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Operate or let nature take its course?

Posted by Sashi (My Page) on
Sat, May 4, 13 at 20:01

Hi, my 12 year old cat had blood work done that showed possible anemia. They did an x-ray and found a mass on the liver (maybe spleen). The next step is surgery to remove, though they don't know if it can be removed until they look inside. My cat becomes feral when going to the vet, hyperventilates in the car, can't even be removed from the carrier without sedation. My question is this: should I do the surgery or let nature take its course? My hesitation on the surgery is that it will cause weeks of trauma for Sashi, who can't wear a cone or tolerate any kind of treatment, and finds the vet highly aversive. What are the odds that he can live with this mass for some time (he is pain-free, eating, playing) if I chose to do nothing? I want to do what's best for him.

Follow-Up Postings:

RE: Operate or let nature take its course?

I vote for nature. I would leave well enough alone if it was my pet in the same circumstance.

RE: Operate or let nature take its course?

I think you ask a really good question. It seems that is the right decision for your cat. You recognize how important quality of life is.

I had a similar situation with an old cat. They saw a mass and wanted to go in to confirm that it was cancer. They couldn't do anything about it; just confirm it.

So I cut to the chase. I asked the vet how would we treat it if it were cancer? And he said the general treatment was prednisone. It reduces inflammation and helps the cat maintain its appetite.

So I chose the pred to maintain the quality of James' life. When he lost his appetite I gave him zantac (to decrease stomach acid) and fluids. When that failed and he was obviously heading towards the end, before he was miserable and in pain, I had him humanely euthanized, in my arms, with the last love I could give him.

So Yes, I think you are doing the right thing. Good luck to you and your dear cat.

RE: Operate or let nature take its course?

Thanks. I think I will be letting nature take its course. Who knows, maybe we still have time left together.

RE: Operate or let nature take its course?

Obviously this is the kind of question where there is no right or wrong answer--each person has to decide what they feel is best for them and their pet.

That being said? I'm on the side of NOT putting an older animal (and I generally consider over 10-12 'getting up there') through procedures they can't understand, will frighten them and that may or may not do them any good in the long run.

I'd make the same choice you have. Medication for comfort or to improve their chances, fine but I won't put my older pets through surgery just to keep them around a few extra months (but possibly in pain or discomfort) for MY pleasure? Never.

Hope you have a good bit of time that you can both enjoy yet.

RE: Operate or let nature take its course?

I'm so sorry for your cat's medical problems. I don't know what you mean by "let nature take its course", but it's important that you realize that if your cat has cancer, nature will not provide a gentle or painless death. Nature almost certainly wouldn't have allowed your cat to reach an age when cancer would become an issue. It was your good care for him - your elimination of nature from governing his life - that allowed him to live as long as he has. There is no kindness in nature left for him now. The only kindness will come from you. Not pursuing surgery may very well be the kindest option for him at this point, but you need to be prepared to provide humane euthanasia when he reaches a level of unmanageable pain. Otherwise, "nature" will likely put him through a torturous end.


RE: Operate or let nature take its course?

It may cost a bit more, but an ultrasound will tell you if the mass is in the liver or the spleen, or elsewhere. Splenic masses are usually rather simple to remove, and most cats tolerate abdominal surgery well, even if old, as long as they are in pretty good shape otherwise (anemia is not 'in good shape', but a transfusion could fix that temporarily).

But a mass in the liver is NOT normally a good candidate for removal. A mass elsewhere (usually GI tract) is in the middle... still, rather poor prognosis with those.

AND I certainly would not consider surgery without a chest radiograph, even if an ultrasound shows no other problems than the spleen... as some cancers spread to the lungs and then, again, no point in doing surgery.

I have done a number of splenic surgeries on older animals and sometimes they end up good news (non-malignant mass or sometimes just a torsed spleen- easy to remove and cure)... but generally, the older the patient, the more likely the mass is bad news and surgery may not be curative.

And ditto on the euthanasia comment Laurie made. I have seen too many old pets 'die naturally' and most are horrible deaths.

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