Having a Heart to Heart Talk with Yourself About Your Pet’s Cancer Diagnosis

Cure Pet Cancer

November is National Pet Cancer Awareness Month. One in every four dogs and one in every five cats will develop cancer in their lifetime and @amcny is doing its part to raise pet cancer awareness by tweeting to #CurePetCancer to raise awareness.

Since cancer diagnoses are common in pets, many of my readers will face the difficult task of choosing cancer treatment decisions for their pet. Here is a list of questions you should ask yourself as you work through that decision-making process.

What kind of cancer specialist does my pet need?
Veterinary cancer specialists are not all the same. At AMC, we have three different types of cancer experts for pets: those that focus on administering chemotherapy, some who specialize in delivering radiation therapy, and the third type have special training in surgical oncology. We all know the basics of cancer treatment principals, but have different strengths within that core information. Your pet may need a consultation with one of us or all of us, depending on the type of cancer that has been diagnosed. The answer to this question lies in the biopsy because the type of tumor your pet has dictates the treatment options.

What kind of treatment is the oncologist recommending and is it right for my pet?
There are three main treatments for cancer: surgery, radiation and chemotherapy. Not every treatment is appropriate for every type of cancer and based on the biopsy, an oncologist will discuss what options are available to your pet and the expected outcome for each treatment option. Chemotherapy and radiation therapy require multiple treatments over several weeks to months. Surgery typically requires only a few visits to the hospital and has the highest chance of curing certain cancers. Cancer is most common in older pets and the grey muzzle set is also most likely to have other medical conditions which have to be taken into consideration in making the decision to pursue cancer treatment.

Do I have the resources to undertake the recommended treatment?
This question isn’t just about money, although cancer treatment can be costly. Another consideration when making the decision to treat your pet’s cancer is your time. Sometimes a trip to the surgical oncologist is all that is needed and other times 20+ trips are required for a course of chemotherapy. Be sure you understand what is required for the recommended treatment protocol. Your emotional resources count too. Maybe you are also caring for a seriously ill human family member and cancer treatment for the pet is more than you can handle. Or maybe it is the other way around and you can’t bear to lose two family members at once.

What is the prognosis for my pet with and without treatment?
This is a loaded question. The question is fair, but pet families who choose not to treat their pet’s cancer don’t often consult with an oncologist. That means oncologists, like me, don’t always have a good handle on the prognosis without treating many types of cancer.

If you have decided to make an appointment for a consultation with a veterinary cancer specialist, read about fancy cancer words that we try to keep out of our conversation with you, but sometimes accidentally slip into a conversation about treating your pet. Being prepared for a visit with a specialist will help to make sure all your questions are answered.

National Pet Cancer Awareness Month: Pet Cancer Treatment Options, Part II

November has been designated National Pet Cancer Awareness Month to raise awareness about the causes, prevention and treatment of dogs and cats with this terrible disease. To raise awareness of the possible treatments for pet cancer, this second part of my two-part blog on cancer treatments for pets discusses three additional treatment therapies: chemotherapy, immunotherapy and targeted therapy. Part I focused on surgery and radiation therapy.

Chemotherapy
Although the use of radiation therapy in humans preceded the use of chemotherapy, chemotherapy was more widely used in pet cancers before radiation therapy. Chemotherapy is administered when a biopsy indicates a tumor has spread or might spread, such as in feline breast cancer.

Chemotherapy can also be administered when a tumor is too widespread for either surgical removal or radiation therapy. At the top of the veterinary list of pet cancers treated with chemotherapy is lymphoma.

Veterinary oncologists treat both dogs and cats for lymphoma using a variety of chemotherapy drugs. Most commonly used is the CHOP protocol. CHOP is an acronym representing the first letter of each chemotherapy drug in the protocol and is repurposed from human oncology. Despite the bad reputation chemotherapy has, both cat and dog owners report a good quality of life in their pets receiving chemotherapy.

Immunotherapy
The concept of harnessing the cancer patient’s own immune system to fight cancer is an idea that has been around a long while. The idea came to fruition when a vaccine to treat melanoma in dogs was approved in 2010.

Dogs suffering from melanoma are given four vaccinations over two months and then boostered every six months. This treatment protocol prolonged survival by 300 days or more in dogs receiving the vaccine. In people with lymphoma, treatment using monoclonal antibodies like Rituxan® has dramatically improved patients’ survival time. In a similar vein, AMC oncologists are currently studying a monoclonal antibody against T cell lymphoma and a monoclonal antibody against B cell lymphoma is also available.

On the horizon for the treatment of lymphoma is a new cancer vaccine for a particular type of lymphoma in dogs called large B cell lymphoma.

Targeted Therapy
In 2009, toceranib phosphate, known as Palladia®, became the first targeted therapy approved for use in dogs diagnosed with mast cell tumors.

A second targeted therapy, mastitinib, known as Kinavet®, has conditional approval for the treatment of the same tumor. Targeted therapies exploit a physiologic abnormality in tumor cells, not present in normal cells. Targeted therapies commonly work by turning on or off a cellular process critical to cancer growth and metastasis, halting tumor growth. In the future, expect to see more targeted drugs used in dogs and cats.

Because cancer is diagnosed in over six million pets each year, you may be faced with this diagnosis in your favorite furry friend. But treatment of cancer in pets is possible. You and your pet have more treatment options and more specially trained veterinarians than ever before to help you achieve a good outcome if your pet is diagnosed with cancer. To find a board certified veterinary cancer specialist in your area, visit the American College of Veterinary Internal Medicine website and use their search function.

Hairball Awareness Day 2014

This Friday, April 25, 2014 is Hairball Awareness Day. Most of us think of hairballs left for us by our pet cats as an annoyance, found typically between the bedroom and the bathroom. Their peak occurrence is somewhere around 3am and appear only when you have bare feet. As annoying as hairballs are to us, to pets they can actually cause a surgical emergency. Here to prove it is my patient Toby.

Toby is an eight year old long-haired cat, but in this photo you can see he has been clipped, thanks to a hairball emergency. The second photo shows him with a full coat. Toby’s story starts with a voice change and trouble breathing. In addition, his owner noticed Toby had not been eating well and was not grooming himself. A visit to The Animal Medical Center emergency room found a tumor on his larynx. Ultimately Toby’s diagnosis was lymphoma of the larynx, readily explaining his voice change and respiratory difficulties. Because the tumor was also obstructing the opening to his esophagus, a soft food diet was prescribed, instead of his normal crunchy hairball prevention formula.

A few days later, Toby started chemotherapy. Within days he could meow, was breathing and eating well and resumed his normal grooming routine. But just before his fourth chemotherapy treatment, Toby vomited up a six inch long hairball and initially seemed to be fine, however, on the day of his chemotherapy appointment, he vomited twice and we began to worry about a hairball obstruction since Toby seemed painful when we examined his abdomen. An abdominal ultrasound confirmed the presence of a hairball obstruction. Surgeons at The AMC discovered a hairball blocking his small intestine and removed it. Toby recovered uneventfully and resumed chemotherapy once he recovered from surgery.

Today, Toby is back on his hairball prevention diet, has completed chemotherapy and is enjoying a complete remission of his cancer. Whenever we sedate him to evaluate his larynx, we clip his fur to prevent another hairball emergency.

How to avoid a hairball crisis in your pet:

  • Feed your pet food or treats designed to move hairballs efficiently through the intestine.
  • Brush, brush and brush your pet daily.
  • Use a deshedding tool to efficiently remove loose hairs before your pet swallows them.
  • Use caution when removing hair mats as scissors can cut the underlying skin if the mat is tightly adhered.
  • Consider a professional grooming if your pet is severely matted.

When Life Gives You Lemons, You Need a Buddy

Tracy and her 14 year old grey tabby, Baller, have experienced a few bumps in the road this past year. In April, Tracy noticed Baller, named after a rap song, was defecating outside his litter box. He also had diarrhea, but he didn’t seem very sick since he was eating well and was his usual playful self. Her neighborhood veterinarian examined Baller and found two pounds of weight loss. Tracy thought she could breathe easier when she heard the blood tests were normal, but an abdominal ultrasound revealed Baller had colon cancer.

Minimally Invasive Testing
Tracy brought Baller to The Animal Medical Center for a consultation with one of our board certified oncologists. Baller’s oncologist, Dr. Maria Camps, explained the most common type of cancer in cats is lymphoma, and recommended a minimally invasive approach to diagnosis since lymphoma is treated with chemotherapy, not surgery. Ultrasonography was used to direct a small needle into the colon tumor and retrieve cells from the tumor. Within hours, Tracy found out she and Baller were facing an uphill battle against lymphoma. The anticipated survival time for a cat with lymphoma treated with chemotherapy is less than one year.

Chemotherapy Helps
Dr. Camps actually gave Tracy so much hope, and Dr. Mollica, Baller’s regular veterinarian and a former AMC intern, was also very supportive. These two veterinarians really gave Tracy that extra oomph she needed to continue Baller’s treatment. Ms. Koch says, “I knew the chemo was working almost immediately. Right after his first treatment he was feeling better again. He is one to make it known when he has issues by hiding under the bed, not eating and not able to use the bathroom. But, it was amazing that right after his first treatment he was back to his normal routine. I thought it [the chemotherapy] would help a bit, but I didn't realize how much better it would make him feel. He was like a whole new cat, which makes me sad because who knows how long he was feeling bad before he really started to show it.”

About one third of the way through his prescribed course of chemotherapy, and just when Baller’s cancer seemed to be in control, a roadblock obstructed the path to further cancer treatments; Tracy was laid off.

Buddy Fund Helps Out
This is where the Buddy Fund comes in to assist Tracy and Baller. The Buddy Fund, one of AMC’s Community Funds, was established to provide financial support for AMC patients with cancer whose owners could otherwise not afford to treat their four-footed family members. The name of the Buddy Fund has a double meaning. The original donors to the fund had a very special cat named Buddy and the fund acts as a “buddy” to owners of pets with cancer. Baller’s oncologist recommended him for the fund because he was responding exceptionally well to the prescribed course of chemotherapy. Discontinuation of treatment would put him at high risk for relapse of his cancer.

Thanks to the Buddy Fund and its generous supporters, Baller completed his chemotherapy protocol just before Thanksgiving and without missing a single treatment. At his most recent follow up appointment he was given a thumbs up because no tumors were detected during the examination. Going forward, Baller will continue to be monitored for tumor recurrence. As the one year anniversary of his diagnosis approaches, everyone has their fingers crossed for Baller. Tracy looks forward to a time when she is employed again and can be a “buddy” to another deserving cat through a contribution to AMC’s Buddy Fund.

A Good Day @The AMC!

I had an especially good day at The Animal Medical Center one day last week and so did everyone else. Our hard work was rewarded with positive outcomes for many wonderful pets.

A cancer check up

Becky, a graceful Golden Retriever, had an appointment for a follow up on her thyroid tumor which was surgically removed nearly a year ago. After surgery, she received a total of four chemotherapy treatments. I administered two drugs, doxorubicin and carboplatin, using an alternating treatment protocol. Now she needed a new chest x-ray since the lungs are where thyroid tumors spread most commonly. It was a tense wait for everyone, her owner and her oncology team, but we were rewarded when the radiology report indicated her tumor had not spread.

A happy heart

The cardiologists saw a Boxer who suffers from a form of heart disease found commonly in this dog breed. In Boxers, fat replaces the normal heart muscle and causes abnormal heart beats which can lead to sudden death. This disease, known as arrhythmogenic right ventricular cardiomyopathy, was first diagnosed by cardiologists working at The AMC and studying Boxers with heart problems. This particular Boxer and her cardiologist were having a good day, like I was. At first she had 22,000 abnormal heart beats measured using a continuous heart monitor called a Holter monitor. Initial results indicated treatment with heart medications decreased the number of abnormal beats to only 51 abnormal beats in over 110,000 beats counted in a 24 hour period!

Renal medicine rejoices over urine

Since every pet urinates, you might think urine would not be a cause for celebration, but The AMC’s Renal Medicine & Dialysis Service does. When kidneys suffer from serious infection or obstruction, they can actually completely stop making even the smallest drop of urine. Using dialysis, AMC’s kidney specialists can replace the filtration function of the kidneys and prevent serious illness from a buildup of toxins in the bloodstream. But until the kidneys start to heal, cats and dogs may not urinate for days. The first time a dialysis patient urinates, an average day becomes a great day since we know the kidneys are finally getting better.

Surgeons perform less surgery and are glad

Henry was diagnosed with a lung tumor. Because his doctors made an early diagnosis, his tumor was small making it amenable to a minimally invasive removal. The surgeons used a thorascope – a device with a tiny camera attached. The camera was inserted into Henry’s chest through a small incision. Its progress toward the tumor was viewed on a large screen monitor. Once the exact location of the tumor was identified, a second small incision was made through which the lung tumor was removed using a surgical stapler. Because of the minimally invasive approach, Henry was discharged from the hospital the next day rather than several days later, which is typical when traditional surgery is used.

Even though these stories are about different pets, different diseases and different veterinary specialists, they share a common theme, improving the health of pets so they spend as little time as possible @The AMC and spend more time at home with their families enjoying life.

Get Well Tuxedo Stan: Political Cat Suffers from Renal Lymphoma

Disclaimer: I am not Stan’s veterinarian and I have not reviewed his medical information nor talked to his doctors. Since lymphoma is the most common tumor of cats, all veterinary oncologists have a good deal of experience in managing this disease.

There are many talented cats who blog. Because I am partial to black and white “tuxedo” cats, Tuxedo Stan from Halifax, Nova Scotia is one of my favorites. Stan believes in taking a political stand. He based his 2012 mayoral campaign platform on the plight of stray cats in Halifax. His politics garnered him endorsements from Ellen DeGeneres and Anderson Cooper.

Early last week Stan announced he was hospitalized at the Atlantic Veterinary College (AVC) on Prince Edward Island for the treatment of the most common type of feline kidney cancer, lymphoma. His most recent tweets indicate he has been released and has returned home.

Lymphoma

Lymphoma is the most common type of cancer seen in cats, approximately one third of all tumors in cats are lymphoma. Stan’s case is a bit unusual since these days most cats with lymphoma suffer from the intestinal form of the disease and, based on his tweets, Stan’s tumor affects his kidneys. During an examination, veterinarians can palpate (feel) large and irregular kidneys. Some, but not all cats with lymphoma of the kidneys have increased values on their kidney blood tests because the tumor cells disrupt normal kidney function. Successful treatment can bring the blood test levels back to normal.

Shaved tummy

In one of his tweets, Stan asked for a sweater because his tummy was cold. He does live in Canada after all. Stan’s abdominal organs were most likely evaluated using abdominal ultrasound. An abdominal x-ray shows the outlines of organs, but an ultrasound lets veterinarians see both the outline and the internal structure of organs as well. Stan’s tummy was cold because we need to shave the fur in order for the ultrasound probe to contact the skin and produce a clear image of the abdominal organs.

Diagnostic test

When oncologists at The Animal Medical Center find a kidney tumor using ultrasound we typically perform a fine needle aspirate to determine the type of kidney tumor, and I suspect Stan had the same or a similar procedure. The radiologist uses the ultrasound images to guide a very thin needle into the tumor. A syringe attached to the needle is used to aspirate (suction) some of the cells out of the tumor. Once the cells are in the needle, the syringe is detached and air is put into the syringe. The syringe and needle are reattached and the air is used to push the cells onto a microscope slide. The slide is stained and evaluated by a specially trained veterinarian called a pathologist. Sometimes these tests are sent to a central laboratory, but because the diagnosis was so rapid, I suspect Stan’s tumor cells were evaluated by a staff pathologist who works at AVC.

Treatment = Chemotherapy

The mainstay of treatment for lymphoma is chemotherapy. At The Animal Medical Center, we typically use a multidrug treatment protocol and rotate drugs on a weekly basis. This protocol attacks tumors using chemotherapy drugs with different mechanisms of action and different toxicity profiles. Administration of chemotherapy drugs to cats requires them to cooperate while the treatment is given intravenously as an outpatient. I hope Stan will give us an update about his ongoing treatments.

Here is more information on signs of cancer in cats.

If you prefer feline social media in 140 characters or less, you might want to use this list to find tweeting cats.

How Many Ways Can the Thyroid Malfunction?

The thyroid gland sits in the neck of dogs and cats, just below the voice box, and controls metabolic functions. Most of the time, a routine physical examination cannot detect the organ if it is normal. Last week, my patient list ran the gamut of thyroid dysfunction. Here is a sampling:

A Tail of Two Thyroids

Some days, strange coincidences happen in the waiting room. Today it was two dogs, both with thyroid cancer. Although measuring 15 centimeters in length, Beckey’s thyroid tumor had been surgically removed. The biopsy showed her tumor trying to escape into the lymph vessels and she was waiting her turn for chemotherapy, administered to halt the spread. Her treatment involves intravenous administration of two different chemotherapy agents and Beckey so far has sailed through the treatment with flying colors.

As Beckey was leaving the waiting room, Henry entered. A CT scan showed his thyroid tumor had already spread to the lymph nodes in his neck, precluding surgical removal. He was in for a check-up following completion of four radiation therapy treatments. Careful measurement of his tumor with calipers showed no increase in tumor size. The radiation treatment arrested tumor growth but had given him a sore esophagus. I had warned the owners about this type of side effect before we started treatment and told them to expect it to start resolving about two weeks after he completed his treatment. Henry did not disappoint us. Through telephone triage, we had already rearranged his medications to make his throat less painful. Henry spends summer in the country but in the fall he will come back to The AMC for measurement of the tumor and a chest x-ray.

Old Patient, New Problem

Otra’s family was worried. This cute kitty had completed chemotherapy for intestinal lymphoma about a year ago, but suddenly her weight plummeted. I could see from the look on their faces they were sure the cancer was back. Auscultation of Otra’s heart discovered a very elevated heart rate, prompting a test of her thyroid levels. Overactive thyroid glands ramp up the cat’s metabolism and they lose weight despite eating well, have a high heart rate, and are very peppy. An abdominal ultrasound showed no evidence the lymphoma had recurred and blood tests showed the thyroid was overactive. I sent thyroid-suppressing medications home with the relieved family and planned to reassess the thyroid hormone levels in two weeks.

Porterhouse to Pork Chop

Every time I saw Mango to follow up on a skin tumor that had been completely removed via surgery, she had gained another pound. This 60-pound Portuguese Water Dog should have weighed 50 pounds. The owners took her swimming, fed her diet food from feeding toys, and still she gained two more pounds. During an evaluation for a urinary tract infection, we noted her thyroid hormone levels were borderline low. When we retested the levels three months later, we confirmed diagnosis of hypothyroidism. Low thyroid function, the opposite of Otra’s problem, can cause weight gain. Since she started treatment with thyroid supplementation, Mango has lost nearly 6 pounds and gone from a 20-ounce porterhouse to a 4-ounce pork chop over the past few months!

There you have it, thyroid malfunction runs the gamut of disease: overactive, underactive, and two different tumors, all in one tiny organ.

Will that be One Lump or Two? A Guide to Lumps on Your Dog

My telephone and email have been ringing and pinging this week with questions about lumps on dogs.

The subject line of the first email said “Lump on Rump” which sounded like a line from an oncology book written by Dr. Seuss. When I examined the dog, I found a firm mass below the skin just to the right of the tail. Since this was a standard poodle, I suspected a sebaceous cyst, a common lump in this breed. But since you can never determine a benign or malignant lump by observation, I performed a fine needle aspiration using the same size needle I would use to administer a vaccination. Within 24 hours the laboratory confirmed my diagnosis. The worried owners were relieved, especially since no surgery was required for this benign lesion.

The second call was from an AMC colleague who has just adopted a foster dog. He’s been vaccinated, groomed and has a spiffy new collar. His owner was petting him and found a lump over his right shoulder. The combination of the recent vaccination and the location of the lump (right where he would have been vaccinated for distemper/parvovirus) made me think it was a small-localized vaccine reaction. Since this dog comes to AMC most days, we carefully measured it on the first day and again a week later and it was already getting smaller. I will continue to monitor this lump but suspect it will go away in another couple of weeks.

The third call was from a friend of mine who is a veterinarian. She had found a lump on her own dog and performed an aspiration which diagnosed a mast cell tumor.

Because these tumors sometimes require specialist level care, she wanted input from the AMC about how best to approach this tumor surgically and input from me regarding an potential chemotherapy.

If you have a lumpy dog, have each lump evaluated by your veterinarian. I keep a line drawing of a dog’s body in each dog’s medical record. On the drawing I sketch the lump, record the size based on measurements and indicate the date aspiration cytology was performed. This process makes short work of determining if this is a new lump or not.

If your veterinarian recommends aspiration cytology or a biopsy, go for it. Without additional information, it is impossible for me or any veterinarian, to give an owner bad news or good news about the lump on their dog.

Don’t hesitate to seek the opinion of a specialist. A dog with a lump in a difficult location may need a advanced imaging to define the tumor location, a specially trained surgeon to successful remove a lump or a cancer specialist to provide follow up chemotherapy.

________________________________________________________

This may also be found in the “Tales from the Pet Clinic” blog on WebMD.com.

For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.

Why Do People Treat Their Pets for Cancer?

People I meet socially are often surprised when I tell them I treat pets with cancer. The first level of surprise occurs because many non-pet lovers don’t know pets get cancer, so of course they are doubly surprised to meet some who treats it. For me, cocktail party conversation frequently centers around the question, “Why do people treat their pets for cancer?”

Since many pets are considered members of the family, pet owners want the same level of medical care for their pet as they do for themselves. At specialty hospitals like The Animal Medical Center, this high level of medical care includes surgery, chemotherapy and radiation therapy.

I am often asked if a dog is too old to get treatment. My patient population and that of most oncologists is elderly. To be trite: “Age is not a disease.” But some older pets may have diseases which complicate cancer therapy or have such a delicately balanced treatment regime that cancer treatment is not a good idea. Other older pets sail through cancer treatments, like Spenser.

Cuddles the Cat is a chemotherapy patient. Notice the short stumpy whiskers on the right side of her face, which are the only outward sign of chemotherapy treatment she has.

Side effects — nausea, vomiting, hair loss — become another worry for pet owners based on their experiences with human family members. Veterinary cancer treatment goals are different. We strive to improve the quantity of life as well as the quality of life for our dog and cat patients. We usually can achieve this goal and if we can’t, we understand if the owners choose to discontinue therapy.

Since I am an oncologist, I bet you think all the pets I see get treatment for their tumors. Not so fast. The decision to treat cancer in a pet belongs to the pet’s family, not me. My job is to provide information about prognosis, complications and expectations. The family has to weigh the tough stuff and this decision is never taken lightly. I had one lovely, but unlucky cat owner client. Both her cats developed the same uncommon tumor. She chose to treat one, but not the other. Why? The two cats had diametrically opposed personalities. We treated the gentle, cooperative cat, but much to my relief, she perceived treatment of her ultra-cranky cat would be stressful for him, a tribulation for her and dangerous for the oncology staff.

If you are worried your pet might have cancer, click here to find the warning signs of cancer in pets.

If your pet is showing any of these signs, see your veterinarian right away.

________________________________________________________

This may also be found in the “Tales from the Pet Clinic” blog on WebMD.com.

For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.

Thinking Outside of the Box: Creative Medical Solutions

Creative solutions to manage tough medical issues.

My colleagues at The Animal Medical Center have recently come up with innovative solutions to two very interesting cases that I’d like to share with you.

The PEG Tube for Bloat

Rufus has a percutaneous endoscopically-placed gastrotomy tube (or PEG tube for short). These tubes are commonly used at The AMC in both canine and feline patients who cannot or will not eat voluntarily. Rufus eats fine. His problem is gas in excessive amounts, so much so he becomes dangerously bloated – commonly known as belly bloat.

Dr. Sarah Stewart of The AMC's Internal Medicine Service determined that a strategically-placed PEG tube would relieve pressure and allow removal of excess stomach gas from Rufus’ stomach without the need for an ER visit.

The AMC team helped Rufus’ owners learn how to use the PEG tube at home to keep Rufus comfortable — and prevent hospital stays — while The Animal Medical Center team formulates a special diet and adjusts medications. I am happy to report that the PEG tube is working so well, in fact, that Rufus’ owners have already managed several bloat episodes at home, by themselves, without any medical support from us. The new diet is working and gas production is way down. Yesterday, Rufus had a low profile tube placed to make him more comfortable. I have included a photo of the new tube taken just after it was placed.

A Pleuroport for Fluid Removal

Mencheese, a beautiful, 13-year-old cat, has a tumor in front of his heart. The tumor is producing fluid which accumulates around his lungs. This fluid build-up makes it difficult — and uncomfortable — for Mencheese to breathe.

Dr. Janet Kovak, a member of The Animal Medical Center’s Soft Tissue Surgery Team, placed a pleuroport which provides a device that quickly and painlessly allowed us drain the fluid from Mencheese’s lungs until the chemotherapy controlled the tumor and stopped the fluid production. Dr. Kovak treats many types of soft tissue injuries or illnesses through the use of minimally invasive surgery such as thorocoscopy and laparscopy.

Take a look at the photo to see the pleuroport in action. Mencheese is sitting comfortably on a treatment table in the oncology treatment area at The AMC. You can’t see the pleuroport — it is under his skin — but you see the special needle and the tubing we use to drain the fluid. Keeping the fluid drained off his lungs has really improved Mencheese’s quality of life. He has been wolfing down cat food like he hasn’t seen a square meal in months!

Some readers may be familiar with a similar device called a vascular access port (VAP). Like the pleuroport, a VAP is surgically implanted. But instead of being placed into the space around the lungs, it is placed into a blood vessel. The VAP is used to draw blood samples and administer chemotherapy to cancer patients without the need for repeated blood draws or catheter placement.

The stories of Mencheese and Rufus are just two stories about “pets on the road to recovery” because of some creative care by The AMC staff and hard work on the part of devoted pet owners.

This blog may also be found in the “Tales from the Pet Clinic” blog from WebMD.

________________________________________________

For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.