[vacation1]

I have a friend who took her cat to UPenn this week to see if they could biopsy a lump on the cat's tongue. She was aware already from regular vet that the lump was very likely a fatal cancer. The vets in the Medicine? dept (cat had anemia, so they went there to see if that could be brought under control for a biopsy) found that the lump was on the mandible, which is more accessible than the tongue and better news, but then x-rayed the cat's chest and found lesions in her lungs. Based on these - the lump, the anemia and the x-rays - they said they felt that the cat has terminal cancer and less than a couple months.

I'm worried about the situation. I had dealings with UPenn once and left feeling devastated by the outcome but clear and trusting in their diagnosis. No matter how bad the diagnosis, if you trust in the vets who made it, you can move on and focus on what happens now. This time, I feel that the owner and I both find the diagnosis less than convincing because of various issues - the vets she saw weren't very kind, they seemed rushed and less than clear and the office staff made big blunders with paperwork (as in, losing the appointment and then sending the x-rays to the wrong vet). It was just after the hurricane, which closed the hospital for 2 days, so the whole place was probably a little frantic.

I haven't burdened her with my feelings, but she clearly has the same misgivings. She's ready to accept a bad diagnosis, but I believe she needs to do a final step with a vet before it really "satisfies" her, you know? She is going back to her regular, long-time vet, who is very kind, I believe, and I hope that leads to a resolution. I'm just devastated for her and for the cat, who is extremely beautiful and engaging, and who my dog just adores.

And now I'm crying again. Damnit. Any ideas on what she could do? Second opinion? Biopsy? Oncology consult at UPenn? The time I went there, the oncology people were very good and very nice.

[SquishTheBunny]

Im sorry

It sounds like the vets made a very likely correct diagnosis. Metastasis to the chest generally means end stage. Once those nodules show up in the lungs, surgery/chemo etc. is not generally worth persuing.

If the owner wanted to get biopsies to know what type of cancer, than a blood transfusion and stabilization for surgery would likely be needed. The added risk of rupuring a lung during anesthesia due to the mets is also a possibility. The end result would very likely be the same, cancer that has spread.

However, yes....a discussion with the oncologists may be able to explain everything to her in a way where she can make the best educated decision for her cat. Sometimes small needle biospies can be taken which are far less risky than large bore needle biospies (tru-cut) for example. They generally just require sedation and not a full generatl anesthetic. While they dont yield the same diagnostic capabilities than a full thickness biopsy does, it may help put a name to the disease. I always think an onco consult with pre-written questions on her part is a great idea. It will really help her wrap her mind around everything.

Again, Im so sorry