Hi Rocky's Mum.
I'm so sorry to hear about Jake. Kay who posted below & gave you the address for the VAS support group sent me an email alerting me to your thread on here as Wiggins & I do have experience of this.
I hope it's okay to ask & I know you've said you trust your vet, but it isn't clear from the post how the lump has been diagnosed as a soft tissue sarcoma. I'm only asking as different types of tumours behave differently and the treatment can vary as well.
Our experience was similar to yours thus far. Wiggins was vaccinated in the scruff in Jan 2005 but it wasn't until March of that year that I found a lump. Like you described, it just appeared overnight. Apparently, it is not uncommon for that to happen. We went to the vet the following day (not the one who had vaccinated Wiggins as I'd just moved) & he told me all about vaccine associated sarcoma and that he believed that was what Wiggins had. We talked about treatment & he said that these tumours were renowned for being invasive & aggressive so he recommended we go straight to see a specialist. I wasn't even aware that specialist vet treatment existed back then. I also joined the VAS support group on yahoo, who were great in terms of their knowledge and emotional support.
Wiggins was referred to a specialist referral centre where he saw an oncolgist and surgeon. They carried out a punch biopsy (fine needle aspirates are not recommended as they are not reliable for these tumours) & the biopsy came back with high grade fibrosarcoma. About as aggressive as it could get. We then did chest x-rays which thankfully showed no spread to his lungs. Due to the nature of fibrosarcoma, they recommended chemotherapy to try and reduce the tumour and give surgery the best chance. Fibrosarcomas are basically not just a mass, even though that is how it will feel to you & I. They have long tendrils, so minute that you couldn't see them even under a microscope, so certainly a surgeon wouldn't be able to.
Wiggins had 3 intravenous chemotherapy sessions with the chemotherapy drug epirubicin. These were given 3 weeks apart. Wiggins dealt with chemotherapy so well. He was very slightly off his food for half a day about 24 hours after the chemo each time but even though he didn't fancy cat food, a plate of prawns always tempted him. After the 3 chemo sessions, he had an MRI scan which gave the specialist soft tissue surgeon a really clear plan for his surgery.
Wiggins came through the surgery really well and was up and about in his pen the same day. It's amazing really, if he was a human, I'm sure would have been laid up in hospital for so much longer. But then cats are amazing, and Wiggins so determined, bless him.
After his op, we had some complications in that the void left where the mass was taken was really quite big, & a seroma kept forming. In the end, he was sent home (to be on cage rest) with his drains in which I emptied and kept clean at home. The reason the void was so big is because the surgeon took both the initial mass plus a big area around it, to make sure they get those tendrils I mentioned earlier as well. It really surprised me how well he dealt with being home and crated, with me nursing him. I honestly wasn't sure how he'd deal with weeks in a crate but he surprised me. He knew it was best for him, I'm sure of it.
His surgery was supposed to be followed up with 3 further treatments of the same chemo, again 3 weeks apart. Unfortunately his kidney values weren't great on his pre-chemo bloody just before the last session so the oncolgist advised to abandon it, which is what we did.
Anyway, I'm pleased to say that I still have my boy... 8 years on. I wouldn't say it's been easy. He has had two recurrences: July 2009, I find a tiny pea (petit pois) sized mass which we removed without any chemotherapy. Sadly, it was back within 18 months in Jan 2011. I truly believe that was a direct result of not having chemo for the previous recurrence. Epirubicin wasn't an option due to it knocking his kidneys the previous time. There were many discussions - with their new oncologist, new surgeon, previous oncolgist (who had moved on), the people on the Yahoo VAS support group, an oncologist in Edinburgh where they have the only veterinary PET scanner, plus a 2nd opinion from Noel Fitzpatrick (the new mass was more a a lumpyness on his shoulder blade than an actual mass/lump so I felt I needed to discuss everything which with Noel included a prosthetic blade though his first & preferred option was the same surgery the new specialist surgeon recommended).
Having two highly regarded specialists recommend the same operation made my mind up & Wiggins was booked in for scan & surgery before I'd even left the car park after his 2nd opinion appointment.Surgery went well -a partial scapulectomy, tissue removed plus spinal processes in the middle. He was sent home on cage rest, again with drains & again dealt with it perfectly. As he couldn't have the epirubicin again, we opted for part of an anti-angiogenic chemo routine. This approach uses an anti-inflammatory (metacam) and a low dose oral chemo tablet (either cyclophosphamide or chlorambucil - we used the latter). This approach basically aims to prevent the cancer cells/spindles from getting access to a blood supply. Without that, they can't grow or multiply. It's a relatively new approach but there are studies showing promising results. Unfortunately Wiggins can't tolerate metacam (gives him GI bleeds), so we just used the chemo part which is obviously experimental. The approach can be used indefinitely but we trialled it for 3 months and so far (I hope) he is okay. I would never say he is cured but that's the same with any cancers. All I can say is so far, so good. Wiggins anatomy is no longer normal around the shoulder so it's really hard to monitor. If/when it comes back, we'll deal with it as best we can. Wiggins deserves that. He's a fighter so I fight for him. He's one very special kitty.
Anyway, that's our story. I hope it's of some help. The chemo Wiggins had is not the only approach. In the States, rafiotherapy is more common & more available although there are more centres opening here. There are also other chemo drugs such as lomustine being trialled.
If you want to email me, please post & I'll see if I can PM you my email address. My advice at the moment will probably sound scary, but if at all possible (& finances/insurance will play a huge part), explore the possibility of getting a referral to a specialist referral hospital. I'm happy to let you know which oncologists we've seen (there's been a fair few over the years) but our surgeons are now in New Zealand & France. If it's not an option, then have your vet at least discuss Jake's case with an oncolgist & specialist surgeon who will be able to share their experience & recommend a treatment plan. In our experience, they usually offer services like that without charge.
Best wishes to you & Jake. xxx
