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Ask a vet: My cat has cancer

I am so upset. My 11-year-old cat has cancer in his mouth and the vet says there is nothing that can be done. Surely there is an operation or some other treatment?

Roger, Belfast

I am afraid your vet may well be right. Cats get a small range of oral tumours, but they are generally all highly aggressive and malignant. The commonest (a squamous cell carcinoma) can be cured if detected early enough, and if there is a rapidly performed radical osteotomy performed. By this, I mean that if the mass and the associated bone and teeth can be removed, and clean margins attained, then it is possible that disease can be arrested.

Unfortunately, disease is often very advanced by the time it is detected, and there can be very significant bony invasion and destruction. Teeth can be loosened by the tumour, and in my experience that adds to any pain being experienced. Radiotherapy (which isn’t available this side of the Irish Sea) may be helpful in controlling oral pain, but often just isn’t yet a practical option for us in NI.

You need have a careful discussion with your vet, especially if there is any possibility of a surgical intervention, because time is critical — success depends on very early treatment. If it is the case that no surgery can be done, then the full range of palliative options should be discussed. Removing loosened teeth and de-bulking the mass itself can help, and we now have access to some really effective painkillers for cats. Some of these painkillers can even be effective without having to be swallowed, simply being absorbed across the mucous membranes, so are a practical option for those cats who simply won’t be pilled.

Owners can learn to inject their cats, too, and if we can keep them comfy and eating reasonably well, then we are doing our job adequately, and there is no need to part with them too soon.

Sadly, it will come to a quality of life decision at some point. Depending on the tumour type, the end point is either local pain in the mouth which can’t be controlled, or perhaps distant disease (in lungs, liver or brain) where the metastases end up. I wish you and he well for the next few weeks: correct management of any discomfort is vital.

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