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My cat had small cell lymphoma, hard to diagnose - Review by Kerry L | Veterinary Specialty Center

Veterinary Specialty Center


My cat had small cell lymphoma, hard to diagnose 11/7/2007

Every once in a while you get a pet that is just an exceptional animal--like those exceptional human beings that become your best friends. My cat Koshka is like that, so I was heartbroken when he was losing weight steadily, developed diarrhea, and we had been unable to diagnose him at his regular vets after numerous tests and monitoring his weight. The vet suggested an endoscopy, and this was one of two places he recommended. At his appointment, Dr. Gokhale, a very caring and pleasant vet, took his history, examined him, and suggested an ultrasound, which might find masses in areas not covered by the endoscopy and might rule out an endoscopy. We did this and found several masses and inflammation. I was actually present at the ultrasound, helping hold Koshka in the "taco" (a little trough they put him in to assist in scanning his belly), and I observed how gentle and careful and thorough the radiologist and the person assisting were. I discussed the options with Dr. Gokhale, and decided to skip endoscopy and aspirations and to do an operation, which, though expensive, would give Koshka his best chance at survival, combining treatment and diagnosis of the masses. Money was an issue, and the operation was a big risk, because he had to be cut open "from stem to stern" as it were; they operated on his pancreas, liver, and colon; Koshka was 15; and he had lost half his body weight since his prime when he weighed 17 pounds. We had also talked about checking his lungs to see if the cancer had spread that far, which I initially decided against, to save money for the operation, but then I decided to do this because I wanted Koshka to have the best and longest life possible in whatever state he was, and felt the risky operation would be wrong if the cancer had reached his lungs, would probably shorten rather than lengthen his life. I did encounter some problems other reviewers have described here, when I was setting up the surgery appointment (and again at the end). They wanted me to bring Koshka back for another pre-op appointment with the surgeon, as well as the chest x-ray, and he did not do pre-op appointments on the same day as the operation. Because I have no car, was relying on friends and this was the busy pre-Christmas season, and both the vet's and the cat-drivers' schedules were hard to coordinate, I was unable to do this. I felt that what really needed to be seen was the chest x-ray, not the cat again, and that this should be able to be done quickly and on the same day, and at this point I was feeling there was more of a focus on money and their convenience and not on my cat's health, so I considered taking him elsewhere. However, they did accommodate me ,and we did the chest x-ray, the pre-op appointment with Dr. Gokhale rather than the surgeon, Dr. Snyder, and the operation all on the same day. I stayed with Koshka to keep him calm, and we sat out in a little room for kids just off the waiting room, where I was able to observe many people bringing their pets in and out all day, and that the staff seemed caring and responsive. Dr. Gokhale, who was assisting at the surgery, came out and told me during the surgery that Dr. Snyder was concerned about trying to remove everything in the pancreas, which could compromise the pancreas too much. We again quickly discussed Koshka's possible diagnoses and outcomes, and I agreed he should not try to remove all the masses. After the surgery, Dr. Snyder came out and talked to me about Koshka, and I learned that the risk of pancreatitis (which is usually quickly fatal) is about 45 percent when you do any cutting in the pancreas at all. He also told me about his own old cat, and it was evident that he, like all the people I met there, cared about animals. I stayed until Koshka had recovered enough from the operation to see me, and he was actually standing up in the cage and poking his paw out to ask me to get him out of there. He stayed a couple more days, and the vets I talked to always gave me clear, specific information and advice, did not encourage me to leave him there longer than necessary, and appeared focused on the cat's wellbeing and sensitive to my money constraints. (I was also told about a specific credit card--by an outside company, not the hospital--that is available for vet bills, but fortunately I was able to use my own credit cards and a settlement to cover the bill.) The checkout was done late at night, by someone who told me it was not her usual job, and she neglected to tell me to refrigerate Koshka's medicine (it also did not say this on the bottle) and that the bandage on his paw where the IV had been was a pressure bandage that should be removed when I got home. I left in on for a couple days and this led to a horrifying condition called "fat paw" (yes, really!), where his paw swelled to literally three times its size, and I called in a panic, planning to rush him to a vet. They told me how to treat the paw and reassured me that it was not necessary to take him to the vet. They also offered to replace the medication (I just got it from his regular vet, but they agreed to pay for it if I wanted), and even mailed back the purring tape I had left for Koshka to soothe him. Koshka's post-operation treatment of meds and blood tests has been administered by his regular vet but overseen by Dr. Gokhale who looks at the blood test results and makes recommendations re frequency of testing and adjustment to medications. Almost a year later, my darling 16-year-old cat with lymphoma is alive, happy, and healthy, thanks to the care by these folks and our regular vet. I could take off a star for the problems at the beginning and the end, but I think results are what counts in the long run, and both times, the center made efforts to help with/fix the problems. Plus, they saved his life! The heartbreaking experience described in a review by the owner of Bart definitely gives one pause and should not have happened. I hope she will contact the center's administrators with her experience and suggestions re improvements. Any business should know that treatment of customers (including here both animals and people) is the number-one priority, both for ethical reasons and for the survival of the business. As far as the money issues/problems mentioned in several reviews, I think staff definitely should all be educated to be sensitive, courteous, and keep the state of the pet-owner in mind while spelling out policies. However, as consumers, we have to remember that these policies are made way up the food chain and there is nothing the staff people (and generally the vets) can do about them. This center is likely more expensive than other, smaller vet places because they have professional-level complicated equipment to maintain, like a surgery center for humans. They also belong to a big chain (as was explained to me by one of the places I considered taking Koshka during the initial problems--the guy who told me this said most of the vet centers in our area do, including his), so there is even less flexibility, I'd assume, than with small centers. We might forget this when we are traumatized about the health of our animals, but it costs a lot of money to provide these services, and a business has to stay afloat, each of the staff people has to make their salary to survive, just like we do, etc. When I first came to Seattle, I had to treat my other dear cat, Koshka's sister, for an infected bite and since I was just starting a job, I did not have the full amount for the wound to be lanced; I offered to leave a post-dated check for the remainder. The vet could not do this (I still remember him saying he "just could not"--it was not up to him), and we ended up doing another treatment with medication and hot compresses (I also remember him saying that he would not recommend this other treatment if he didn't think it would work). I went with another place for my cats' vet services, but then a few years later I had a coupon, had forgotten which place this was, and went back there as a "new patient." This same doctor looked a little familiar, but I didn't remember until years later I happened to see that original bill in my file. This same place now will let you split up your payments if you need to; they have put a procedure in place that accommodates both the patients' financial needs and their own, and they have taken good care of Koshka and also his sister, right up until the day she died. Thanks to these two vet places, I have had the joy of my cats' company for many, many years. more
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