Wednesday, April 23, 2014

Very Good Vet Visit

Cayenne might disagree, because she thinks there is no such thing as a good vet visit, but I am very satisfied with the visit to the vet today.

I took Cayenne to see Isaac's vet because I was uncomfortable with the visit I'd had with her vet of the past 10 years Monday.  I've always liked and trusted her vet but Monday I felt like I was being pressured to consent to immediate surgery and that they weren't really answering many of my questions.  So I decided to make an appointment with Isaac's vet for a second opinion.  I figured it would be worth the cost of an office visit.  I am so glad I did.  It was so worth it.

The reason Isaac and Cayenne have - or had, she may be seeing his vet from now on - different vets is because Cayenne had been seeing a vet for many years before I got Isaac.  I had planned to take Isaac to the same vet, but then another local vet offered me a discount on veterinary care because Isaac is a service dog.  I decided it was worth checking out a new vet for a good discount, though I would have taken him to Cayenne's vet even if it cost me more if I didn't like the new vet.  But it turned out I liked the new vet a lot.  You can read more about Isaac's vet here.

Anyway, Dr. Stuart, as we call Isaac's vet, feels surgery is one option but not the only option and not necessary the best option.  He felt we could try treating the wound on  Cayenne's belly topically, as well as with oral antibiotics (which the other vet did prescribe Monday), for at least a week or so and see if there is any improvement.  If there's not any improvement, or if the wound gets worse, then we may want to consider surgery again.

But he strongly felt that surgery would only be a temporary fix.  They would not be able to remove all of the cancer.  It would give the wound nice clean edges so they could stitch it up and it would heal, for a while.  Then the tumors would grow some more and the skin would break down again and we'd find ourselves back in the very same position.  He couldn't say how long that would take, maybe a couple months, maybe a year, but it would happen.  And then we'd be faced with the same decisions again.  He was very clear that surgery would not be a cure.

He also discussed the risks involved with surgery in a 15-year-old diabetic cat.  I was pretty much already aware of the risks, but I appreciated him pointing them out to me.  The other vet did not really do that Monday.  He focused on the potential benefits of surgery, but did not discuss the risks or any alternatives.

So the bottom line is that surgery might help temporarily but it might make matters worse or cause other problems.  Topical treatment, basically intensive wound care (it sounds like loads of fun, I'll explain it in a moment), won't cure her, either, she'll still have cancer and the tumors will eventually grow and kill her, if an infection doesn't kill her first, but topical treatment (along with oral antibiotics) can get rid of the infection in the wound at the moment and probably allow it to heal.

Well, with that information, why on earth would I choose to do surgery without even trying the wound care?

The vet pointed out that doing the wound care would be more work for me than scheduling surgery.  It will take time, it won't be fun (not for me or for Cayenne).  But it is safer than surgery and more affordable than surgery, and while it won't be enjoyable for Cayenne, well, neither would surgery and spending a few nights at the vet's on IV's and stuff.

So, wound care.  It basically involves gently washing Cayenne's wound with a surgical soap, then flushing the area with lots of water, twice a day.  Which, you know, sounds simple.  Except Cayenne is a cat.  What cat is going to sit still, or rather, lie still on her back with her belly exposed, while you gently wash a big gaping wound and then flush it with lots of water?  Come on.  Cayenne objects to having her butt washed when she has poop on it.

I'm thinking I should wear long sleeves so my arms aren't shredded to bits.  My sleeves will end up soaked with water, I'm sure.  But maybe I'll end up with less blood shed that way.  Whatever I'm wearing would end up soaked with water, anyway. 

This is a job for which it would sure help to have more than two hands.  I figure I need at least two hands to hold Cayenne still.  Maybe three.  Then one hand to wash the wound.  A hand to hold her long hair out of the way would help, too.  So four or five hands would be good.

Wish me luck.

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