Herman Must Die

If you have been into the office during the past week, you've seen Leon walking around with a clipped spot over his left shoulder.

Leon, back in 2007. 

That's where his little buddy Herman lives.

Leon is my oldest hospital cat.  He's somewhere around 16 now, we guesstimate.  We aren't sure.  He was brought in to be euthanized way, way, WAY back in 95.  So we think he probably was born in 1994.  16 for a cat is about the human equivalent of 80, for a pet his size, if you are wondering. So he's no spring chicken. 

And I am always sort of watching for him to be doing like most old cats-  weight loss, drinking lots of water, urinating too much-  all the signs of old cat problems-  kidney failure, diabetes, hyperthyroidism.  There has been a few times that he didn't want to eat his food, which is highly unusual for him.  But he got over that.

It was probably 2 weeks ago I was petting him and felt something that shouldn't be there. Located under the skin and over his left shoulder blade.  Maybe a little larger than a golf ball, sort of oblong.  It's under the skin but I can pick it up. At this point I don't think it's attached to muscle.  It's close though.  It isn't raised much so it's sort of tough to see in the photo, but you can definitely feel it.

And since Leon is forced to live with a bunch of women- Priscilla, Maybelline, and Sunshine-  he chose to name his little friend Herman.  A little male bonding, you know how it is.

So, what to do, what to do about Herman?
For a 16 year old cat, do you do nothing? Watch for signs of pain, and eventually put him to sleep?
It probably depends on where Herman is,  what Herman is attached to, and how large Herman is.

Some places, some attachment, or with lymph node involvement, removing it isn't possible.
Some tumors are so large that trying to close the wound is a problem.
Then there's the whole issue of a 16 year old cat under anesthesia.

So, I've decided since Leon is fairly healthy otherwise for 16, and since Herman is hopefully not attached to much, to try and laser him off tomorrow at my Cousin's hospital with his fancy "big city" laser.   Herman might be malignant, with a high recurrence rate, something like fibrosarcoma.
Leon might have complications from anesthesia- and it that's the case, then I'll deal with that at the time.   Passing away under anesthesia, doesn't seem much different than being euthanized really.

I am gonna try and minimize the risks by giving him a low dose injectable anesthetic,  top it off with an inhalant anesthetic that doesn't have to be metabolized (it's just breathe in, and breathe out), and maybe use local anesthetic as well.

What's nice about the laser, is that it zaps tissue as it cuts.  No bleeding, no lymphatic drainage that might reseed  tumor cells, and zaps the nerve ending so less pain upon waking up.  

Hopefully, Leon will still be here this time tomorrow.  Without Herman.

If so,  he'll show you his scar and you can tell him how cool it looks.  He'll like that.

Leon is still among the Living.

And Herman is floating in a jar.

Everything was rather uneventful.  Worse case scenario is that Herman is a fibrosarcoma.  They are malignant, and have a very high recurrence rate.   From what we can see, it does look like all of it was removed.   I might send Herman to the pathologist. I might not.

Leon is still rather groggy from anesthesia. I am a little surprised by that, but that is fine if he sleeps a little longer than some.  He does have some pain medication on board.

Here's Herman.

Leon has been teased about his husky self all his life.  And spent a lot of the time snacking on diet cat food.  In this case, that might have been a good thing as the tumor is surrounded by fat, rather than muscle tisse.   Plus, that means extra skin to pull closed over what was removed.

Check out what a "Cool" scar this is going to be . . . .  All the other kitties on the playground are going to be jealous.

We'll see what happens over the next few days, weeks and months.   Thanks to everyone for your good thoughts.   Have a nice weekend.

Anyone seen any Cat Kidneys on Ebay? A functional one, perhaps?

Mr. Leon needs one.  For the past 2 or 3 weeks, I've noticed that Leon wasn't his usual self.  Not eating so well, vomiting up hair balls a little more frequently, pooping off schedule, etc.  He had lost a little weight. He was ADR- Ain't Doin' Right.

Sure, he still gives clients the Stink Eye if they happen to sit in his chair before he gets there.  That is sort of funny, by the way, to see a 17 year old cat sitting in front of a chair, staring at the client,  while everything else is going on in the background.

So I sent off a blood sample to the lab, to check for the usual suspects in old cats- diabetes, hyperthyroidism, kidney problems.   This is what came back.

 

Some things were fine.  His glucose was good. His thyroid levels were okay.   But that BUN and creatinine are too high.  I am sort of surprised that his phophorus is still normal.  Usually it starts creeping up in kidney failure.   

I switched his food to K/D, low protein food for kidney patients, and gave him some fluids subcutaneously.  That was Saturday night.  He seemed to feel better on Sunday morning.  Ate his K/D canned food.  Gave him more fluids last night.  He had to pee in a cup this morning.  (Totally true- he was using his litter box about lunch time, and here comes this little cup from the side. . . )   Specific gravity of urine, which is a measure of how concentrated the urine is,  was 1.008.   Ideally, with normal functioning kidney you expect to see 1.030- 1.040 or higher.  1.008 means not much happening with those kidneys.  

You can lose 2/3 of your kidney function and still concentrate urine normally.  You won't see BUN and creatinine start to go up until you've lost about 3/4 of your kidney function.  Just so you know in case you ever need those little facts in the Trivia Challenge at Blind Pig Tavern on Baldwin Street.  You could win some bucks.  

It was a year ago that Leon grew Herman. and had him removed.  Y'all remember Herman. He lives in a jar.  In case you don't, here's a link to all things Herman.  And if Herman had been anywhere else at the time,  like in the oral cavity, or under a leg involving blood vessels, or a lymph node, I wouldn't have been able to remove him.  And would have had to put Leon to sleep.  So in that one respect, Leon has been living this past year on borrowed time.

Leon has been here from almost the beginning.  He was brought in to be euthanized back in 1995. We think he's a 1994 Model.  We weren't exactly looking for another hospital cat at the time, but no one wanted him.  (This was before Petfinder.  almost before the internet, actually) .  So I kept him.    He's like an institution of Granite Hills Animal Care.   The Colonel Sanders of GHAC.   

I think he's feeling a little better this week than last week, and his kidney values might stabilize on the food and occasional fluids. And they might not.  So I'm watching him closely to determine when it's time to send him to Cat Heaven. Not too early and not too late.

I'll have to put a plaque on his chair.  "Sit here at your own risk of being haunted by a Grey Tabby Ghost.  Giving you the stink eye."

Happy Friday Everyone

It's a good thing Leon has connections.  And connections with access to anesthetic drugs, at that.

It has been 2 weeks today since Leon had his surgery.   To remove Herman.  I intentionally left his sutures in for 2 weeks.  Often times with young dogs and cats, sutures can come out in 7 days.  But I left Leon's in for 14 days.

And everything was perfect when they were removed. Well, for about 15 minutes.  And then this happened.   I'll link it, rather than post it, in case wound photos make anyone squeamish.
If you enjoyed biology class, this photo isn't a big deal.  Looks sort of like chicken. ;)

Here's what it looked like after I anesthetized him again, and sutured it closed.  About the same as 2 weeks ago.

So, these are staying in for at LEAST 2 weeks, and I might remove only 1 per day at that time.


In better news, Beethoven, an 8 week old Saint Bernard puppy, came in this afternoon for his puppy vaccination.  Well,  a vaccination, a tummy rub,  a treat, and a nap. 

 Enjoy your weekend.