Waiting

I'm still waiting for the ophthalmologist to get back to me with a treatment plan.  With the exception of the eye that we are treating with ophthalmic ointment and artificial tears, Pika seems to be in good shape and acting normally.  I was looking through some photos from early in the year, I unfortunately don't have many of the cats, and found two that show the time window where symptoms began.  The first, to the left, was taken on January 13th.  There is no noticeable squinting of the left eye.  The second, to the right below clearly shows him with the squint.

On Monday our regular vet called, she had received the report from the opthamologist and just wanted to know if we needed anyone to talk to about the diagnosis.  Unexpected, but the vets at Family Pet Animal Hospital have always been great.  We talked about the treatments that may be proposed, steroids and chemotherapy are the two most likely.  Betty and I talked about it and we would probably prefer the steroid therapy, it can be done at home where he is comfortable.  The chemotherapy would require Pika to go in for multiple days to get IV treatment, which he would hate, and would most likely make him sick and miserable.  It would also be much more expensive and we don't exactly have piles of extra cash laying around to pay for this.  Besides, I can't find anything in my searches to indicate that chemotherapy would have a better outcome than any other treatment option.

 Information about this condition in cats is sparse, the vet gave us a copy of this article before we left the clinic on Friday.  Another page shows a slideshow presentation in the condition here.  WARNING, this page contains some graphic images.  

Since I work at a hospital, I have been able to peruse Medline and Pubmed for articles.  There isn't much about the feline disease but I've found a lot of papers about human myofibroblastic sarcomas.  I don't know if the condition in humans is similar enough to what Pika has to be applicable, but one treatment that seem to show promise is pulse steroid therapy followed by a large dose of steroid or radiation therapy which in some cases has resulted in remission.  A second promising therapy in humans is the use of an ALK inhibitor.  I'll have to bring these up when I talk to the opthamologist (hopefully) later today.