Stella has cancer... Recommended nutritional plan of action?

My 6-8 yo female tortie Stella was diagnosed with cancer last week.  The radiology report indicated possibly intestinal lymphoma or adenocarcinoma.  There are two infiltrative bowel lesions with gastric distension.  My vet seems to think it is most likely adenocarcinoma, and wants to cut her open to remove the small lesions, and biopsy the thickened stomach wall to determine the cancer type.  She said that by doing nothing the partially obstructed bowel will eventually fully obstruct, thus resulting in vomiting and dehydration, and I would have to put her down. 

Stella is currently a good eater, playful and happy.  She had vomited twice in the past month (once with a detectable amount of blood).  Urine and stool are normal.  She was adopted 15 months ago, and underwent a full mouth extraction from chronic stomatitis.  She was fully recovered from this surgery, with the help of Atopica twice a week to keep any residual inflammation at bay.  She currently eats canned grain-free wet food from Only Natural Pets (also carrageenan-free and BPA-free cans).

I'm not sure that I want to put her through the trauma of abdominal surgery to type, and to POTENTIALLY remove the cancer.  Chemo is not an option for me.  The other option is to start her on prednisolone to, hopefully, slow the process down.  This is my decision alone to make.

My question is:

There are many nutritional supplements available as alternative dietary therapies for feline cancer patients.  Although none can CLAIM they cure cancer, I've read many user comments about feline patients that have responded well to such products.  For example, Pet Well Being offers a "Cancer Support Kit," which includes many herbs and nutrients:

http://www.petwellbeing.com/products/cat-cancer-kits

And Only Natural Pet offers two products, with many similar ingredients, to support immune response:

http://www.onlynaturalpet.com/products/Organic-Pet-Superfood-Super-IMMUNITY/371001.aspx

http://www.onlynaturalpet.com/products/Only-Natural-Pet-BSST-Herbal-Formula/999040.aspx

Can anyone speak to the above products, or other nutritional supplements for a feline cancer patient?  Does anyone have personal experience with getting a positive response against cancer through dietary changes and supplements?  I am also considering switching her to a raw food diet. 

I also feel like my time is limited due to the partially obstructed bowel.

Thanks!

So sorry to hear about Stella. Unfortunately, I can't help you with the cancer support diet, but I wanted to send you my best wishes for little Stella and you.

Best regards.

First off, I'm so sorry to hear about Stella.  She is one stunning cat!

I'm not familiar with using any of these particular products to stave off cancer, but I am familiar with folks using herbal supplements (mainly Chinese) along with chemo to fight Lymphoma in their cats, some with great success. 

That being said I also have a friend who actually helped her own mother's Lymphoma go into remission by using what most of us would call "snake oil" , so I wouldn't discount anything   And for the most part, the Petwellbeing product seemed to get really great reviews, so if you say chemo is NOT an option, then I don't know what it would hurt to try this...if it works, SUPER, if not, then at least you tried.  Then perhaps you could consider the surgery?   

zirkel said:

 
My 6-8 yo female tortie Stella was diagnosed with cancer last week.  The radiology report indicated possibly intestinal lymphoma or adenocarcinoma.  There are two infiltrative bowel lesions with gastric distension.  My vet seems to think it is most likely adenocarcinoma, and wants to cut her open to remove the small lesions, and biopsy the thickened stomach wall to determine the cancer type.  She said that by doing nothing the partially obstructed bowel will eventually fully obstruct, thus resulting in vomiting and dehydration, and I would have to put her down. 

Stella is currently a good eater, playful and happy.  She had vomited twice in the past month (once with a detectable amount of blood).  Urine and stool are normal.  She was adopted 15 months ago, and underwent a full mouth extraction from chronic stomatitis.  She was fully recovered from this surgery, with the help of Atopica twice a week to keep any residual inflammation at bay.  She currently eats canned grain-free wet food from Only Natural Pets (also carrageenan-free and BPA-free cans).

I'm not sure that I want to put her through the trauma of abdominal surgery to type, and to POTENTIALLY remove the cancer.  Chemo is not an option for me.  The other option is to start her on prednisolone to, hopefully, slow the process down.  This is my decision alone to make.

My question is:

There are many nutritional supplements available as alternative dietary therapies for feline cancer patients.  Although none can CLAIM they cure cancer, I've read many user comments about feline patients that have responded well to such products.  For example, Pet Well Being offers a "Cancer Support Kit," which includes many herbs and nutrients:

http://www.petwellbeing.com/products/cat-cancer-kits

And Only Natural Pet offers two products, with many similar ingredients, to support immune response:

http://www.onlynaturalpet.com/products/Organic-Pet-Superfood-Super-IMMUNITY/371001.aspx

http://www.onlynaturalpet.com/products/Only-Natural-Pet-BSST-Herbal-Formula/999040.aspx

Can anyone speak to the above products, or other nutritional supplements for a feline cancer patient?  Does anyone have personal experience with getting a positive response against cancer through dietary changes and supplements?  I am also considering switching her to a raw food diet. 

I also feel like my time is limited due to the partially obstructed bowel.

Thanks!

Click to expand...

She's beautiful and i'm sorry for all this.  I don't have experience with diet and cancer but i have experience with infiltrative cancers of the intestines and small cell lymphoma can be treated for a period of time with either prednisilone or Leukeran.  I have no experience with adenocarcinoma.  Based on everything all my vets told me, general practitioner and specialists, that when it gets to the point of being cancer, its past the poinbt where diet will have a meaningful effect, although trying diet is certainly worth trying, especially if you don't give up other options.

Generally once you start prednisilone, you can no longer effectively biopsy for small cell lympphoma.

May i ask what causes your reluctance to start chemo?

I agree with StephenQ - and I've got a kitty in remission from large cell lymphoma that presented as a massive mass in his stomach (and took up most of the room in there - and was inoperable), and a kitty on leukeran for her small cell intestinal lymphoma.

I simply want to caution that if "chemo is not an option" due to experiences you've had with (human) friends or family, that cannot be equated to the experience of treatment in cats. The management of chemo in treating cancer in cats is completely different. In people, it is all about quantity of life, and it is used in relatively much higher doses, and therefore with many more toxic side-effects. In cats (and dogs), it is all about quality of life, and thus used in much smaller (relative to body size) amounts. It is generally very well tolerated by cats, and the oncologists generally work very closely with you, monitoring every aspect of your kitty's health and well-being.

If it is due to cost, or your kitty's ability to travel (though if it turns out to be small cell, then you generally just treat at home with blood work check-ins), that's different. :rub:

I was the opposite of you. I wanted to know what it was, so we could decide how to proceed. I wanted to be able to accurately treat whatever it was. I figured we could always start the chemo, and if it was too hard on either cat, we could always stop. Thankfully, we haven't needed to. My large cell lymphoma kitty is now over 3 years in remission, knock wood. I feed a homemade raw diet with omega 3s and curcumin as an anti-inflammatory supplement. I transitioned to this diet while our cat was in treatment, as it is my understanding that a low-carb, high protein diet is the least inflammatory for cats, and that carbs feed cancer in humans and animals.

Many vibes to you and your beautiful girls as you navigate the process. :heart2:

Thanks for your kind thoughts and words.

Honestly, I am struggling with this decision, in my mind, to either make her as comfortable as possible, and let her go when the time arrives, or to go the surgery/chemo route.  Is it cruel and inhumane to make her suffer through (another) surgery and possibly chemo, all to extend her life briefly?  I feel like it is.

She has been through A LOT already: stomatitis, mega-colon, tapeworm, etc.  Yes, the cost is an issue.  And the nearest oncology vet is a four hour drive.

I wish I could just ask her.

Well, we used an animal communicator to ask Lazlo. :lol3: But between our scheduling the appointment and the communication session, we made two trips to the oncologist (on a Friday and a Monday). We knew what she was going to tell us: he wanted to fight.

But I completely understand. :heart2: Momofmany has a name for their approach to palliative care: Love and cheese danish. It was officially written up here: http://catcentric.org/2014/10/13/love-and-cheese-danish-a-compassionate-end-of-life-concept/

zirkel said:

 
Thanks for your kind thoughts and words.

Honestly, I am struggling with this decision, in my mind, to either make her as comfortable as possible, and let her go when the time arrives, or to go the surgery/chemo route.  Is it cruel and inhumane to make her suffer through (another) surgery and possibly chemo, all to extend her life briefly?  I feel like it is.

She has been through A LOT already: stomatitis, mega-colon, tapeworm, etc.  Yes, the cost is an issue.  And the nearest oncology vet is a four hour drive.

I wish I could just ask her.

Click to expand...

There is nothing wrong with putting her on Prenisilone, and keeping her comfortable and happy for as long as possible, and then letting her go when the time comes, particularly  if you don't wait too long and are strong enough to make that decision before she suffers.  If the vet believes the life extension to surgery/chemo is brief, then that would be a reason not to do it.  Is that the vet's opinion?

I had my cat biopsied in the intestines at age 14, major surgery, big incision etc, and he did fine.  Pain meds after, a few days of being "slow", but a fairly easy and full recovery.  But every patient is different, and your cat has been through a lot.  The other question is how much benefit might your cat receive?  If she is going to die in a month without surgery, and with it could live a year that might be worth it.  But is she will live 6 months without surgery and 8 months with it, that might not be worth it.  I would have a clear detailed conversation with my vet about this, knowing that they might not be able to give you a clear answer.  Medicine is half art and half science.  You make the best decision that's right for you,  and then you accept what follows, adjusting your treatments and response with the next "best decision" always doing your best until the story ends.  That's all we can do.

One note about chemo for pets, to tag on to what @LDG  said.  There is a philosophical and a practical difference between chemo in humans and animals.  Humans will endure chemo suffering in order to gain either a cure or a significant extension to life.  "chemo" in animals, cats in this case, are prescribed it such that a reasonable number of patients feel little discomfort - and they continue on treatment, and another percentage don't react well, and when this happens we immediately cease treatment, and either try something else or make them comfortable for their remaining time.  No vet will make an animal suffer on chemo, there is no point, as the animal will stop eating, or will fail in other ways.  

So chemo on animals isn't cruel because we don't do it if they don't tolerate it.

And surgery isn't cruel, but its a big deal and worth asking if its worth putting your cat through it.

Since our animals live entirely in the moment, anything that you do for your cat is in many ways for you and your relationship with your cat, but they know nothing of the future, just of today.  So either way you go - if your decision is made with compassion and love, and if it follows with more timely and compassionate decisions is 100% ok.  Remember, your cat thanks you every day, for today. 

Stay in touch.

Quote:

StephenQ said:

 
Since our animals live entirely in the moment, anything that you do for your cat is in many ways for you and your relationship with your cat, but they know nothing of the future, just of today.  So either way you go - if your decision is made with compassion and love, and if it follows with more timely and compassionate decisions is 100% ok.  Remember, your cat thanks you every day, for today.

Click to expand...

I thought this was really insightful.

I spoke with an oncologist in Reno and am taking Stella in on Friday for an US guided biopsy.  This is a conservative first step, as he suggested.  It will be an eight hour round trip drive, and I have "kitty sedatives" on order from my vet.  I may need a few myself.

http://baringvet.net/veterinarian-sparks-nevada/bob-baker-dvm.php

Thanks!

zirkel said:

 
Quote:

I thought this was really insightful.

I spoke with an oncologist in Reno and am taking Stella in on Friday for an US guided biopsy.  This is a conservative first step, as he suggested.  It will be an eight hour round trip drive, and I have "kitty sedatives" on order from my vet.  I may need a few myself.

http://baringvet.net/veterinarian-sparks-nevada/bob-baker-dvm.php

Thanks!

Click to expand...

Does your cat have trouble in the car?  If its significant - like they have a really bad time traveling, defecating, or being terrified - then i would consider sedatives, but i personally wouldn't for a mildly upset cat.  Cats can actually get quite upset when put on sedatives, i tried it once and never will again, and even if you get the dosage right, going down, and coming out of it can still be very disturbing to them.  They don't know what's happening, you can't explain it to them, all they know is they are feeling weird.  A gentle relaxer is Rescue Remedy as it simply has a calming effect and is gentle.

In any case, think about it and keep us updated.

Well, this just got interesting.

Second opinion:  Oncology vet was unable to palpate the mass that my vet supposedly felt in Stella's left side abdomen.  Re-did abdomen x-rays and added chest X-rays.  All appeared normal.  Sent them out to be read by a second radiologist and came back normal.  He did an ultrasound and was unable to locate either of the two supposed masses on there left kidney.  Stomach wall appeared normal.  He disagreed with my vet and the first radiology report from last week that a mass was present.  He felt it might have been a shadow.  Good news: no cancer?!?

Bad news: He noticed the stomach was not contracting.  Apparently you can visualize peristalsis on an US.  The residual food from breakfast was just sitting there.  Additionally, he noticed the bile ducts were dilated.  Apparently, this was something you generally cannot see on an US, but there they were.  

He recommended a follow-up stomach wall and proximal intestine biopsy via endoscope by my vet.

Any other ideas?

The eight hour RT drive sucked, by the way.  And the Rescue Remedy was key!  Thanks for that tip #StephenQ.

zirkel said:

Any other ideas?

The eight hour RT drive sucked, by the way.  And the Rescue Remedy was key!  Thanks for that tip #StephenQ.

Click to expand...

I'm glad the RR helped, and wow she is gorgeous.  And great news, at least the first part.

I'm going to offer a thought that shouldn't by itself change your mind about anything, but could allow a discussion with your vet.  In the world of human medicine we have long believed that earlier diagnosis (and hence earlier treatment) would lead to increased lifespans and more cure, but what we've learned that in many case of cancer, that simply isn't true.  The reasons are unclear and confounding.  An article recently by a doctor who found a very very small tumor in a woman's thyroid led him to tell the woman that surgery wasn't indicated because this type of growth would almost certainly never kill her, they could watch it over time and if it grew they could then take it out, but right now the surgery was more dangerous than the growth.

The woman insisted on the surgery and it was performed and she did ok.  His point was, she wasn't sick, but high quality imaging found a "problem" that didn't need fixing and that if you look hard enough at all of us, most of us would have something "abnormal" inside of us.  To make his point he pointed to south korea which has a certain national craze about diagnosing thyroid cancerr, in fact its the #1 diagnosed cancer in the country.  The dangers to the surgery are real and significant, and yet its the most performed cancer surgery in S Korea, and yet the death rate from thyroid cancer in south korea hasn't budged one bit, not even a fraction of 1 percent.

All of this is to bring me to my question for my vet if this was me.  Dear Doc, my 6-8 year old cat eats well, poops well, and seems happy.  The initial diagnosis seems to be an error, but the new imaging has lead to a new problem involving bile ducts and lack of motility in the stomach.  Is this a real problem, or just something my cat is living with happily?  What kind of diagnosis might a biopsy lead to, and if it leads to that diagnosis, is there a reasonable treatment?  Is it possible my cat is living with something that isn't going to cause symptoms now or in the foreseeable future?

Also, in your fist post you referenced a diagnosis by radiology in your otherwise healthy and happy cat.  What caused you to obtain an x ray in your cat who was eating well, pooping well and generally happy?

I am just reading this post. I cannot add anything except to give you my ((hugs)) and lots of moral support...

The people here are wonderful....

((hugs)) to you and Stella....

@StephenQ   I brought Stella in to see my vet after finding a small amount wet clear vomit with, what looked like, blood in it.  She did a physical exam and weighed her, and said let's watch her.  After a second vomiting episode (no blood) I brought her back for an x-ray and bloodwork.  That's where my vet said she felt a left side mass and saw, what appeared to be, stomach wall and proximal bowel thickening.  The bloodworm came back normal.

Stella pees 2-3 times a day (I hydrate her wet food) and poops every 2-3 days.  This has been pretty consistent throughout the year and a half since I've had her.  My vet was worried about how Infrequently her bowel movements were.  X-rays 1 year ago looked as though she MAY have had an enlarged colon, hence the possible megacolon diagnosis and cisapride.  I've since weaned her off that.  As previously mentioned I removed a tapeworm from her feces at one point.

She eats a quality canned grain-free food (1 @ 6 ounce can split into 2 servings per day) watered into a slurry (remember, she has no teeth).  Previously, I've added a squirt of krill oil and 1/2 cap of probiotic (one recommended on this site) per meal, but have since discontinued that.  The only med she is on is Atopica 2-3 time/week.  Her food and feeding times are consistent.

So her current symptoms, which concerns me, is that every couple of days she gets lethargic and inactive and not her usual active self.  She hides under the covers at the foot of the bed.  She doesn't finish her food.  She just appears to be not feeling well.  She becomes agitated, noisy and follows me around the house.  The agitation, jumping from bed to window sill, is a clue that I need to pay attention to.

My vet is out on maternity leave for two more weeks, and I don't feel like this is critical and needs to be addressed immediately, but something is going with her.  I am NOT a fan of diagnostic biopsy or medicating symptoms.  I have an appointment next week to consult with a holistic vet about Stella's cancer.  Now that the diagnosis may have changed, I'll be interested to hear what her take on the problem may be.  And I'll pass along the thyroid concern.

Thanks again.

 

Ah I agree with those symptoms and the current diagnostic work it sounds like more diagnostic work is in order. My reference to thyroid cancer was only an analogy of what can happen when there is too much diagnostic work done but was not a specific suggestion for you to look at.

Here is a link that discusses bile duct inflammation. http://m.petmd.com/cat/conditions/digestive/c_ct_cholecystitis_choledochitis

From the oncology vet's report:

DDx proximal bowel obstruction (partial), motility disrder.
Feel best dx/tx test at this time would be abdominal explore, run bowel for parital obstruction, repair if found, otherwise get gastric SI bx, eval biliary tract.
O. would like to avoid sx if at all possible, next best step would be ugi scope, at minimum to get biopsy. Could consider medical mgmt with prokinetic (metoclopromide) If vomiting becomes a feature, patient fails medical mgmt, no abnswer of scope, then feel owner will have to reconsider surgical option. 

Well, first off, I'm so glad she doesn't have cancer .

Now, couple of questions for you.  You said Stella gets lethargic every couple of days, along with agitated, etc.  Do these days coincide with her not having pooped?  If they do, then she may be slightly constipated, so is "off", then when she has a bowel movement, she's okay again for a few days, until the cycle starts up again.  Is that the case? 

Also, WHY did you stop the probiotics (and the cicapride)?  I find that probiotics really help ME stay regular, and I also give them to my cats each and every day just because I want them to have the best gut flora possible.  If Stella is not pooping regularly, I would think gut flora might have something to do with it.  I also have a cat who, because of kidney disease, is now chronically constipated, so I give her just a tiny bit of miralax once a day, and that seems to do the trick, aside from the obvious adding extra water to her food, AND giving her sub-q fluids.  With the Miralax, I give her just 1/8 teaspoon mixed into some of the water that I add to her wet food in the morning.  It's completely tasteless and doesn't gel up like other of those type of products.  

The spitting u of the clear frothy stuff is usually indicative of too much stomach acid.  My girl does this too, unless she eats small frequent meals.  To combat that, is there anyway to feed Stella more than just two meals per day?  Maybe one in the morning, one when you get home from work, and then once right before bedtime?   Same amount of food, just broken up between 3 meals vs two?  Usually that does the trick.  But I did see Metoclopramide was a possible recommendation, and I had another cat that was on just that for his upset stomach.  So, if nothing else, that's worth a try.