My 14-year-old cat has a large, rapidly-growing tumour in her abdomen - scared she is near the end - advice and personal stories appreciated

[MyLittleFluffball]

Hello,

My beautiful and beloved 14-year-old cat, who has been with me for over half my life, went to the vet on Friday because she was a bit lethargic and less interested in her food over the past 3 weeks or so. She had also lost around 1-1.5 kilograms. We just hoped it was her getting old, but were worried. The vet found a huge tumour in her torso - between the ribs, over the whole abdomen, probably the same size or larger than my hand just in terms of the surface it covers. You can feel it through her skin - a very hard, unmoving lump. I have no idea how I did not notice this, but my sister first felt it a week ago but did not think into it because my cat had lost some weight and so assumed it was a reflection of her being "skinnier". Even if I had noticed it I don't think I would have made the connection that it could be a tumour, it feels flat and very hard and not like a sticking-out lump because it is so internal, I guess. Anyway, the vet was very sombre and essentially said that this was very likely a cancer, he didn't know how long she had, but we had some "big questions to think about". He did not recommend chemotherapy, radiation or surgery and discussed why. My cat has been to the vet a few times recently, including to get her teeth cleaned, and this was never picked up/ felt, despite her having hyperthyroidism and feline asthma and being palpated at each vet visit. So I imagine it's a tumour that grew very rapidly, though I cannot know.

I absolutely adore my cat and don't want her to suffer needlessly. To me that is so much more important than any selfish desire of my own to keep her with me for as long as I can. My problem is that I don't know "when" to know that it is time to "let her go" - have a vet do a house call and put her to sleep (I won't mince words). She is terrified of the vet - will meow relentlessly during the drive, begin to pant due to her asthma and stress, and usually evacuate her bladder or bowel during the car trip. I don't want to put her through anything unnecessarily distressing.

The problem is that she seems to be deteriorating quite quickly, but at the same time is not showing any "classic" signs of extreme discomfort (though I know she is in discomfort as the tumour is large and pressing against her ribs/ internal organs, no doubt - she is spending all her time lying down and repositioning herself, and you can see the tumour sticking out a bit like she has a bloated tummy even though she is skinny elsewhere). She will still eat, though her appetite has waned today; she is not vocally expressing discomfort, incontinent, vomiting, or experiencing diarrhoea. At the moment she is hiding underneath a table in the living room, lying down/ trying to sleep and breathing quite quickly/ her heart pumping quite fast. I think that if the tumour grew rapidly, it is likely still growing rapidly and causing her increasing discomfort. Earlier today she purred when I approached her/ patted her but this afternoon that has stopped, she tries to move away or just tolerates me. We have a very close bond and she adores me so this behaviour is unusual.

I just want to know from fellow cat-lovers who have been through this kind of thing: What cues would you take to know that it is time to say goodbye to your beloved cat? What level of illness/ distress/ symptoms would you look for to know? Where do you draw the line? Do you have any idea how long she might have left to live, based on any similar experiences? Do you have any regrets about how you dealt with similar situations with your own cat, that I can try to avoid? I am considering taking her to the local university vet clinic, the best in our region, on Monday, as it is only emergencies on the weekend (though they said they'd take her - my rationale for not doing so is it will stress her out, they may want to keep her overnight there which will distress her and she may die in that environment, and there are no specialists there on the weekends - plus I only saw a vet yesterday to learn what was wrong with her and seeing a vet again will not really accomplish anything as far as I know). My aim with that is to get a second opinion and maybe a scan to see where the tumour is - is it isolated or separate/ potentially treatable. Do you think this is a good idea for my cat, the likely "wasted" money doesn't bother me but the distress of the car ride for her does, it is 30 minutes away.

Thank you. Any advice would be hugely appreciated.

That's what I mean by I doubt anyone will disagree with you, it's what's right for you and your cat - my other cat, there's no way shed be happy with going to the vets every few weeks, it takes her a couple of days to get over going in for her booster. The one that's ill demands food for compensation for going and a bit of a fuss made over her for a minute, but that's about it, lol.

Things like that make a massive difference.

I'm so sorry. With the two cats we've had pts, we knew when it was time. And knew that neither of them would be happy to take tablets or be back and forward to the vets, so we didn't persue treatment after they were diagnosed with kidney cancer.

The vet made it as peaceful as possible, and was very gentle. With both of them, we made the final journey with them wrapped in a towel on my lap so they were cuddled.

It sounds like a good idea to have the vet come to you, OP. From what you're saying it doesn't sound good.

Big hugs to you and your kitty. I'm so sorry.

Hi all, thanks for your messages. We did have a vet make a home visit yesterday - an absolutely lovely woman. She did confirm that my cat has a large abdominal tumour which she is almost certain is cancer (as certain as you can be without doing scans/ biopsies, etc.). The confirmation of the diagnosis was very important to me, and it was wonderful to be able to get this without driving my cat somewhere.

The home-visiting vet said that my cat may have around 1-3 weeks remaining to live, but if my cat were her cat, she would not put her to sleep yet as my cat still enjoys quality of life - my cat darted around when the vet was there, tried to make a dash for it down the stairs, and is still eating and drinking and going to the toilet appropriately and sometimes responds well to affection/ cuddles. The vet said that although we cannot know whether my cat is in discomfort/ feeling unwell or in actual pain, she felt it was more a general feeling of unwellness at this stage. The vet prescribed steroid tablets to reduce inflammation and make my cat more comfortable. My cat is almost impossible to feed tablets but we did manage to give her her first dose yesterday and she has really perked up. It is like we have gone back in time a little - her tumour looks smaller/ less obvious; she is back on the ironing board where she climbed herself, which was her favourite place to rest before she started going downhill; she is still eating and drinking (though her appetite is reduced, it is still there); and she really enjoyed me patting/ hugging her this morning and purred continuously. Also her eyes have lost that "confused/ dark" look today.

So I am going to do what this vet recommended - take things day by day, and I will "know" when it is time to put my cat down - I think when she loses interest in eating altogether or becomes 100% lethargic will be an indicator. I am so happy the steroids seem to have helped my cat, even though I know they are a palliative measure rather than a curative one. I now know of at least 3 vets who are happy to make a home visit to put my cat to sleep when the time comes, so that is reassuring.

And guess what - today is officially my cat's 14-year birthday. (An arbitrary date because we got her from a rescue shelter - the vets believe she is already 14 but today is the day we set as her birthday.) Congratulations to her. :) I am spending the day at home today to be with her and also spent yesterday at home with her. :)

The downside of choosing to take things day by day is that I'm having horrible, anxious half-sleeps at night, where any sound immediately awakens me and I rush to check my cat.

I'm glad she's doing so well, Fluffball, but sad for her prognosis. Jasper (my 14 year old cat who we lost to cancer) was made much more comfortable on the steroids. I know what you mean about the half-sleeps, it's a horrible place to be.

Big hugs to both of you and I hope you have a lovely time with her, and happy birthday!

Good news

and if you are that stage and happen to have metacam in the house - use it all up
we did for old cat in his last few weeks and it gave him that extra zing :
triple dose!!!

Thanks guys. She is doing even better today. The steroids have had a miraculous effect. She actually seemed her old self today - begging for food and eating quite a bit, alert, walking around normally, sitting in the garden now but in a normal pose rather than her sick, "huddled up uncomfortably" pose. Always purring when I give her attention/ affection. The swelling under her chin has massively gone down, the lump is still there but not visible to the naked eye anymore. We are arranging that there is always someone in the house to look after her, but I'm actually planning to spend a large chunk of time at work today as I'm as confident as I can be that she won't die while I'm gone (my mum will be in the house to look after her - my mum is coincidentally sick anyway and took the day off work). If only this were a curative treatment rather than a palliative one!

And amusingly she still HATES taking the tablets, it is a massive ordeal to get them down her throat even though they are responsible for her huge improvement.

I'll look into metacam, I've never heard of it before!

Onemorning, I'm very sorry to hear about your loss of Jasper. :( But it's wonderful that the steroids helped to make his final days more comfortable. I remain baffled why my first vet didn't mention or recommend these... and quite disappointed in him really if he didn't have a valid reason not to do so... like, "she's almost dead anyway, why slow down the process" when in actual fact she is now in a LOT less discomfort and had I euthanised her on Monday before trialling the steroids I would never have known what quality of life she could have reattained/ enjoyed in the subsequent days.

Ah I've looked into metacam. I'd love to use it if it could help her, but the vets both didn't recommend painkillers due to the additional toxins/ substances that would then be in her bloodstream, possibly triggering kidney failure. Maybe we can look into it again if she appears to be in pain... I don't want to trigger kidney failure for her, only a few months ago she had blood tests showing her kidneys were in perfect working order, but who knows what they're like now...

Short update: I took her to the university vet today. Her improvement on the steroids has been amazing and she tolerated the trips to and from the vet well. She had an ultrasound, blood tests, and an "aspiration" of the "mass".

Results: Ultrasound shows that the "mass" involves the spleen, with some abdominal lymph nodes and possibly a small part of the small intestine also affected. She is anaemic, too.

Full blood test results and results of the aspiration will be in on Monday. We are all suspecting it is cancer - most likely lymphosarcoma, but we will see. At least I feel fully content now that I have done everything for my cat without traumatising her/ risking her life in the process - once we got home from the vets she seemed to happily forget all about it and is currently resting under the coffee table again. :)

Her appetite is great too and she currently voluntarily eats the steroid tablet each day, covered in liverwurst.

Still not deluding myself, but so happy that we have had more time to get used to the idea that my cat may die soon... and so happy that she has had some additional wonderful days that I could never have imagined were possible at the beginning of the week.

I'm so glad you are getting this extra time with her.

What Nutella said.

There's a charity that does email counselling for anticipatory bereavement, they were lovely when I needed to talk about Jas:

www.ease-animals.org.uk/frame.html

Hi, MyLittleFluffball, sorry to hear about your cat but good that she's a bit more comfortable.

I had my beautiful old cat pts last winter, she was 18 and I feel I grew up with her. She became poorly, very lethargic and trip to vets found large lump in her kidney area, vet said at her age too much for her to explore and we should assume cancerous, would just go downhill from there but to keep her 'as long as she is comfortable'.

She went downhill very quickly, very weak but still eating, drinking & using litter tray until last week or two. I was very worried at first, kept thinking 'how will I know when its time?' and wondering every day if it would be her last . I decided to just take each day at a time, like you've been advised to and to try not to worry unless she deteriorated further.

As she got more poorly, didn't get up much, very dilute wee, little poo & drinking lots (acute kidney failure) I knew it wouldn't be much longer and on her last morning she couldn't get up so that made the decision

I still miss her, but have great memories of her because she was a fantastic cat.

Thank you all for your support, stories, and the links. MrsVoltar I am very sorry to hear about your cat but am glad that you took the same approach that I am, and that you knew when it was "time".

I thought I would provide an update (hard to believe it has been 2 weeks since I began this thread - and I'm still grieving sometimes like I have only just found out) - the aspiration of the tumour confirmed that my cat has Stage IVB multicentric lymphoma. She is terminally ill. She has the treatment options of chemotherapy (either a tablet every 6 weeks with weekly blood tests, or weekly intravenous chemotherapy with weekly blood tests), or remaining on the steroids. With intravenous chemotherapy she has a predicted 6-9 months to live; with steroids, a predicted 1-2 months. The effects of the chemotherapy tablet are under-researched and unknown. The vet said that her primary obligation is to "do no harm" and with the chemotherapy tablet, she has the greatest risk of doing harm as it is not a properly evidence-based treatment.

After a lot of agonising I have decided to stick to the steroids, which have been working so well for her, and then when she becomes sick again we will have a vet euthanise her at home. I did a "pros and cons" list of both the chemotherapy and the steroids and could only think of 3 pros for chemotherapy:

• She will have more time alive
• We will continue to share our history together for longer (i.e., this chapter of my life, with her in it, will continue for longer)
• I will feel like I have done everything I can to treat her

I felt that all of these "pros" were in essence quite self-centred ones, and there was a huge list of cons for chemotherapy that my cat would not understand like a human could (e.g., "Yes I'm vomiting and have diarrhoea and need to go to the vet every week, but it's worth it because I have cancer and without this treatment I will die" - she's not capable of this type of thought, for her it would just be "I'm stressed/ in pain/ in discomfort"). The chemotherapy would also require her to stay one whole day at the vet's every week for the rest of her life, and it would not save her life, just prolong it, because her cancer is very advanced and she is terminally ill regardless. My decision not to pursue chemotherapy is based very much on the fact that my cat hates tablets, vets, and car drives - for other cats these would not be problems and therefore chemotherapy would be a good option. With the steroids my cat has guaranteed quality of life for the life she has left, and will never have to leave her home again.

Very devastating but I am very gradually coming to terms with it. My cat remains happy and hungry and perky, etc., on the steroids, but her tumour is very palpable and reminds me that her life is limited. :( Any thoughts on my decision not to pursue chemotherapy are welcomed, I question what the right decision is here...

Well as you know, mine hasn't been so well this week, lol

I did chemotherapy because... She was given a time frame of 3-6 months without it and up to 2 years with it ( depending on how well it worked) she'd only need to visit the vets every few weeks for blood tests and they could be done at my vets which is literally 5 minutes drive and that I could stop at any point if the side effects were affecting her quality of life

I wouldn't have put her on it if it involved weekly vets visits either - and like I said, she isn't too stressed (for a cat) by going to the vet.

Obviously I'm at the point just now where she is getting side effects and I'm having to see whether we'll be carrying on or not, I'm still happy enough that she got 6 months of good quality life out of it even if I do end up stopping now

I felt that the possible benefit for my cat outweighed a blood test every few weeks, but with the protocol you'd be doing I would have decided the same as you

I completely understand your decision not to have chemotherapy. My cat would have hated any intervention, I think she was happy to be at home for her last few weeks without any vet trips etc.

On the morning we took her to the vets I held her in an open box, said that if she was to surprise us & have the energy to try & jump out, I'd be delighted and we would take her straight back home, she had always been a 'full of character' cat.

When I would take her to vets for check-ups in the past I would warn the vet that she was the grumpy one & to be careful, vet always said its nice to see 'character'

Enjoy the time you have with your cat.

tabulahrasa I think you made the right decision for your cat. I really hope she's doing better lately.

MrsVoltar thank you, everyone I have spoken to about this has said that they would not do chemotherapy if my cat were their cat (in the context of her personality and prognosis). I hope they mean it and aren't just being nice, but I think they do mean it. Haha your cat certainly does sound like she had "character". :)

Just thought I'd give a little update: On Monday my cat seemed to be gradually deteriorating again, so with the vet's agreement we doubled her daily steroid dose (to 10mg which was actually the dose recommended by the specialist vet, whereas the local vet had initially suggested 5mg a day). I know this is a large dose but expect my cat will only be on it for 1-2 weeks or so before we need to euthanise her. The dose had a dramatic effect again - the day after it was doubled my cat attempted to stalk and pounce on a whipsnake (!!! - she had to be dragged back) and was happy, active and alert again. She is now getting slower again and prefers to spend her time under the coffee table, but still purrs when I hold her/ pat her and still eats well. So the medication has been a godsend, though I know it's a very temporary reprieve, and at least has given me the time to come to terms with my cat's diagnosis and instead of feeling shocked and desperate for a cure I am just hoping my cat will die comfortably in her sleep before I have to make the decision to euthanise her. But I really doubt that will happen so I expect I will have to make the decision to euthanise her within 1-2 weeks, based on her current state. The specialist vet said that when the steroids stop working, my cat's health will decline over a few days, and I hope to "catch" her at the beginning of that decline so that she is put to sleep before she begins to suffer.

Thank you so much for all your messages and support, it has been so, so helpful for me in terms of wrapping my head around this and also knowing what options are out there, and what is best for my cat.

awwh poor kitty :(

:( I know. I hope you don't mean what I've decided to do to treat her, though?

She is loads better thanks, she was horribly jittery and upset for a couple of days after being away overnight - so I've told them that she's not going back there for any more diagnostics, after she settled back down she's been eating well, she's now off all her extra drugs and we're still really none the wiser about what happened, lol.

She's also definitely only in a partial remission, so new tumours are going to form sometime fairly soon - we're carrying on with chemo and steroids, but if she gets an upset stomach again the chemo will stop.

So I'm basically watching for her going downhill or if she does something like completely stopping eating again and that'll be when I have her PTS - I'm not putting her through going back to the vet's school as she was really traumatised by it this time. Hopefully she has months rather than weeks, but not a kick in the arse off your situation anyway.

no just poor kitty been ill i lost my ten year old cat 6w ago :(

ilovesprouts thanks for coming back and clarifying. I am feeling so over-sensitive about what I've decided to do to treat my cat and constantly questioning whether I've made the right decisions so I read into things too much and get upset easily. I'm really sorry you lost your little cat recently.

tabulahrasa I'm really glad Willow is feeling better - I remember you saying she takes a chemotherapy tablet, right, and I remember the university vet telling me that generally cats with lymphoma go into partial remission with that (rather than the weekly intravenous chemotherapy, where full remission is possible but the lymphoma will still eventually come back regardless of the type of chemotherapy). I had to google "not a kick in the arse off..." (I'm in Australia and have never heard of that saying) - you're saying our situations are pretty similar at this point? Very sorry that the situation has changed for you again then, going from feeling like your cat's doing well and there's no end in sight, to feeling like maybe the end is in sight again. It's such a rollercoaster and as some of my friends who've been through similar have said, this "limbo" stage can be more agonising than the actual death, after which you draw a line and can start to move on. Though I guess it doesn't feel that way when you're still just hoping the death is as far away as possible (provided the animal has good quality of life).

Anyway, I spoke to my neighbour yesterday, who is a paediatric nurse in the emergency department of a hospital and sees a lot of death. She unintentionally upset me because she said she saw my cat in her garden two days ago - which made me happy as it means she's still roaming around - but that she "looks unwell and is not the cat she used to be". I then immediately started wondering if she was implying that I really need to put the cat down, and am being cruel in prolonging her life.

But we talked and she said she didn't think it was my cat's time to be put down at all - she's not in pain, still enjoys affection and food. She said that dying is a natural process like any stage of life, and if my cat is not in pain there is no gain in putting her down prematurely unless I can't cope emotionally. She said that all humans go through this life stage but sadly don't have the choice of escaping once they begin to suffer. She also said that with lymphoma, the deterioration process is more about getting slower, more tired, and anaemic, rather than it being a painful cancer (of which there are many) - though she said the tumours associated with lymphoma can cause problems. She said that I should use this time to enjoy my cat and come to terms with her imminent death, and said that in the emergency department of the hospital people often don't have that opportunity before their loved one dies, sometimes of awful and tragic and totally unexpected circumstances, so I was lucky to have this time. She doesn't even like cats so it was very nice of her to talk to me and I found her words very reassuring. I hope others who are going through similar on here might also find my neighbour's words reassuring.

Sadly we are 99% likely to euthanise her tomorrow - I have booked the home visit.

Her hind legs and feet have become bloated over the past few days and she has difficulty walking more than 3 steps without sitting down; there is fluid/ bloating accumulating in her tummy; she can't reach her hind legs/ bottom to clean herself because of the bulge of the tumour and accumulated fluid; and she struggles to find a comfortable position to settle into. She is showing less affection towards me, though still eventually purrs when I pat her and shows no sign that I or anything else is hurting her.

The positives are that she is still eating and drinking well (though her appetite has waned again), and she is still going to the toilet well. She is not showing any "classic" signs of pain. However the fluid accumulation in particular is negatively affecting her quality of life as she can no longer walk properly, and like others have said, you do "just know" when it is time, because you love your pet so much and don't want them to go through unnecessary suffering. It is a no-brainer once you feel their quality of life is significantly affected. It's not like things are going to improve for her. Sadly I can't book the appointment today as it is an immediate family member's birthday and I don't want to spoil it for them.

Thank you all for your support in this thread, it has all been devastating but at least having some more people to talk to about it has helped me vaguely come to terms with this. xxx

Oh and it is late afternoon 10th November here, and the appointment is booked for tomorrow morning, so I hope all is OK for her tonight.

I'm sorry, I hope everything goes as well as it can

Thank you, I hope so too. It is a shock how quickly she has deteriorated but I guess Joolyjoolyjoo was right - she coped and coped and now suddenly she isn't. And everyone has also been right in that I know it is time for her to be put to sleep. Very sad today. :(