u/Durej

Species: Cat

Age: 12

Sex/Neuter status: Female spayed

Breed: Domestic short hair

Body weight 10lbs

Location: Seattle

Diagnosis: Salivary adenocarcinoma in mouth/jaw area

Treatment so far: Surgical removal followed by Palladia

Current status: On Palladia for 1 year; follow-up chest X-rays and bloodwork scheduled tomorrow

My cat Luna was diagnosed with salivary adenocarcinoma in the mouth/jaw area. She had surgery to remove a small mass on her jaw, but the vet did not believe clean margins were achieved. At diagnosis, there was no known spread/metastasis.

She has now been on Palladia for about a year and has been clinically stable. She still eats, interacts with us, sits with family, and has not had any confirmed progression. She has had some intermittent vomiting/GI upset, including occasional bile/yellow liquid vomiting on an empty stomach, but overall her quality of life has still seemed good.

Tomorrow she is having chest X-rays and bloodwork. If everything looks clear/stable, we may need to decide whether to continue Palladia or stop/hold it and monitor closely. My vet has been honest that with this type of cancer in cats, there may not be enough data to know whether stopping Palladia after a year is good or bad.

My questions are:

In a cat with salivary adenocarcinoma, incomplete surgical margins, no known metastasis, and about 1 year of stability on Palladia, is a monitored “drug holiday” a reasonable thing to consider if X-rays and labs are clear?

If stopping Palladia is reasonable, what kind of surveillance schedule is typical? For example, exams/bloodwork every 1–3 months and chest X-rays every 2–3 months?

If the cancer recurs after stopping, is restarting Palladia commonly considered, assuming the cat is otherwise stable?

With incomplete margins, is recurrence more likely to show up locally in the mouth/jaw area first, or in the lungs?

I understand no one can predict Luna’s case exactly, especially because this cancer seems very rare in cats. I’m mostly trying to understand what questions to ask my vet and what a reasonable monitoring plan might look like if we decide to stop or pause Palladia.