Leukeran side-effects?

Hi all. Our cat has been diagnosed with Chronic Lymphocytic Leukemia. The vet (of whom we think very highly) prescribed Prednisone daily and 2mg Leukeran once every 4-5 days. Everything we've seen online suggests that this is the standard treatment.

However, the Leukeran really seems to hit our cat hard. Each time we give it to her she's totally wiped out for the next 2-3 days. Her appetite goes down to about 50%, she sleeps the whole day and wants to be off by herself, she doesn't purr or miaow (usually a very chatty and very sociable cat). Our vet also seems a bit puzzled by this. We know it's the Leukeran and not the Pred because she started the Pred a few weeks before the Leukeran and was fine.

Has anyone else seen this? How did you deal with it? Reduce the frequency? Reduce the dosage? What were the effects of this?

Thanks a lot!

Maggie

Hi there,

My cat had lymphoma and was on leukeran for a couple of months, given every other day. It was a rough experience for all of us, and when she had side-effects, our vet had us administer it less often. We couldn't give a smaller dose because the pills are so dangerous that we were forbidden to cut them.

Leukeran can be hard on a cat. It's possible your cat has nausea; it's a side-effect. There are anti-nausea medications you might try. You start giving them before the Leukeran dose.

On Leukeran, our cat still had a good appetite, from prednisone, but she spent most of her days and nights lying awake but not moving, under a chair, which was extremely unlike her normal, sociable self.

Our vet encouraged us to be hopeful that our cat's cancer would go into remission for weeks/months/years, but in hindsight we realize that the treatment was too hard on her. We should have given up while she still some decent quality of life, but we thought we were doing the right thing at the time. I don't even know if the Leukeran was working; our cat developed heart failure and seizures on top of her lymphoma and we had to let her go.

What vets tell us and what our cats tell us can be very different things. The next time I'm in this situation, I'll be listening much more to the cat.

With a disease like leukemia, it's important to keep asking yourself if your cat's quality of life is out-balancing the miseries of treatment. It's very hard to know that answer — and every situation is different. I've never known anyone who had total peace of mind about their handling of these issues.

A vet advised us to make a list of all the things our cat enjoyed when she was healthy: laps, toys, sunny windowsills, cheese... and how many things she could still enjoy while she was ill and having treatment. It was illuminating.

I hope you will continue to monitor your cat's peace and comfort, and keep that foremost in your mind and heart. I hope the Leukeran is working! Best of luck to you!

Sounds like you are really going through a tough time with your cat. It is hard to face something like this and I am sorry your cat is so sick.

Bunnelina,

THANK YOU for sharing your experience, your advice and for sending my cat and me the good vibes. It helps to know someone else has gone through this. Although I am sorry for your loss and the pain you felt at trying to do the right thing by your beloved furry friend.

Originally Posted by Bunnelina

What vets tell us and what our cats tell us can be very different things. The next time I'm in this situation, I'll be listening much more to the cat.

With a disease like leukemia, it's important to keep asking yourself if your cat's quality of life is out-balancing the miseries of treatment. It's very hard to know that answer — and every situation is different. I've never known anyone who had total peace of mind about their handling of these issues.

Click to expand...

This is how I feel, too. All the websites say that Leukeran is *the* drug of choice for leukemia chemo treatments, but if it is not sitting well with my kitty, Winnie, then it is not *her* drug of choice.

Our vet agreed and we've stopped giving Winnie the Leukeran. I don't know if what happened next was a side effect of the Leukeran or just coincided with us taking her off, but she became very constipated and would not eat. She is still down and lethargic despite giving her laxatives and an enema. The poor thing. If it's not one thing, then it's another.

I'm hoping she'll bounce back soon. She's 14 years old and not a spring kitten anymore, but as you said above, I'd rather she enjoy the time she has left in as much comfort as possible.

(Hey! That sounds like a great philosophy of life whether you have 4 legs and claws or 2 legs and thumbs! )

Again, thank you for your advice and support. It made me feel less alone in dealing with this.

blueeyedgirl: Thank you for your concern and support about my poor kitty. It's nice to have a forum to come talk about this. I appreciate it!

I hope she bounces back quickly!

An illness like this is a sad thing for both cat and human to go through, and I believe you've made a very careful and wise decision. I'm really glad if I could help.

If you haven't already, I'd suggest you try to learn about the subtle signs of pain that cats try not to show us. I wish I'd known more on this subject when my cat was ill. Here's one link, there are probably better ones.

There is deep peace of mind in knowing that we can control what our cats are going through, at least to some extent. When we can ease their pain, the decision is terrible on us, but it's ultimately a huge gift that we can spare them so much misery. Controlling life and death is supposed to feel rotten, otherwise we'd all be murdering each other, I guess.

I hope that time is still far away for Winnie! Take it one day at a time. I hope she sleeps in the sun and enjoys her dinner. And your love.


When I lost Bunny, I had to keep reminding myself that having her for so many wonderful years was an amazing gift and a privilege. I was so lucky to have her. She was the best cat ever. Each of our cats is a magnificent gift, for as long as we're allowed to have them.

Good luck, and keep in touch!

Mgeeq71
Reading your comments we are experiencing the same symptoms with our cat jasper we were told by the vet to administer every two days and when we do his appetite drops drastically as he stops eating and just as his appetite starts to gain we administer another tablet and process starts again, we did suspect it was these tablets so we moved the frequency to every three days and was pleased to see him eat a lot more so before we give him anymore we are going to confront the vet. The way I see it at the moment if the cancer don't get him the tablets will by starvation.

Thanks for all the posted comments

Tiggerreg:

Our Lazlo has large cell lymphoma. He underwent chemotherapy treatments for six months. The cocktail included Leukeran.

We supported him not only with prednisone, but with an anti-nausea medication (cerenia, used off-label, 1/4 pill given daily), and an appetite stimulant: we used mirtazipine.

These worked very well for him. His appetite would dip the day after treatment, but it did not prevent him from eating, and as time on treatment progressed, he clearly felt better and better. :nod:

Sometimes they may also need an antacid, like pepcid a/c.

Chemotherapy is not a choice for all cats; they all respond differently. For us, it put his cancer into remission. He completed his chemo in January - it's now September. :cross: :heart2:

He was happy and pretty comfortable throughout. I do hope that with supporting therapy, your kitty will tolerate the treatment better, so he has a chance to beat this thing!

Hi all,

I wonder how mgeeq71's and LDG's kitties are doing now?  Your description (mgeeq71) of your kitty on Leukeran exactly describes mine while on the 2 mg. every other day dose - wouldn't eat for 12 hours afterwards, sat and starred for a couple hours at a time or stayed in the bedroom and slept a lot, and quit purring.  The vet told us to give her half a pill every other day (their office split them for us and warned us not to split them ourselves) and she eats better on the lower dosage tho still sleeps a lot and often meows as if trying to tell us something. 

Our kitty was a stray that we took in over 3 years ago.  We think she is between 4 and 8 years old.  Ten months ago she began vomiting and not eating.  After treating her for all the common things (worms, parasites etc.) our vet put her on prednisolone for IBD.  She quit vomiting and would eat, but developed diarrhea and continued losing weight.  Later she was diagnosed with pancreatitis which we were told often goes along with IBD.  Our vets have slowly kept upping the amount of Pred. to keep her eating (she's on one pill per day now).   

She has been on the Leukeran and Vitamin B12 shots now for 3 weeks and on the positive side she eats most of the time and has gained 2 ounces (after losing weight continuously - 4 pounds total).  But she still has diarrhea.  And I'm wondering if the Leukeran is still making her nauseated as she moves her tongue in and out a lot.  I usually give her the pred. a half hour before the Leukeran and it seems to help her keep eating. 

Like some of you, I'm not at all sure we are doing the right thing.  There are those times she acts almost like her old self and that keeps me going with hope, but lots of other times I have my doubts.             

Well, Mgeeq71's posts were back in 2010, and she (or he) has three posts, so I doubt this person will be back to update.

Lazlo had large cell lymphoma, not small cell, so leukeran was just part of a cocktail, not his sole treatment. Large cell lymphoma chemo is quite different: it's once a week for the first two months, and then every other week for the next four months.

But Lazlo is doing great! His cancer remains in remission. In fact, I just posted a one-year anniversary of completing chemotherapy update TODAY. !!! http://www.thecatsite.com/t/234030/mega-massive-vibes-for-lazlo-urgent/570#post_3303828

How long does she need to be on the chemotherapy?

I do know that they don't always feel well - it's a tough treatment. :nod: But that doesn't mean they don't want to keep going. :heart2: :rub:

I don't know if you're familiar with this site for IBD kitties, but if not, you may find it really helpful: http://www.ibdkitties.net

Is diarrhea a side-effect of the leukeran? Or part of her diet/IBD issue?

I do know that we transitioned Lazlo to a raw diet towards the end of his chemo, and he's done VERY, very, very well on it!!!! Given it's considered the cancer fighting diet, I have to believe it's helped keep him in remission.

Vibes for you and your kitty!

Momma Mia......just accidentally ran into this forum a few minutes ago.  I was actually looking up information on Chlorambucil (Leukeran).  Maybe this will help you in your concern with your kitty. 

My cat, Sneezer, was diagnosed with Lymphoma of the lower GI tract in December '09.  A normal, healthy cat of 11 pounds, was dropping weight, suffering with diarreah, etc.  My vet, of course, ran tests on Sneezer numeous times, but nothing bad was showing up.  We tried different foods (thinking that it may be IBS or IBD) but, to no avail.  Finally, I took Sneezer to a college here in Texas that specializes in veterinary science, Texas A & M University.  So many of our veterinarians graduated from there!  Anyway, they are at the top of their game in research, the diagnosis of diseases, etc.  I could not have had a better experience!  The way that they treat animals (and their owners) is wonderful.  After a few days of testing, it was discovered that Sneezer had Lymphoma. 

He was put on a regimen of Prednisone (twice daily) and 2mg of Chlorambucil (3 times a week).  I never saw any ill effects from the drugs.  Actually, the Prednisone seemed to make him hyper.  It's now 4 years later and he is doing fine.  He immediately gained 6 pounds, but after cutting back on the Pred, he leveled back out to his normal 11 pounds.  He is 14 now......playful, makes his crazy cat runs through the house, eats most everything I give him and, the best thing is that he seems happy and pain free. 

I know that the chemo pill has side effects and can certainly affect his immune system.  But, I'm scared to change anything!  You know the old saying....."if it ain't broke..."  Here's the horrible thing that I found out today........I purchase the Chlorambucil through my vet and had called yesterday to order another 50 pills (the only amount the drug company will give you and it lasts for about 16.5 weeks).  The cost has gone up gradually over the past 4 years and the last time an order was filled for me, it was $307.  Over a year, that's around $921.  Now, I will have to pay $622 for 50 pills!!!!!!!!!  That is absolutely ridiculous! Well, we kinda know what's going on for humans with chemo drugs, etc.  That's why I was online....looking up Chlorambucil to see if there is a cheaper way around this.  And, I ran into this forum.  But, that's beside the point.......this increase in price is my problem!

I ran into an interesting case study on cats with Lymphoma (saw a similar one 4 years ago).  Here's the link......it's interesting to read and it does discuss another drug that has been used when Chlorambucil didn't work, or there was a reoccurrence of cancer.  Here's the link, and it's worth reading......http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3092124/.

Good luck with yout precious kitty.  I've had fantastic luck and just thank God every day that I've had Sneezer with me for an extra 4 years!  Unfortunately, I'm taking one of our other cats, Dude, to the vet to be put down tomorrow.  We are SO going to miss him!  He shares a fudgesicle with my husband every night, and loves corn on the cob. I've put this off for 3 weeks, but it's time.  I'm just not ready.  But, it's not about me, right?!!

Anyway, read the article and take it to your vet.  If your cat is just not doing well on the Leukeran, maybe the other drug that they mention in the study (for reoccurring cancer) would be better.

Hi Cat Fancier,

Thank-you so much for your kind and informative response and for the government site address to read about the studies on chlorambucil and glucocortaids (sp?).  I'm so happy to hear that your Sneezer (love the name) responded so well to treatment and is doing so well.  That is encouraging.  

As of last Wednesday Kikiboots gained 2 ounces, which was wonderful since she had gone from 11.5 pounds to 6.9 lbs.  But then the last two days she hardly ate anything so we stopped the chlorambucil for a few days.  Our local vet has been so good, and we did take her to a specialized vet in another city who put her on the chlorambucil after an ultrasound showed thickened mid intestines, from either severe IBD/and or lymphoma.  We chose not to put her thru a biopsy or chemo but to try the chlorambucil instead.  Kiki has had so many issues from urinary tract infections, abcesses, to a squamous cell cancer removed from her back.  She also developed a bad infection while being on the pred. last summer.  

Before filling the subscription for the chlorambucil, we called all the pharmacies around and we paid $70 for 15 doses!  And that was by far the lowest price around.  They told me the price has gone way up.  My husband isn't happy with all we are spending on her, and we have one son with no medical insurance who has health problems which makes it hard to justify spending so much on my beloved Kiki.  Each day is different, some days I'm so hopeful she well get better, but other days I feel maybe she was started too late and I'm not at all sure she's happy with the result, or if all we are doing and spending are only delaying the inevitable for a short time.   

I wish you and Sneezer continued good luck and will keep you both in my prayers.  Let me know how she does and if you find the chlorambucil at a better price.   

Cat Fancier,

P.S.  I'm sorry about Dude.  You'll know when the time is right.  We sometimes call our Kikiboots "Little Dude".  We also had another kitty, Black Velvet, we had to put to sleep last month so I know how difficult it is. 

Hi LDG,

I'm so happy for you and Lazlo!  Reading about cases like yours is so encouraging.  All along I've suspected that processed cat food may not be any better for our cats than it is for us humans.  Hopefully, Lazlo will stay healthy for a long time.  I know unprocessed food sure improved my health.  (not cat food tho  : ).   

Thank-you for sending the site on IBD - I will read it right after this.  The vet told me Kiki will be on chlorambucil all her life - not what I'm reading is the usual - not sure why she told me this.  She did say we will reduce the pred. soon if she improves.  But since that seems to keep her eating and the chlorambucil seems to reduce her appetite, I've got my doubts it will work.  

Kiki began with vomiting and not eating, then after beginning the pred. and the hypoallergenic diet she developed diarrhea.  It seemed to me the diarrhea might be from the pred. or the Hills hypoallergenic food, but the vets say no, it's from the IBD/pancreatitis and/or lymphoma. 

Thank-you for writing.  I wish you and Lazlo continued good health.  Keep us posted. 

We have a 15 year old cat, Kinkie Tail, that has been on leukeran and prdnisolone for over 4 years. She's on a different dosage than I've seen listed here, but it's worked. She takes two tablets of leukeran for 4 days, then is off for three weeks. She was on prednisolone tablets for a short time, but pill giving was a nightmare. My vet suggested a company that makes it into a cream and I rub it in her ear everyday. She did loose all the hair on her ears, but that's all. She's a bit down on the days she gets her leukeran, but that's all. The cream for the ears is so easy to give, beats fighting pill giving by a long shot! I get her leukeran at Costco and was amazed too how much the price has gone up. 4 years ago, I paid $70 for 16 tablets, two months ago, I paid $93! Today I paid $179! I don't know what caused the huge price increase, but 6 months ago I called every pharmacy in the area and Costco was by far the cheapest. I 'm not willing to try an online pharmacy. Besides the new pricing, the hardest part has been giving her the pills. She has developed very strong jaws, tongue and strength in her front legs!

Hi Tiggereg

 Our cat Oatley is 9 years old. He has had IBD/ pancreatitis for the past 6 years and eaten Royal Canin Hypoalletgenic biscuits and Hills z/d in a can.  He also has 1  Metamucil capsule before breakfast and dinner!! Amazing how this has stopped the loose poos and blood .We live in Australia and dont have access to the same variety of cat food for IBD. 

  Six months ago it turned into cancer. The vet says its a lymphoma. He has been on Leukeran and macrolone(prednisone) since then. The dose was 8 leukeron tablets over 4 days every 3 weeks and half a macrolone every 2 days. 

   His appetite has slowly  deteriorated. He seemed hungry but wouldnt eat his special diet food but was trying to eat anything we were eating especially ham and butter.  So now he has mirtazapine or periactin as an appetite stimulant. They work slightly but the howling all round the house is terrible.

  After the doses of Leukeran he hardly eats for the next 2 weeks , then is ok for the next week until he has his next course of leukeran so like you I feel that if the cancer doesnt get him then startvation will.

  2 days ago he wouldnt eat anything so we gave him steamed chicken in desperation and waited for what would happen in the litter tray. Everything was good so he's eating mostly steamed chicken and the Hills z/d in the can.

 Yesterday after consulting his specialist in gastro medicine our vet  has said the dose of leukeran is upsetting his appetite so next time he has his course it is going to be 1 leukeran every 3 days continuosly for the remainder of his treatment (another 6 months) and 1 macrolone (prednisone every day) and also vitamin injections every 2 weeks as he a little low in iron. We are hopeful he will improve on this new   treatment .

My 10 year old cat was recently diagnosed with small cell gastro-intestinal lymphoma. He was experiencing chronic diarrhea and vomiting and had went from a 15 pound cat down to an 11 pound cat. He was put on 0.25 ml B-12 injections weekly for 6 weeks, 10 mg prednisone daily for 2 weeks then every other day, and 2 mg leukeran (chlorambucil) daily every other day. During the first 2 weeks of treatment his chronic diarrhea and vomiting reduced to 1 day a week. Immediately upon going from prednisone daily to every other day and on opposite days of the leukeran, his vomiting increased from once a week to 4-5 times a week. The diarrhea completely cleared up. The vet then put him on 2 mg Zofran daily for the nausea. He has been taking this for 11 days now and there hasn't been any improvement in his vomiting. All else being said, he is otherwise doing really well, except for the vomiting. During his last visit he gained a little weight for the first time and was at the weight which he was at 2 weeks earlier. The vet said if the vomiting didn't improve by our next visit (this Friday) he would like to do another ultrasound. Frankly I am not sure that will be very beneficial and it is very expensive. Has anyone else experienced this? I am just wondering what the next step should be?

Hi Lisapawl,

  What are you feeding your cat? My cat with the same condition started on Royal Canin Hypoallergenic dry food. It was really good at first and he put on weight.

 The appetite stimulants that we have tried also stop nausea. They are mirtazapine and periactin.

My cat is now on Luekeran 2x weekly  and prednisone 1/2 tablet every day. We have no vomitting or diarrhea at all (now) . As he now doesnt like the Hypoallergenic dry food, I think he's bored with it as he has been eating it for 6 years as that was when he was diagnosed with IBD  This week when he wouldnt eat at all  I started  giving him steamed chicken mince, he cant get enough and has put on weight  this week, the first time sine he was diagnosed with the lymphoma ( 6 months ago).  We waited all day to see what would happen in the litter tray and he  was ok!

   We have aso tried Hills Z/D in a can with some success.  At first he had Luekeran twice daily for 4 days and then a break of 3 weeks. The leukeran made him vomit his food and not eat much so that is why the dose has been changed to 2x weekly.

  I hope you can find something to help with the vomitting. I know how expensive the ultasound is and we have resisted it as well this week and just changed medication and food. Sometimes the ultrasound is not always conclusive  anyway. Ask the vet about changing the leukeran dose. we haave had conflicting opinions about the leukeran.

 The oncologist specialist told our vet the Leukeran wasnt making him sick and it was the cancer coming back and we should have an ultrasound  AND the gasto specialist told our vet that the leukeran does make cats sick and we should alter the dose. So we decided to do the least invasive thing and alter the dose.

 Hope this helps  you both feel better soon.

Hi Oatley. Thank you so much for responding. It is nice to talk to people with the same issues and get feedback. My cat is on his 6th week of treatment. He is also on the Royal Canin Hypoallergenic Duck and Pea formula and gets Hills Hypoallergenic treats. He also started to get bored with it bc he was used to being able to eat a variety of cat fiids, so I started boiling chicken breasts and putting them in the food processor and adding some water to make my own wet food for him. He loves it and also put on some weight for the first time right after I started doing this It just occurred to me today that when he was on the prednisone daily for 2 weeks along with the leukeran every other day his vomiting was only once a week and it increased after the prednisone was reduced to every other day. Maybe he needs it daily right now? I will call the vet tomorrow to see what he says. There have to be some other things we can try. I frankly can't afford another ultra sound. And after getting the first one I know how little they actually tell you bc right after he had his first one the vet recommended an endoscopic biopsy. What mg is the daily dosage of prednisone that your cat is currently on? Thank you so much for all of your help. Looking forward to talking to you again soon! Good luck to you and your cat!

Hi lisapawl,

  Oatley is taking macrolone which according to the internet contains prednisolone. The tablets are 20mg and he has half tablet each day. Last week and for the previous 5 months he was having half  every second day. The vet specialist at Sydney University Vet Hospital whom our vet  is consulting regarding Oatley  says he may have pancreatitis as well and the treatment for that is macrolone daily. The pancreatitis would make him feel sick . 

So far all is going well with his new regime of cooked chicken and Hills z/d in can  for dinner and Royal Canin Hypoallergenic biscuits for breakfast.