WARNING - LONG POST
I've been so busy with work projects that I haven't had time to write about the situation with Elvis' right ear. Then, I considered NOT writing about it because it exposes a very shallow side of me - more on this in a minute. After weeks of worry, at-home procedures and the ear causing him pain, I need to let go of my angst over this situation, because we still have a long way to go.
What happened? The answer to that question is ... no one knows.
A few days before Elvis was scheduled to see Dr. Rose for his annual physical (9/22), I noticed a strange "spongy" spot in the middle of his right ear - it felt like bubble wrap. It was maybe the size of a nickle and about that thick - it was growing in size, but not rapidly.
Well, we all know how the first vet appointment turned out and we had to come back the next morning (9/23) for him to be "gassed" before the examination. They checked him out from nose to tail and aspirated the ear, trying to determine what it was and what to do next.
The cells were "cystic in nature", which lead Dr. Rose to conclude that a cyst or hematoma had formed at the site of some small injury. There haven't been any known injuries to his ear, but as I've done more research and exchanged about 10,000 emails with Dr. Rose, "injury" could be as simple as him firmly scratching his ears or even just quickly shaking his head. Who knew?
So at this point, the choice was to #1 wait and see if is resolves, #2 wait to see if it refills with fluid and then aspirate again or #3 perform surgery to remove the cyst.
Now is the time that I should remind everyone that Elvis is a bit of a special case. He is sweet to us and to most visitors at our house, but he is NOT well behaved at the vet. It's gotten worse over the years and taking him in for a quick exam and treatment is not an option. He's not letting anyone do anything to him (while conscious) other than me or Jerry.
Back to the story. Within a week of this first procedure, the ear had filled back with fluid and was now larger than the original site. Dr. Rose and I talked again and were still hopeful that the fluid would be reabsorbed and would not require surgery. Unfortunately, this didn't happen and the "balloon" in his ear was getting larger.
Several days before the Winnsboro trip it was so swollen we were worried it would burst. We consulted about what to do and decided it would be best for me to aspirate the ear. I picked up my equipment (10/20) - a butterfly needle set, attached to a short tube, which is then attached to a very large syringe - and recruited "Vet tech Jerry" to help me drain the site. Over the years, I've given shots, Sub-Q fluids and done lots of other stuff for the boys, but I had low confidence in this process because I struggle with trimming his nails, much less holding a needle in his ear!
We wrapped him in a towel (to reduce injury to us), placed him on a pillow on the floor with my legs across him so he couldn't move and hoped for the best. I was on the needle end and Jerry had the syringe ... one, two, three ... the needle is in and I'm holding the butterfly to the ear and Jerry is drawing the fluid out through the tube with the syringe. Considering this was something we had never done, on a cat who is not partial to being held down, the results were amazing. Didn't get it all out (doesn't matter), but we withdrew about 2CCs of a clear fluid with some blood. It was important to take the pressure off the ear.
We returned from Winnsboro to find the ear almost full again. More photos and emails are exchanged with Dr. Rose and we decide to drain it again the next week. Next butterfly set was the wrong size (smaller than the original set-up) but we didn't know this until we attempted THREE TIMES to aspirate the ear (10/26).
I don't need to tell you how upsetting this was. Elvis was in shock, Jerry was stressed out and trying to clean the syringe/tube between each attempt. Elvis escaped twice, blood dripping on things and I did not escape without a few scratches - he was not trying to attack me, he was trying desperately to get away from me. After the first successful aspiration, this was a great disappointment. It was an epic disaster, to tell the truth.
Next day, I'm back at the vet for a pep talk and more equipment - we went back to the "green butterfly" and attempted again that night when Jerry got home. We were sort of in a rush because we needed to leave for the UofH game and I think Elvis sensed pending doom when I wrapped him in that towel.
I kid you not, he did not move a muscle - not one whisker - while we drained the ear. It was a snap; however, the fluid was very different this time - thinned down blood instead of the more clear fluid typical of a cyst. So, back to the original question ... is it really a hematoma or a cyst? Who knows and does it matter? I exchanged photos with Dr. Rose and she started leaning towards hematoma as the culprit.
In spite of our best efforts to give him some relief, the ear is still warm and the weight of the "balloon" has caused the ear to tip forward, sort of like a Sheltie's ear. Now, I LOVE Shelties, but this is a Maine Coon cat and the ears are very important!
Dr. Rose was getting concerned about infection and felt we should move forward with surgery - she could have done it mid-day Friday (10/28), but I had to manage an event set-up all afternoon/early evening and was leaving the house Saturday before 6am for the event. Jerry was also leaving Saturday morning for a board meeting in Galveston, so this was not good timing. The surgery is kind of a big deal and requires significant after-care, so we decided to wait until Monday.
My new instructions were to give him an antibiotic shot, followed by a cortisone shot about 6 hours later and to aspirate the ear again on Saturday morning. Back to Memorial 610 for more equipment.
After all we've been through, you would think that giving him a shot would be no big deal, but I knew it would take a while to empty the syringe (big dose) and it's just not as easy as they make it look. Jerry to the rescue again on Friday night - he kept Elvis entertained while I was pumping drugs into the scruff of his neck. Saturday morning 5am, we were at it again, cortisone shot and aspiration. I'm exhausted from thinking about all of this and Elvis is still in pain and still has a balloon on the end of his ear.
My little goofball ...
and his awesome, original "Lynx tipped" Maine Coon ears ...
So this brings me to the very shallow, vain part of me ... after all of this effort, pain, money, emails and insanity, Elvis's ear will likely be permanently deformed because of this mystery ear cyst/hematoma.
I am grateful that it's not cancer, I'm grateful to have a vet like Dr. Rose who is willing to work with me 24/7 via email, because my cat is such a challenge at the vet. I'm grateful for Jerry for many reasons, but especially because he is a good sport about helping me do whatever is necessary for the cats. I'm also grateful for you guys, who are probably ready to jump off a bridge after reading this story, but I know that you care about Elvis too.
What I am not grateful for is having no options - at any price - to guarantee a good result from this surgery. It's my understanding that if we do not do the surgery, the cyst/hematoma will eventually resolve (months of aspirating/suffering), leaving scar tissue that will shrink and "wrinkle up" like a wadded up piece of paper.
If we do the surgery, he will suffer through recovery (more on this Monday), but it will eliminate the risk of infection, get rid of the swelling/fluid build-up and give him a chance of minimizing deformity. Dr. Rose has been very clear that there isn't much tissue to work with on the ear, and while she will do everything possible for a perfect outcome, there will likely be some "crinkling".
Will I love him less with a shriveled ear? No.
Will he still be my special Velvet Elvis? Absolutely, but this certainly isn't what I thought would happen when we picked him out at 3 weeks old. He was pick of the litter.
It's not what you would think would happen to the grandson of Cheaptrills Cactus Jack, the number 2 Maine Coon
in the nation (2002). Not that Elvis was a show cat, but he could have been.
This was taken on the way home from Dallas in May of 2004 - the boys were only 8 weeks old, but his ears were a prominent feature!
I love this picture! He was so WILD as a baby and he went through this really awkward stage while he grew into those big Lynx ears.
It's really disappointing because I have been so careful with them - there aren't any items they could swallow laying around, no cords they could get tangled in, if a door is left open there is a shoe or pillow blocking it from accidentally slamming on a tail. They have cat-sitters when we are away. I've gone overboard trying to protect them from "damage". Then, for absolutely no reason, out of the blue, a cyst/hematoma formed and there's no way to avoid a damaged ear.
I admit it - I'm shallow and vain, but it's making me ill to think that my beautiful Maine Coon might not be such a perfect specimen after this is over.
I took this photo today to show how the weight of the cyst/hematoma has caused his ear to droop. It's not a good sign, but I'm still hoping it will look OK after the surgery to remove the cyst.
He's kind of bummed out by all of this and he does not like the ear flopping around - on top of the discomfort & pressure of the swelling. You can see it better from the inside of the ear.
We're headed to the vet about 9:30am on Monday and she'll probably start surgery around 11am - I'll write again Monday night with photos. Please keep Elvis in your thoughts and prayers, he's suffered enough for no reason and the surgery will not be easy.
