—mimics the signs of a brain tumor, but the symptoms of a
stroke typical y improve over time. Symptoms due to a brain
tumor tend to get progressively worse. An inflammatory disease,
such as encephalitis, can also cause these signs, and
sometimes a spinal tap or test for antibody levels in the blood
(titer) wil be checked for specific diseases.
A general neurological workup may include an MRI—magnetic
resonance imaging—that shows the veterinarian the inside of the
brain to determine if it’s structural y abnormal. “It’s pretty
straightforward now that we have the imaging techniques,” says
Dr. Klopp.
Senior Symptoms
Symptoms of a brain tumor are vague and vary according to what
part of the brain is affected. Symptoms may grow progressively
worse, or very suddenly turn bad. Watch for:
Seizures, by far the most common symptom, which are
typical of the forebrain
Any behavior change, often similar to cognitive dysfunction
symptoms
Head tilt, weakness, circling, or muscle atrophy on one side
of the face, typical of tumors of the brain stem.
Treatment
Owners of pets diagnosed with brain tumors may opt either for
pal iative care—keeping the cat comfortable perhaps with anti-
seizure medication until the end—or treating to get rid of a tumor.
Surgery, radiation therapy, and chemotherapy from the cancer
arsenal may be helpful, alone or in combination. Surgery is
usual y the treatment of choice.
“I don’t see people who aren’t committed,” says Dr. Klopp.
“They say, I just want it out. I want to know it’s not growing in my
cat’s brain.” The nice thing about cat brain tumors is they can be
treated and after surgery they don’t tend to come back.
“Frequently they can be considered curable,” says Dr. Klopp.
“Cats can live for years after having a meningioma.” Because
most patients are already senior citizens, adding two or more
years of quality of life is a significant benefit.
The drawback with surgery is that it can be expensive. “You’re
talking about a pretty big emotional and financial commitment for
the owner,” says Dr. Klopp. While radiation or chemotherapy is
an option, she says she’s not had much luck with chemotherapy
for brain tumors in pets. “It’s not my first choice,” she says, but
she wil offer it as adjunct therapy or if clients can’t afford or don’t
want surgery. “It depends on the client and patient individual y. I’m
not going to offer brain surgery to every single case that has a
brain tumor. The goal is to give them back a happy quality of life,
and if I don’t think I can do safely, I’m not going to offer that.”
It can be difficult to avoid damaging normal tissue with
radiation therapy. Yet an innovative method is now available at
University of Florida’s Evelyn F. and Wil iam L. McKnight Brain
Institute. The system uses a three-dimensional ultrasound
guidance system to pinpoint the location of the tumor, and target
radiation beams precisely, while sparing the surrounding tissue.
With the new technique, pets can be treated in one high-dose
treatment, rather than through repeated sessions over a period of
weeks. Radiation therapy requires anesthetic to keep the pet in
the proper position, so the single treatment session avoids the
repeated doses of anesthesia that is a concern in geriatric cats.
The procedure costs roughly the same as for traditional veterinary
radiation therapy, but a limited number of animals may be eligible
for subsidies or free fol ow-care and imaging.
“So far we’ve done a total of 22 animals, including both cats
and dogs,” says Nola Lester, BVMS, a clinical instructor in
radiology with the University of Florida Col ege of Veterinary
Medicine. “In some cases we’ve seen fantastic results and the
tumor completely disappears. In others, this is not the case.”
Bottom Line
“I’m probably pretty cheap,” says Dr. Klopp, of University of
Il inois. “The majority of the cost is the after care.”
· Most of brain tumor surgeries performed by Dr. Klopp, with
fol ow up care, run about $2,000.
· Traditional veterinary radiation therapy costs approximately
$2,200, thought the amount varies in different parts of the country.
Golden Moments: Fixing Phantom’s Pain
Phantom, a beautiful blue Persian show cat, had just
celebrated his eleventh birthday two years ago when his owner
Judy Miley noticed a problem. “When I showed him in the
American Cat Fanciers Association (ACFA) he was the third
best cat in the nation,” says Judy. “You get real y close to your cat
when you travel with him al the time. He’s just one of the family.”
So when Phantom suffered a seizure, she was concerned.
“My vet real y didn’t know what was causing them, and said just
keep an eye on him.” Medication was an option if the seizures
became frequent, but Phantom only had one more in October—
and the five-month interval between the two episodes didn’t cal
for drugs.
“Then he started acting odd,” says Judy. “He’d give me very
low, deep in his chest meows, tel ing me ‘Mom, help me,’ and he
started hanging his head way down low when he walked, as if he
had a terrible headache.” Yet another set of X-rays of Phantom’s
head stil didn’t reveal any problems. The veterinarian knew
something was wrong but didn’t have the proper equipment to
find out. Judy, who lives in Lafayette, Indiana, told her vet, “I’l do
anything to try and find out what’s wrong with him.” Because no
neurologist was available at the veterinary school at Purdue
University, right across the river, Phantom was referred to
neurologist Dr. Lisa Klopp at the University of Il inois.
In early November, Judy and her husband Fred traveled to the
school for Phantom’s appointment, and Dr. Klopp gave the cat a
ful neurological exam. Dr. Klopp stil found nothing, but she
recognized that Judy and Fred knew Phantom best, and that
something was surely wrong. “She offered to do an MRI on him to
see what we’d find,” says Judy. The test would cost $380.
They left Phantom overnight for the test and drove home.
The next day, Dr. Klopp cal ed that she had the results, and Judy
returned to the clinic, this time with her daughter, Denise, for
moral support. “Denise is an RN, and she loves this cat, too. And
she knows how I feel about my cats.”
The MRI—magnetic resonance imaging—clearly showed
that Phantom had a tumor in his brain. “My daughter and I both
sat there and cried. It was terrible,” says Judy. The tumor was
also producing fluid that encompassed three times the space of
the tumor itself. “It was pressing his brain outward into his skul ,”
says Judy. Phantom’s tumor, shaped like a cone, was located
between the two spheres of his brain. The fluid it produced fil ed
the space between and was splitting the t
wo spheres apart.
Certain kinds of brain tumors have a better prognosis than
others, but the MRI didn’t diagnose what type Phantom had. A
biopsy—analysis of tissue from the tumor—would be required
and that would require surgery. At the same time, as much of the
tumor as possible would be removed. “Dr. Klopp said the surgery
would cost between $2,000 to $3,000.”
The proposed expense rocked Judy, but she was more
concerned about potential surgical risk to Phantom because of
his age. “So we thought hard about it for a short time, but then we
said yes. Do what you need to do. See if you can help him and
give him a chance.”
Phantom stayed overnight, and his surgery was performed the
next day. Unfortunately, the tumor was in a position that made it
impossible to remove. Only enough was taken for the biopsy, but
Dr. Klopp was able to extract al of the fluid and relieve the
pressure on the cat’s brain. “We had to wait for the biopsy tests
to come back,” says Judy. It was good news. “It was a
meningioma. And it was nonmalignant.”
The whole family was relieved at the news. Phantom stayed in
the hospital for only three days and was ready to come home. Dr.
Klopp explained the further treatment options available to
address the tumor. Radiation treatment was suggested as the
best option. It would include anesthesia each time to ensure the
exact same spot was targeted.
The radiation would run $1,300 to $1,500 on top of the surgery.
The estimated final bil , including surgery, radiation, medications
and exams, would be about $5,000. “My husband and I said,
absolutely. Go ahead. Let’s see if we can stop the growth of that
tumor and the production of the fluid.”
Radiation treatments began right after Thanksgiving.
Phantom stayed at the hospital, undergoing 16 sessions of
radiation, one for every day of the week—and came home to be
with Fred and Judy on weekends.
Being away from home was rough on everyone. Phantom
didn’t want to eat when he was at the hospital, and he dropped
from 10 pounds down to 6 ½ pounds during the treatment
regimen. “Dr. Klopp would bring him turkey and ham, feed him
baby food and try to get him to eat,” says Judy.
The final treatment occurred right before Christmas. Before
Phantom went home, Dr. Klopp did a second MRI to check the
status of his tumor. It was the same size, but the treatment had
prevented any return of fluid.
Judy worried that with al of the invasive treatments, the
sweet personality she loved about Phantom might somehow
change. The biggest problem, though, was the food issue.
“Phantom acted like he was absolutely starving, but he forgot
what to do and how to take it into his mouth,” she says. But once
the anesthesia was ful y out of his system, he started eating
again.
That was almost eight months ago. “Now he’s back up to
almost eleven pounds,” says Judy. “He doesn’t hang his head
anymore, and he runs and plays with my other cats. He’s like he
was before anything ever happened.” Phantom’s most recent
MRI, performed at the end of July 2001, showed the tumor in his
brain had shrunk, and only a tiny, insignificant amount of fluid
remained.
At the time of the surgery, Dr. Klopp wouldn’t guess at
Phantom’s prognosis. After his surgery, and the biopsy, she
estimated he’d live at least a year or more—but there was no way
to tel . Now that the radiation treatment has been so successful,
“She’s not putting any time limit on him at al ,” says Judy. “We’re
going to do another MRI in the spring to keep an eye on it.”
Other than the tumor in his brain, which no longer causes him any
problems whatsoever, Phantom’s health is excel ent. “They find
nothing wrong with him,” says Judy. “His treatment was worth
every penny. I’d do it again if I had to, if only to take him out of his
pain.” After al , at 11 years old and counting, Judy says every
single day is a gift.
CANCER
Feline cancers can strike at any age, and the kind that is often
associated with feline leukemia virus (FeLV) and feline
immunodeficiency virus (FIV) tends to strike young to middle-
aged cats. But cancer mostly strikes older cats, and 80 percent
of tumors found in cats are malignant. The Veterinary Cancer
Society says cancer accounts for nearly half of the deaths in cats
over the age of ten.
Cats can develop many of the same types of cancers that
affect people, but some are more common. According to
veterinary oncologist Carolyn J. Henry, DVM of University of
Missouri, the most common sites for feline tumors are 1) lymph
glands, 2) skin and subcutaneous and 3) mammary tissue. The
most common of the skin and subcutaneous tumors, in
descending order of frequency, are basal cel tumors, mast cel
tumors, squamous cel carcinoma, fibrosarcoma, and sebaceous
hyperplasia and adenomas.
“Owners of cancer patients are in a state of shock,” says
Barbara Kitchel , DVM, an oncologist at Michigan State
University. “It’s the C word, the chemotherapy, the horror, the
fright.” The good news is that a number of cancers can be easily
treated, some can be cured, and in al cases, treatment can help
maintain the cat’s quality of life.
Nearly 90 percent of lymph gland cancers are caused by FeLV,
and affect the lymphatic system and blood cel -forming organs
common types, usual y affects the face and head, often due to
overexposure to sunlight. Fibrosarcoma is a malignancy of the
connective tissue of the body, with a wide range of subtypes—
col ectively referred to as soft tissue sarcomas. Vaccine-
associated fibrosarcomas are included in this category. Breast
cancer is also very common in cats, and Siamese are reported to
have twice as much risk as other breeds. Other common old-cat
cancers include digestive tract tumors, oral tumors, and bone
cancer.
Senior Symptoms
Signs of cancer vary from type to type depending on what part of
the body is primarily affected. In general, the Veterinary Cancer
Society lists ten common signs of cancer:
Abnormal swel ing that persists or continues to grow
Sores that do not heal
Weight loss
Loss of appetite
Bleeding or discharge from any body opening
Offensive odor
Difficulty eating or swal owing
Hesitation to exercise or loss of stamina
Persistent lameness or stiffness
Difficulty in breathing, urinating or defecating
The cel s of the body die and are replaced al the time in a
normal process cal ed mitosis, in which a cel divides into two
identical cel s. Sometimes the new cel s mutate for unknown
reasons. Instead of duplicates of the parent cel , abnormal, fast-
growing cancer cel s take the place of healthy one
s and interfere
with normal body functions. A breakdown in the immune system
can al ow tumors to grow either in one isolated place (cal ed
benign) or proliferate throughout the body (malignant).
Occasional y certain families of cats show a predispositions for
cancers, but these show up pretty early in the cat’s life. Cancers
are more likely to develop as a consequence of a lifetime
accumulation of injuries or insults, says Dr. Kitchel . “We’re
seeing the extremely old geriatrics, like the nineteen-year-old
cats that come in with cancer,” she says. “We tend to see more
carcinomas in the elderly, maybe because carcinomas appear
most often in epithelial tissues [such as skin].” Skin, lungs, and
bladder tissues are more likely to be affected by contact with the
outside world, so damage from the sun over a lifetime ultimately
causes old-age cancer.
There’s added concern with geriatric cats. “When you reach
that advanced age, you lose a lot of reserve capacity in a variety
of your organs, like your liver and kidney function,” says Dr.
Kitchel . “We have to be so careful with what we try to give to very
geriatric patients when we try to treat them.”
Encouraging news from researchers at Purdue University
suggests that the “oldest-old” among pets, similarly to very old
humans, seldom develop lethal cancers.
Cats that don’t develop cancer until very old probably have a
better chance of surviving it because of the same extreme good
health that has al owed them to live so long. “Just because they’re
old doesn’t mean they shouldn’t be treated,” says Susan G.
Wynn, DVM, a certified veterinary acupuncturist in Marietta,
Georgia.“If you take, for instance, a twelve-year-old cat with
lymphoma, we’ve had lymphoma cats live another four years or
longer.”
Reducing Risk
Many feline cancers are associated with feline leukemia virus
(FeLV) and feline immunodeficiency virus (FIV). A number of
preventative vaccines are available for FeLV, but it has taken
many years to develop similar protection against feline AIDS.
Dr. Niels Pederson, DVM, an international authority on these
viruses at University of California-Davis, and immunologist Janet
Yamamoto, a professor at University of Florida, first identified FIV