My cat has squamous cell carcinoma | Dr. Justine Lee, DACVECC, DABT, Board-Certified Veterinary Specialist
If your cat was just diagnosed with squamous cell carcinoma (commonly abbreviated “SCC”), I can whole-heartedly empathize. In this blog, I share my own story, along with some important information for cat owners to know if their cat was just diagnosed with this horrible cancer.
My own 19-year-old cat, Seamus, was just recently diagnosed with SCC last month, and I’m heartbroken. Seamus was previously diagnosed with chronic kidney failure (CKF) and so I weighed him once a month for years. I wanted to make sure he maintained his weight. Well, last month, he lost 0.7 pounds, and I instantly knew something more severe was going on. That’s when I did a complete physical exam and found a fast growing tumor in his mouth.
I took him to our board-certified veterinary dentist at my specialty clinic, where he was sedated and put under general anesthesia for dental x-rays, lymph node aspirate (for cytology), extraction of tooth and biopsy of the mass. Unfortunately, days later, he was diagnosed with SCC on the biopsy and lymph node aspirate.
SCC is one of the most common cancers seen in cats, and accounts for approximately 10% of the type of cancers that cats get. Unfortunately, the most common location that cats get SCC is in the mouth, which is hard for pet owners to be able to “see” it. Unfortunately, this is a really rapid, fast-growing cancer and is very invasive (which means it grows into the nearby tissue and lymph nodes). While it rarely spreads to other parts of the body, it can grow so quickly and cause pain and discomfort that it prevents cats from eating. Often, cats will express interest in food – in other words – they’ll still come to the food bowl, but then they turn away or eat only a few bites before giving up due to oral pain. That’s why it’s so important to diagnose it as soon as possible so treatment can started immediately.
Clinical signs of SCC in cats include:
- Drooling (even discolored brown drool)
- Bad breath (halitosis)
- Weight loss
- Not eating
- Frequent tongue movement or licking
- Dropping food
- Swelling on the side of the jaw (resulting in asymmetry)
- Pain on opening the mouth
Unfortunately, any aged cat can get SCC, but in research studies, the average age was 12.5 years of age (range 3-21 years of age). Some studies have looked at environmental toxins like tobacco smoke having an increased risk for cats developing SCC. For cat owners who smoked 1-19 cigarettes a day, their cats had a statistically significant 4X increase in the risk of SCC compared to non-smoking households. (No, I don’t smoke, and even my cat got SCC). In another study, cats that wore flea collars also had a statistically significant 5X increased risk of SCC. The same study that evaluated smoke exposure also found an increase in SCC in cats that frequently ate canned cat food (compared to those that ate dry food). This may be related to the nutrient content of these foods, the chemicals used in canned food, or even the hypothesis that cats that ate dry food have less tartar buildup and less dental disease. There is some thought that chronic inflammation or chronic dental disease may be a causative predisposing factor for SCC.
Diagnosis of SCC is typically based on:
- Oral exam
- Physical examination
- Blood work (as an elevated calcium level can sometimes be seen)
- Dental x-rays (which typically need to be done under general anesthesia) which may show a “lytic” or eaten away appearance to the bone
- Biopsy (which needs to be done under general anesthesia)
- Cytology of the lymph node (where a small needle is used to aspirate cells out)
- X-rays of the chest to make sure cancer hasn’t spread elsewhere
Treatment
Unfortunately, there isn’t much treatment or advances with treating SCC in cats, as it’s so aggressive. While surgery and radiation therapy can be considered, along with chemotherapy, they have been often unsuccessful with a poor long term survival. Only 10% of cats survive to 1 year, with most cats surviving an average of 3 months even with aggressive therapy. Without treatment, the average survival is only about one month.
So, what did I do as a veterinary specialist when my cat was diagnosed?
My goal was to preserve his quality of life. To spoil him. To make each surviving day a good quality of life where Seamus was happy. That meant keeping him on pain medications (such as buprenorphine and gabapentin). Since the mass is in the mouth, it’s often hard to pill your cat. And as my cat had a really painful mouth, I elected to use Simbadol (which is a once a day injection that lasts 24 hours) – your veterinarian will have to administer this, but it can be used for a few days initially to help. I also used a long acting antibiotic injection called Convenia for 2 weeks (1 injection, 7 days apart), as I was worried that there was a bacterial infection in his mouth from the decaying cancer tissue.
Lastly, canned food and cat treats…whatever Seamus wanted to eat. Here, my favorite treats that he loved:
- Bonito flakes
- Gerber Meat-based baby food
(e.g., chicken, turkey, chicken/veggie blends)
- Canned tuna in water
- Shrimp (frozen shrimp that was microwaved to cook it)
- Greenies cat treats
- Royal Canin Savory food
(e.g., chicken, turkey, chicken/veggie blends)
What about prevention?
While SCC is aggressive, the sooner it is found and the smaller it is at the time of diagnosis, the more treatment options are available. That’s one of the reasons why daily dental home care, regular oral exams and regular dental cleaning increase the chances of finding SCC early. When in doubt, talk to your veterinarian about this, as dental health is so important!
Most importantly, consider humane euthanasia when you feel like your cat’s quality of life is deteriorating. For me, the signs below indicate a poor quality of life. When in doubt, talk to your veterinarian.
- Not eating for 2 days in a row
- Continued weight loss
- Hiding
- Not moving
- Difficulty breathing
- Sleeping all the time
I wish I had better news for you. I’m right there with you, heartbroken with my old man. When in doubt, talk to a board-certified veterinary dentist or veterinary oncologist for more information… and hugs to your cat. This veterinarian’s thinking of you.
More information can be found here at Cornell’s website. Further information for your veterinarian (with links to the studies) can be found at DVM360.
Thank you for this post. My cat was just diagnosed and I, too, am heartbroken and feel lost. I plan to spoil him unconditionally until his time comes, and even though I know euthanasia is the humane course of action, the thought of saying goodbye is tearing me apart. It’s nice to hear the perspective of a professional in the veterinary field who also dealt with this in their personal life.
My heart goes out to you and your cat. It’s a terrible disease but my cat was very happy until the very end… talk to your vet about pain medication options to keep your cat eating and comfortable for the last few weeks. Prayers for you guys. Best, Dr. Justine Lee
My guy was diagnosed today… and has had symptoms for a few weeks. The vet gave him steroids to help with pain. He is still so happy and constantly wanting attention. He also has an ulcer in his mouth so it bleeds slightly… the vet recommended to wait to see how bad it is with the biopsy(he did a FNA and looked to diagnose) and sutured the ulcer.. but I feel like I should have put him down. But then I feel like I’m giving up on him since he is so incredibly happy. I know some time next week will be the time because I don’t want him to start suffering. It’s just very hard
I’m so sorry. I will say that I rarely have an owner regret euthanizing too early when it comes to cancer…
Should I even wait for the biopsy then? The vet said he saw a large tumor under the tongue which was causing the deviation… he still wants a lot of attention but he’s a small cat anyway so his weight loss is significant on him. My vet said let’s wait for the biopsy then speak about options but I just don’t know what to do. I feel like he is still a happy cat but he isn’t the same. I know I wanted at least the weekend to say my goodbyes
Tiffany, how are you and how is your kitty? would love to share my story with you
Dr. Lee,
Thank you for sharing your touching story and such a lovely cat. Our cat Chloe was diagnosed in May this year and the mass under her tongue grew to 1cm (by June) where she could no longer use her tongue to eat. She was otherwise still energetic, engaged, and in good spirits. When we noticed her unable to eat on her own, we immediately started feeding her with a syringe and only give her pate wet food that she loves and eats 2-3x/day which we squeeze little by little with the plastic syringe. As you mention above, as long as we’re seeing she’s happy and engaged, we will continue to feed with the syringe, lots of love, playing, and massages. We give her pain med and antibiotic as needed and the Vet also gave us anti-inflammatory. Did you administer anti-inflammatory? What are you thoughts on anti-inflam medicine (metacam)? Many many thanks for your insight.
My guy was diagnosed in early May and I think we’re coming to the end soon. He’s having trouble eating. And started bleeding within the last week. Im having trouble with the fact that I know I’ll have to make the call soon, but he still snuggles and purrs and loves laying in the sun. I just don’t know how long to wait.
My Moses was diagnosed in early May and I know we’re coming to the end soon. He’s having trouble eating and he’s started bleeding within the last week. Sometimes he seems frustrated that he can’t get this thing off of his chin. I know I’ll have to make the call soon, but he still loves snuggles and he purrs and loves laying in the sun. I just don’t know how long to wait.
Dr. Lee,
Thank you for sharing your touching story and such a lovely cat. Our cat Chloe was diagnosed in May this year and the mass under her tongue grew to 1cm (by June) where she could no longer use her tongue to eat. She was otherwise still energetic, engaged, and in good spirits. When we noticed her unable to eat on her own, we immediately started feeding her with a syringe and only give her pate wet food that she loves and eats 2-3x/day which we squeeze little by little with the plastic syringe. As you mention above, as long as we’re seeing she’s happy and engaged, we will continue to feed with the syringe, lots of love, playing, and massages. We give her pain med and antibiotic as needed and the Vet also gave us anti-inflammatory. Did you administer anti-inflammatory? What are you thoughts on anti-inflam medicine (metacam)? Many many thanks for your insight.
I’d make sure to use buprenorphine/buprenex for pain. I typically don’t use Metacam chronically, but as SCC is end stage and survival is typically only 5 weeks, I think it’s ok as long as the kidney function is normal! I’d check with your vet to be safe! Best of luck and prayers for Chloe.
Thank you for your response! Another thing we are considering as Chloe is eating less and less, is to have the vet set up a esophageal tube for feeding her. What are your thoughts on tube feeding at this stage of the disease (Chloe was diagnosed in early May).
Thanks,
Philippe & Sandra
I do prefer feeding tubes over syringe feeding, honestly, as it’s much less stressful to your cat!