Today, Moush Moush will be feasting on a meal of fresh rats if I can find some in this building. It’s a celebration! She had surgery for myxosarcoma 6 months ago and from her oncology appointment last month, she appears to be cancer-free still and has no signs of metastatic disease. While her oncologist wasn’t doing cartwheels since he prefers to count years, I was doing them in my head.
The median recurrence for feline soft tissue sarcomas is 79 days, or less than 3 months. So, while Moush Moush isn’t in the free and clear, she’s beaten the odds so far. She is still taking Palladia—a newer, targeted cancer drug that works to prevent recurrence and even shrink inoperable tumors, but only if the cancer has a specific genetic mutation. This was Moush Moush’s only hope per her oncologist.
We don’t know if Moush Moush has the genetic mutation, although I am hoping that reaching this 6-month milestone means that she does. She had this same cancer 4 years ago, which resulted in an amputation of her front leg that should have been curative, especially after so many years, so if this were a recurrence of the original cancer due to the tumor being where her arm once was, it would be even more aggressive. Soft tissue sarcomas are very aggressive in general and have a poor prognosis if on the body due to the inability to get clean, wide margins—unless Palladia works, of course.
When Moush Moush’s regular veterinarian did a biopsy of the tumor I found this summer and called with the results, there wasn’t any hope and I literally fell to pieces as she’s all I have left, but her doctor told me to call her former oncologist just in case there were any new treatments. I had little hope, but thanks to the fabulous, specialty surgeon, her oncologist, and hopefully Palladia—a magic bullet of sorts—I still have Moush Moush by my side.
We have an even closer relationship as I know how close I was to losing her and I can only hope that despite many more follow-ups and tests, this is truly behind us forever.
Perhaps we got a break, at last.
Update: As of today, July 12, 2014, Moush Moush has been in remission for exactly one year. I hope with all my might that the Palladia continues to work to control the myxosarcoma she developed again a year ago. I wanted to offer hope to my readers who are trying Palladia for their own pet(s). My heart is with you…
Apparently, I will be posting on occasion now. What’s new for someone who sees quitting anything as the biggest failure known to humankind?
Since my short departure from blogging, my cat, Moush Moush, has had surgery at the specialty center here to remove as much of the myxosarcoma that has recurred after nearly 4 years of being cancer-free. I mentioned this in my last post. Her oncologist said “recurrence” at our post-op visit and I was too worried to ask if he’s not suspecting vaccine-associated sarcoma now or not, as I’m not sure which is really worse. Regardless, she had an excellent surgeon again and he was even able to get clean margins from the area excised per the histopathology report, although he couldn’t get the necessary 3 cm margins in all directions and with soft-tissue sarcomas, getting clean or even wide margins is rarely curative. This is what I haven’t figured out and am so frustrated by.
Due to the fact that Moush Moush already had an amputation 4 years ago, which should have been curative at this point, as well as her age (around 12 or 13), her oncologist and and I vetoed surgery that would have removed part of her body wall, including her ribs, to obtain wider margins underneath the cancer—again not usually curative—and we are passing on radiation, as it would involve a full month of M-F treatments, is again not normally curative, and is hard on pets. I won’t even mention the cost of radiation, as I’ve already blown a good chunk of my savings thus far, not that I care when it comes to Moush Moush.
So, we settled on surgery to get as much of the cancer and clean margins as possible and then planned to start a new, cancer drug called Palladia that falls into the class of targeted therapy. It is off-labeled in cats so no studies are available at this time. In layperson’s terms, it works to kill the cancer cells by cutting off the blood supply and at the gene level it cuts the rungs of the DNA, per my blogging friend who is a biologist. Chemistry is all Greek to me! Unfortunately, it only works if the cancer has a certain gene, or was it genes, involved. However, if it works, it controls the cancer and what more could you ask for as Palladia has a rather safe profile, although Moush Moush will need blood work every 2 weeks for a month to make sure her kidneys and liver are okay.
Due to Moush Moush’s small size, the Palladia had to be compounded and I was told I could get a liquid with a flavor. Goodie. Oh, I should mention I am giving this to her every other day all by myself, which seemed so great with my driving issues. It arrived this Friday on ice packs at my request and the fear factor started when I saw the bag it came in—see photo above. I did know I needed to wear disposable gloves when dealing with Palladia, even if in a pill form, and her oncologist’s assistant really stressed all of this to me due to my own health issues, which I disclosed this time around. I decided midnight would be our set time and sat and stared at that bag with my crappy vision the rest of the day.
I started to get this sick feeling in my stomach that wouldn’t go away. Everything I’ve read says this is not traditional chemotherapy, but her oncologist calls it chemo. Even then, pets do very well with chemo and the low doses they are given. It wasn’t helping as I counted down the time until I had to give Moush Moush this drug that has to work, but can also cause things like kidney failure. What had I gotten myself into?
Midnight was drawing near, so I had a talk with my late grandfather, who I often talk to when things get bad. I’m aware this is probably not normal and don’t really care. My grandfather was tough as nails and also a stomach cancer survivor, which led to peritonitis after his GI tract ruptured post-op and a 3-month stay in the ICU on the brink of death 2 years before I was born. Who else to talk to? I like to think he looks over Moush Moush, not that I ever saw him around a cat in my life. Being the strange person I am, I lit the Shabbat candles for the first time in years, but I only have one scented candle in glass so I hoped that would suffice. After all my bizarre rituals were done, I got my gloves on and got down to business.
I carefully got the lid off the bottle of the compounded Palladia after shaking it. Oh, did it stink. Was it the artificial chicken flavor or the drug? I saw there was a plastic plug in the opening, which I presume was to prevent it from exploding in flight. Well, it took 10 minutes to get that off with my stiff fingers and I was so afraid it would pop off and the liquid would fly all over me, but I went very slowly at the end and no spillage. I noticed the liquid was mustard colored, almost like a bouillon cube. Again, was this the flavoring or the drug? It’s not like Moush Moush equates mustard coloring to chicken, which she’s allergic to, hence my need to make sure this flavoring was artificial.
From there, I struggled to draw the thick liquid into the teeny syringe with the goal of not knocking over the bottle, which I’m known to do. She takes 1 mL of the liquid and that was the entire syringe so I was freaking out that she’d never swallow all of this nasty stuff. Per the assistant’s instructions, I grabbed some paper towels to hold under her in case she spit it out and headed over to her temporary bed under the table like the most evil person on earth.
I swear my hands were trembling at that point. The clock had struck midnight and how would Moush Moush react? Would the Palladia work? I won’t ever know unless it doesn’t, which is doing wonders for my nerves. Would she get the GI side-effects I have to watch out for and then I’d have a toxic mess to clean up and if she did, could it just land on all the towels on the floor? Oy vey.
I knelt down with the syringe and paper towels and held her head up and got the syringe into the side of her alligator mouth and tried to push on the plunger and nothing. The liquid was so thick I had to push really hard to finally get it to come out and then came the awful sounds from Moush Moush—so much for the artificial chicken flavor. It felt like it took 5 minutes to get 1 mL into her mouth, but I did it and her tongue and teeth were bright mustard, like I really gave her some radioactive substance that was glowing.
A drop got on the towel I have on her pillow and the liquid was on my gloves, but what to do with the glowing syringe? I had to rinse it. Now the sink was going to be toxic and my gloves were a mess so I tried my best to lift the faucet’s handle with my forearm. I rinsed off my gloves and wrapped the not-so-clean syringe in Kleenex and threw it in the scary, chemo bag where I’m keeping the bottle of Palladia. I had a plastic, grocery bag ready ahead of time and took my gloves off inside-out and threw those in there with the paper towels and tied it in a knot. It still felt toxic so I double bagged it, washed my hands for 5 minutes, and then took the bag to the garbage down the hall. I came back and washed my hands again, but still hadn’t gotten rid of the fear factor.
Moush Moush was fine all last night and today, not that she’s taken this drug long enough to notice anything I suppose. I now have a massive case of OCD, but if Palladia works, I’ll just add that to the long list of issues to work on with my counselor.
Moush Moush hasn’t played with her rats much in 4 years, but it’s rather odd that she chewed all the fur out on the side of the one on the left ions ago, so at least she has a friend with a similar look.
After 11 months, it’s time to give blogging a rest. I need to take care of my cat who has cancer and myself—as I finally came to terms with the fact that I had turned blogging into a full-time job, which is typical of a workaholic who can no longer work. I stared this blog right before my cross-linking surgery (CXL) for keratoconus with the aid of my brother from afar and only had the intention of posting on my experience with CXL, as I couldn’t find any patient-perspective information online. Then, I researched a co-morbid condition, saw a geneticist, and was correctly diagnosed with Ehlers-Danlos syndrome after 11 years of illness, and thus the blog continued.
Personally, I don’t find writing posts cathartic or a form of self-expression for the most part like so many other bloggers. I really didn’t even know much about blogging before my brother created a blog for me. I wrote in my About section nearly a year ago that I am a scholarly writer by nature and a horrible perfectionist, and writing posts seems more like work to me, and I’m on disability due to my inability to work from Ehlers-Danlos syndrome. Blogging has actually made my pain worse, yet I continued to write posts that were so carefully thought-out with over 1,500 word counts. It may sound like a small feat, but for me, it would take a week to put a post together and hours upon hours of writing and editing.
However, what I finally found in my little life of solitude were some great friends on WordPress and they know who they are: the ones who always commented on my posts (and vice versa, of course) and have been there when no one else has since recently posting on my blog that my beloved cat, Moush Moush, has cancer again after 4 years in remission with an excellent prognosis due to an amputation. Moush Moush’s story, which is really our story, can be found in this very long post.
As I can’t find any better way to manage blogging and I refuse to fold my cards due to the positive aspect of having friends on WordPress, I plan to stop posting indefinitely and continue to comment—or chat—with my friends on here. I hope the day will come when I can figure out how to just write a short post and call it a day, but I think I would need a lobotomy for that. I would like to again express my deepest gratitude to my true friends on WordPress, who are really the only friends I have. Living with a debilitating disease and losing a lot of vision has left me stuck in a motel room nearly 24/7, so this is my lifeline and I miss talking with people and sharing information and all that comes with finding people in this world dealing with the same trials and tribulations. It makes me feel less alone and I hope my friends feel the same.
While I have been in constant contact with some, not everyone has had an update on Moush Moush, and I do appreciate everyone who finds my blog through search engines and hope this will be of some help to the cat-owner community, as well.
After seeing Moush Moush’s wonderful oncologist at the specialty center who dealt with her primary cancer—a myxosarcoma deep in her shoulder joint 4 years ago—it is suspected that Moush Moush actually has a type of vaccine-associated sarcoma (VAS) from when she was vaccinated in her scruff in the early 2000s and this created an area predisposed to developing these cancers, akin to a human having sunburns in youth and then developing skin cancer years later. This was a concern 4 years ago, but the shoulder location was atypical. Her oncologist feels this is possibly a new cancer and not a recurrence, even though it is in the area where her arm was, as the chance of recurrence after an amputation with wide, clean margins 4 years out is maybe 1%.
Moush Moush had a CT scan a few days ago which revealed 2 superficial tumors, one which was biopsied a couple weeks ago and one which just popped up. The cancer is superficial and there is no sign of metastatic disease in her lungs or elsewhere. This seems like good news.
However, due to the fact that the cancer is on her body where most of her connective tissue was removed during the amputation, it would be impossible to get the 3 cm margins needed without cutting into her body wall and ribs, which I wouldn’t do and her doctor agreed, but she was scheduled for less invasive surgery as I trust her oncologist’s advice. After the surgery was completed Friday afternoon, the surgeon called and said she did have some muscle left over her ribs after the amputation and he was able to remove some tissue under the cancer, as well as laterally, and he performed a scar revision on her recent biopsy, as that area would also be full of microscopic cancer cells.
Moush Moush did fine in surgery and in recovery and I was able to get her around 24 hours later, which was Saturday. She is 1/4 bald and has a long, arc-sharped incision going from her lower neck near her spinal column clear to the middle of her chest, which is almost a reversal of her amputation scar, which I can’t see. I must say I wasn’t expecting that huge incision, but she is acting fine and is on a strong narcotic for pain, which gives her too much energy for her lounge-y self and then she passes out into a deep sleep, which is best as I’m supposed to limit her activity, which normally isn’t an issue.
We are waiting on the histopathology report to see what the margins show and to get a definitive diagnosis, although any type of soft-tissue sarcoma on the body, not just myxosarcoma, is essentially the same as far as surgery and prognosis. If it is VAS, wide margins aren’t exactly curative, but I am trying to hold on to hope. Looking at that incision, it sure seems like she had radical surgery, but I know she didn’t. Moush Moush will return to the oncologist in 9 days to have her stitches removed and hopefully start a targeted, cancer drug taken at home that was not available until 4 years ago and is now being off-labeled in cats. It will be hit or miss if it works to keep the cancer in check, so I’m having to bet all my money on Palladia, this promising new drug, even if the efficacy rate is less than 50%. There is little information on use in cats, but Palladia is being used on vaccine-associated sarcomas. For basic information on Palladia, click this link.
I have primarily been updating on my friends’ blogs, but if you have a pet affected by cancer, please check back as I will attempt to update this post if I have good news, which may take awhile to determine, and I presume information will be in my comments, along with lots of unrelated chatter.
To end on a positive note, this post only has a 1,199 word count.