A feline problem that we encounter in predominantly outdoor, white haired cats is a cancer called Squamous Cell Carcinoma (SCC). Excessive amounts of sunshine are the main source of the problem, so the disease is prevalent here in California. White haired cats have more than a 13 times greater risk of getting this disease than do cats of other colors due to their lack of pigmentation.
White haired cats usually get the problem on the ears, head, eyelids and tip of the nose. Cats that are not white usually develop the lesions on unpigmented areas or areas of sparse hair. It occurs mostly in older cats, but the age it occurs depends on each individuals' amount of exposure to sunshine and lack of pigmentation .
Early symptoms of the disease can be subtle, such as a minor irritation or scab on the head, ears, or nose. In more involved cases there is obvious redness, irritation, scabs, and hair loss. These symptoms mimic other diseases, especially skin conditions caused by Sarcoptic mange and allergies, so an accurate diagnosis is imperative.
This tiny ulceration at the tip of this cats nose is typical of the subtle lesion that is possible with SCC.
It is important to make a correct diagnosis early in the course of the disease because it can significantly affect the final outcome. The primary method of diagnosis for this disease is a skin biopsy. Any suspicious lesion should be biopsied because the prognosis is much more favorable the earlier the treatment. Many cats have lesions that are so suggestive of the disease that we perform surgery at the same time.
Most SCC's do not spread throughout the body, but they can recur at the site of the original lesion. Those that do spread will go to lymph nodes and the lungs. Prior to any treatment it is important to take a blood sample, a chest x-ray, and a sample of lymph node tissue for analysis. This helps stage the disease and let us know what the proper treatment regimen should be. All cats with this disease must be tested for FeLV and FIV
Squamous Cell Carcinoma is a malignant cancer that needs immediate and aggressive therapy if we hope to arrest it. The primary treatment method is surgical. It involves removal of the affected area or partial amputation of the ear or ears.
If the lesion is on the nose or head a great effort is made to preserve a cosmetic look. Again, this emphasizes the need for an early diagnosis. If the lesion is on the ear then a partial amputation of the ear is performed. It is important to remove a significant amount of the ear because recurrence is common if the amputation is incomplete. The redeeming part of this surgery is the fact that most cats look great when healing is complete.
Some SCC lesions are very extensive. In a case like Ashley's, we have to amputate almost the whole external ear due to the extensive nature of the lesion. We prefer to care for these situations long before they become this extensive. 
This cat has been positively diagnosed with SCC on both of its ears, even though the problem only seems minor compared to Ashley. The small amount of redness and the minor scabs are the only apparent lesions. It has been prepped for surgery and the amputation of both ears is about to begin. 
The following pictures are from an actual partial ear amputation that we performed at our hospital. If you do not want to view them click here to see the ears when they are healed and to continue learning about SCC without looking at the actual surgery.
Since it is impossible to determine just how far the tumor has spread, wide margins are cut to minimize the potential for recurrence.
The delicate suturing of the ear takes the most time in this procedure. The cosmetic appearance when healing is complete makes the time invested well worth it.
This is the appearance of the ears immediately after surgery. The look longer than they actually are because the hair has been clipped on the top of the head. Within 7-10 days these sutures will be removed.
Four weeks later this is the final appearance. Many people do not even notice that any surgery has been performed. It is important to keep this pet out of the sunshine indefinitely.
SSC can occur in other locations. This cat has it on its lower jaw (arrow) on the right side. The diagnosis was verified during a biopsy while its teeth were cleaned.
A closeup view shows how extensive the problem is. A lesion like this typically has been there for several months and does not get noticed by the owner until symptoms of drooling and lack of appetite appear. This emphasizes the importance of routine physical exams on a yearly basis when pets are presented for vaccines.
The radiograph of this cat shows how extensive the lesion is. There are two areas to note on this view of the lower jaw. The right jaw bone is affected. It has a moth eaten appearance that can be visualized by comparing it to the left side of the jaw. In addition to the bone lesion, the tissue of the mouth surrounding the bone is also affected. This is visualized on the radiograph as the whitish area surrounding the right jaw bone. This is the tissue that was biopsied to confirm the diagnosis. At this stage of the disease the jaw on the affected side needs to be completely removed. This surgery will be undertaken only if there is no evidence that the tumor has spread by taking an x-ray of the chest and biopsying one of the lymph nodes in the neck. It is an extensive surgery, yet most cats do fine postoperatively.
A new and promising treatment for SCC is called Photo Dynamic Therapy. It involves the use of a laser beam to selectively destroy cancerous tissue only. An injection of photosensitive chemical is given to a pet that has SCC. The only cells that absorb this chemical are the cancerous ones. It is only these cells that are destroyed by the laser, the laser beam harmlessly passes through the normal cells that do not absorb the photosensitive chemical. If Dr. Nurse feels that this therapy is appropriate he will let you know.
The best method of prevention is to eliminate exposure to sunshine. The use of sun block on the tip of the nose and ears is helpful if your cat does not lick or rub it off. White haired cats should be kept indoors, and should be prevented from sunbathing for long periods of time in the window. Even though windows filter out ultraviolet radiation, they do not filter enough of the radiation in the case of SCC.
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