Possible Cancer of the Tongue in Elderly Cat
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Possible Cancer of the tongue in elderly cat.

June 1999

Q: Hi Dr. Mike,
I need a very honest opinion on what to do about my favorite little
calico, Mooshkie. She will hopefully turn 16 in August but, I was just told that she has a malignant tumor under the left side of her tongue. It was not noticed 4 weeks ago when i brought her in for a check up and when I brought her back to have (what I thought) one of her teeth pulled, our vet said that the drooling and licking and tongue hanging out the right side was from an inoperable tumor. She suggested to wait a few weeks then put her to sleep or to have a biopsy done and see about some kind of chemotherapy that cats supposedly respond well too. However, she didn't think I was going to extend her life that much and that the quality would be lessened.

I love my cat so much, and do not want to cause her pain, just to have her leave me anyway. I also don't want to lose a chance at a treatment if it could actually work. My vet said that this kind of "mouth cancer" was common in cats. Is this true? And is there any chance that they didn't notice the tumor 4 weeks ago and then did two weeks afterward because they may have used a "contaminated" needle during her check-up visit. By the way, they said that for a cat her age, her blood work looked good.

I'm just wondering if you had esperience witht his kind of cancer in cats, and any chemotherapy that worked well.

Thank you in advance for your honest opinion.

Peg S


A: Peg-

My honest opinion is that your vet can't tell if this is a tumor by appearance alone. That might sound weird but there are some disorders that look just like tumors that aren't. So I think a biopsy is a really good idea.

The most likely thing is that this is a squamous cell carcinoma. These can sometimes be reduced in size with radiation or surgery and radiation. Lately I have been reading about injecting these with carboplatin (a chemotherapeutic agent) but I don't know what the success rate is with this treatment. It may be worth a try since it isn't too invasive. The radiation is paliative, meaning that it won't cure the problem but may give her several months of additional good quality life. Sqaumous cell carcinomas are the most common tumor of the oral tissues in cats and they do occur with some frequency.

It would be hard for me to decide to do radiation therapy for this tumor on a cat of my own on the premise of an additional six or seven months of life because I don't view that as long enough to justify the expense and discomfort of radiation therapy -- but I have clients who have felt this was worthwhile and still thought so after doing it.

Eosinophilic granulomas can look exactly like some tumors in older cats, including oral squamous cell carcinomas. These are often responsive to therapy with corticosteroids or other immunosuppressive medications and would definitely be worth treating. I don't know what the odds are that this would be the problem but they are fairly low. However, an oncologist that I know to be straightforward posted a note on the Veterinary Information Network that stated that she has seen several of these that she mistook for cancer --- and that is her specialty!

Mast cell tumors can affect the oral tissues in older cats. These are more responsive to radiation than squamous cell carcinomas, I think. I don't know of an effective chemotherapy option for them but sometimes they respond at least somewhat to corticosteroids and cimetidine (Tagamet Rx).

Realistically, the odds are really high that this is a squamous cell carcinoma. But I'd still consider doing at least this much of a work up:

1) X-ray the chest to see if there is any evidence of spread of a tumor 2) Carefully check for enlargement of regional lymph nodes 3) Biopsy the lesion to be sure it isn't something other than a tumor --- and to know for sure which type of tumor it is.

At that point, you have enough information to make are a really rational decision about how hard to pursue this.

Your vet might be squeamish about biopsies of the tongue. They can bleed profusely. I can't remember a case in which we couldn't get the bleeding to stop but I do remember having to really work at it once or twice.

Good luck with this.

Mike Richards, DVM
6/28/99


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