Lymphoma diagnosis - eating issues

*sigh*, well I have spent a few days reading others posts on here to assist me with my current situation but haven't got the "correct" answer yet so I thought I would send my own shout-out for help!

My little 7 year old girl started making strange breathing noises a month ago (we joked it was like Darth Vadar). First they thought it was an allergic reaction, then asthma. An endoscope exam and xray of nasal showed nothing. The next step was a chest xray before the costly MRI.

The vet decided while she was sedated to have another check around her nose/mouth and it was then they found a large mass in her palate. It appears a steroid injection had reduced the mass and so didnt show up on the earlier exam. The path tests came back the worst we could ever imagine and it was indeed cancer - lymphoma.

We made the decision to give chemo a shot on the really strict guidelines that we would never ever let her suffer.

Her first chemo took place last Friday and she did so well that by Monday the mass has clearly reduced as there is no more noise with her breathing!

Perfect!

Except she now refuses to eat (she was not eating much in the 2 weeks before chemo), we gave her an appetite stimulant and unsure as to whether it has worked as she still wont eat although she pretends she is interested (the vet thinks it may just be behavioural, i.e. I know I am supposed to eat in the morning).

Today we were given something to settle her stomach and she did come home and drink, lick some gravy and still no appetite.....

We have tried cooked chicken, 4 different types of wet food, dry food, tuna, deli meats, prawns with no success. We have warmed food to entice her but it's all failing.

Tonight we syringe fed her, something I feel is going outside the boundaries we set but we are hopeful the vet can come up with a solution to this in the next few days.

She has lost a lot of weight in the last 2 weeks (5.4 - 4kg) although she still has spark and will chase my hair

I suppose I would appreciate genuine advice in getting her to eat, especially from people who have had the same problem with their cats on chemo.

If she doesn't eat, when do we stop trying? :'(

Many thanks xo

Oh I'm so sorry for her cancer, but was so pleased to hear she's responding so well to the chemotherapy!

My Lazlo was diagnosed with lymphoma. He had a massive mass in his stomach. He was given four weeks to live without treatment - he was one VERY sick little boy. (He went to being sick to being REALLY sick in the month it took to find the cancer and get the proper diagnoses. He went from 14 pounds to 9, and was skin and bones then).

Like your little girl, the chemo affected his appetite. Maybe his sense of smell? Both? But it was hard to get him to eat for a while. I also syringe fed him, but he didn't fight it. I only had to syringe feed him his entire daily requirement of food for about a week, but after that he still didn't eat enough on his own, so I would syringe feed him as needed. I think this was up to a month? Maybe a little more? His course of chemo spanned six months. We were very fortunate in that he went into complete remission. We celebrated his one year anniversary of completing chemo Jan 30, and he remains in remission.

So, I wouldn't consider syringe feeding in the realm of going beyond the bounds of suffering. For Lazlo, we used an appetite stimulant and an anti-nausea medication the entire course of his chemo. I think he needed the anti-nausea medication for a little longer than that, even.

And we did have to use all kinds of enticements to get him to eat on a lot of occasions. I don't know where you're located, but in our arsenal we had freeze dried chicken and beef liver, which I would crush into a powder on top of his food, a pet probiotic called Fortiflora; I would sometimes feed him chicken baby food (nothing but chicken and chicken broth in it).... he would enjoy Fancy Feast canned food (the classic pate style with warm water added). We kept freeze dried salmon, freeze dried shrimp, used the tuna water, ummm.... you can also use Temptations treats crushed up (we bought an actual pill crusher to crush them into powder to sprinkle on top of food)..... I actually started a thread in nutrition asking for suggestions, I'll go see if I can find it.

He would act hungry, but then just sniff and sniff and sniff at his food. We definitely wasted a lot of food trying to find what would work. But cats livers will shut down without food.

Basically, I think decisions about what kind of supporting therapy is "too much" is based on a number of things, and not just what that form of support is.

My father is 83. His memory is completely gone, but he doesn't have dementia. His motor skills are completely gone, and he has very few words. But he's happy. He's in skilled nursing, and needs someone to help him do literally everything. He can't walk. My mom is there twice a day, and has been wondering the same thing - what is too much? There is a group run by a psychological nursing counselor, and they discuss different aspects of palliative care. My father has a living will, and he states that he wants no artificial means used to provide support, and specified kidney dialysis as one such thing. But a feeding tube was never discussed. Well, after talking tot the counselor, they've decided that if his swallowing function stops working, they will not use a feeding tube. But let's put that into persepctive: He's lived a full, wonderful life. He will never regain the use of his muscles or his memory, he'll never have his words back.

But if a 30-year old was in a tragic accident, and needed all that same level of care - but had the hope of having their memory back, the use of their muscles, and their words, of course the decision is going to be to provide a feeding tube!

Your 7-year old girl is responding to the chemo. She's that 30-year old that potentially has more years left to live than she's already had alive. There is no reason, IMO, if syringe feeding her isn't overly traumatic, to get the nutrition she needs into her simply so her liver doesn't shut down. :heart3:

It can be frustrating to find what will work on any given day to get our kitties feeling "off" to eat.

FYI, sometimes it can be a texture issue, or it can be a temperature issue. Sometimes he liked his food warmed up. But please don't let her nausea stop you from forging ahead! This will pass. If she otherwise feels fine, it comes with chemo, that nausea and inappetance. But it does get better!

:heart2:

OK, found the thread: http://www.thecatsite.com/t/235692/food-to-entice-cat-with-smell-problem-to-eat

I hope you find some suggestions in there that will help your baby!

OH! FYI, I'm not sure what was given to settle your kitty's tummy. But Lazlo needed famotidine (pepcid a/c) daily. If you use this, it needs to be given at least one hour after food and at least one hour before food, or it only helps with an individual meal, not 24 hours. He also needed an anti-nausea medication daily. The one we used was called Cerenia. It worked really well for him (even though he did need syringe support anyway for a while).

Many, many thanks LDG and so sorry to hear of your kitty cat's troubles as well.

A few days later and limited success. Yesterday 2 bites of food and some water drinking, today some syringe feeding and a wee. it is amazing how important these things become in your world!

She was given some tablets but they were more in case she has a gastro upset. I am picking up some anti-nausea on the way home tonight, so fingers crossed. They can find nothing "physically" wrong. Bloods are normal, mouth is fine, tumour has shrunk (no breathing issues), so it's a mystery and terribly frustrating when she cannot tell me.

I have far from given up on her, I won't until she tells me to. Unfortunately I have to go away next week (please no judgements anyone, my guilt factor is already sky high!), I need to work to pay these vet bills! I spoke to the vet and they are happy to have her board there, my hope is that having her 24/7 they will be able to figure this out.....or maybe that is me just trying to limit my feelings of guilt

She is the sweetest little thing and has had a tough life....cat flu as a kitten which required syringe feeding, followed by eye surgery for rolling lids, cuts and stiches and now this.....and she has always been an indoor cat! So she deserves, love, attention and to be fought for. I have made the decision to take each bit day by day, at any point should she be in pain or be miserable then the choice becomes me being the stronger person and doing what is best for her and not driven by my grief at the thought of not having her in my life.

I tell you though, this has been hard to explain to a non-animal lover, I have had a few funny looks at work!

lots of love and many thanks xo

:heart2: :heart2: :heart2:

And no judgment - as slaves to our kitties, we understand having to travel for work. I'm sure they'll take very good care of her. :heart3:

YES! That is exactly it. One day at a time. With Lazlo, he never gave us a sign he wanted to stop. And let's face it.... our kitties love us and life too! So just let her know you're listening, and that you'll be OK whatever she decides or needs. :rub: That way she'll feel more comfortable letting you know. :heart2: :rub:

:grphug2: :grphug2: :grphug2: And many vibes for your baby girl!

Hi. Just wanted to add my comments that Famotidine and Cerenia also helped my cat with lymphoma. also making sure he was well hydrated since dehydration can cause nausea. so i gave SC fluids at home as needed.
Maybe that was just a particular problem of his though.... he had multiple complicated medical problems besides the lymphoma.

I am glad to hear that on the whole she is doing well. I hope they will figure this issue out. It may actually work out very well that she'll be boarded at the vet .
I had to sometimes board my cat at a 24 hour emergency /specialty vet hospital if I had to go out of town and he did great --- they loved having him.

I know what you mean about non-pet lovers having a hard time understanding. I do not even tell most people how much I spent on Louis's medical bills. I used to joke he was the million dollar rescue cat. OK , so it wasn't even close to that. but I know it was way more than a lot of people would think was sane. I did finally have to let him go last year at age 15, and still miss him terribly, but i am glad to have been able to help give him some extra years because he loved life so much.

Thanks so much for th extra information and advice! It is a huge blessing.

She did great at the vet hospital for the week and made some new fans Her eating was limited but they don't seem concerned. She has been home a few days now and has eaten almost nothing but is drinking. We have tried everything and I am spent....so I have relented and syringe fed her. Not good for either of us but I cannot bear to have her starve to death.

Week 4 of the protocol coming up...another IV dose and then a week off. Hoping that she can hang in until week 5 and maybe the breathing space will help her recover her appetite.

Much love to all and their kitties.

xoxo

Yeah, we did a fair amount of syringe feeding that first month.

I'm glad she did well when you had to board her, that's a comfort!

Continued for your girl.

Wait - so she has an anti-nausea med. But has she been given an appetite stimulant? Laz had both, the prednisolone, and the acid reducer....

Thanks LDG

We tried her on an appetite stimulant but it didnt go well, she reacted really badly.

We got an alternate anti-nausea drug today which I am hoping does the trick, will keep you posted.

xoxo

Oh, I'm sorry the appetite stimulant didn't agree with her. I don't actually know where you're located, but in the U.S. there are two principle ones, and they work very differently, so one causing a bad reaction definitely does not mean the other will. One is mirtazipine, which is actually an old line antidepressant. This one can work really well, or, as you say, cause a very unpleasant reaction. The other is cyproheptadine, which is an antihistamine. If you're not in the U.S., I expect they use the same drugs but they may have different names. It's worth asking about, depending on how she does with this new anti-nausea med. :cross:

HI LDG,

We have been on the new appetite stimulant drug (not anti-nausea) for the past week and her appetite has picked up. I still don't think it is what it should be but for the first time in a month she is actually asking for food

We took her to the vet on friday for her 4th week of chemo, I expressed my strong concern regarding her weight so they decided to do a full exam and bloods. From their assessment they could find no evidence of the cancer (clearly it may be there floating in the background). She had lost another 200g and was down to 3.4kg Based on this they decide to bring forward the "gap" week and not give her chemo this week. So we are working on the eating trying to get some strength back.

Getting to the point of not overthinking, everything seems to change on a daily basis and I am slowly going bankrupt haha kidding but geez they really expect an open cheque book.

btw I am in Melbourne Australia.

cailea xo

I'm REALLY glad to hear there's an app stim that's helping! I did support Lazlo with syringe feeding when he wasn't eating enough. Silly kitty, he actually seemed to enjoy it for a while. It's like he knew he needed the food/nutrition, but just didn't want to eat.

And yeah... know that accumulating cost thing. You're always wondering, hoping, it's the right thing to do for your baby.... :heart2: All you can do right now is take one day at a time, and count each moment with your kitty as a blessing, a gift.

Our oncologist also altered things as necessary, depending on how Laz felt. :nod:

Lots of vibes she'll enjoy - and do well - with the week reprieve! I hope her appetite picks up! (I also really hope you'll have the same results we have! We're approaching 14 months in remission! :cross: ). !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Good to hear that the appy stim is helping. I hope she puts back on some weight this week off. Pretty nice to find no sign of cancer too! Hey sometimes you do just have to assist them to get food into them. , get them past that period when they dont feel like eating. Your kitty is so lucky to have you!

My little girl Abby xoxo

Just a little update.

We had improvement and then she was back on the vincristine drug, albeit at a reduced dose and it resulted in the same issues as before, no eating for 6 days now. Sleepy, unresponsive and generally ill looking and acting. She is terribly cold all the time as well.

In the last day or so, I could be imagining it but her breathing is not smooth. Which was the sign of the intial oral cancer diagnosis, so that has me worried. Also one of her eyes is looking different in that the iris is less dilated than the other. I am beginning to wonder if I am imagining things!!! I think the lack of sleep may be affecting my brain!

Tomorrow we head back to the vet, initially for more chemo but I have said no more until she improves but they are going to do a check up anyway.

I am trying so hard to stay positive but I am for the first time very scared that I am getting close to losing her.  However long she has, I don't want her to be miserable and constantly sick from chemo.

lots of love

xo

Aw hun....

We definitely skipped a treatment or two. The oncologist always asked how Lazlo was doing, and would either adjust the treatment schedule or the dose of whatever was being delivered.

But hun.... you can't let her not eat. :heart2: She needs to be assist-fed with a syringe. Do you have syringes and the prescription food for critical support - a/d? Is the problem that she throws up if you assist feed her? Her liver needs the food moving through her body, and her body needs the nourishment. :heart2:

Is she on a steroid? And an anti-nausea med? AND the appetite stimulant? Lazlo was on all of these for his entire chemotherapy, AND an ant-acid. Perhaps she needs some supporting therapy?

Hey LDG,

I have been syringe feeding her 4 times a day (up until yesterday) with a high calorie mix from the vets.

Unfortunately I came home yesterday and she seemed worse. Its hard to explain but I just knew things were different.

I called the vet and explained what was going on and they think the tumour is back, her breathing is like it was at the beginnng and the eye problem could be linked. I have made an appointment for saturday, my husband has changed his flight so he can spend tonight with her. I think we both know it's time.

If the vet confirms tomorrow the cancer is back we have decided to let her go. There is of course a small chance an infection is causing the breathing and eye issue but we are trying to also realise the chemo is making her badly sick and whether we can continue to do this to her. If it were just a case that I had to feed her for the next 4 months I would do it in a heartbeat but it's more than that, 7 days out of 7 she is sick, that is not quality of life for her.

Tonight is going to be one of the longest nights of my life but I want to savour every moment of her, the guilt is just tremendous though. I am just hoping we can be strong enough to do what is right for her and not for us.

Thank you so much LDG for all your support and words xo

Oh I misunderstood about the eating/feeding.

I'm so sorry, sweetie. :heart2: I'm holding you and your beautiful Abby close to my heart. :heart2:

No worries LDG. Thank you for all your support and advice over the past weeks, we said goodbye to our little girl yesterday.

Words can't explain how much our hearts miss her already. I have posted on crossing the bridge.

Many thanks all x

I'm so sorry for you loss. May Abby rest in peace.

Abby's Bridge thread can be found here:

http://www.thecatsite.com/t/257056/my-beautiful-abby