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Thursday, December 6, 2012

Chewy's 15mins Eosinophilic Plaque Removal Surgery

Mom didn't blog about an incident which happened on June 2012. Chewy jumped off our kitchen window and Mom only found out like maybe less than an hour later. They ran down searching for her frantically & finally saw 2 guys pointing into the lift with great amusement. Mom dashed in and found Chewy sitting all wrapped up kitty-loaf style (like a hen laying eggs) in the lift!

Smart Chewy! Must have been sitting in there waiting for Mom to get her. Mom always brings her out via the lift so I think she knows that's the way home. Only thing is she can't press the buttons! Haha. God knows how many times she's been up and down the flat with all the neighbors!

Anyways, right after that incident, Mom felt a very small internal soft and movable lump on her mid-back near the spine. There was no visible redness, itch or balding on the outside at all. One would have to molest the animal very thoroughly to feel it. So yea if you haven't been doing this at all, pls do it to feel for any tiny lumps.

Mom thought it was fatty tissue deposit and left it. And it did reduce in size ALOT till it was so tiny in the end since it was already small to begin with. But at around end Oct, the lump sorta ''split'' and it felt like two lumps. So Mom decided to bring her to the vet in case it was the scary cancer.

Now this is gonna be a super long wordy story... so bear with it and read it if you're interested in the drama.

The first vet (let's call the vet Cruella) initially couldn't feel the lump too till Mom told it (Mom doesn't want to reveal the gender of Cruella so let's just use the word ''it'') to feel more thoroughly for it. And after that Cruella did a fine needle aspirate (which is to use the needle and extract some cells from the abscess to look for cancer cells), of which Chewy was super cooperative. It looked under the microscope and then told Mom that it saw cancer cells. Even showed Mom the cells on screen. It then suggested it's most likely sarcoma cancer. Mom then said that Chewy has never been vaccinated before so how could she have contracted sarcoma cancer at such a young age. Vet Cruella then said that jabs during spay could also cause it.

So Cruella suggested a surgery to not only remove the abscess, but also the MUSCLES surrounding it to ensure the cancer cells are removed too. Next step would be to send the mass overseas for a hystopathology report to determine the exact type of cancer, grade and whether all cancer cells has been eliminated. If there's still cancer cells, then either open Chewy up again to remove MORE muscles or chemotherapy. Muscles will never regrow so Chewy would be left with a permanent ''dent'' on her body. It assured Mom that this wouldn't affect Chewy's movement at all.

Overall cost was estimated to be around nearly SGD1.8k. Hysto report was quoted as SGD700+ (no discount because vet Cruella says this is based on the charges overseas), surgery SGD500+, 1 day hospitalization SGD100+ and other misc. cost.

Mom arranged for surgery to be on a Monday because she trusted vet Cruella. Cut the long story shorter, Mom's friend rei-ki-ed Chewy and found her to be perfectly healthy and fine. Mom also spoke to Chewy and all Chewy said was not to worry about her and that she'll be fine. Mom was so depressed because on one hand she's thinking the vet wouldn't lie to her about such things and on the other hand she can't help but wonder why Chewy was so calm and cool about what was gonna happen to her!

So with help from more friends, she decided to seek a 2nd opinion from another vet (let's call this vet Lucky. Yes they're characters from 101 Dalmations if you haven't guess it). When Lucky first saw us at the clinic (Mom brought all of us along), he only wanted to see Lauryn first rather than Chewy. Ok this is another story about Lauryn which Mom will blog later on cuz its another super long story. Point is, vet Lucky is the kindest vet Mom has ever seen. He saw Lauryn for free and gave Mom some advices about her.

Ok anyways, vet Lucky felt her lump and said its nothing to worry about and most definitely NOT cancer because its so soft, small and movable. Cancer lumps would be hard and definitely not movable at all. Much less sarcoma cancer since she's NEVER been vaccinated before and far too young to contract it.

He then said either leave it or he could remove it within 15 minutes with a very very low sedation (since its such a minor surgery and she'd be awake immediately once he's done) and I could bring her home immediately once he's done with it. Mom also insisted on a CBC (complete blood count) and FIV test for Chewy.

And so we waited at the clinic while Chewy was brought into the surgery room. We could hear her MEOWING like mad inside haha. The nurse then carried her out cradled in her arms like a baby haha! Mom asked if she scratched her and she said a lil' bit but still manageable. Chewy was so cute in her arms! Mom forgot to snap a pix.

Anyways after about 30-40mins, Chewy was out of surgery room and jumping around already! (check out the videos below). The abscess was removed and it looked like chicken fats! Vet Lucky said there's no need to send for hysto in his opinion because it really shldn't be cancer at all from his experience. But just so that Mom could have peace of mind, he told her to send it for a local hysto instead of overseas (Canada) which would cost SGD200+ compared to SGD$100+ for a local one. Note the above the first vet Cruella quote SGD700+ for overseas hysto & insisted NO discount because that's their charges over at US!

Vet Lucky said the abscess could have resulted from her fall... trauma to her injured area and forming as abscess. So sometimes the abscess would disappear on its own depending on the body's immunity to fight it or we could just leave it for it to disappear slowly on its own.

Ok finally we'll let the pictures do the talking. We spent SGD700+ at Vet Lucky's instead of nearly SGD1.8k at Vet Cruella's not to mention all the unnecessary pain and permanent cosmetic issue Chewy would have faced there.

Pls also do not ask Mom which vets they are. Especially Vet Cruella because we don't wanna invite unnecessary trouble.



 


07 Nov. the removed abscess






my vainpot! still pretty lah... didn't do anything to your face





spent $714 instead of $1.8k!












































07 Nov

10 Nov. Day 3
12 Nov. Day 5

14 Nov. Day 7

16 Nov. Day 9 (De-stitching day!)

de-stitched















glad to be off the cone!
21 Nov. Day 14















21 Nov. Hystopathology Report
















28 Nov. Day 21

















Yes i'm sexy & i know it!






















Good luck to those who're with Vet Cruella. Mom shudders to think what his vet is up to. Imagine what Vet Cruella would do just to prove that Chewy had cancer. ie sending another animal's cancerous mass for the hysto instead of Chewy's?? Putting a healthy animal through so much unnecessary pain & torment just to earn money! Mom thought back about all the consultations with vet Cruella and things began to make sense.

Consults were mostly pretty rushed with the staff knocking on door informing Vet Cruella that the next client is here or asking for advices or updating about the boarding animals' situation. All these were so distracting and as tho' hinting to Mom to cut short the consultation because the next client is here. So unprofessional! Alota other instances too but we shall not go too much into it. Mom just hopes Vet Cruella gets his/her just deserts one day.

No wonder Vet Cruella says its an EASY surgery for him/her! Because it's not even cancer at all! All vet Cruella gotta do was to remove the mass and the muscles! To cheat Mom! How can a vet be so cruel and unethical! Vet Cruella should go back to med school to re-learn what ethics and conscience is and recall the oath they had to take when they graduated! Mom felt SO betrayed.

Sigh... anyways the hysto report says it should be due to a flea/mozzie bite and that Chewy happens to be hypersentive to it. Recalling back, Mom brought home many stray cats at that time for TNR (Trap N Release) sterilization. Probably a flea or two got unto Chewy and bit her. But she's flea-free as we've checked her umpteen times. So that's prolly what happened.

So we're all really glad that the drama is over and we hope Vet Cruella just freaking runs outta business.

Click here to read about Eosinophilic Plaque (or just read below). Mom has never heard of it before until this. There was also NO cancer cells visible as what Vet Cruella said he/she saw. DAMN that Vet Cruella!! Mommy wishes death upon him/her for wanting to destroy Chewy and God knows how many other animals have been tormented under his/her hands! Lying to patients that they've cancer and removing their muscles. WTF!

Eosinophilic Granuloma Complex in Cats

Eosinophilic granuloma complex in cats often is a confusing term for three distinct syndromes that cause inflammation of the skin:

Eosinophilic plaque - circumscribed, raised, round to oval lesions that frequently are ulcerated. They are usually located on the abdomen or thighs. These lesions contain a type of white blood cell called an eosinophil.

Eosinophilic granuloma - a mass or nodular lesion containing eosinophils usually found on the back of the thighs, on the face, or in the mouth.

Indolent ulcer – circumscribed, ulcerated lesions most frequently found on the upper lip.

The three syndromes are grouped together as eosinophilic granuloma complex, primarily according to their clinical similarities, their frequent simultaneous development, and their positive response to the same treatment with steroids.

Eosinophilic refers to eosinophils, a type of white-blood cell usually involved in allergic responses. Granuloma is a large inflammatory nodule or solid mass. And a complex is a group of signs or diseases that have an identifiable characteristic that makes them similar in some fashion.

The genetics are unknown, although several reports of related affected individuals and a study of disease development in a colony of cats indicate that in at least some individuals, genetic susceptibility (perhaps resulting in an inheritable dysfunction of eosinophils) is a significant component of the disease.

Specifically, eosinophilic granuloma complex is restricted to cats. While eosinophilic granulomas do occur in dogs and other species, they are not considered part of the eosinophilic granuloma complex. Breed does not appear to play a role in cats.

Eosinophilic plaque is circumscribed, raised, round-to-oval lesions that frequently are ulcerated and usually appear on the abdomen or thighs. The lesions contain a type of white blood cell called an eosinophil and usually affect cats in the two to six year age range. Genetically initiated eosinophilic granuloma is generally seen in cats that are younger than two years of age.

Allergic disorders usually develop after a cat has reached the age of two. In cats, females may be more likely to develop one or more of the syndromes of eosinophilic granuloma complex than are males.

Symptoms and Types

Lesions of more than one syndrome may occur simultaneously. Lesions of all three syndromes may develop spontaneously and suddenly.

Eosinophilic plaques:

Circumscribed, raised, round to oval lesions frequently ulcerated
Moist or glistening plaques (may have enlarged lymph nodes)
Abdomen
Near the chest
Inner thigh area
Near the anus
Under front legs
Hair loss
Red skin
Erosions

Eosinophilic granulomas:
Linear orientation
Back of the thigh
Multiple lesions coming together
Coarse, cobblestone pattern
White or yellow
Lip or chin swelling (edema)
Footpad swelling
Pain
Lameness

Indolent ulcer:

Ulcers of the mouth
Found on upper lip
Within the oral cavity, ulcers on gums
Slightly raised margins
Non-bleeding
Usually painless
May transform into a more malignant cancerous form (carcinoma)

Causes

Non-specific allergies
Allergic hypersensitivity reaction
Food allergy
Fleas
Insects
Genetic predisposition

Diagnosis

Your veterinarian will perform a complete physical exam on your cat. You will need to give a thorough history of your cat's health, onset of symptoms, and possible incidents that might have preceded this condition, such as an allergic reaction or flea infestation. Any information you have about your cat's genetic background may also be helpful in diagnosing this disorder. Your veterinarian will order a blood chemical profile, a complete blood count, an electrolyte panel and a urinalysis as part of the diagnostic process.

The physical exam should include a dermatologic exam, during which skin biopsies for a histopathology study will be taken. Skin scrapings will also be examined microscopically and cultured for the presence of bacteria, mycobacteria and fungi. Impression smears of the lesions should also be taken.

Treatment

Most cats may be treated on an outpatient basis unless the condition is severe and is causing your cat severe discomfort.

A food-elimination trial should be started for all cases in case it is a simple allergy. A diet which the cat has never been exposed to should be put in place using high protein meats, like lamb, pork, venison, or rabbit, exclusively for 8–10 weeks. After this time, reinstitute the previous diet and observe your cat for development of new lesions.

An environmental allergy (atopy) may be identified by intradermal skin testing in some cases. Your veterinarian will inject small amounts of dilute allergens intradermally (between layers of skin). A positive reaction (allergy) is indicated by the development of a hive or wheal at the injection site.

Your veterinarian will recommend and prescribe anti-inflammatory medications for immediate relief from the swelling and inflammation. Hyposensitization injections, which use minute amounts of the allergen to lessen sensitivity to the allergen in question, works for most cats and is preferable to long-term steroid administration.

Living and Management

Your veterinarian will schedule follow-up appointments with you in order to determine your cat's response to the food-elimination trial, and to monitor your cat's bloodwork. The results from the bloodwork is especially important if your cat has been prescribed immunosuppressive medication - as this will lower your cat's immune responsiveness to viruses and infections.

As much as possible, follow your veterinarian's recommendations regarding the dietary guidelines for your cat. The treatment plan will be adjusted at each follow-up appointment according to your cat's progress. If your veterinarian is able to determine an environmental cause of the allergy you will need to prevent your cat from being exposed to these allergens.


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