October 27

Traci found the lump under Bella’s jaw a year ago today. Bella had recently had dental work following a tooth abscess in September; though the mass wasn’t near an affected tooth, we hoped it was a reaction to the surgery. She was to visit the vet for a follow up the next day, so the timing was relatively fortuitous. Dr Hoerner would perform a fine needle aspirate on the lump during the checkup.

And we had good reason to worry.

Bella was a robust if slightly chubby cat, but she’d had more than her share of health issues. She suffered from food sensitivity and an irritable bowel. Changes in weather triggered sinus infections that often led to conjunctivitis. And though she was always an indoor pet, in 2018, she suffered from a flea infestation that led to anemia and an irregular heartbeat. We almost lost her then; she became lethargic and spent her days curled up on a printer, presumably seeking safety.

In each case, veterinary intervention and timely doses of medication curbed the problems. Though she hated her all-too-frequent visits to the vet, she always left the carrier with her tail held high and her remarkable resilience intact.

When a small bump appeared on her lower right jaw in July of 2020, we were concerned, but we didn’t immediately comprehend just how dangerous her condition was. We assumed it was acne, or perhaps a cyst or another growth. At seven, Bella was approaching an age when skin tags or fatty tumors might appear, and as an indoor cat with a dark coat, cancer seemed unlikely.

The lump grew slowly over the next few days, and our concerns led to yet another trip to Dr Hoerner’s clinic.

The growth, now a raised lump with a distinctly concave surface, perplexed her as much as it did us. She measured it as 4mm, less than a quarter of an inch.

She sent Bella home with us with the admonition that we keep an eye on the lump for changes.

The changes came shortly afterwards. Though the lump appeared to grow slowly, the smooth surface soon ulcerated, healed overnight, then opened like a grotesque flower.

We brought Bella back to Liverpool for another examination. The lesion was now around 8mm wide, and Dr Hoerner took a sample with a needle.

She examined the cells under a microscope and called us immediately afterward. She had never seen anything quite like it; the cells were ragged, jumbled, irregular. She couldn’t identify the specific type of malignancy, but it was clearly cancer.

We’d suspected as much, but the diagnosis was devastating.

But there was hope. The tumor was relatively small, and there was no indication it had metastasized. The lesion’s edges hadn’t quite reached Bella’s lower lip, so surgery was a viable treatment. Although the pandemic was raging, we scheduled an appointment for the surgery.

Bella came through with flying colors. We removed the protective cone when we got her home as she started thrashing. The inflatable collar we’d bought for her suited her well until the anesthesia wore off. After that, she paid the wound no mind.

She was always remarkably resilient that way.

We were ecstatic; surgery was the most effective means of treating the cancer, and while we knew there was always going to be a threat of reoccurrence, there was a strong possibility that Bella could enjoy a long, cancer-free life.

We received news from the lab a few days later. The margins looked good, meaning that a layer of healthy tissue surrounded the malignancy in the tissue removed in the surgery. That was the good news.

The news about the cancer itself was grim: The lab identified the tumor as basosquamous carcinoma, a comparatively rare cancer with characteristics of basil cell and squamous carcinomas. I couldn’t find much information about the cancer in cats, but in humans, it’s an aggressive cancer that can be challenging to treat.

There was no way to know how Bella developed the cancer beyond genetics. She was a dark-furred cat who never ventured outdoors or spent time in the sun, meaning that some of the most likely causes of skin cancer were unlikely.