Small Cell Lymphoma - Lukeran Question

On thursday of last week my cat 12 year old female cat Fiji was diagnoised with small cell lymphoma.  It took a few months to get this diagnosis.  Her condition all started with a cough one morning.  It sounded like she was trying to pass a hairball.  I did not really think too much of it at the time, but when I heard this cough happen a few times over the next week or so, I took Fiji to the vet.  The vet suspected a GI problem and changed Fiji's diet to Royal Canin SO and started treating Fiji with Doxyciclyne.  The next night Fiji had very liquidy diahrea and for the last few months and two vets I have been trying to treat Fiji for chronic diahrea.  In the beginning of September I took Fiji to an internal medicine specialist, ASEC in West Los Angeles, were they did an endoscopy and through clonality testing at UC Davis diagnosed Fiji with small cell lymphoma.

Fiji is currently taking 5mg of Prednisolone and 5mg of Pepcid 2 times per day.  She is now also taking Lukeran 2mg every other day.  Last night was her second dose of Lukeran.  She seems to be tolerating it well.  She seems to be eating good and her relative demeanor is calm.   However I am concerned about possible side effects from the Lukeran with each dose and cumulative effects?  Will the side effects get worse or is it a great sign that she has tolerated the first two doses well? 

Another question:  I am giving Fiji the pills with a pill shooter and chasing the pills with water through a syringe.  I give her about 5ml of water with each pill and then an additional 5ml of water at the end.  Is this okay?

We love our Fiji and she is a huge part of our family and we are absolutely devasted.  Our Vet is telling us that we are lucky she has small cell lymphoma and we are hopeful that we can keep her around and give her a great quality of life for several more years.  Any advice regarding supplements, diets, vitamins, alternative treatments that could increase her quality of life would be greatly appreciated.

Thank you,

Kevin

It sounds like you are doing a good job with your kitty.  You might also try the pill pockets to give medicines.  I did the pill shooter until my Muffin had to get his dose of medicine reduced and the partial pill was too small then for the pill shooter.  That is when I discovered the  pill pockets and it is so much easier. 
 

I don't have any experience with Leukeran or small cell lymphoma. But our Lazlo had large cell lymphoma, and we opted for chemo. He handled that very well. :nod: I have NO idea if the treatments are in any way comparable. His were weekly treatments, often a cocktail.

I do know the most common side effects of chemotherapy in general are nausea, and keep an eye on the litter box, for constipation or loose stools. Lazlo would sniff and sniff and sniff at his food, and drooled quite a bit (both signs of nausea). I needed to use various things on top of his foods on a number of occasions to get him to eat. Freeze dried beef liver powdered on top was a favorite.

I don't know if Leukeran will have this same side-effect, but Lazlo lost all his whiskers by the end of the six months of treatment. His fur was dull, even though he was grooming again by the end of treatments. But those both fixed themselves once off the chemo: his whiskers are all grown back in and he is soft, silky, and shiny again!

It can be a really difficult time when your kitty is first diagnosed, and you're given meds and you start... I'd go ahead and call the vet to ask all these questions, even if you asked them before. When your head is still buzzing from the news, it's hard to absorb all the information they give you - either that, or the questions don't occur to you while you're there. :nod: I should think they're used to this, and I'd hope your vet would be happy to discuss these things with you. :heart2:

Unfortunately, most cancer supplements you'd want to use are NOT recommended during chemo: antioxidants reduce the effectiveness of the treatment. There are three things you can do. :nod: One is provide your kitty an omega 3 supplement. I recommend using NOW Neptune Krill oil. You can buy the softgel, and if Fiji likes it, you can just squish it onto her food. This will go a long way to helping her coat, and won't interfere with her treatment. My kitty doesn't like it, so I just pill her with it before breakfast. It is a LITTLE large though, so if Fiji likes it, probably best to just mix it in her food. :nod:

The next is to provide her with a probiotic. Our holistic vet recommended a HUMAN acidophilus supplement. Most probiotics for pets are made of "fermentation" products, which are not live cultures. Helping her GI tract be healthy will help boost her immune system in a way that doesn't interfere with the treatment, and may help increase it's effectiveness. :nod: Our cats weight from 7 pounds to 15 pounds: they all get the same thing. 10 billion CFU (colony forming units). I use Natural Factors double-strength acidophilus+bifidus. They like it, I just sprinkle it on top of their food, but it can be mixed in.

Finally, what is she eating now? A "cancer starving" diet in a cat is a high protein, low-carb diet. When Lazlo approached the end of his chemo, I switched my cats to a raw diet. The holistic vet applauded, our other two vets weren't opposed to it. :lol3: This isn't necessary, there are some canned foods out there that are high protein, low carb. The only one coming to mind right at the moment is Nature's Variety Instinct canned foods. Obviously you want to make any food transition as stress-free as possible. Right now that she eats is most important. :nod: But if that food is available to you, it has a lot of varieties of proteins, and you can add just a little bit at a time so a "quick switch" doesn't upset her tummy.

BTW, IBD and small cell lymphoma often go hand-in-hand. You can learn more at http://www.ibdkitties.net. If she does have IBD, a raw diet would likely be good for her, though you may want to wait until she's done with the chemo. I know a lot of people aren't comfortable with it, but there are a lot of commercial foods available that make feeding it quite easy. It would provide excellent support for her immune system once she's done with her treatments.... :heart2:

Please feel free to ask more questions, and many vibes for you and your girl!

Thank you so much for the reply and the advice.  Fiji and I greatly appreciate it.  Fiji has a history of Stuvite Crystals and Urinary tract infections.  I have fed her Hills CD Diet a combination of dry and wet until recently.  I know feed her Royal Canine SO a combination of Dry and Wet, but I try to give as much wet as possible.  I will read the website ibdkitties and research a raw diet.  In the interm, she seems to be eating well and acting like her normal loveable self.  She is two Lukeran treatments in, so I am a little concerned with changing her diet until we get a few more treatments in and I see no symptoms of distress. 

Not sure were you and Lazlo live, but how would I go about finding a good holistic vet in my area.  I would like to consult with one more in regards to general health and maintenance?

Thank you so much for your response.

Kevin

If you're in the U.S., you can search for a holistic vet here: http://www.ahvma.org You can also try googling "holistic veterinarian XYZtown, State" and see what pops up. For me, it was important to find someone trained as a D.V.M. - a real vet - that also had additional training. I looked for Chinese Medicine, nutrition, and western herbs. :nod: We were lucky, and found someone 45 minutes from us.

And while she's being treated for cancer, you don't want to rush into anything.

Another way to find a holistic vet is to see if there is a local B.A.R.F. Yahoo group (B.A.R.F. is Bones and Raw Food). If your local BARF Yahoo group is anything like the one here, it'll be 99.8% dogs. BUT - a lot of them use holistic vets, and if you have a somewhat active BARF Yahoo group, you'll likely find recommendations for a holistic vet there. :nod: (Don't necessarily get raw feeding advice from the group - dogs have VERY different feeding guidelines than cats...though if they have a buying co-op, it can help with saving money buying meat. Just a thought for down the road....).

FYI, three of my boys had ongoing UTI problems. Two had struvite crystals; one had calcium oxalate crystals Two had to be catheterized a number of times. My cats ate the prescription Hill's c/d food for 7 years. I free fed the kibble and then added two meals of the canned. It was my holistic vet that talked me off both the kibble AND the prescription food. I wasn't ready for raw at the time, but they boys did do VERY well on the all canned food, high protein, low carbohydrate diet. And you might want to consider reading through the information in this thread: http://www.thecatsite.com/t/249233/apparently-cindy-has-crystals

If she's doing well on the Royal Canin, no need to make any drastic moves. BUT.... please do consider trying to keep changing that balance of canned to dry, potentially eliminating the dry altogether.

I know.. it's a lot to take in all at once, especially when you're dealing with cancer. Maybe bookmark it for future reading.

My cat Toby also was diagnosed, like Lazlo, with large cell lymphoma. But before the pathologist's final report came back, my vet and my oncologist both thought the report pointed to small cell lymphoma. They told me that small cell lymphoma is a disease that cannot be cured but that it can be slowed down considerably and it responds very well to treatment. And in the research that I did, I learned that many pathologists have a hard time distinguishing between small cell lymphoma and inflammatory bowel disease. And in fact, in many cases, both are treated with leukeran as IBD can morph into small cell lymphoma.

I have not read Laurie (LDG)'s replies to your post in detail, but I can tell you that she knows more than anybody about what is the best diet for your cat with lymphoma. Finnlacey on this board also has a wealth of knowledge about IBD kitties, and can help you with diet since, in many ways, you will want to treat your kitty's diet as if it is IBD. Also, in the case of small cell lymphoma, diet is extremely important because this type of lymphoma if I remember correctly, is always intestinal. 

I am attaching the link to the thread about my kitty Toby, and on page six there is a graph that lists everything the holistic vet prescribed for him. She recommended all of this before he had a final diagnosis and when she believed he had small cell lymphoma, so I know it is applicable for your kitty too. http://www.thecatsite.com/t/243465/toby-vomiting-and-losing-weight-fine-otherwise/150

Also, both my vet and Laurie gave me several good recommendations for a raw diet. I started Toby on Stella and Chewy's freeze dried raw "finger licken chicken" because it does not have to be refrigerated and he liked the dried version of it, altho you can reconstitute it by adding water. Right now the most important thing for your cat with lymphoma are these two words- "grain free". 

What I have learned is that you have to walk that fine line between giving your kitty food and medicine that is good for him/her, and making sure that (s)he eats enough. I think in the case of your kitty, transitioning her, using the holistic remedies, and sticking to a grain free diet is very important, and I would also try the Stella/Chewy's freeze dried raw bc many cats enjoy it like they would crunchies, and the latter is really bad for any cat with cancer so the freeze dried substitute is good, plus you can get a small package of it to try out at first. 

I have also learned not to add any holistic ingredient to a food that my cat has already eaten because he can tell when I have tampered with it lol, and so it is best to put stuff into food your kitty hasn't tried yet. The doctor's office also recommended using things like butter, whipped cream, and the like for delivering stuff that kitty doesn't like, OR to make sure and give kitty butter or whipped cream AFTER giving kitty something (s)he doesn't like. 

I hope this helps! Here is a picture of my Toby on the bed, we call him little bunny boy because he holds his paws like a bunny rabbit the way he is doing in the picture LOL. He is doing pretty well but still has about 4 more treatments over the next 8 weeks. Good luck to you and to Fifi I hope you will continue to post on this board and share pictures of your sweetie with us!!  

Hi everyone!
My puss (Bradley), was diagnosed with small cell lymphoma after a mass was found in his intestine which was initially diagnosed as an abscess. They did further tests and lymphoma was found :-(

He has today had his first Leukeran and will be getting one tablet every 8 days. He will get Prednisolone twice daily and his bloods will be taken regularly.

I can't see anyone on here with the 8 day regime.. Am I alone? LOL!

I hope he's going to be ok on it. Any signs of distress and I will stop.. He's quite a nervous cat and nearly 12 yrs old.

My last cat had mediastinal lymphoma and had IV chemo and this gave him a good 5 extra months. I'm hoping for a lot more extra quality time with this one!

So glad to have found this site. I have secondary breast cancer and find forums a godsend!

My 13 year old cat Max was diagnosed with small cell lymphoma. I just started giving him Leukeran, twice/week (first dosage was yesterday). He is also taking Prednisolone and Pepcid (daily). I'm really worried about giving him Leukeran because he is very sensitive to any medication. Except for Leukeran (liquid) all his meds are injectable because he usually vomits right after taking liquid meds or pills. About 4 hrs after taking Leukeran he vomited. Does anyone here have experienced something similar while giving these meds to their cats? I would appreciate any advice you can give me. Thanks!

Hi! I'm new to this forum.

My kittie maya is diagnosed with small cell lymphoma (11yrs old). She is on Lukeran once a week and Dexamethazone (stereoid) 2mg Injection every day, She is on her 4th week and doing pretty good. Till now-no side effects.

Wish all the best for Your kittie.