the CT. CT is even
more revealing than the ultrasounds I suggested. The CT scan should clearly
show the borders of the tumor. Since the tumor is slow growing and small,
the CT might indicate that there might be a good chance the tumor can be
removed entirely without amputation.

Best of luck,

Phil

News Reader
September 21st 05, 12:51 PM
That's exactly what I was going to ask the vet today -- if once we get
the CT done and/or once the surgeon evaluates him, maybe there's
something less radical that will still give enough of a margin. Right
now only the oncologist has seen him, and, while I have no doubt that
she is an expert in oncology, she's not a surgeon.

Thanks for the advice.

I'd also be very interested in hearing from folks who have gone through
with the amputation. It just seems like such a horrible thing to do to
him -- I'm not sure I can bring myself to do it if that's what's
necessary. Can cats really do well on three legs? Can they still run
(well, maybe not run, but walk) around the house with no problems? Go
up and down stairs? Jump? Will he be OK with his litterbox downstairs
and his food upstairs? Will he hate me for the rest of his life? I just
don't know how big an impact this will have on HIS life -- I know it
will be hard for me, but maybe it won't be a big deal for him...?

Betsy
September 21st 05, 02:34 PM
As I said, Aggie had her entire back leg amputated and was probably even
braver than before in my household of (at the time) 12 cats and a collie.
She ran, jumped small distances, and acted basically normal. She still
craved attention as before.

"News Reader" > wrote in message
oups.com...
> That's exactly what I was going to ask the vet today -- if once we get
> the CT done and/or once the surgeon evaluates him, maybe there's
> something less radical that will still give enough of a margin. Right
> now only the oncologist has seen him, and, while I have no doubt that
> she is an expert in oncology, she's not a surgeon.
>
> Thanks for the advice.
>
> I'd also be very interested in hearing from folks who have gone through
> with the amputation. It just seems like such a horrible thing to do to
> him -- I'm not sure I can bring myself to do it if that's what's
> necessary. Can cats really do well on three legs? Can they still run
> (well, maybe not run, but walk) around the house with no problems? Go
> up and down stairs? Jump? Will he be OK with his litterbox downstairs
> and his food upstairs? Will he hate me for the rest of his life? I just
> don't know how big an impact this will have on HIS life -- I know it
> will be hard for me, but maybe it won't be a big deal for him...?
>

News Reader
September 21st 05, 03:13 PM
Thanks -- that's reassuring.

I'm wondering if it is worth getting a second opinion now. I'm not sure
if there's really a lot of time to do that and I wonder if it will only
make me start second-guessing myself...

And while I don't care that much, I wonder if prices vary
significantly.

Did [m]any of you who faced this problem seek out second opinions?

Deborah, DVM
September 21st 05, 09:50 PM
"News Reader" > wrote in message
oups.com...
> That's exactly what I was going to ask the vet today -- if once we get
> the CT done and/or once the surgeon evaluates him, maybe there's
> something less radical that will still give enough of a margin. Right
> now only the oncologist has seen him, and, while I have no doubt that
> she is an expert in oncology, she's not a surgeon.
>
> Thanks for the advice.
>
> I'd also be very interested in hearing from folks who have gone through
> with the amputation. It just seems like such a horrible thing to do to
> him -- I'm not sure I can bring myself to do it if that's what's
> necessary. Can cats really do well on three legs? Can they still run
> (well, maybe not run, but walk) around the house with no problems? Go
> up and down stairs? Jump? Will he be OK with his litterbox downstairs
> and his food upstairs? Will he hate me for the rest of his life? I just
> don't know how big an impact this will have on HIS life -- I know it
> will be hard for me, but maybe it won't be a big deal for him...?
>

I've seen plenty of animals who've had limbs amputated. They do great, as
long as they are not clinically obese! The most recent one I did was a 10
yr old min poodle with a recurrent mast cell tumor down on the hock (ankle),
where there was no way to get good margins. We amputated, and within a
couple of days she was running around like nothing had happened. I had
actually referred that case to an oncologist, simply because it does seem
kind of extreme to amputate a leg for a tumor that's less than an inch in
size. But sometimes you have no choice, and what seems drastic to us isn't
so bad for the animals, and can mean the difference between living another
6mo-1yr or living another 5 yrs. And from personal experience, if it's a
vaccine-related (or I guess now we're supposed to call it "injection-site")
sarcoma, they are nasty and if you try conservative surgery and *don't* get
it all, it will come back much nastier, and will probably spread. Be
aggressive early -- your cat will thank you for it ;-).

Deborah, DVm

News Reader
September 21st 05, 10:36 PM
Thanks for your reply. I've now talked to several people and they all
say pretty much the same thing -- that the cats do very well and go on
about their lives. That makes me feel somewhat better, especially
hearing it from a professional.

But still, I'm having these terrible doubts and I wonder if I'd be
doing this just for me. My cat probably doesn't think about his future
and I don't think he really has hopes and dreams. If I had to guess
what he'd prefer, I'm sure he'd rather go on living [intact] for as
long as he has while still more or less healthy and then before he gets
too sick and starts to feel really bad, someone just puts him into his
box and takes him to the vet and he just goes to sleep. He doesn't know
what's going to happen so there's no reason he'd be afraid or stressed.
I'm sure he'd rather have that than be cured but disabled and have to
live out the rest of his [possibly many] years hopping around on three
feet. In his opinion, someone just took away his leg and sentenced him
to live the rest of his life disabled, rather than just allowing him to
live with four legs for a shorter time and never know the end is
coming. So it really does feel like I'd be doing it for me.

I just wish I could ask him. Well, I can ask him. I wish he could tell
me. Maybe he'd want me to let him go, or maybe he'd want to make me
happy by having him around longer and he'd be willing to go through
this for my sake -- but of course he can't tell me that, even if it
were true.

Or maybe I'm just anthropomorphizing. Maybe he doesn't have an opinion
at all and will just roll with it regardless of what I decide. I wish I
could be as zen-like about this.

Well, I haven't made a decision yet. He's going in for a CT scan next
week. Maybe that will provide some information that will push me toward
a particular option.

Thanks again to everyone -- you've all been so helpful!

cybercat
September 21st 05, 11:18 PM
"News Reader" > wrote in message
oups.com...
> Thanks for your reply. I've now talked to several people and they all
> say pretty much the same thing -- that the cats do very well and go on
> about their lives. That makes me feel somewhat better, especially
> hearing it from a professional.
>
> But still, I'm having these terrible doubts and I wonder if I'd be
> doing this just for me. My cat probably doesn't think about his future
> and I don't think he really has hopes and dreams. If I had to guess
> what he'd prefer, I'm sure he'd rather go on living [intact] for as
> long as he has while still more or less healthy and then before he gets
> too sick and starts to feel really bad, someone just puts him into his
> box and takes him to the vet and he just goes to sleep.

This, rather than years and years of more ear scratching and playing
and good meals and snoozing in the sun? Nahh.

>
> Or maybe I'm just anthropomorphizing. Maybe he doesn't have an opinion
> at all and will just roll with it regardless of what I decide.

Evidence suggests that he would indeed "roll with it," and have years
of pleasant life and give you years more of the pleasure of knowing
him. Sans one leg.

Best wishes with your decision.

News Reader
September 23rd 05, 04:06 PM
I took my cat back to the primary vet's office today for a recheck (to
removal a suture from the biopsy and to look at his teeth as they did a
dental cleaning and had to pull one -- we did both at the same time as
they were putting him under anyway). I saw yet another vet today (I had
to reschedule my appointment and the original vet wasn't in today).
This was probably a good thing as I got yet another perspective.

I talked to this vet about the options and while she is not an
oncologist, she was certainly familiar with this condition and the
possible treatments and she concurred that given my cat's age and the
good chances of removing the entire tumor, she strongly recommended the
amputation. She said that's what she'd do with her own cat. She, like
everyone else I've talked to, also told me that cats do remarkably well
on three legs, especially when the missing leg is a hind leg (cats put
most of their weight on the front legs), and she also pointed out that
cat's don't really have a "sense of self" like we do, so he's not going
to "feel bad" about it. So I'm feeling a little bit better (well, a
little less terrible) about taking this approach.

So I've now talked to three vets, all of whom have both seen the cat's
records and physically examined him, and I got a response online from
another vet. They've all said the same thing. And I know that the vets
I actually saw all trained at different places, but their answers were
very consistent. This vet told me that if I wanted to see another
oncologist to make me more comfortable, I could of course do that, but
she doubted that another oncologist would tell me anything
significantly different. For a tumor of this type and in this location,
she said that amputation is very much the standard treatment. So I sort
of feel like I've gotten several opinions now.

There's still a possibility that the CT scan will indicate that the
tumor has extended into the pelvis. If that is the case, removing the
leg won't help and they'd probably have to do radiation (and of course
there would not be nearly as good a prognosis). But, again, she
stressed that if it has not spread beyond the leg, then there's no
question that the best thing to do is to take the limb.

I also asked about how this happens and she mentioned that studies have
shown that this type of tumor can be associated with the feline
leukemia vaccine, but she wasn't aware of it being associated with the
rabies vaccine, which is what the first vet thought might be the case.
It's also what the oncologist thought might be the case (although she
did mention that the pathology didn't have all the hallmarks of a
vaccine-related tumor). We may never know. But based on the location
(right hind leg), that's what both the original vet and then oncologist
suspected. Apparently the feline leukemia vaccine is given in the left
hind leg, so that wouldn't explain a tumor on the right hind leg (the
vet today said she hadn't seen this type of tumor on the right hind
leg), but I suppose it is possible that at the clinic he went to before
this one, they didn't follow the standard protocols and gave it in a
different location.

So that's the update. The CT scan on Wednesday should tell us more.

Oh, and apparently his suture didn't need to be removed because it was
already gone! I swear it was there a few days ago. I guess he decided
it was time for it to go!

buglady
September 25th 05, 05:51 PM
"News Reader" > wrote in message
oups.com...
But based on the location
> (right hind leg), that's what both the original vet and then oncologist
> suspected. Apparently the feline leukemia vaccine is given in the left
> hind leg,
.......well, supposedly. But all vets do NOT follow the suggestions from
Cornell to separate vaccinations to different limbs. In fact, I do not
think the practice is very wide spread, even though most vets are aware of
it.

.......In any case, hope the cancer is localized and the amputation is
curative.

buglady
take out the dog before replying

PawsForThought
September 25th 05, 09:15 PM
News Reader wrote:
> Thanks -- that's reassuring.
>
> I'm wondering if it is worth getting a second opinion now. I'm not sure
> if there's really a lot of time to do that and I wonder if it will only
> make me start second-guessing myself...
>
> And while I don't care that much, I wonder if prices vary
> significantly.
>
> Did [m]any of you who faced this problem seek out second opinions?

Hi, I'm sorry to hear about your cat. A friend of mine's cat had a leg
amputated and he did just fine. Have you been to the website
www.catshots.com? It's really quite good, lots of good information.

Lauren

See my cats: http://tinyurl.com/76tg8

Rhonda
September 28th 05, 04:36 AM
Good luck with the CT scan tomorrow. Hope it's localized and one surgery
takes care of it.

Rhonda

News Reader wrote:

>
> So that's the update. The CT scan on Wednesday should tell us more.

GoodTimeJake
October 9th 05, 03:28 PM
As suggestion go to Yahoo Groups and check for a Group that handles Feline
Vaccine Related Sarcoma. I'm not sure of the group's name but do a group
search and you should find it. A few years ago I joined a Yahoo Group whose
members had cats with feline lymphoma and the people were great and so
helpful. My vet was great and very knowledgeable but these people live
every day with a cat suffering from cancer so they really understand what
you are going thru.
Another great place to get information is at UC Davis' school of Vet. Med's
web site. Much of their info is geared towards Vets but you can learn a lot
there.
John Love aka CatManDo
"News Reader" > wrote in message
ups.com...
> Hi,
>
> My otherwise healthy 8 year old cat was recently diagnosed with
> vaccine-related fibrosarcoma (the vet believes it was the 3 year rabies
> vaccination).
>
> He has an appointment with the oncologist on Tuesday.
>
> Can anyone give me some advice as to what questions to ask, what things
> I should read up on, what I can expect in terms of treatment and
> prognosis, etc.? Any pointers would be helpful.
>
> Thanks
>