Second thoughts on starting chemo - torn...

Rocky is scheduled to start chemo tomorrow at 3pm.  I've had misgivings about it from the beginning, but now I'm losing my mind over it.

I'd specifically asked the oncologist about heart toxicity from  adriamycin (doxorubicin).  Like most vets these days, he dismissed what I'd read about it because the info was found on the internet.

Still feeling unsure, I did some more research.  There's a heck of a lot of info available, and seems to me from reliable sources.  Heart toxicity has been seen in humans and animals.   It does not appear to be a myth.  Kidney problems can occur as well.  If the drug leaks out of the vein (it's given IV) it will kill tissue it touches!    Yet after all this, some articles will say the drug can be a valuable tool in fighting cancer.

The last thing I want is to cause even more problems for my poor baby.   We're going to do palliative radiation for him (4 "doses" total, once per week) as well.

My deepest wish is to do everything in my power to extend Rocky's time here as long as possible.  But I don't want to hurt him in the process.

Does anyone have experience with this particular drug?  The oncologist intends to give him a total of 5 doses of it, once every 3 weeks.

Rocky has inoperable fibrosarcoma, non-vaccine related.

What a nightmare this is.

I wish I had some advice for you, but I don't. All we can do is our best. Many prayers being sent your way!

PM BarbB, her kitty received that drug. You can also look up her thread here. Actually, this is it: http://www.thecatsite.com/t/243465/toby-vomiting-and-losing-weight-fine-otherwise

He has large cell lymphoma, and the first few pages are just getting the proper diagnosis.

Our Lazlo had large cell lymphoma, expressed as a massive mass in his stomach. We opted for chemo. Our thinking was it's worth the try. If he can't tolerate it, we'll stop it.

Chemo in cats is completely different than chemo in people. It's all about quality of life. If that is the chemo agent your oncologist thinks is appropriate to treat your kitty, then you can opt to listen to their expertise, or simply provide palliative care. There is no right or wrong. :heart2: We did provide additional support to Lazlo that helped him: an appetite stimulant, an anti-nausea medication, and prednisone. All of these really helped him feel better during the treatment. :rub:

I'm so sorry for the cancer. It's a very difficult decision, but if you can afford it and it doesn't completely stress out your cat, I see no reason not to try it. These are powerful drugs, which is why they do their job. They do have side effects, and whether those are tolerable or not.... is a personal choice, and should, IMO, be based on how your cat reacts. :heart2:

Vibes to you and your kitty during this difficult time.

Peaches08, thank you very much for the prayers, which are gratefully accepted.

Laurie, thank you for the information.  I'll PM BarbB and will look into the thread.

13 years ago, my Louie had cancer and did chemo.  People thought we were crazy, and actually cruel to do that, not understanding that cats tolerate chemo so much better than humans.  We do feel it extended his life, but Louie's cancer was different than Rocky's.

Don't want to jinx anything, but Rocky is doing very well - you would never know he's got a level 3 inoperable fibrosarcoma.   Unlike 13 years ago, I do my homework now, researching everything, especially something like this cancer.  Sometimes all that does is complicate things.  We all know chemo has potential side effects like nausea and inappetance, but adriamycin can cause irreversible heart damage, among other things.  So what's worse, the damn disease or the treatment?

I thought I'd made the decision to go ahead with chemo, but now that I know more about the specific drug, I'm agonizing over what to do.   And since time is something in limited supply now, there's pressure to decide quickly.

I hate that this has happened to my boy and that I don't know what is the right thing to do for him.

Thank you both for replying and for the good wishes.

Hi KT, I sent you a long message but the upshot is I think you should do it. Yes there are risks but they are the same as any time you take your cat to the vet and have to watch them take him back to where you can't be there watching. In fact, if it is a specialty center and it sounds like it is, considering there is an oncologist on staff, there is a good chance the people administering chemo do specifically this, all day every day so the error risk is less than if your cat was at the vet. 

I would though, ask the oncologist what made him/her decide to give that particular protocol instead of another one- not because of the potential heart etc. risk, but just to have them tell you what weighed in favor of the doxo instead of asparaginase or another chemo. I'm sure they will have a reason or as you said they will act dismissive as they did with your internet research. I have had this experience and learned to be nice but also persistent.

And I would ask about doing a baseline ultrasound and then another one 4 weeks after the last treatment (at the same location since they will tell you it is not comparable if done at different locations by different ultrasound technicians). And I would ask if there is no improvement, what other rescue chemo recourse is available. Toby's current rescue chemo is the asparaginase and lomustine and he is doing well with that. He has had no negative effects from the doxo and he is tested every few weeks. 

http://felinelymphoma.org/docs/ChemoProtocols.pdf  

Did you make your decision overnight? 

I wanted to give you my opinion.  First, I believe that you should always go with your very 1st instinct...  especially if you continue to switch back and forth and agonize to the point that you have been.

Second, my cat had cancer.  She was a feral stray when I found her, I gave her a great life for 10 years.  I asked my vet for her very honest opinion.  I told her that I too was agonizing over what to do for treatment, that I have a terrible time making decisions, "what if I make the wrong one?", I confided that I have the worst depression and suicidal tendencies....  She said she could relate to the agony, took my hands and gave me her honest advice:

"Do NOT put the love of your life through it.  Unlike humans who can show and tell you how much they are suffering, cats are masters of disguise, more so than any other animal.  They will hide their suffering from you.  Will you be able to give her the treatment knowing that?  I could not.  She reminded me of the great life I gave the "alley cat" who probably wouldn't have lived past the day I found her with her neck ripped apart from an evident fight.  Then she said that SHE would not do it, given the age, the progression of the cancer, and the fact that she hid the pain for so long. 

I decided to give her a dignified death.  No losing her bodily functions (like living in a nursing home), etc.

I have never regretted my decision.

I now have another cat from a shelter who had a very rotten life before her current "lap of luxury".  I still cry now and then for my Sylvie, but that is normal and good.

Sorry this is so long.  I hope you make a decision that leaves you able to sleep at night.  Best wishes.

Danni

:heart2:

Awwwww it sounds like you made the right decision, Silviesmom. 

For my Toby, it has been a different experience and a different decision. I can't say he has not felt any suffering, but I can say the quality of his life is still very wonderful. He still plays and he still enjoys every day. I dread the day when I know it is his time to go to the rainbow bridge. But I will always do what is best for him. Right now he is happy and I thank god for that. 

On chemo, they don't give animals the same doses that they give humans because the animals cannot tell you how much they are suffering, which is a good thing. Still, chemo is definitely not for every animal. It is a situation by situation decision.