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Feline ultrasound

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  • Feline ultrasound

    We have a cat who has quit eating, lost weight, and lethargic. We took him to the vet yesterday, and although the blood work was mostly good, an x-ray revealed an abdominal tumor. The clinic wants an ultrasound done, and then suggests that after the ultrasound, possibly surgery. I'm curious, but can you diagnosis a tumor's status, ie malignant or benign, with an ultrasound? Isn't a biopsy required for that? Is surgery on an abdominal tumor that is malignant common?

    Just for my own information, does anyone know why a feline ultrasound is so much more expensive than an equine ultrasound? I recently took a pregnant mare to a vet hospital for a late term ultrasound. She received both a trans-abdominal and a rectal ultrasound for a total cost of $175. I'm being quoted $500 for this ultrasound, on an eight pound cat. Since the clinic has no idea why they cost so much, does anyone?
    Mystic Owl Sporthorses
    www.mysticowlsporthorses.com

  • #2
    I believe there are differential diagnoses for a few types of more common feline intestinal masses that can be obtained through ultrasound, and that localized abdominal disease (mass) can be differentiated from more widespread diffuse disease, which may preclude doing extensive surgery. Regarding the surgery option, I think a lot depends on what the vet's prognosis would be for survival and quality of life, age and health of the cat, and the financial realities and beliefs of the owner. A biopsy would confirm a diagnosis of what the mass is, but staging would need to address if/how much the lesion has spread.

    I had a lovely cat that had three cancer surgeries before we decided it was time to let her go. She was (relatively) healthy and only 8 years old, and recovered quickly from the surgery each time, but it became apparent we were never going to get ahead of the disease. I felt better having given her a chance, and I don't think we put her through too much turmoil and pain in the attempt to remove the malignancy, but in the end we were unsuccessful.

    As for the cost of U/S for small animal vs. equine, in this area, that is pretty much the case for almost every diagnostic. I can have a barn call for my horses in the middle of the night on a holiday that is less expensive than a routine office visit for a cat or dog. To a certain extent, I think it may boil down to what the market will bear.

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    • #3
      I pay three times as much for a dental for my cats as the horse. I've never understood it, but what can you do?

      I'm sorry you got the diagnosis of an abdominal tumor. I wish you and your kitty all the best.

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      • #4
        I always find it pretty interesting how much more expensive small animal vet work is versus large animal.

        I had a cat that presented with the same...weight loss and not eating well. Took her to my regular vet who did a bunch of blood work for a $300 bill, that all came back fine. They referred me to a vet hospital specialist for an ultrasound. My vet did not recommend doing xrays in house because if they did see anything, the ultrasound would be necessary from there. So I did skip over the xrays and got the ultrasound which showed a mass, likely malignant and not operable but only way to tell exactly what it was was a biopsy. I did the biopsy and learned she had aggressive large cell lymphoma. That bill was nearly $1,000 but at least I knew what it was. I opted for no chemo, best case it would have given her 6-9 months and maybe not even that. We did prednisone and I got another 3 months with her. She was a really good cat.

        I'm sorry about your kitty.

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        • Original Poster

          #5
          Originally posted by Lah0808 View Post
          I always find it pretty interesting how much more expensive small animal vet work is versus large animal.

          I had a cat that presented with the same...weight loss and not eating well. Took her to my regular vet who did a bunch of blood work for a $300 bill, that all came back fine. They referred me to a vet hospital specialist for an ultrasound. My vet did not recommend doing xrays in house because if they did see anything, the ultrasound would be necessary from there. So I did skip over the xrays and got the ultrasound which showed a mass, likely malignant and not operable but only way to tell exactly what it was was a biopsy. I did the biopsy and learned she had aggressive large cell lymphoma. That bill was nearly $1,000 but at least I knew what it was. I opted for no chemo, best case it would have given her 6-9 months and maybe not even that. We did prednisone and I got another 3 months with her. She was a really good cat.

          I'm sorry about your kitty.
          Thank you. Other than having the x-ray done in the office, your scenario sounds exactly like mine. We are still wresting with what to do, but my feeling is that the ultrasound will reveal the mass, which will require a biopsy, and then surgery or not. Clearly a slippery slope, and this guy is very sick, in a short period of time, without any procedures being done. I have a good friend whose dog, not acting right, had a mass palpated in the abdomen. She was sent immediately to a surgeon, who did an ultrasound, saw a mass, operated and found it malignant, and then the dog was put on chemotherapy. This all cost almost $18k, and he died nine months later.
          Mystic Owl Sporthorses
          www.mysticowlsporthorses.com

          Comment


          • #6
            Sometimes its so hard to know what the right thing to do is. You (general you) don't want to make money a factor but for a lot of people, it is. Some people wouldn't hesitate to spend several thousand to get a few more months but I just can't financially do that. And for this particular cat it wasn't even a question, not only the money but her chemo would have needed to be weekly trips to the vet and there's no way I could have done that to her, she was terrified to go the vet.

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            • #7
              I'm sorry, OP & others. I've heard several scenarios of why small animal procedures are so much more costly, but none of them made sense. I'm afraid it's because a lot of these smaller clinics are purchased by large corporations, who are in it for the profit.

              I had a 9 yr old cat who presented with this. We did exploratory surgery & found cancer. He didn't recover from the surgery & was euthanized within 48 hrs. I just had a 15 yr old cat who had the same symptoms, also showing normal blood work. I tried appetite stimulants & prednisone & euthanized her shortly thereafter, when she was losing a pound a week.

              Sorry to say, I haven't heard of many success stories with this scenario. Sometimes the kindest thing you can do is let them go. Hugs

              Comment


              • #8
                I think I would consider euthanasia. Most cancers come back no matter what you do. My cat has breast cancer. The first surgery involved 3 separate incisions and she recovered well. That lasted 5-6 months. This time it invaded the abdominal wall. Surgery again went well, but the cancer returned before or slightly after the stitches were removed and it rapidly grew along the incision cite. I would say the surgery was entirely useless, or even hastened the disease process. Or perhaps it would have spread this fast even without intervention.

                My cat is still bright eyed and happy- the cancer is not internal or affecting major organs yet. She's not suffering yet, but it is only a matter of time. Given the progression i expect a rapid decline when it does occur.

                If you do the surgery, it could buy your cat a few months or not. That is the gamble. I think if it were my cat, i would skip the ultrasound and just go straight for the surgery. $600 was about what I paid for my cats first surgery and histopathology. Get it removed if you can. I would also request a phone call. If the tumor is too large or involved, be prepared to have the cat pts there and then. You could even skip the histopathology if you wanted.

                I think the histopathology is only useful if you can afford chemo or radiation. It will tell you if you have clean margins or not. But what use is clean margins? If the margins aren't clean are you going to do a second surgery? Does knowing the type of tumor provide you with more treatment options or change the outcome?

                My friend who works at the vet school said only 10 percent of her cancer patients survive 3 years. All you can do is buy time, and a limited amount of time at that. The focus should be on quality of life over survival time. If you do opt for chemo, the focus is not to cure the animal but buy a little more time.

                And yes, abdominal ultrasound is about $600. Ridiculous. The vets make up for low cost surgeries like spay and neuter by putting big price tags on optional services like cancer treatment. How is it they can spay a cat for $100, but removing a lump from the skin is $600? Spaying is more complicated and invasive then a lump removal...but they have to make money somewhere.

                Goodluck whatever you decide. I think if my heart kitty gets cancer, i would break the bank trying to save him. Perhaps now i should start thinking about health insurance for him. It is so tough to say "no".

                When my dog went into acute kidney failure, the vet said they could treat him... For $20k. But there was no guarantee he would even survive treatment. We put him down. The necropsy showed he had endocarditis which is lethal, and that was if he even survived the kidney failure. Just because you can attempt treatment, doesn't mean it is the right thing to do.



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                • Original Poster

                  #9
                  Thank you 4horses; that is a very thoughtful post. I don't think we are going to do anything invasive. Two days ago one of his eyes became cloudy with an enlarged pupil, so I don't think anything is going to save him. We will euthanize Levi soon.
                  Mystic Owl Sporthorses
                  www.mysticowlsporthorses.com

                  Comment


                  • #10
                    I think to get a clear ultrasound on a cat it would need to be anesthetized, but that sounds high for my area. I'd check the lungs out with a simple x-ray. Often that's the first place cancer spreads to. If it's already in the lungs, the odds aren't good.

                    Comment


                    • #11
                      Sorry you are going through this. I lost my dog to cancer last week. We did a biopsy because it started as an enlarged lymph gland that wasnt lymphoma so there was a chance it was something else. But in hindsight I wish the vet had been more forthcoming about possibilities when they found the throat mass.

                      Like your kitty, he was already sick. Looking through the information on line, there was very little chance of buying any real quality time. We tried pallative care, but the disease process worsened rapidly and I had to let him go.

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