S.O.S. - Kinney has anorexia/anemia

Dan32 is using Primal commercial food, which is treated with High Pressure Processing. It is sterile, no pathogens.

Nekochan said:

One thing about raw, I would discuss with your vet whether it may be an issue while undergoing the chemotherapy. My dog's oncologist said not to use the raw diet while my dog was on chemo, because chemo compromises the immune system and can make them susceptible to infections from bacteria that can be found in raw. She was on raw before we started, but I used a low-carb cooked freeze dried food and then a no-carb pasteurized food for her (and some home-cooked stuff like the liver) while she was on chemo.
That is also why I am not using raw for my cats now, because they are on Atopica which is an immunosuppresant and my vet (who likes raw diets) said the raw could be an issue.

Click to expand...

For folks facing the bacteria question, there are options. One, you can deal with bacteria by searing the outside of the meat and still have the inside raw. Or, you can do a home-cooked diet. Just don't serve cooked bones.

I'm not insisting that anyone feed a certain diet; I just wanted to mention other options for folks that might be interested.

Info on HPP, which is used by Primal, Stella & Chewy's, Nature's Variety, and now Bravo:

http://healthypets.mercola.com/sites/healthypets/archive/2012/10/22/sterile-raw-pet-food.aspx

http://holistichealthypets.net/2013/05/15/high-pressure-processing-and-raw-pet-foods/

peaches08 said:

For folks facing the bacteria question, there are options. One, you can deal with bacteria by searing the outside of the meat and still have the inside raw. Or, you can do a home-cooked diet. Just don't serve cooked bones.

I'm not insisting that anyone feed a certain diet; I just wanted to mention other options for folks that might be interested.

Click to expand...

Right. Or commercial sterile raw foods.

LDG said:

Right. Or commercial sterile raw foods.

Click to expand...

I keep forgetting this option! Thanks for adding it!

Since we are only three weeks into the chemo treatments, I am still questioning everything.  I can see that once we get through one rotation - I will have a better idea what reaction each of the meds has on him and can relax a little.  It is still so new to me, it isn't routine yet and I am biting my nails constantly.

I am thinking tonight (his first day on the medicine) that the Cerenia is a worthwhile addition.  He still slept today, but seems in better spirits and more alert when he is awake.  LDG, you gave Lazlo the Cerenia on a daily basis?  That is what the instructions on the medicine say DAILY, but I was thinking it was only on an as needed schedule.  I will give him it tonight along with his pred and see what day 2 (after chemo) looks like. 

Kinney is only getting raw in the form of Nature's Variety chicken bites mixed about 40/60 with canned food.  I have stuck with just Primal and NV, as I thought these two were safe for him.  Even at that though, I haven't tried any other flavors on him other than the NV chicken.  Up until his illness, he only ever got a few teaspoons of Gerber baby food a couple times a day (his wet food) which only comes in a few flavors (chicken, turkey, ham) - so many of the protiens would take some adapting.  Maybe now is not the time to try new stuff out.  It would be nice to have at least a second flavor - he didn't like the Primal turkey much at all.  NV doesn't make a turkey.

Thanks for feedback.

Your boy is on the exact protocol that my Toby was taking. I looked back at my information, it is on post #190 of my thread about Toby. Also I went back into my records including the information they faxed to me in the beginning.

Toby's chemo was supposed to be all IV but what they did was also inject the other medications except with the [color= rgb(24, 24, 24)]cyclophosphamide; they gave him orally despite their original info stating it would be via injection or IV. He was always extremely sick after getting it that way and it drove me crazy. I apologize, I mixed that up with the doxorubicin as it also knocked him out but in a different way. [/color]

[color= rgb(24, 24, 24)]A[/color]nd they too used IV only, for the doxorubicin as it is such a strong agent it cannot be given any other way. The doxorubicin also knocked him out pretty good, he did not bounce back as quickly as with the other meds.

Looking at his records they gave him Cerenia injections as well and sent me home with 4 half-pills to give him for 4 days following each treatment.

He did not get l-asparaginase except as rescue chemo, but I believe Lazlo got that as part of his regular protocol. With Toby the l-asparaginase was the most effective of all his chemo. 

Laurie, did your Lazlo get both l-asparaginase and doxorubicin? I was looking at one of your earlier threads in which you mention that. If so, that would have been a really good combo. I wonder what protocol that is called (?)

Dan, my advice that I wish I had done- don't skip any of the progress ultrasounds considering what you have invested in him,  and ask them at what point might there be consideration given to switching protocols what/when are the critical checkpoints where these discussions take place. In other words not waiting until the last chemo as they did with my Toby. Your group sounds better than mine as far as dialog. Good wishes :-) for both you and Kinney :-).

Laurie, I looked up your post on my Toby thread about what Lazlo was taking, i hope you don't mind my quoting you here, since you said you were not sure of the protocol. Dan, this is right after my post #190 on Toby's thread,from LDG: 

"[color= rgb(24, 24, 24)]Lazlo had a different protocol. They used VinBlastine, not Vincristine. I don't know why - the local vet administers chemo, and they use vincristine. He also had... I've got the papers here, let me look it up. OK. His also included Elspar, Cytoxan, and Adriamycin. I think they were all IM except the Adriamycin. The adriamycin was given at the end of each 4-treatment cycle. The cytoxan can be given orally, but he was on IM because he was getting a more specific dose than can be given orally.[/color]

Lazlo was given weekly injections for the first month. Then the 5th week was off. Then four weekly injections. Then it went to every other week. So he started the end of July, and had his final treatment at the end of January.

He was on anti-nausea medication (Cerenia, used off label. 1/4 tablet, I think it was, every day). He was on an appetite stimulant (Mirtazipine, given every 3 days). He was on 5mg of prednisolone throughout. And because of his ulcers, he was on pepcid a/c (10mg once a day) and sucrulfate (1/2 a pill 2x a day).

He usually felt fine after the injection. It would be the next day or two that he'd sleep a lot, and his appetite would be off. The oncologist had a sheet we had to fill out before each appointment, and it asked questions about his activity, his appetite, his bathroom habits, his overall demeanor, and they would sometimes adjust the amount of chemo given at the next treatment (less) if he didn't feel well for more than a day or two.

But Lazlo was feeling so poorly BEFORE we started, that we started seeing him feel better very quickly, just because of the anti-nausea med, the appetite stimulant, and the pred.   In fact, after a few weeks, he was feeling great. I don't remember off-hand, but I only had to assist feed him with a syringe for the first few weeks - and even then, it was just because he wasn't eating enough, not that he wasn't eating. I do think the chemo affected his sense of smell, and I did have to use things like fortiflora or powdered salmon treats on his food, and what was appetizing to him would change. But I could tell he was hungry. But we came to expect those dips after a treatment, and then he'd perk up, and as we kept going, he just kept getting better and better. The vets made a mistake in taking him off the ulcer meds, so we had a set-back a couple of months into it, but that was a Lazlo-specific problem.  "

Yes, Lazlo's treatments included Elspar (l- asparaginase). It was part of a cocktail in the first treatment of each cycle... and might have been included in the 3rd treatment as well. I'll have to dig out the paperwork. VinBlastine was the most common "ingredient," and Adriamycin was always the last treatment of the cycle.

None of it was oral (other than hurricane-necessity).

And yes, Dr. Clifford had us use Cerenia off-label. The directions for use in dogs (there were no trials in cats) is four days on, four days off. But our instructions were to give him the 4mg daily. I do think it is a drug used as-needed. That's how I use it now. But during chemo, it made such a difference for Lazlo. Of course, he felt nauseous anyway, with that big fat tumor in his stomach, and related ulcers.

Thanks for looking that up, Barb! I couldn't remember the other part of his cocktail. Cytoxin, that was it. :nod:

Dan, I'm glad you got the meds! Perfect timing too. One question, how in the world do they keep a cat still that long? Especially with an IV.

Roxie: They take him in the back to do the procedures away from my prying eyes, so I am not sure how they get him to sit still.  There are a lot of employees there.  They also do not sedate for ultrasounds, so I don't know how they accomplish that either.  He does have a mysterious shaved patch on the underside of his tail from when he was in the ER for his transfusion.  I never have been able to figure out what that was for. 

That is a strange place to be shaved! Bubba's neck was shaved when he came home from the hospital. He had a small sore there so I'm assuming it was where they drew blood, had the IV, or both. I wondered then how they could keep a cat still for an IV. We may not want to know! I hope he does well this next round. I check everyday for any updates on him. There are so many people with cancer and now a lot of pets are getting it more often. Makes you wonder what's causing it.

Barb, Dan32: Elspar is no longer on the market. Had a chat with the vet. ( http://www.thecatsite.com/t/263981/lazlos-ultrasounds-results )

Is Kinney still doing okay? Is the Cerenia helping? I hope he's not having a lot of nausea.

I only ended up giving Kinney the Cerenia one additional night after chemo #3 last Tuesday.  He doesn't seem to have a horrible reaction to the Vincristine which was last week's medicine, so figured I would save the Cerenia.  I am not sure it does anything for his appetite.

I did buckle and gave him one weekend dose of Cyproheptadine in hopes of fattening him up a bit ahead of chemo #4 which is Adriamycin.  That is the first appetite stimulant he has had in a month and a half - boy did he eat!  I think the Cypro makes him sound nasally - I had forgotten that from before.

Today Tuesday was the Adriamycin.  Dr. Risbon wanted me to give him Cerenia for five additional nights this round.  I asked her if the Cypro and Cerenia were mutually exclusive (had read this in another post) and she said it was Ok to give both.  His weight was only steady - no longer the ounce per day weight gains before the chemo began.

There was a concern that his temperature was 103 and the Dr. was quick to prescribe Baytril for that, but I am leary of piling on needless antibiotics.  I will pick the prescription up but will hold off starting him on it until I get a confirmation on that high temp at home.  I tried getting an amateur temp reading with my digital thermometer tonight, but failed miserably.  I will have to try again tomorrow.  Another nursing skill to conquer.

A new wrinkle is that Kinney's roommates - the brothers Kyle and Kegan have started to randomly pick on him, right as he is coming around from sleeping quite a bit.  I think initially they were wanting to play thinking maybe he was better, but he is clearly not in the mood and is taking it as an afront.  There has not been anything serious, but this is one problem I really don't need at the moment.  I would hate to think of starting to have to lock either Kinney or the brothers up to keep the peace.

One bright note is next Tuesday (week 5) is a CBC only.  VSEC schedules the first follow-up ultrasound along with chemo #5 - the week after.  You might think in that case, they would let us have one week completely off instead of having to trek down there for a bloodwork.  This is all pretty tiring.  We could use a week off.

They make you get the CBC on your week off?

As to Kyle and Keegan... when they start to pick on Kinney, maybe distract them with play? :cross:

And oh shoot - I don't know where my brain is. I have to go find that thread. I was thinking cypro was anti-nausea, not app stimulant. :doh3:

Kyle was charging at Kinney repeatedly last night.  It seemed as soon as I would turn around, he would be right on Kinney's tail looking for trouble.  Despite group play, heart-to-heart talks, baits of treats, and threats of the spray bottle.  I ended up putting Kyle down in the basement overnight to give Kinney a rest.  Kyle's brother Kegan doesn't seem to be as much of an issue, as there were no problems overnight with him out upstairs.

I just can't imagine having to go through the whole isolation/introduction thing again.  The three of them have been getting along fine for years.  As far as I see it, it was Kinney's house first - so it will be the brothers who get locked up if that is what needs to happen.  It just adds more work to the daily routine with spray bottles, extra dishes, visitations, etc.

Meanwhile, Kinney looks quite delighted to have Kyle out of the picture temporarily.  He is stretched out on the floor rather than scrunched up in a ball.  It may have been that this has been going on for awhile and me not noticing.

Poor Kinney, I hate that they're picking on him. Could it have anything to do with the different smells when he goes for treatment? I know you don't want to have to split them up. I just had to put one of mine on the porch for about 30 minutes because of similar behavior. There's no new smells here so it was just him picking a fight. I don't know much about chemo in cats, but how many treatments all together does he have to get? I'm glad he's still eating. That's a plus. I can only imagine how tiring it must be. Not just physically, but mentally and emotionally.

I am doubting it is a foreign smell thing, as this started last week several days after his third chemo visit.  I am trying rotating the brothers in and out of the basement and Kinney in and out of the bedroom to give everybody some space.   Kinney was pretty happy to have the house to himself today and I am thinking these little breaks do him a world of good.  Certainly on those days after his visits to the doctor when he really isn't up to fussing with his room-mates.

The entire course of chemotherapy (should I decide to go the whole distance) is 16 treatments.   Four weeks in a row - a week off - four weeks in a row - a week off - every other week for eight weeks - a week off - every other week for eight weeks - end.  We just completed the first round of four, then will have an ultrasound done again after our week off to see if the chemo is working.  Presumably, if the ultrasound reveals that the first four chemos has put the lymphoma into remission - they consider the regimen he is on to be a success and continue on the same.  If it has not worked thus far, back to the drawing board.

So, we got a long way to go..