Cindy Update

Here is an earlier thread about Cindy's issues:

http://www.thecatsite.com/t/251565/vibes-for-cindy-please

I just spoke with the vet.  She said they didn't find any cancer in the needle biopsy, and that what it looks like is a "reactive lymph node." She did make a point of telling me that just because they didn't find cancer in that sample, doesn't mean there isn't cancer somewhere. She said she spoke with another vet who has seen cases in cats, where they get enlarged lymph nodes.  Choices of treatment are surgery so they could get a better look at what's going on, or steroids with a follow up ultrasound.  I asked her recommendation, and she said if it were her cat she would try the steroids first.  I agreed, and we are going to pick up the prescription tomorrow.

DH wants to talk to her some more and has some questions, so we're waiting for her to call us back.  Or may have to talk to her tomorrow, because I know the clinic is closed and she may not have gotten the message.  We may get a chance to talk to her when we go pick up the pills tomorrow.

Does anyone have any experience with reactive lymph nodes?  Did I do the right thing by going with steroids first? I should mention that Cindy is eating, drinking, not vomiting, and normal acting except for being frightened of something in the room with the litter boxes and urinating on our bed.  We do have a litter box downstairs now and she used it twice today.  We also have one the bathroom counter and she was "checking it out" earlier this morning. 

I'd also like to thank everyone who has sent their vibes, prayers, and good wishes for Cindy, it means more to me than I can ever tell you

Oh that is FABULOUS news!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!


OK - that said, I'm wondering why they're starting with steroids, and not an antibiotic?

http://veterinarynews.dvm360.com/dv...denopat/ArticleStandard/Article/detail/600276

http://www.justanswer.com/cat-health/4883z-hello-my-cat-swollen-lymphnodes-biopsy.html


After what BarbB went through with Toby, and what happened with Lazlo, and based on my understanding of causes of swollen lymph nodes because of various issues Flowerbelle just had, I wouldn't treat with steroids first, I'd want to treat for infection. BUT... I'm not a vet, and I don't know what the results of the biopsy showed, so that very likely is a major determinant of why the vet wants to use steroids vs. antibiotics. :dk: I'd also want to check back in on the swollen lymph node via ultrasound after 4-6 weeks before starting steroids - only because if it is cancer, the use of steroids now reduces the effectiveness of chemotherapy if needed. Though really, it seems this is most likely not cancer. :cross:

See, this is why I love this board!  I'm not a fan of steroids, and not happy to have to give it to her, but I didn't know about it reducing the effectiveness of chemotherapy. This vet has suggested steroids in the past as a means of clearing up her skin infections, if that means anything.  I am going to study the links, and we will discuss it with the vet before starting her on steroids.  I want to do what's best for Cindy, but I don't want to be causing her any more harm.  I can't help but wonder what part stress plays in this, because she has been one stressed out little kitty what with the giving her pills, putting methigel on her paws, etc.  She is not a cat who you can do that too and she says whatever and goes about her business. 

LDG, you are an angel!

Yes, the links are VERY helpful. But they also indicate that based on the biopsy, the vet may well have a reason for suggestion steroids rather than antibiotics. BUT... steroids are also a standard suggestion for issues of inflammation with many vets, so I do think it's best to figure out whether this is based on biopsy results OR just a "standard of treatment" kind of thing.



FYI, steroids at a low dose are used in conjunction with chemotherapy - but given prior to, they also interfere with potential diagnostics. If you want to know more about it, it's discussed in BarbB's thread. http://www.thecatsite.com/t/243465/toby-vomiting-and-losing-weight-fine-otherwise

Now - the problem was different, she was dealing with IBD. But it will give you a sense of the issue as re: steroids and diagnostics when it comes to enlarged lymph nodes and the various reasons and getting to the root of the problem.

DH and I are going over to talk with the vet at 2:30 today (just us, not with Cindy) to get a better handle on everything, including why steroids and not antibiotics first.  I know she did try to have me put Cindy on steroids in the past because of her allergies / skin infections, but when I expressed reluctance, she gave me antibiotics instead.  So, she does listen to us, and I really do like her and everyone there at the clinic. It's hard to get the complete story at first, especially when your heart is in your throat and you're shaking as you pick up the phone.  Later you think of things you should have asked, and DH had some questions as well.  We are willing to pay her for an office visit to get her undivided attention, and we will go from there.  I just want to do what is best for Cindy, and not cause her any more harm.

Spoke with the vet at length, and it was something to do with the report that steered her toward the steroids, so we are going with that.  We have Prednisolone 5 mg, 2x a day for 7 days, 1x day for 7 days, then every other day for 14 days.  We will take her back in 4-6 weeks to see if it has gone down (the vet with physically check her rather than go right to an ultrasound), and go from there.  We also got some Composure that is supposed to help cats feel calmer when they're stressed, so I might give that a try too.  Cindy is getting more relaxed, but still afraid to go in the bedroom, and still using our bed in the  middle of the  night (although  we got her in time to divert her last night).  I'm fairly optomistic that we will get through this

Oh I'm so glad you have that peace of mind, and now understand the course of action!

Hopefully she'll feel better quick. Steroids really are a miracle drug, especially for kitties!

I feel better about steroids after talking with the vet.  What side effects should I look for?  The vet said basically increased thirst, increased eating, and increased urination.  Anything else I should know about and watch for.  I'm a real freak when it comes to pills, human and kitty.  I've seen too many people have bad side effects (myself and DH included) and have the doctor deny it's from the medicine.  But I am hopeful and happy

In one of my kitties, the steroids make him more aggressive (Tuxedo), but we don't see that in Lazlo (who's been taking 10mg once a day since late July 2011 But this should be a rather short course of treatment. Tux was on a HIGH dose of steroids for years (to suppress his immune system: he has feline hemolytic anemia and steroids were the only way to keep him alive). Laz, like your Cindy, is on a relatively low dose, though he'll be on them... forever.

I hope she doesn't get aggressive, but I am seeing a difference already after only 3 days.  I don't think it's just my imagination, she seems more active and alert and she's down off the recliner chair and sitting on her chair in the window.

And yeah, Tuxie was on a much higher equivalent dose. Laz didn't get aggressive on the same dose Cindy's on.