by Kirin
(Evanston IL)

Dear Doctor,

I have an 11-year-old spayed female tortoiseshell with mammary cancer. I discovered it about two years ago when it was about the size of a small pea, and the vet removed it and did a biopsy, discovering the malignancy. I have not been able to afford any other treatment, and my vet also said that eventually the cancer would be fatal anyway.

Since then, Sophie has behaved in a fairly normal way, although she has lost a lot of weight. When she was healthy she weighed slightly over 11 pounds (a good weight for her, according to the vet). Now she weighs 7.2 pounds. She still eats with enthusiasm, and drinks a lot of water. She also seems to want more comforting, asking to be held (she used to enjoy being brushed and petted, but not held). She sometimes is playful, still enjoys being brushed every day (and purrs), and occasionally chases my other cat (the 7-year-old orange tabby who is usually the alpha and is sometimes aggressive towards Sophie). She still greets me at the door, and is as shy and nervous as usual too when anyone comes to the door of my apartment. In other words, she seems to be pretty normal.

The tumor is now about the size of a grape. It doesn't seem to hurt Sophie when I touch it lightly (which I don't do often). However, I am afraid how much she will hurt if/when it bursts...and I don't know whether I will be able to cope with that happening as I am very empathetic and certainly do not want her to be in pain.

Here are my questions: How will Sophie let me know that she is suffering? Can the tumor be reduced in size and can the ulceration be at least delayed if fluid is removed from the tumor? Is that possible? (I am wondering whether the tumor is at all like a cyst.) Is there anything else I can do besides surgery, chemo, or radiation? (I can't afford any of those, as I have been unemployed for more than 15 months.)

Does it make any sense to euthanize her now, before the tumor bursts? I love her a great deal and will miss her terribly, but I don't want her to suffer.

Thanks for your help.

Dear Kirin,

Only you can decide when the time is right to euthanize your dear kitty. I can tell you what my experience has been.

It does not sound like she is in any discomfort. It doesn't sound to me as if now is the time.

Mammary tumors may have small cystic areas contained within the tumor, but are not cysts themselves. Aspirating any fluid contained in the cystic part of the tumor would not really make a difference.

At some point, most mammary tumors will indeed ulcerate (not really rupture), and can become irritated or infected. Your veterinarian may prescribe antibiotics when that time comes.

Most often, that is still not an indication for euthanasia. These tumors can grow to be quite large before your cat's quality of life is decreased.

I personally would base my decision about euthanasia on her appetite, activity level, comfort level, etc. and certainly if she is not eating and appears to be in pain, I wouldn't want her to suffer if she were my cat. However, it doesn't sound like you are at that point.

I wish you and your kitty the very best and hope you can enjoy much more quality time with her.

Kindest Regards,
Dr. Neely