Original Question: "Hello Dr. Greenway my parents are big fans of yours and suggested that I should ask you for some advice. My cat who is 11 years old developed a lump in December just under her left nostril. At the beginning of June she managed to scrape it open. We had it biopsied right after that and she was diagnosed with squamous cell carcinoma. It hasn’t healed since then. We were using the Kong Soft Cone but unfortunately she was able to access her nose and rip off the scab. We tried a hard cone but it wasn’t long enough either. We tried the nylon black cone but it squished her head. So we created a cone similar to the hard cone but used a leg warmer to hold it around her neck. It worked for 3 days. She has just ripped the scab off again. The wound keeps growing larger and larger. When she eats wet food it sticks to the wound and infects it. I just had to pick up and antibiotic injection on Friday. Do you have any other suggestions on how I can encourage the wound to heal faster or stop her from accessing it? I am washing the wound with warm water daily and applying Vetericyn to keep it clean. She is a very small cat (2.7kg) and has had gallbladder issues that have affected her liver and pancreas so surgery and chemo don’t seem to be viable options. Any help or advice would be amazing. Thank you!" - Melanie
Thanks for your question. I'm sorry to hear about this.
I'm sorry to say that a squamous cell carcinoma like this is a very serious disease. No doubt your veterinarian has informed you of this and the lack of good options that exist to treat it. This disease has a very poor prognosis. I would recommend that you consult a veterinary oncologist to discuss treatment options and the expected progression that this may take.
As for your question, there are limited options I'm afraid. This tissue is not healthy and it will have difficulty healing. While the tissue is exposed it will be prone to infection which will further impede healing and cause discomfort. I really can't think of something beyond what you are currently doing which is to apply an antibacterial cream to prevent secondary infection of the tissue. It's possible to consider a steroid cream to reduce inflammation but this has contraindications as well. It can reduce immune system response and also prevent epithelialization or skin generation over the area. Another potential treatment is surgically removing the diseased tissue but given the area, I would recommend you review this possibility with a surgeon.
As for the gallbladder and liver, I would recommend you assess this with blood work and live function testing, along with imaging. It's possible that the lesion could have spread to these locations or a concurrent condition is going on. I wouldn't rule out surgery, chemotherapy, or radiation therapy until that is assessed and your working with a veterinary oncologist.
Sorry I can't be more helpful but you have a significant challenge on your hands. I wish you the best and good luck.
Dr. Clayton Greenway
Disclaimer: healthcareforpets.com and its team of veterinarians does not endorse any products or services mentioned in any responses and answers. All advice presented by our veterinarians is not meant to replace a regular physical exam and consultation with your primary veterinarian. We always encourage you to seek medical advice from your regular veterinarian.
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