Cat Loses His Voice
2-Year-Old Cat Breathing With Difficulty
“Doc, I don’t understand it. Pluto was fine yesterday. This morning, he looked a little tired, didn’t want to eat much of his breakfast and he can’t meow,” said the concerned dad of a big black and white short-haired Tuxedo Cat. “In fact,” he went on,”we never heard him purr until this morning. Usually we could feel the purr, but never hear it.”
VirtuaVet felt a firm lump just under Pluto’s chin, right where only the voice box should be. The lump was not soft, fluctuant or oozing. It was just a firm, annoying, painful lump. Every time Doc Truli pressed near the area, Pluto would open his mouth slightly, and breathe with his mouth open and his neck stretched out.
“A cat breathing with his mouth open and the neck stretched out is an extremely bad sign of a huge problem,” says Doc Truli. “Cats do not open-mouth breath unless they have to. It is a choice of last resort for them. Get to a veterinarian right away!”
"I feel better in here with extra oxygen in this air!"
Diagnostics for the Neck Bump
Unlike the kitten from Monday, Pluto did not have a fever. He also had a normal white blood cell count, normal blood chemistries, and negative feline leukemia, and feline AIDs retrovirus tests.
Puto’s breathing became more and more difficult every time he was removed from the comfort of the oxygen incubator.
“We need radiographs (x-rays) to see what’s going on in his neck,” said the Doc.
More Diagnostics for the Neck Lump
We started with radiographs of the neck. We could supply oxygen by a breathing mask if Pluto became distressed and we did not have to do anything invasive or painful to him to get the test results.
Radiograph of a cat voice box.
The first x-ray shows the voice box toward the left of the picture. The head faces left. The round curves at the top are the bottom of the middle ear tympanic bullae. The finger-like bones in the middle of the left of the picture are the hyoid apparatus, the fine bones of the voice box that string the vocal cords. The lump is the irregular, lumpy thing on the right of the picture sticking up into the black air space of the windpipe.
After you’re done looking, scroll to the next picture, where the lump is marked for you to pick out.
The red arrow points to the lump. The blue arrow oints to the tiny little tube for breathing that this cat has left!
“No wonder Pluto is having such a hard time breathing! He’s only got about 10% or less of the windpipe diameter left to breathe through,” said Doc Truli.
Possible Causes for the Throat Mass
1) Lymphoma
I know…he’s only 2 years old! I know, unfortunately, lymphoma strikes any age cat, even the young adults.
2) Granuloma
Granuloma is a wall-off mix of infection and scar tissue. It blocks up airways as effectively as cancer. This voice box location is a heckofa spot to try and surgically cut out a lump!
3) Other
Weird, unlikely, hard to think of, you know…”other!”
One Last Test
There’s one more only slightly invasive test. Pluto was such a good cat, we could put a small needle into the lump and take out a sample to look at under the microscope. This kind of fine needle aspirate often diagnoses te difference between infection and cancer.
Unfortunately, the sample looked like lymphoma. A pathologist’s specialty review of the sample is pending, but it looks like Pluto is that rare, but not impossible case of a cat with cancer at the tender age of two. 🙁
Outcome So Far
Pluto started on a conservative treatment aimed at shrinking the throat lump with steroids. He is a candidate for an oncology consult with a board certified veterinary internal medicine specialist subspecialty oncology. And lymphoma is the most treatable of cat cancers. There’s up to a 50% remission rate among lymphoma cats treated with a state-of-the-art multidrug protocol.
“We really can’t afford an oncologist, or even just the medicines to treat the cancer with a multidrug protocol,” said Pluto’s people.
“You must understand, if you change your mind in the future, then the option of a proper chemotherapy protocol helping Pluto will have been lost. The lymphoma needs to get treated by the different drugs from the beginning, or else the cure we want is unlikely to materialize,” said Doc Truli.
“We understand,” said the family.
“My job, as a doctor, is to let you know my opinions, my understanding of the facts, my interpretations, and the scientific options you have open to you. Working the medicine, meaning, getting a diagnosis. Using all treatment options from the most simple to the most complex, gets patients better more often than not. Once we’ve discussed the whole situation, then it’s up to the family to let me know the path they will take,” says Doc Truli.
"Is that my Daddy out there, coming to take me home?"
Pluto felt much better by the next morning with his medicines. He ate well, purred, and came out of the oxygen comfortably. The throat lump felt half as big as the day before!
Update: Pluto is still doing fine. His family never opted for biopsy or surgery, and his throat is swollen on and off. Because so much time has gone by, Doc Truli suspects a foreign body or strange sequestered infection. Unfortunately, delicate surgery might be the only way to clear out this part of the cat’s anatomy, and the family is categorically opposed to surgery. Hopefully, everything will continue to work out okay for Pluto.