Small Cell Lymphoma

Hello everyone. I have read some Lymphoma related posts on here so forgive me for starting a new thread.

Last week I finally found out what was wrong with my kitty. He's a 9.5 yr old domestic short hair. He had been exhibiting respiratory problems for about 3 months. He started with reverse sneezing, that turned into regular sneezing, which turned into a secondary bacterial ear infection, and eventually he began making an awful snorting type noise. I took him to 2 vets (I wanted a 2nd opinion), but the first vet took Xrays and basically concurred with his primary vet. I like my primary vet very much. He was just as baffled by my cat's respiratory issues as much as I was as a frustrated pet owner. We treated him empirically for allergies, bacterial, and viral problems... I bought Sentry pheronome plug ins to ease any environmental stressors... we did everything!

After boarding my guy at his vet (we had to board him bc he's very difficult to administer antibiotics), and after my vet's last attempt to alleviate the problem via different specific antibiotic shots -my vet said it was time to take him to a specialist. A CT Scan revealed soft tissue in his nasal and near eye area -which the biopsy revealed was small cell Lymphoma. Over the course of the 3 months we tried steroid shots twice, combined with antibiotics to "boost" his ability to fight off what ailed him, but at the time we didnt know was small cell Lymphoma.

So he had two steroid shots that seemed "miraculous", he went from sick as ever, to seemingly back to normal. Since the diagnosis last week, I took him in for his 3rd steroid shot and again, he's back to loving life, no healthy problems or symptoms visible.

So I was wondering if anyone can share their Lymphoma stories, or lend some advice? Money is becoming an issue bc after 3 months of treatment, and a very expensive Specialists extensive tests, Im not able to spend money on IV Chemo nor Radiation (secondly, I think those treatments would affect my cat's wuality of life as he hates car rides and I cant see 2x's a week chemo or radiation visits making him a happy camper.

Im wondering if we caught it early enough for him to be responsive to the Steroid + Leukeran (Chlorambucil) type treatments Ive read so much about? I cant afford an Oncologist, but my vet is so great he is going to devise a treatment plan w/ the aforementioned med/steroid.

My guy is VERY difficult to for eg., administer meds orally. The only time I was able to do it was when he was in so much pain, no steroid shot to ease swelling, he let me administer his paid meds.

Im cautiously optimistic, but Ive read about some cats exhibiting complete remission for 5+ years! Again, my guy is only 9.5 yrs, and he had steroids administered early on, as well as currently. He has tremendous "fight" and he has an excellent quality of life as long as he has steroids in his system.

Does anyone have any advice for dosing kitties their Leukeran and Oral steroids for the "resistant" type patients? My vet is going to have some meds made into an edible treat, but Im not sure if that can be done for the Leukeran (I know steroids can be made into treat like foods).

Any success stories, advice, even the not so successful stories would be welcomed. Im really scared for my guy as I know its probably just a few more days before his last steroid shot wears off. Its remarkable how fast steroids help, but conversely, how fast they wear-off.

Thank you all for your time and help. I apologize for starting a new thread (especially as a Newbie), but most of the posts Ive read about Lymphoma see Gastro related. My kitty has it in an isolated area, small cell, and he's been relatively healthy his whole life (well, at least for the four years Ive had him -he was a stray who moved in with me, and I couldnt find his owners). He's my first pet that's my sole responsibility, so Im taking it pretty hard but trying to stay positive.

Thanks again, and Happy Thanksgiving to you all!

I'm bumping this up because I know there are people who have cats with small cell Lymphoma here.  That is definitely an issue, though, when you've got a "difficult" patien though .  And if any of these meds make your little guy feel ill, then he's definitely not going to want to eat a medicated treat .

One suggestion I have is possibly asking around at different Vet's offices in your area  to see if any of the Vet Tech's would be interested in coming over to your house to pill him for you.  If you can find someone who lives near you, they might be willing to do it for next to nothing (money wise) and it would be less stressful on everyone.  You'd be surprised how money Vet Tech's are out there wanted to earn a couple extra buck, AND how easy they can pill someone else's cat .  We ended up finding someone who lived less than a mile away, and she came over and did sub-q fluids for our kidney cat while we were on vacation.  I think she only charged us $20 per week or something absurdly low like that.  (it WAS a few years ago, but still)

I was JUST going to suggest that very thing. I was at the vet last week, and a woman was there with a cat with CKD. She had brought the cat in for fluids. The front desk was chatting with her - turns out several of the vet techs will go to people's homes in the evenings to administer fluids or meds or whatever.

TOTALLY worth asking around about this!

And if that's not an option, consider a grooming bag, like a Cat Sack (just search grooming bag on amazon or something, and you'll see various choices). Use treats to get him to step in the bag, and zip! zip! and he's all closed up. Use a piller with a water chaser.

OR if there are any treats he really likes, and he's a gobbler, toss down a treat, let him gobble, another one, gobble, then the bit of pill pocket with the medicine in it - and more quickly than the space between those three - toss down another treat, so he swallows the one with the med in anticipation of the next treat. This has a short a video demonstration: http://www.catinfo.org/?link=pillingcats

I have a kitty with small cell lymphoma, but it's GI. I don't know if the two compare, and we definitely caught it early, as the first sign of a problem, we took her to the vet, and the ultrasound saw thickening - so we didn't bother to wait and see, we had the full surgical biopsy done. Totally different than coughing and sneezing. :heart2: :rub:

Hi LDG.  I've seen a lot of your posts on this forum w/ respect to your kitty w/ Large Cell Lymphoma.   In one of the posts you (I think it was  you), mentioned you had not heard of the steroid Depomedrol being used in combination with Leukeran/Chlorambucil?   My vet and I have gone back and forth between the Depo (shots), and my trying to reduce his steroids with oral Prednisone.  Unfortunately, he's finicky and sometimes I think I get the Prednisone in him, and then other times if he hasn't been eating his food we'll give him a boost with Depo (via shot).  Since I have to take him to the vet for his Leukeran dosing it seems like a good idea?  Or, from your experience is Depo/Leukeran a bad idea?

There's so many threads with Lymphoma themes.   I feel bad as a newbie for posting as a new thread, but I honestly can't find anything, or any others who have had a similar situation.  

My cat has small cell lymphoma.  The tissue mass is located behind his nose and towards his eye.   We treated him for everything "respiratory" related, over the course of about 3 months before my vet recommended a Specialist.  A CT Scan by the Specialist revealed the soft tissue mass behind his nose/eye (hence all his respiratory symptoms, sneezing, coughing, et).  We tried steroids before the Lymphoma was found and diagnosed, so there were two intervals over the 3 months where my cat seemed to be "healthy as a horse", lasting about 2-3 weeks after steroid shot was administered. 

Question, how can I tell when or if the Lymphoma goes into remission?   (Other than another CT Scan).  Money is becoming a factor as I've spent thousands & thousands of dollars trying to figure out what the heck has been ailing him. 

The little membrane in the lower section of his eye (the side where the tissue mass is located) begins to cover part of his eye.   He is no longer coughing or snorting like before, he's sleeping soundly, and is in overall good heatlh (he's still strong as an Ox and has excellent appetite from the steroids).   But when his eye becomes visibly 'covered' by that little white membrane, starting in the lower corner, I of course begin to be scared for him.

He had his first blood work done yesterday, after 4 doses of Leukeran (2mg) over the course of about 2.5 weeks.   His white blood cell count was normal, his overall bloodwork was "good".  

I guess I just don't know which one is helping my kitty, the steroids, or the Chlorambucil?   My primary vet is great, but he's not an oncologist (I couldn't afford the Oncologists in my area)... fortunately my vet agreed to help w/ the chemo & treatment plan.   In your experience, is there anything else you can suggest to help him?   He does seem sleepier today after yesterday's 2mg dose of Chlorambucil (and the eye membrane is still pronounced -but again, no breathing difficulty).   Should I just get used to the idea that his eye will not be 100% healthy, or healthy looking?  

I suppose I'm worried that I should be giving him more Chlorambucil and/or steroids b/c his eye looks kinda bad (it's looked much worse, for eg., when he was finally diagnosed w/ Lymphoma he hadn't had any steroid shots for weeks, couldn't breathe from his nose, et., his eye looked awful -it was probably 1/3rd covered by that whitish membrane). 

In a nutshell, what's the best way to empirically discern what aspect of treatment for isolated, small cell lymphoma is working best?   (fancy testing aside)  Is there a way?  

Thank you so much for your time if you've read this.   Please, if anyone has experience in treating their cat w/ Small Cell Lymphoma, I'd love to hear from you and share in your experiences. 

Much obliged! 

I've never had a cat with Lymphoma, but my friend's cat did and it was pretty heartbreaking, so I feel for you having to watch you pet go through this.    I remember him saying that he had to watch the cat try and be his old self, but he just couldn't do it anymore.   He didn't try much in the way of treatment because the prognosis was so bad.  I know people feel horrible when cost is the deciding factor in what treatment their cat gets, but that's an illusion of a sort, because what's really making the decisions here is the disease. 

Thanks Reba. My vet actually said something really cool the other day... he said "if you wanted to put your cat down I wouldnt do it". He wasnt being a jerk or anything, moreso commenting on "the fight" my guy has w/ respect to dosing his meds. He puts up a huge fight! 3 vet techs just yesterday to hold him in a blanket and get his Chlorambucil down him. I hope his lethargy today is simply a result of the poison (chemo med). I will do what's best for him ofc... and yes, it is absolutely heart wrenching to bear witness to my once "Mountain Puma" kitty feeling less than stellar. He's only 9.5yrs so all of this came as a shock. His eye is what troubles me now, although the past respiratory problems are gone at the moment. Here is a photo of him now (he wasnt really cooperating for photo opps however).

Awwww - what a handsome man.  That's great that your  vet gave you that support.  His eye doesn't look too bad to me, I was really expecting it to look much worse.  Your description of how the steroids helped him was pretty amazing. 

I still have hope, and my kitty still has decent quality of life. I am worried I'll be losing him soon. It breaks my heart. I will detail start to finish my experience with treating my cat for small cell, nasal/orbital lymphoma. I want to detail the experience, my good and bad decisions... my whole experience in hopes it can help someone else someday. More to come... hopefully more positives before negatives. Thanks everyone!

I wanted to share with readers my cat's experience with Small Cell Lymphoma.  He let me know it was time last Sunday... not quite a week ago to the hour my amazing vet came to my house, in a blizzard & on Superbowl Sunday, and helped give my beloved kitty a peaceful means to rest. 

My cat was diagnosed with Isolated Small Cell Lymphoma in his nasal region and also effecting the orbital region.  As many of you know, the hardest part about figuring out what ails your pet is the time it can take to empirically rule out more typical causes.  My cat began "reverse sneezing" in Mid-August.  The reverse sneezing occurred a couple times a day, but from what I read online it wasn't a cause for immediate alarm.  After about a week of reverse sneezing he developed more frequent sneezing.  He also had labored breathing.   So I took him to the vet, we tried to treat him for allergies first, then viral related (using Lysine), and then eventually bacterial.  The first time we gave him an antibiotic we also used a steroid in combination.  He seemed like his old self, albeit with a stronger appetite from the steroids, but the anti-inflammatory nature of the steroids seemingly cured him.  That lasted about 3 weeks.   Then his symptoms began again, just as bad as they were before seemingly overnight.  So another trip to the vet and we treated with a different type of steroid, and antibiotic again.  The 2nd round it was clear that if that didn't work, we had to look into polyps.   The second round of antibiotics/steroids lasted maybe 2.5 weeks.  So then I took him for a 2nd opinion (just to be safe, I like my primary vet very much).  The 2nd vet took Xrays, nothing visible, and thought it was likely viral (at this time he had developed a secondary ear infection -albeit slight).  

I continued an oral syringe antibiotic from home, and tried my best to get some ear drops in for the ear infections (he was a tough cat to medicate).  After a week or so I saw it wasn't helping.  My primary vet's last idea was to target a bacterial infection with very specific antibiotics (at that time I had to board him at my vet's).  After these shots didn't seem to work it was time for the Internal Specialist.

My advice to anyone at this point, do your homework when looking for your Specialist.  I found a qualified Specialist, who diagnosed the Small Cell Lymphoma for $3300, but afterwards I wasn't given the time of day by the Dr. nor the staff.  They passed me off to their Oncology Dept., where for starters you were required to spend $159 to "talk options".  Oh yeah, my Specialist left me a voicemail stating my cat had cancer (great bedside manner, thanks Doc).  Since the Specialist's Office didn't seem to care about my cat b/c I wasn't really able to afford $159 (I could afford the $159, but it was the treatment thereafter that I was concerned with cost), I turned to the internet and my primary vet.

Again, in hindsight, I wish I had a Specialist who at least gave me some idea about treatments... I mean this guy gave me nothing (he flippantly mentioned "Radiation" in his voicemail, also noting it costs around $7000).  Anyway, I found many threads on the Leukeran/Prednisone combination.  This was still a pricey endeavor for me b/c I couldn't medicate my kitty at home.  He was a rascal, and needed to have it done at the vet's (although I did eventually find one person, a manager at a cat shelter who had this 'magic touch' and helped medicate him from home for the last 2-3 weeks). 

My regret, not looking into Radiation for his Isolated Small Cell Lymphoma.  I've read in numerous articles where this can be the most successful treatment for isolated small cell.

http://sites.tufts.edu/progressnotes/2011/11/current-concepts-5/

Since my cat was a handful to medicate, and he didn't eat Oral Prednisone, I had to give him shots of Pred-Acetate (similar enough, but probably not ideal).  In hindsight, I wish we were more aggressive with treatment earlier on, but b/c of difficulty medicating him, and his seemingly "ok" behavior with steroid treatment we limited the leukeran to 3 doses over 10 days.  I wish we went 2 mg every other day (live and learn, who knows if it would have made a difference). 

Once his health started to slowly deteriorate, even though he still enjoyed a decent quality of life, I made sure to give him Buprenorphine.  This pain med was very beneficial for my kitty.  So much so that the when given the pain medicine (at least the first few weeks) if he was having a rough go breathing he could muscle through it w/ the pain med helping. 

The end was beautiful, but sad.  I'm sure most of you would agree if you can find a vet to provide in-home euthanizing it's the best way for your beloved kitty, or pet, to be put to rest. 

His symptoms towards the end were pretty sad... he became more lethargic (but he had moments where he'd climb his tower or scratch his post... he'd eat well, also due to the appetite stimulant Mirtazapine).  His third eyelid would become so red and inflamed I knew for weeks that his days were likely numbered.  However, sometimes after a dose of Antibiotics, Leukeran, and Steroids his eye would appear better. 

So from diagnosis to departing, the treatment I described above lasted about 2 - 2.5 months.  From when his symptoms first started that brings the total to 7.  If you look at that Tufts article I posted above, that kitty about mid-page looked almost identical to mine (w/ respect to symptoms).  I'm not a vet, but if I were to do it all over again I'd have chosen a different Specialist, one that comes highly regarded (mine did, but they also care more about their bottom line than for the pets brought to their center).  I'm speaking about you Dr. Bob, at PVG... your lack of communication with me after my cat's diagnosis will never be forgotten -thanks for the Voicemail though. 

I'm sure there are many here that have loads more experience with Lymphoma than I... however after that voicemail I became pretty schooled in a short amount of time.  I'm not second guessing what my primary vet and I decided to do... boy oh boy did we try!   But my advice to someone in a similar situation is it may not hurt to be aggressive w/ Leukeran (when we finally started Leukeran every other day it seemed to help his symptoms).  I'm sure opinions vary, and what I'd like to advise first and foremost is make sure your kitty still has quality of life.  Mine did... he was my tough, tough good boy.  I previouslyl posted about "how will you know when it's time".   To those of you with the same question, like others have posted here often, "you'll just know".   I knew last Sunday when I came home and my boy wasn't moving (he always greeted me when I came home, never failed).  Last Sunday, he did lift his head up to give me a hello after a minute or two, but I knew right then he was telling me "it's time".  I called my vet, bless his heart, he came over that night and we gave my boy a nice send-off.  Thankfully my kitty rebounded with some energy, had a nice meal, sat in front of the fire, and enjoyed our pets as we talked about him.  He passed as I held his head and gave him pets and kisses until his little heart stopped beating.  He went very peacefully.  

Cancer is a beast.  Explore your options, there are many success stories... try to act on addressing Remission sooner than later.  

Thanks to everyone who helped me through this with feedback and insight on this website.  I'm forever indebted, and beyond grateful.   

This is all I have to remind me of your company as you so patiently waited for me to finish my work.  I know I'll be Ok in time, but losing a pet is really rough.  Especially when you tried SO hard to help.  Thanks for the memories my sweet kitty.  I know you'd be sleeping next to me while I work... here in one of your favorite cat beds, which is why your last paw prints rest here.  I loved you so much.