Options/Advice on possible Lymphoma treatment

Hi there,

I am posting on this forum as I'm torn between what option I should take in regards to my 12 year old, FIV positive kitty.

2 months ago, he was losing weight so we took him to the vet. He was still eating, etc, so it was determined he had a thyroid problem. The vet prescribed Tapazole. Since then, he's gained weight, and eating normally.

This past week, we took him back to the vet as we noticed a lump under his jaw. The vet examined him, and also found a slight lump around the shoulder and another on the back of his hind leg. We opted for a antibiotic shot and we are taking him back to the vet next week when it's time to re-examine. The thought was that it could be a bacterial infection and because he is FIV positive, he needs the meds to fight it.

It's been 6 days now since the shot, and there has been no change in the masses. Therefore, we are suspecting, he may have lymphoma. We did discuss this with the vet, and they gave us two options. Option 1 would be to take an FNA from the areas and test the results under a microscope. I understand that this is not 100% accurate. If the vet were to take samples from all 3 areas, I'm wondering what the odds were that they would find something? Does anyone have any experience with FNA tests? Option 2 would be to do a full biopsy and remove the lesser two masses. Because the biggest one is right under the jaw, the vet did not want to perform surgery there. There are too many nerves, etc. Of course, the two options differ in $$ great. $450 vs $1200. Then of course, depending on what stage it could be, would determine chemotherapy costs....which I have no idea what they would be. Anyone have any idea?

I'm really torn at these two options. If anyone has gone through this, or have any suggestions as to what they would do, please guide me here. I really want to do what is best for him but I don't want him to suffer in the long run. He's my pal after all.

At this point, he shows no signs of sickness. He is eating well, and just being the typical cat that he is. The vet did do a full physical on him and found no masses around his stomach, etc.

Thanks for reading.

I think a lot of it depends on your philosophies and how far you are willing to go in treating your kitty. Were it me, I'd always choose the less invasive treatments/tests first and go from there, remembering that your cat has no idea why he's suddenly in a strange place and experiencing pain/discomfort. Find out what you are dealing with and decide if surgery and chemo have a good chance of curing your kitty.

Sorry you are going through this.

One key thing that most people can be uncomfortable talking about with their vet is prognosis from the different options. It's hard to talk about how much time you have left with your baby when you can focus on what you can do to extend his life. I lost a cat to lymphoma one time. We had the mass removed and put him through chemo. It was very hard on him. Had I known it would have only extended his life by a couple of months, I would not have done that, as his discomfort was not worth those few short months. He died before he was fully adjusted from the treatment. I was young and failed to ask the vet about his prognosis.

Realize that when a vet does a cancer biopsy, they do their best to remove the entire mass along with any surrounding tissue, just in case it is malignant. If they get all of it during that surgery, they can sometimes avoid any subsequent treatment.

If it were me, I'd do what is least invasive, simply because it sounds like they can't remove the mass from his neck, and if he does have a malignancy, you don't want his recovery time to be long.

Sending vibes that it is not cancer.

Yes, you are absolutely correct. I will ask the vet what they think his chances of survival are in the longterm. If it only means a few months, I will not put him under such stressful situations.

I have been leaning towards the FNA, as it's not as evasive and I'm hoping I do get some lab results from the 3 different areas. As well, Since the biopsy cannot remove the largest of the 3 areas, if I was to decide to proceed with chemo, that money saved from the FNA (rather than having a biopsy) would be better spent towards chemo if the prognosis of survival for the longterm was good. Had the vet told me they could remove all 3 masses, I may be leaning towards the biopsy, in the hopes it all would be removed.

To Momofmany - I'm sorry to hear of your kitty. If I may ask, do you happen to recall what stage of cancer your cat was in, or where it was located?

I'm so sorry to hear this, DJC, and I'm praying your kitty doesn't have cancer.

Like jenwales and Momofmany, I'd recommend the less invasive testing, the FNA. If it does turn out to be cancer, I agree with Momofmany that you should talk with your vet about the prognosis and how much any treatment options can help -- how much additional time your kitty might have (especially with more than one mass found already) and the likely effects on his quality of life. Sometimes just opting for palliative care, managing pain, is the kindest option (that's what I chose when my 13-year-old tabby Tiger was diagnosed with very rapidly growing cancer of the jaw, already in the bone, six years ago this March; she had only a few weeks after that, but they were happy weeks for her, spent at home, playing and cuddling with Frosty).

But I'm praying you won't have to worry about this, and that the masses will turn out to be benign, maybe just fatty tumors (lipomas) which I don't think would have been affected by the antibiotic that would have helped if these were bacterial infections. The FNA will be able to check this.

Hugs, and prayers for you and your kitty,

Cindy