Anybody know how much chemo costs for a cat?

misty8723

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Does it vary by type of cancer, location, etc.?  I'm just trying to get an idea so I don't go into total shock.  I'm just going nuts waiting for the results to get back so I can talk to my vet about treatment options.  If it is lymph node, apparently they can't remove it by surgery, so that would be out unless we wanted to see what else is going on and I'm not sure I want to put her through that if they can't remove the darn thing anyway.
 

ritz

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I'm sorry you're going through this.   I have no idea but imagine the cost varies from city to city/state to state.

But you could (1) call vets in your area and ask them and/or (2) call pet insurance companies and ask what is the customary charge for chemo.  Pet insurance companies would certainly have this information based on claims history,
 
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misty8723

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Thank you
.  We talked to our vet today and she said the most expensive is when you are dealing with radiation, and there are all kinds of different treatments so it's hard to say but some is not that bad.  It's not cheap I guess, but it's not massively expensive like my s-i-l told DH last night.  Vet also said she would check into the local vet school because they were always doing studies that could pick up a lost of the cost for us.  Basically, our vet gave us a lot of hope today, so we just have to wait and hope we can get a diagnosis from the needle biopsy and not have to do surgery.
 

ln6271

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I just want to make sure you're aware that not all animals are able to receive chemo treatments. I have a cat who underwent two radical mastectomies last year and we tried to get her on chemo after the first one but her veins just would not cooperate. The vet did some research to see if there were any oral chemo treatments that could be used, but there weren't any with solid proven results for the type of breast cancer our girl had. 
 

ldg

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Oh no!!!! What did I miss? I thought Cindy had the biopsy and it came back negative! :hugs: :hugs: :hugs: :vibes: :vibes: :vibes:

The cost for chemo definitely varies based on the type of cancer, though I think given the issue was a lymph node, you'd be looking at either small cell or large cell lymphosarcoma. Small cell lympho I'm almost positive, but don't know, costs a lot less than large cell. It's usually treated with one type of pill (don't remember the name of it off-hand) that you give orally at home. I don't know how long it's given.

Large cell lymphoma is treated with a cocktail of drugs, depending on the location, slightly differs.

BarbB's Toby had large cell lymphoma, and his only symptoms presented as IBD and an enlarged lymph node. My Lazlo had large cell lymphoma. It presented as a "massive mass" in his stomach (a large tumor).

I think Toby's treatment (Chicago) cost about as much as Lazlo's (NJ). The course of treatment is always 6 months, done in cycles of four. We both saw cancer specialists, not local vets. It cost about $1,000 a month (roughly) PLUS ultrasounds and sometimes complete bloodwork. Lazlo's cocktail included a drug called Elspar, and after the 2nd ultrasound, we decided to stop having them done every month - we saw no point. We were going the full treatment, regardless of what they showed. He handled it very well. Toby's cocktail did not include Elspar, and he did not appear to go into remission by the end of his treatment. They then did a "rescue cycle" that included Elspar, and he does appear to have gone into remission.

Of course - with Lazlo it was much easier to tell he was in remission. A number of his lymph nodes were swollen, and after the first month of chemo those were greatly reduce, and after the second month, they were no longer swollen (but his tumor was only down 40% in size). At that point, we stopped checking in. And I'm glad we did. We waited until three weeks after the end of his last treatment to do the next ultrasound, and that's when there was "no mass to measure."

The first two cycles of treatment are given weekly, the fifth week is "off" (no treatment, kitty gets a break). After that first two months, then it's every other week until the 24 treatments are done.

Chemo treatment in cats is VERY different than chemo in people. It is given at a reduced amount (per body weight) than in people, so far less side effects (typically). In treating animals for cancer, it's all about quality of life, not quantity (which is the goal in people). So a very different approach.

After their treatment, they usually feel nauseous for a day or two, and the "heaviest" of the chemo therapies is given at the end of every four week cycle - that one is harder on them.

With Lazlo, and I think BarbB's Toby, we used an anti-nausea medication (Cerenia), an appetite stimulant (Mirtazipine), and 5mg of prednisone daily is usually a companion therapy.

It's a big expense, and a big commitment. But if it works... :heart2:

FYI, Lazlo's oncologist said that with small cell lymphoma, treatment is effective about 85% of the time, and if the cancer goes into remission, it typically stays in remission.

If it is large cell lymphoma, remission is only temporary. The kitties usually come out of remission within 9 - 18 months. About 15% of cats don't tolerate the treatment (meaning side-effects are not worth having the treatments done), and remission occurs about 50% of the time (the literature states 60%, but our oncologist's experience is that it's really about 50%). The cancer is usually more aggressive when it comes back, and chemo treatment less effective - and if chemo puts it into remission again, remission times are less each subsequent treatment. If and when (I like to think "if" :heart2: ) Lazlo comes out of remission, we will not do chemo again. Not because it was difficult. He actually handled it and the trips to the vet really well - which is why we continued with it. Our thinking at the time was - let's give it a try, see how he handles it and responds. If it's too stressful, we won't continue. Well, it went well, and he only felt better and better.

I don't know how Cindy's doing, and I'll have to go find what I missed. But if, like before, she feels fine, then it may be a more difficult decision. :heart2:

Here is a link to BarbB's thread: http://www.thecatsite.com/t/243465/toby-vomiting-and-losing-weight-fine-otherwise (The first few pages were getting the diagnosis)

And here is Lazlo's thread: http://www.thecatsite.com/t/234030/mega-massive-vibes-for-lazlo-urgent
 
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misty8723

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LDG, I haven't really updated Cindy's problems, so you didn't miss anything.  It's been an almost unbearable week, DH and I have been crying a lot.  In a nutshell, here is the situationi:

We did get the biopsy back negative, but the vet warned us at the time that it didn't mean there was no cancer because it was such a small sample.  Cindy went on Prednisolone 5mg - twice a day for 7 days, once a day for 7 days, every other day for 14 days - after which we were to take her back to the vet to palpate the area.  We took her back Monday, and not only was the mass still there, it had grown.  And she had lost .7 pounds since we were there last. I knew she was losing weight, it's very evident.  She is still eating, drinking, using the litter box fine.  The vet told us sometimes the only symptom is weight loss.  We scheduled a second ultrasound, but since it's a mobile unit the only appointment we could get was January 17th.  They put us on a waiting list, but were only able to bump it up one day.  Meanwhile, DH decided he wanted to talk to a second vet in the area who is highly recommended.  So with the approval of our vet, and Cindy's records, we went to see Vet #2 on Wednesday.  They did a check up and also XRays of her chest. There were no masses, but one additional lymph node appeared to be enlarged.  However, it only showed in one view so they weren't sure.  As it turned out, the Mobile ultrasound unit was scheduled for that clinic the next day and they were willing to fit us it.  We took Cindy back Thursday morning and found it had grown quite a bit.  They also did blood work for us since her pica seemed to be getting worse (eating pieces of cardboard from her scrathies, licking the carpet, and DH saw her eat a bit of litter) and they were concerned she might be anemic, which I guess she isn't.  They also took more samples to biopsy and that's where we are now - waiting for the results to see how to go forward.

Here is the ultrasound report:

Assessment in comparison with a prior study on 11/28/2012:

1. The lobulated, hypoechoic mass in the  mid abdomen now measures 7.39 x 2.51 cm, greatly increased over the prior 4.60 x 2.56 measurement. Again, the mass doesn't appear associated with any organs. Several aspirates were obtained with 22g needles with no apparent complications.

2. The spleen appears normal.

3. The left medial iliac lymp node is mildly enlarged (2.23 x 0.61 cm).

4. There is still suspended debris in the bladder.

Diagnosis:

Mid abdominal mass, likely lymphoid, increased in size, likely neoplastic.

2. Left medial iliac lymphomeagaly, likely reactive or neoplistic

3. Continued debris in bladder

Her blood test had slightly elevated Neutrophils (8514 with normal range 2500-8500 /uL) and Monocytes (1161 with normal range 0-600 /uL).  The second vet said it could be indicitive of infection or cancer, my primary vet wasn't overly concerned because she said it could be attributed to stress (and Miss Cindy was certainly stressed).

I've spoken with our primary vet serveral times.  She has told me to call her on her private phone when we get the results and she will get us in for a consultation.  If we get a diagnosis, we can discuss treatment.  If not, we will be looking at potential surgery.  The surgeon she uses is board certified and someone that all the area hospitals call in when they have out of the ordinary surgery.  They do laser surgery, but as the vet explained, they would have to do a combination of both because they would need to excise some of the tumor to biopsy it and can't do that with laser.  She has also recommended her oncologist.  When we talked to her yesterday she was explaining some of the potential treatments (because DH asked her if there was any hope, and also expressed our fear that it would so massively expensive we wouldn't be able to afford it).  She told us that they are always doing studies at the local Vet school and she would check if they were doing any that might benefit Cindy.  A lot of the expensives would be paid that way.  We first have to see what it is, what the treatment would be. Likely, Monday we will find out something more definitive. DH wants to have consultations with both vets, and also the surgeon and oncologist.

I've read some of the threads you pointed me to, but I will definitley go back and study them more carefully now that I know it is cancer.  As always, thank you so much for your continued support, and I will say a prayer that Lazlo remains in remission for a very long time
 

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Well, I'll keep up the vibes it's not cancer. !!!! :heart2: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes:

...though that's great you live near a vet school!

I do need to provide a correction. I was wrong to say it cost $1,000 a month, because after the first two months, the treatments were every other week! Basically, the cocktail Lazlo was on ranged in price (and depending on what bloodwork was done) from $180 to $250 weekly. So obviously it cost more those first two months when he had weekly treatments. And we stopped having ultrasounds done after the first two months, so that saved some money they wanted us to spend.

Interesting that surgery may be an option.

:hugs: :hugs: :hugs: I remember all too clearly what you're going through right now. :hugs: :hugs: :hugs:
 
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misty8723

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Thanks!!

Surgery is not an option for removing it.  As the vet explained, if it's in one lymph node, it's in all of them, and they can't take out all of them.  Surgery would only be if they don't get a good diagnosis from the needle aspirates, so they could see what it is.  Can't treat it if they don't know what kind of cancer it is.  Since they took several this time instead of just one, I'm hopeful they will have something definitive.  Unfortunately, if it still comes up negative, I guess it will have to be surgery.  What other reason would there be for it to increase so much in size along with her weight loss than cancer? 

Yes, we are lucky, we live near NCSU Vet School, which is a really good school as I understand.  All of the vets we've seen are graduates of there (I think) and have many contacts as well.  Our former landlord when we first moved down here almost 20 years ago was a professor there (we are thinking about looking him up to see if he's still teaching there). We're also fortunate that there are a LOT of vets around, and two (3 actually, but one of them I would never go to) specialize in cats only.

Well, $250 every other week after the first couple months is not bad!!  I'm going to look at that care credit thing to see if that's an option, and see where we can cut back on our expenses.
 

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Oh gotcha. I should have known, but obviously my brain isn't functioning well this weekend. :anon:

Honestly, for us the costliest part was all the trips to the vet BEFORE diagnosis, and the repeat blood work, ultrasound, biopsy etc. involved in getting the diagnosis. At that point, once we had a diagnosis, we went to see the oncologist. We figured there was nothing to loose in at least meeting with him. He explained everything I did to you: prognosis, potential outcomes, possibility/probability he couldn't tolerate the chemo, etc. He explained the treatment method (the cycles, what diagnostics they wanted done when, etc.), and then gave us a print-out of the protocol he'd use for Lazlo's cancer. The real difference, I think, between an oncologist specialist and a vet, is the more-specific tailoring of the cocktails of drugs, and adjusting the cocktail and the amounts given as you go. I don't really know how much of an impact that makes. :dk: But when Lazlo didn't have a good week as re: appetite, energy, etc., they'd cut back a little on the amount. But a vet is just as capable of doing that as a specialist is. :dk:

For us, the oncologist was 1.5 hours away (one way). Lazlo was really good about the trips, so we went. But we found out later the local vet could administer the treatments, and we had the protocol from the specialist! I wish we'd figured that out sooner, we'd have saved a lot of time, stress, and gas. :rolleyes: The problem with that was that one of the drugs is really expensive, and Lazlo's dose didn't use all of it - and they didn't have stocks of it because they didn't have other chemo patients using it. But I mention this, as it's something to consider if she does have cancer ( :cross: :vibes: :vibes: :vibes: ). And let's not forget - if it IS cancer, it may be small cell lymphoma. For that, you administer leukeran at home - it's an oral pill. I don't know how much it costs, but I do know that typically the prognosis is quite good, and it's usually well tolerated.

:hugs: :hugs: :hugs: and more :vibes: :vibes: :vibes:
 
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misty8723

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You are giving me fantastic information and I truly appreciate it.
  We will also be meeting with the oncologist once we know what type of cancer it is, and hopefully it will not be a 1.5 hour drive each way.  Cindy doesn't mind the rides too much I don't think, but she's so high strung and right now she's just nervous about just about everything.

One thing I want to ask about is a medicine that is supposedly a pain / anxiety medication for cats.  I've forgotten what it's called, but I think it's something like buporian (?).  She  has had it before after a tooth extraction and did really great on it.  Very relaxed.  One of the vets we spoke with mentioned it, and we want to follow up.  I know it will be easier for her to fight this if she is more relaxed. 

I am a ball of anxiety right now.  I pray we get a definite diagnosis and don't have to put her through surgery.
 

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I'm pretty sure you're referring to the pain medication, buprenorphine. I don't know if it's a good choice for somewhat long term use, it's a synthetic opiate. I suspect there are better meds for "just" anxiety, but I'm not really familiar.

A natural one you can discuss with the vet is L-theanine. In supplements (for people and for pets), premade, it's called Suntheanine. For our highly strung kitty, I use NOW (the brand) L-theanine, not a premade "anti-anxiety" supplement. I buy the 100mg capsules, and sprinkle about 1/4 on her food daily. Don't know if it would help Cindy, but can't hurt to look into it. (It's safe to use 25mg - 50mg. It's a naturally occurring amino acid).
 
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misty8723

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No, I wouldn't want to use anything on her long term.  I'm even very suspicious of supplements.  But I just hate to see her so stressed out and I know it would help her with the process if she could get over her anxiety.  I'll talk it over with the vet to get her opinion.  This morning Cindy found a new hiding spot and neither DH nor I could find her.  Fortunately, this is not the day for her Pred, but we need to know where she found so we can get her tomorrow.  She is one smart little cookie, probably watching us frantically search, laughing at us the whole time.
 
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