Gastric Tumour

I have just got home from the vet. My lovely cat & friend Marmite, has a suspected Gastric tumour.

She has had sickness for about 2 months which was successfully controlled with some steroid injections indicating a possible pancreatic problem. However her 2nd monthly injection seemed to have little effect & she started being sick again. I tried to spread out her feeding times with small amounts over a day & even got up at 4am to feed her. But she started being sick at night, after drinking water. The night sick was brown water. Last night she was not sick, I think because I did not feed her at all after 9pm because she was fasting for 12 hours for the x-ray. I had mopped up some of the watery sick the night before & it was tested today & found to contain blood. Marmite has been a good girl at the vets all day today & has had a series of x-rays which indicate an irregular shaped lump on one side of her stomach.

The vet has given us 3 options, which we have over the weekend to decide.

Note. We live on a small island & do not have easy access to the very best equipment. Specialist visits usually involve a 4-hour ferry trip to the UK. We do not have insurance, we also do not have much money, but will find the money to do whatever is best for Marmite.

We do not have the facility on the island to do an endoscopy & biopsy. We do have an endoscope, but a biopsy would need to be taken by an invasive operation.

Option 1

Refer Marmite to an oncology specialist in the UK. They would have the best equipment & best surgeons available. They could do an endoscopy, take a biopsy & refer back to us to decide on the next step. If necessary, they could operate on the tumour. The costs would be substantial.

Optionally, we could bring her back to the Island for any operation, therefore giving the vet the additional information of what type of tumour is present.

Option 2

The vet here could operate & expose the stomach where she could check for a tumour from the outside of the stomach. She could also check whether the cancer has spread to any other organs. On that information, if the cancer has gone too far, or the stomach tumour is too large, she could either stop any further work & sew back up again, or enter the stomach to take a large biopsy & try to remove the tumour.

Option 3

If Marmite does have a Gastric tumour, the chance of survival is low. We could manage the pain & let her go when it is best for her.

Please help.

:heart3: Oh, I'm so sorry. It's devastating to learn news like this, I know. Our first kitty, Lazlo, was diagnosed with a cancerous tumor in his stomach at the end of July. Without treatment, he was given maybe 3-4 weeks to live.

His problems was treated the same way yours was, it sounds like, at first. When he didn't respond to the depo, the vet did an xray. They found a "massive mass" in his stomach, and from the xray, it looked like it had spread to various other organs. They scared us very badly! But they recommended an ultrasound. I don't know if that is an option for you, it was expensive, and is not definitive. But an ultrasound can tell you if it's spread, and depending upon the experience of the technician/radiologist, can help you be pretty certain whether or not it's cancerous/malignant. Is that not an option?

I'm also wondering about the biopsy. Lazlo had his done that same afternoon as the xray and the ultrasound. It was a needle biopsy - quick and not invasive. Can you ask about that?

The results came back the next night, and our vet recommended we see an oncologist. For us, that was only a 2-hour drive (one way), no ferries involved. :heart3: It is expensive, but it dramatically improved his quality of life (along with the other meds given as part of the treatment: a small dose of prednisone, an appetite stimulant, and an anti-nausea medication). That anti-nausea medication made ALL the difference. Our Lazlo also had bleeding ulcers - and the brown water you say she threw up says to me she may also have bleeding ulcers. We are treating Lazlo's with a drug called sucralfate, which helps coat the lesions, and pepcid a/c, to reduce acid.

We dont' have insurance either, and treatment is expensive. We've had to sell what we could to help pay for this, though there are some chemotherapy treatments that aren't so expensive.

If the local vet cannot perform a needle biopsy to get the diagnosis, what you may want to consider is going to the specialist oncologist to get the biopsy and diagnosis. I do believe an ultrasound would be the most economic (even though still expensive) way to determine if it's spread or not, and if that cannot be done locally, perhaps they can do that as well.

The problem is that without THESE tests, there is no real way to know what the course of treatment would be, what the options are, and what her prognosis is.

What you do need to know is that cats tolerate chemotherapy FAR better than humans do. Also, when caring for cats, unlike in treating cancer in people, the vet's main concern is about the QUALITY of life of the cat, not the LENGTH of life. Very different approach than in treating people. :nod: Cats are given smaller doses of chemo than people are relative to body weight, so toxicity is rarely an issue. About 15% of cats do not tolerate chemotherapy (when administered at proper doses).

However, what TYPE of cancer it is will also be important in deciding what and how to treat her. Lymposarcoma is the most common form of cancer, and it's what our Lazlo has. There are two types of Lympho - large cell and small cell. The large cell is cancer of the more mature white blood cells; it can be treated effectively with chemotherapy about 50% of the time. The small cell is cancer of the new white blood cells; it can be treated effectively with chemotherapy about 85% of the time; and when "small cell" lympho goes into remission, according to our specialist oncologist, it "stays" in remission. If the large cell lympho goes into remission, it is usually only for 6-8 months, and each time it goes into remission, it is usually for a shorter and shorter period of time.

Lazlo has been on chemo through August and September. The first two months were weekly treatments with an ultrasound each month - four weeks on, one week off, the ultrasound done during that week off from chemo. His tumor has shrunk 40%. Now he moves into cycles of treatment every other week, and after two months, we'll see where things stand. If his tumor doesn't go into complete remission, he may stay on a low dose of "maintenance" chemotherapy for as long as he's comfortable.

But the difference in him is amazing, truly.

There is a chemotherapy pill that may be effective for the cancer if it's lymphoma. Perhaps it's worth finding out what type of cancer it is, and perhaps the specialist oncologist would be willing to work with the local vet to guide them on treatment, so you don't have to travel so far just for treatment?

Also, if your baby suffers a lot from the vet trips, and if the treatment would wipe you out financially, then what you may want to do is figure out just how to best make her as comfortable and as happy as possible. A low dose of prednisone (our cat is 11 pounds and on 5mg), an anti-nausea medication (we use 1/4 of a 15mg Cerenia pill every day), an appetite stimulant (we use 1/4 of a 16mg Mirtazipine pill every 3 days), and treatment for what may be ulcers may go a long way to making her feel better again.

We have had to syringe feed Lazlo at times to keep his weight up.

I'll write more in a bit, I want to provide a couple of links to other threads. Just know we're here to help!

And vibes for you and your baby (LOVE her name!)

Just wanted to tell Marmite and your family will be in my prayers.

OH hno: I am so very sorry for you and Marmite . Laurie has some excellent advice above and I just want to send along my vibes and prayers to you. News like this is just really hard to take.... :heart4:

OK, here's a link to our odyssey with Lazlo, once the tumor had been found: Mega massive vibes for Lazlo, urgent

And here's a link to the "treatment" (an approach to loving our terminal kitties) called "Love and Cheese Danish" by the member who first shared how she handled the terminal cancer one of her dogs suffered: Love and Cheese Danish :heart3:

Thank you so much for your replies & especially to LDG for your helpful post which has given me some hope.

I seem to be at a crying stage, so won't be able to write very coherently at the moment. Marmite, appears not to be too bad. She is doing most of her regular Marmite things & we had a short play earlier with some string & her favourite bubble-wrap. She is an indoor only cat & I have an interest in cat behaviour. I have noticed that occasionally the will settle somewhere unusual, which could indicate that she is in occasional pain. She is not hiding or refusing contact. She is eating normally, although I am feeding her meals in two parts with about an hour & a half between. Last night, she was not sick & slept with us on the bed as usual.

Reading my old posts, I think that Marmite started to get problems back in April this year. I have tried to contact my old vet in the UK, but was only able to speak to the emergency receptionist due to the weekend. I was able to confirm that they do have the correct equipment. It would be a long trip though, 4 hours by ferry, then another 6 by car. It feels that the trip would be unfair on Marmite. I think that I will take Monday off work to try to sort out all my questions with the vets. I will ask about the needle biopsy, I'm not sure why the vet didn't suggest this. Is a needle biopsy possible with stomach cancer? I was also not offered ultrasound. Maybe again, they don't have the equipment. I wasn't told about chemo either. I am going to spend some time looking at getting a loan, I can't face not being able to do everything I can for my friend.

That would be a very long trip, and hopefully you'll be able to find an alternative. :cross:

Right now, you don't know if she has stomach cancer. A gastric tumor may be lymphoma (or another type of cancer, though lymphoma is the most common form of cancer in cats), not stomach cancer. Lazlo has a large tumor in his stomach, but it is not stomach cancer. I don't know if a needle biopsy is an option. But if it is a mass, as indicated by the xray, I would imagine it would be an option. But I'm not a vet, and I'm new to this too. :nod:

I know those tears. Many of us do.

But the GREAT news is that your baby feels well! She's eating and playing! When Lazlo's cancer was discovered, he'd lost significant weight, was no longer playing, grooming, eating, and was mostly hiding under a chair. So hopefully you caught this early enough (We believe Lazlo's problem started in December or January, even though the tumor wasn't large enough to detect on an xray in January) that you will have some options. :heart3:

Thank you so much. This takes away the feeling of hopelessness that I had earlier.

I seem to be on the verge of crying all the time, but am trying to keep strong for Marmite. We have been playing again & I give her my time every moment that she wants it.

I think that I am heading for a decision to ask for her to be referred to the Liverpool University Oncology Hospital. They look to have the best equipment & best experience in this area. If there is a chance of helping Marmite, I think that they would be the best option. The trip would be a 4 hour ferry crossing, then probably an hour in the car. The issue here on the Island just seems to be that the vets just don't have the advanced equipment available.

I am taking Monday off work to arrange everything I can & talk to the vets, also the bank to try to finance it all.

I found out about this only yesterday about 28 hours ago. Sitting here now, watching Marmite sleeping on her radiator bed, it feels like I've been in this state for a month. Friday seems a very long time ago.

I have called my vet this morning & asked them to refer her to a specialist. They were happy to do that & I got a call from Liverpool University small animal hospital within a few hours. I have booked Marmite in to see them next Monday. They had an appointment ready for her this Thursday, but I simply could not get Marmite there in time. We live on an Island & the ferry company is now in the off-season, so we have trips to the UK only at certain times of day. I considered flying her, but Marmite would have had to travel as cargo & I could not put her through that. Next Monday, they will start tests on Marmite to get the type & stage of cancer. If necessary, they will also operate. Marmite will be at the hospital for between 2-7 days.

Meanwhile, I have called my bank & asked for a further advance on my home loan, called a mortgage in the UK. This would give me a secured loan for the same period as my mortgage & at relatively low rates. Although with quite high costs to set up. At least if I get this, I would be able to afford to do whatever was needed for my Marmite.

http://www.liv.ac.uk/sath/

I hope to God that I have done the right thing for my little friend.

Please keep us updated - again, you and Marmite are in my thoughts and prayers.  Marmite is blessed to have your love, no matter what happens in the days ahead.

It can be so very hard, especially in your situation where the specialist is difficult to get to. :heart3: Just know that you are not alone, and if you need to chat, we're here! Waiting is the most difficult part! At least with this course of action you'll have what you need to make informed decisions. :heart3: And of course I completely agree with Darlili. :heart3:

:heart3:

Thank you so much for your kind words.

Today I received the confirmation letter from the University hospital & the ferry was booked yesterday. The bank haven't called back at all yet. I really could have done with getting that moving, at least I would have warning if they are going to refuse me. If they don't call tomorrow, I will try to get a bank loan instead.

I am managing Marmite's food to keep her sickness under control. I feed her half her meal in 4 dishes, so she has to hunt around for her food. (Although the dishes are always in the same place). I then feed her the second half of her food in the same way about 1½ hours later. I make sure in the evening that she has finished her food before 8pm. When we go to bed, she always sleeps in our room on the bed next to me & I give her 3 little yummy treats. I pretend to hide them & I have always done this for her. I feel now that I'd like to give her a whole packet of treats because she likes them so much. But I try to be strong & keep with the program as at this level, it doesn't make her sick & I need to keep her strong for the operations. Marmite's last sickness was a little bit in the night last Saturday.  If she is sick, it seems to be between 4am & 6am when she gets up for a drink of water & use her toilet. The vet told me that it takes 2 hours for food to get through a cat's stomach. I really don't understand how that ties-in with her sickness early mornings.

I'm not sleeping well at all & am starting to feel "drained" all the time. I suppose that is normal?

First of all, it's just great she's eating! :cross: that keeps up. :nod:

And I know what they say about the digestion, but perhaps the tumor has affected the process. Does she throw up digested food? Or bile? Or does it just look darkish? If it's digested food, then it's just not moving through her system normally, and that's not unusual for the situation. If it's just foamy, you'll want to ask the specialist about an antacid. Of course, you already know she has bleeding ulcers - are they being treated? You might want to call the local vet to ask about these medications: Sucralfate (I'm sure it, or an equivalent, is available there :nod: ) Sucralfate coats the tummy, and adheres to lesions like ulcers - it's like a bandaid for a bleeding ulcer. http://en.wikipedia.org/wiki/Sucralfate An antacid before sleep might also be a good idea. It could well be that an empty tummy is the problem, and it's too acidic, causing her to throw up. This is one of the reasons I'm up all hours of the night feeding Lazlo when he asks for food. I'm no longer trying to force him into the "normal" meal times. In the U.S., they typically prescribe a 10mg dose of pepcid a/d as an antacid for cats. It's a very common antacid you can buy in any pharmacy here. I'm sure there's an equivalent there. :nod:

And as she's eating now, it wouldn't seem she needs an anti-nausea medication, at least not yet. For Lazlo, this was critical, and it's something you should ask the specialist about if you decide to pursue chemo treatments, if that's an option. :nod: This made all the difference in his eating on his own.

As to the treats... if it were me, I'd be spoiling her a little LOL. Lazlo is thriving on all the extra attention, and I think it increases his willingness to put up with everything he has to go through. :heart3:

BTW, can you obtain any Flower Essences there? The line of flower essences most commonly seen here, Bach's, originate in the UK. Most health food stores and many pharmacies carry them here. You should see if you can obtain some Bach's Rescue Remedy before the trip. Dabbing just a little on the back of her neck, the base of her tail, and under her chin before the long travel may help calm her. And if you don't already have a product called Feliway (also available in most pet stores in the UK, though obviously I don't know about where you live - it's worth asking about though), if you can find it, you might want that too. The spray. Spraying the inside of her crate the night before you travel (with a fair amount of it) may also help her feel better for the long trip. :cross: :heart3:

As to feeling drained, tired, and stressed, yes, that's normal at this point. Well - the being tired may be the norm for some time. We don't let the cats free feed, and last year we switched them all to wet food only. There are two that refused to competely switch, but I don't leave dry food out. They get it at meal time. But with Lazlo... if he wants to eat, he gets to eat. And he wakes me up at all hours of the night to have a nibble. I'm just tired all the time now. Although I will say that once we knew what we were dealing with and decided on a course of action, it didn't seem as much of a drain. I'm sure part of what you're feeling is anxious - you've got a long trip, you don't have an answer on the money, and you don't know what type of cancer she's got or what the prognosis is. I'm sure all of that is weighing heavily on you. :heart3:

But you'll start to get answers. :nod: And of course, the waiting is the worst part!

Thank you Laurie

As I seem to have the sickness under control right now, I don't really want to treat Marmite with anything else until I get the diagnoses on Monday. I also doubt that the vet would want to prescribe anything so close to the tests, unless Marmite gets ill. We can get Bach's & I already have Feliway spray. I will check out the Back's remedies.

The sick is different, depending on the time of day & time after a meal. Before I split her meals into two parts, she was sicking-up partly digested kibble. Sometimes she sicked up the kibble very soon after she had eaten. Now I have that under control she has not been sick like that for over 2 weeks. Her sick at night was just a brown water type substance & she has not sicked this since Saturday. A month or so ago, she sicked up some whitish foam in the night, but I think that her steroid injections seem to deal with this. She has not sicked this foam up again The only treatment she has at the moment is her slow-release steroid injection, which she had about 2 weeks ago, it should have another 2 weeks of slow release left in it.

I also thought that she may have been sick due to an empty tummy. I set the alarm for 4am a few nights to feed her a small amount of food. But it made her sick. It seems that food in her tummy at night makes her sick. I expect that the specialists on Monday may be able to explain that one.

The bank hasn't called today, which is a real concern. I will call them tomorrow & try to look at other options. On Monday, I am going to need to pay half of the initial test fee. I can handle that, I think.

Marmite is getting my attention every moment that she wants it. A little earlier this evening, we've been playing in the bubble-wrap again. There was a pesky piece of string in there somewhere! When Marmite is awake, I sit talking to her. I love how she looks into my eyes, especially when I say her name. She also sometimes watches my lips when I talk to her. Sometimes , when I say her name, she has the cutest silent meows ever. At night on the bed, I stroke her until she is ready to sleep. I stroke her if we wake up in the night too.

Tiredness is creeping up on me, time for bed I think.

Biscuity said:

...Marmite is getting my attention every moment that she wants it. A little earlier this evening, we've been playing in the bubble-wrap again. There was a pesky piece of string in there somewhere! When Marmite is awake, I sit talking to her. I love how she looks into my eyes, especially when I say her name. She also sometimes watches my lips when I talk to her. Sometimes , when I say her name, she has the cutest silent meows ever. At night on the bed, I stroke her until she is ready to sleep. I stroke her if we wake up in the night too.

Tiredness is creeping up on me, time for bed I think.

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Awwwwww.................... :heart3: :heart3: :heart3: Just so sweet and heart-melting! You two have a very special relationship, and I am sure she knows you're trying to help her. :heart3: I'd be telling her about the trip you'll be taking. :heart3:

I'm glad you've gotten the sick under control. :nod: Poor Lazlo, just before the diagnosis, he was throwing up - but not from his stomach, like upset, it's like it came up from the floor, wracking his entire body.

Given the circumstances, I'm sure it can all wait until Monday. :nod:

And continued !!!!!!

We are on the early ferry tomorrow morning. No breakfast for little Marmite as she has to fast for the tests.

I am hoping for the best for my little friend.

I am so sorry for what you're going through with Marmite!  She is such a beautiful kitty and very lucky to have you.  I wish you an Marmite the best of luck tomorrow!  

:heart3: I'll hold both of you close in my thoughts!!!!!!

I know it's later there by five hours, and I don't know if you're staying off the island tonight or returning tonight, but wanted to pop in to let you know I've been sending good thoughts and vibes all day.