Mast Cell Tumor in Feline & Pushok's story
We understand you are going through a LOT so I will keep this concise and factual. Take action ASAP as MCT (Mast Cell Tumor) does not waste a second.
This started with an itch around March 25th, 2020. For weeks we thought it was a skin issue and kept treating it as so. I knew vets are quite expensive so I got Pushok pet insurance to cover his vet bills, but due to their policy of not covering pre-existing conditions (in this case we checked him out at the vet's a few weeks prior and the doctor put it down as a skin problem, so the later visits were not covered), I cancelled it within a month. He was prescribed Entederm and Zymox spray for topical use, and Prednisolone for oral intake.
We saw that his condition was not getting any better but rather he was covered with little bumps all over his body within a few days. After a few visits, our primary vet noticed that the bald bump on his inner thigh was increasing in size and was looking irritated (more red and puffy rather than pink and flat as it has been for years). Our doctor decided to perform a fine needle aspiration procedure on June 27th, 2020 & this is when we got a whiff of it possibly being cancer.
Our primary vet suggested a few hospitals specialized in oncology such as BluePearl, VERG and another which I do not recall but after checking out their reviews, we decided to do our own search. This is when we discovered Dr. Hunley working at Gold Coast Center for Veterinary Care located in Long Island, NY. You can find his biography here. He caught our eye with his reason as to why he became a vet oncologist, and we called the place right away.
We were able to get an appointment with him within a few weeks and made our first visit on July 16th, 2020. This was the day we confirmed that Pushok had Mast Cell Tumor. You can find the notes from his first visit here. We went ahead with the first chemotherapy option called Chlorambucil (Leukeran) which was given daily. It was the least aggressive as we considered Pushok's wellbeing through it and the possibility of it helping without doing too much damage.
August 1st, 2020 we went to our primary vet for blood work to check if everything was fine to go ahead with the chemo.
A month later (August 16th, 2020) we came back in for a check up to see how Chlorambucil has been working for Pushok. You can find the notes for that visit here. Although he had no serious symptoms, it has not improved Pushok's condition as well as we thought it would so we went for the next option which was CCNU. It is given once a month so it is a bit more aggressive and we expected to have more bad symptoms such as vomiting and diarrhea.
The next visit on September 18th, 2020 showed a low white blood cell count so we had to take a two week break to make sure he was ready to continue the treatment. Notes are here. During this time we was only given prednisolone and gabapentin (just before visits) since he did NOT like anyone touching him too much and he was super anxious during the car ride.
A few weeks later on October 6th, 2020 we came back to recheck the blood work. He was ready to try something else - in this case, Palladia. He was itchier and his nodules kept popping in and out all over his body so at least to keep him comfortable Dr. Hunley suggested antihistamines such as Hydroxyzine, Claritin or Benadryl (not all at the same time, just to see which one had the best affect).
Dr. Hunley knew that we were coming from Brooklyn and did not have a car of our own so we were renting with ZipCar which would cost wound $75-100 each visit on top of the visits themselves so he suggested an appointment with a tech to save on the cost of the visit.
Missing notes from visit on November 3rd, 2020.
On December 1st, 2020 we found out that Pushok has gained a bit of weight since my sister has been treating him super good when it came to his diet. We went ahead with the treatment giving Palladia as it seemed to be keeping MCT under control. You can find the notes from that visit here.
Visit on January 6th, 2021 showed progression in his nodules. They were not just everywhere, but bigger and sometimes even erupted/bloody and with scabs. Pushok has always been an over-groomer but these things were super itchy and he kept making himself bleed to the point where we had to get him a onesie and from time to time put on a cone. We decided to increase the Palladia dose from 10mg to 15mg in hopes that it will counteract the MCT's progression. You can find the notes here.
In between this and the next visit on February 23rd, we have ordered Masivet from the UK and have been administering it every other day. It seemed to have been working until Pushok started vomiting and having uncontrollable urination on February 18th/19th. We thought it was a side affect of Masivet so we discontinued to give it to Pushok until our visit on 02/23/2021 with Dr. Hunley. After this started he ate only one or two times and since then refused to eat or drink.
At this point he would refuse any of his favorite things and would just hover over water without actually drinking it.
In fear that he may not be getting his fluids we brought him to Kings Bay Vet on February 22nd, 2021 to Dr. Moreno who was working that day to give him fluids and check if there was something we could help him with. They did an xray and Dr. Moreno could not tell whether the little tumors that was showing up were external or internal. They gave Pushok subq fluids and sent us home.
On February 23rd during our visit with Dr. Hunley, a technician performed an ultra sound and they discovered that the MCT has moved internally. Here are the notes.
This may have been the reason behind him throwing up but we were not sure as to why he refused to eat or drink. So on February 24th, we went back to Kings Bay Vet to see Dr. Max to get more subq fluids to at least keep Pushok hydrated and comfortable as we were not able to get in as much water into him with syringes. After getting lab results on his blood Dr. Max suspected diabetes which for us, was more positive news than anything else. We thought there was hope to treat this, and possibly a reason for refusing to eat/drink.
Ever since Pushok refused to eat or drink we had to force feed him and even though he was not as energetic as before, he used all his might to fight us off. We bought the most calorie dense foods (mostly kitten food) and even got a few Hill's a/d prescription foods home to try to give to him. More caloric food was just for the sake of not torturing Pushok too much and have less syringes to force feed him with.
On February 25th, Dr. Max called us and he said that Pushok's lab results did not look good and he was to be taken into the ER and get insulin shots and other things that may help his condition. We found Veterinary Emergency Group in Brooklyn and took him there straight away. The doctor on call suggested two options - one to give him subq (Subcutaneous (SQ) fluid) fluids, do more tests to find out if Pushok was diabetic or do aggressive fluid therapy and have him under their care for 24 hours. The lab results did not show that he was diabetic but he was still to have the aggressive fluid therapy even though there was no promise to get him back to normal. We went with the second option despite finding out that it was going to cost $2100.
We picked up Pushok on February 26th. He was very alert comparing to the last few days. On the way home we picked up the bag to administer subq fluids at home. After the ER at VEG Pushok was moving around from room to room, wanted to go outside as per usual so we were super hopeful.
During the week ending in February 28th, we spoke to 5 different vets 5 days in a row, and spent around $3000. All spoke about quality of life but only one understood the fact that we did not want to give up that easily. Dr. Hunley was ready with different plans depending on what we thought was better. We asked him a thousand questions during every visit but that week we spoke almost every day and looked for guidance from him. He was there from the start and praised us for all the work that we have done.
Pushok's full history report from VEG can be found here.
It was mostly my sister, Shake, who endlessly researched what supplements would help Pushok fight the cancer, had a schedule of all the medications that he had to have to have an easy day, and finding the BEST foods that was grain free, carrageenan free and delicious for Pushok. She made special trips to Petco and got everything in bulk, spending at least $150-200 with each visit. So everything that is put together here is mostly thanks to her and the time and efforts she has put in.
Most of the food we stuck to was by Tiki Cat, Soulistic, Wilderness, Weruva and some of the broths by Solid Gold.
Some of the supplements my sister added to Pushok's diet that we think has helped a lot to keep him strong were:
[NuLeaf Pet CBD, LifeGold by PetWellbeing, Probiotic Miracle, Slipery Elm by Wild Harvest, Super Immune by Animal Essentials, Yunnan Baiyao Capsules, Mushroom Immune Gold, Detox Blend by Animal Essentials, Rescue Remedy by Bach, Milk Thistle Powder, Vetenerian's Apawthecary, Dr. Mercola Mushroom Complex]
Most of these things can be found on Amazon and pet websites. Do your research as to what each thing does so you are not mixing items with the same properties in one meal. Please speak to your vet about these and see if they do not counter-interact anything your pet is getting.
All these supplements were incorporated into the daily eating schedule (almost 5-6 times a day) in smaller portions in order to get all the daily intake of supplements. A lot of the stuff can be given for regular cats as well to keep them strong and healthy, but all of the portions/dosage was given according to Pushok's weight and Dr. Hunley suggestions.
I would like to add that your pet may start to reject certain foods once they taste the medicine. My sister hid the pills multiple ways and somehow Pushok would end up spitting it out. Some of the things that helps to mask the taste/smell of pills and supplements were:
On a more personal side...
It is one of those things that you do not think about until you are faced with it. Watching your beloved pet slowly dying hurts more, not just because it is cancer but because you cannot explain to them what is happening and why they are feeling shitty and drowsy, or why their food tastes a little funky (with addition of prednisolone and a ton of other supplements).
On March 2nd, 2021, we have made the decision to let him go, seeing as force feeding was causing more torture than actual good for Pushok. We have been crying for 2 weeks straight. Sleepless nights, change of carpets from accidental urinations, force feeding and constant sleeping on Pushok's behalf has made it hard to have hope even though we pushed to the very end.
He slept on me for a little. It was like holding a baby who was too weak to make a move or a sound. After almost a year of fighting cancer, Pushok was covered with the mast cell nodules all over his body, mostly his face. Despite having bloody scabs on most of his forehead, not being able to fully open his left eye, barely holding up his neck, he looked up at us when we called his name and we saw our most beautiful member of the family and his big green, dreamy eyes.
We went through all 5 stages of grief, on repeat. We asked for help from the universe, we asked Pushok to stay strong while we force feed him, gave him fluids and assist him to the bathroom before he gets better. He lost weight, could not use his back legs and walked a few steps at a time before taking breaks.
It pained us more to watch him suffer than to know that he will not be with us any longer. It is our choice to let him on our time rather than his because watching him "decay" in front of us while we are powerless was the worst feeling in the world. While he is conscious of his surrounding and while he knows we love him, we let him go so his physical body can let his soul rest. Wherever he might be after he left us, I hope he is happy. I hope he sees our guinea pig, Pusik, once again and plays with her like when they were younger. Most of all, I hope he will come back to us, or at least visit.
At the end, we realized that we did not have much time with Pushok and he was getting skinnier by the hour. My once fluffy, beautiful, energetic cat that was roaming in my neighbor's yard, and catching mice and bringing them home was now lethargic, rugged and skinny. We called HomeHeart Vets and requested a home visit. Despite it being during COVID times, Dr. Lori Holland came to our house with her assistant Kelly. Kelly had a very soothing voice and kept petting Pushok as Dr. Lori was administering the shots. We kept talking to him through the whole process. But it only hit me, and it hit me hard, when Dr. Lori put Pushok in her car and drove off.
It has been very empty without Pushok. Who would've thought that a 13 pound cat could take up so much space in our hearts and in our apartment? Our other cat Mowgli who is younger has been acting strange 2 weeks prior to Pushok leaving. She would avoid him, or even hiss as she passed by him. But after he was gone, she was anxious. She kept coming down the stairs to greet us every time someone would come in and look behind us as if expecting Pushok to be there. Even though Dr. Lori let Mowgli smell Pushok before taking him away, she is constantly crying the hallway and doing a lot of the things that Pushok used to do.
I guess it will take time for all of us to get over this. The only thing that is giving me happiness is the fact that I will see him after.