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Your veterinarian may perform a partial gastrectomy to remove a portion of your cat's stomach if disease or tumor of the stomach necessitates the removal of stomach tissue. Gastric tumors are not common in cats, and this procedure is not frequently required. When this procedure is required it is usually the lower part of the stomach that is removed which necessitates rerouting of the stomach contents to the lower intestine, referred to as a Billroth I or Billroth II procedure depending on the portion of the small intestine connected to. This procedure is performed by a veterinarian surgeon under general anesthetic and requires post-operative care.
A partial gastrectomy may be indicated when gastric tumors are located by your veterinarian during endoscopy, a procedure in which a tube with a camera is passed into your cat's gastrointestinal system, or by imaging such as x-rays or ultrasound that reveal masses. It is also possible that stomach disease is detected during exploratory surgery to discover the source of gastrointestinal distress in your cat. This procedure is performed under general anesthetic and may be performed laproscopically, but in cats it is usually performed by traditional open surgery.
Your cat will need to fast for several hours prior to surgery and take any medication prescribed by your veterinarian. When you arrive at the veterinary clinic for partial gastrectomy your veterinarian will examine your cat to ensure they are healthy enough to undergo anesthesia and surgery. Your cat will be sedated and given anesthesia intravenously. Intravenous fluids and any other medication required will also be administered at this time. An intubation tube will be passed into your cat's esophagus and anesthesia by gas maintained throughout the procedure. Your cat's vital signs will be carefully monitored throughout the procedure. Your cat's abdomen will be shaved and cleaned and surgical drapes used to isolate a sterile site for surgery. An incision will be made in your cat's abdomen and gastrointestinal tissues and organs carefully manipulated to expose the stomach. The area of the stomach to be removed will be clamped off at both ends and the diseased stomach area excised. If a tumor is present, the tumor will be removed with the stomach tissue and any lymph nodes affected will also be removed at this time. As this procedure is most commonly used in the lower portion of the stomach, the stomach will then be repaired and an opening left to be connected to the small intestine in a Billroth I or II procedure, where an incision is made in the small intestine and the organs connected via an anastomosis. If cancer is present the upper duodenum may also be removed and connection to the lower intestine made at the jejunum in a BIllroth II procedure. If the upper stomach is affected the lower portion of the stomach will need to be reconnected to the esophagus after removal of the upper stomach tissue. All incisions will be closed and vascularization addressed. Your veterinary surgeon will observe anastomosis and surgical closures to ensure hemorrhaging or leakage of gastric contents does not occur prior to surgically closing the abdominal cavity.
If tumors were removed, tissue samples may be sent for laboratory testing to confirm the type of neoplastic cells present and ensure that large enough healthy tissue margins were excised to prevent cancer spreading.
Hospitalization to provide intravenous fluids and medication and to monitor your cat may be required for 24 to 48 hours. If malignant tumors were removed, chemotherapy may be recommended following surgery.
Partial gastrectomy for malignant tumors are associated with guarded prognosis and pets undergoing this procedure for this condition may survive less than a year after surgery. The procedure is more effective at addressing benign tumors. The possibility of tumor recurrence exists.
Post gastric surgery, your cat will require cage rest for a few days and restricted activity for 2 weeks in order to allow healing of incisions. The use of an E-collar will be recommended to keep your cat from licking or scratching their abdominal incision. Painkillers and medication provided by your veterinarian should be administered as directed. The surgical incision should be monitored for signs of bleeding or abnormal discharge. Your cat's food and water intake and overall alertness and body temperature should also be noted and any concerns addressed with your veterinarian. Your veterinarian may suggest a special diet postoperatively to reduce stress on the gastrointestinal system during recovery and possibly on an ongoing basis. If ulcers were present antacids may be prescribed. If malignancy was present, chemotherapy may be required.
The cost of this procedure including tests, medication, anesthetic, procedure and postoperative care ranges from $1,000 to $3,000 depending on your geographical region and the degree of care required. Chemotherapy treatment will incur additional expenses.
Short-term complications are rare, however long-term risks associated with partial gastrectomy include gastrointestinal disorder including dumping syndrome, anorexia and malnutrition.
As long-term prognosis when cancer is present is poor, and surgery is invasive, pet owners should discuss options with their veterinarian prior to choosing surgical intervention.
Prevention of gastric tumors is problematic, however closely monitoring your cat for signs of illness, regular veterinary care, a healthy diet, and adequate exercise will increase your cat's overall health and wellbeing and address medical conditions at an early stage.
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