46. Breast tumours in an old spayed cat

"Can I get some medicine for my cat?" the man came to Toa Payoh Vets and showed me a handphone picture of his 10-year-old cat with a large growth.

"Your cat appears to have breast tumours," I said. "No drugs can make them disappear. She needs surgery. What cream did you apply onto the tumours? Is she still eating?"

"I applied some antiseptic cream. My cat eats very little for the past 2 weeks," the man showed 1 cm width between his forefinger and thumb of his right hand.

What can be done now? Surgery would be the answer. There was the cost. More important this was a high-risk anaesthetic case as the cat had lost appetite for 2 weeks. Surprisingly, her temperature was normal. She was thin. I informed the owner that the cat could just die on the operating table due to her poor health. The pre-blood test was not done to save veterinary costs.

The following was done for this cat on the day she was admitted.

CONSULTATION. To enhance her survival chances, I injected baytril, anti-fever and anti-spasm drugs in 10 ml dextrose saline SC and had to decide whether to operate 2 hours later or wait till the next day. This was a difficult judgment. I decided to operate 2 hours later as the cat was not eating but her rectal temperature was normal. IV glucose was given first and continued during surgery.

PRE-ANAESTHETIC SEDATION Zoletil 50 @ 0.1 ml IV. The cat shot out a paw wanting to scratch my assistant Mr Saw when he put the Zoletil bottle noisily on the table. Today, Mr Saw seemed to be noisy. The cat had hissed at him before that. This was surprisingly as she did not behave similarly towards me and my second veterinary assistant Mr Goose.

"Maybe you are too noisy," I said. Mr Goose said as he grasped the scruff of the cat's neck and held the hind leg for IV injection of Zoletil. "Cats and rabbits at the preparation room for surgery get nervous when the place is noisy."

(In retrospect as I type this report at 5.46 am on Friday Feb 12, 2010, the cat could be defending herself from being given antiseptic ointment by her owner who had cleaned her breast tumours for some time. Her owner had a dark complexion like Mr Saw. This was one explanation as the cat associated Mr Saw with her owner and knew that she would be applied antiseptic ointment. It must be painful getting this application.)

Mr Goose pressed the medial side of the thigh to bring out a dark blue vein. Zoletil 0.1 ml IV is safe for this 2 kg cat. She was sedated. She had an IV glucose drip in her forearm prior to this sedation.

Gas mask isoflurane anaesthesia after this gave her freedom from pain during surgery. 3 minutes before the end of surgery, the isoflurane gas was cut off. The cat was given oxygen to breathe.

SURGERY
Two things to note:
1. The wound was very large as the tumours were scattered. Ensure sufficient skin to stitch up.
2. Bleeding from the superficial epigastric arteries (cranial around MG1 and MG2 and caudal around MG4 and MG5). Clamp the bleeding points and ligate.
3. Subcutaneous fat stitched to provide less tension for the skin.
4. Skin stitched.
5. Body wrapped. E-collar.

POST-OP CARE
The cat was very weak and slept. I checked her tongue at the end of surgery. It was bright pink as she had been given glucose IV. Glucose by IV drip is necessary for such cases to have a chance of survival under general anaesthetic. Continue IV drip of dextrose saline and Hartmann's solution over the next 24 hours.
Will the cat survive? It is hard to say. Goto: www.toapayohvets.com for updates.

TIPS FOR OLD OWNERS
This is a case where a spayed cat still gets breast tumours. Spaying reduces the incidence and most spayed cats and dogs don't get breast tumours.
It is a matter of probability rather than a guarantee that spaying will prevent mammary tumours in old age.

It is best to get breast tumours in cats and dogs removed by your vet when they are much smaller. It will be less costly. I can give a high discount for some cases with financial distress. I can't do it for every case as it is costly for the surgery and post-operation complications and nursing for the next 7-14 days. Big tumours of the mammary glands get ulcerated and infected. The cat would then stop eating and die a painful death.