New to the board...my cat is dying of stomach cancer

[puck]

That's what I keep thinking...my old teacher went through chemo for lung cancer and it was so bad, she chose death when the cancer came back

not that I could afford chemo for Blackie if it came to that...so unfair...

This type of cancer, at this stage, is not a good responder to chemo or radiation, sadly. By stage, it's obvious with a palpably large mass, she is in later stage neoplastic development, and likely has metastases, as abdominal masses spread their lil cancer cells everywhere. She needs palliative care, aka Pain Management, in the form of buprenorphine, to administer in her cheek pouch or under her tongue 2 to 3 times daily, and possibly compounded gabapentin suspension you can give orally 3 times daily, both for Pain.  She is in pain.  Without a doubt.

I treat renal cats and cancer cats every day. Blackie is no exception. You don't need to afford chemo. You need to ask your vet to fill a prescription for buprenorphine (aka Buprenex) syringes, or a volumetric bottle from which you can pull volume needed from adapter tip, and call in a prescription for compounded gabapentin to RoadRunner Pharmacy, 877-518-4589, https://www.roadrunnerpharmacy.com/vets/about-us/  or Veterinary Pharmacies of America, 877.838.7979, http://www.vetrxrx.com/vparx/indexer.aspx. I prefer VPA as they'll fill the most volume for the minimum price, which was $43.00 minimum per compounded med. The suspension is easiest for gaba, but they make chews, dissolvable tongue strips, exact dosed tabs/caps, transdermal gels, pastes, otic meds, etc.

You are Blackie's palliative care advocate. That your vet's "face fell" and she wants a second opinion to verify her "suspicions" are moot, but she has to cover her ass, so to speak; request the pain meds anyway, without another exam, as money is best vested in pain therapy, and potentially an ultrasound to confirm, not just another palpating of the abdomen. That doesn't tell them anything except something big and weird is in the belly.

She needs to be fed whatever she will eat at this point. Any groceries are good groceries. Hold back on gross meds that will discourage appetite due to bitterness, like sucralfate (Carafate), metronidazole (Flagyl), no tramadol (Ultracet), and antihistamines. Food, pain meds, and B vitamin/iron/potassium supplements are your prioritized oral meds right now. Even the binders need to wait on the back burner, as they test horribly, and will reduce palatability of any food she does show interest in.

Good Luck with Blackie, and, please, keep us posted as to her progression, be it negative or positive.  Euthanasia is not a wrong answer here. Keeping her comfortable until that point is your only option; no pain meds is not an option.

 

[puck]

Thank you...where can I get hemp oil? I tried Google but didn't really find much in my state, NY.

She actually was diagnosed with not great kidneys last year so the vet gave me renal wet and dry food for her. She also eats low phosphorus people food like chicken and fish. She doesn't seem in pain, just...lethargic. She's eating but not as much and not with the same gusto. But she's eating.

Lethargy is a sign of pain. So is reduced appetite/joy of eating. She needs pain management. Cats don't say "hey out of a scale of one to ten, I'm an eleven." They show you. Like she is. Reduced activity. Reduced appetite. Reduced Blackie. Help her feel better. Get her whatever she wants to eat, as low protein nor low phosphorus are priority in the face of diminished appetite.

You came here seeking help. Advice. You've gotten:

• Seek Pain Management
• Seek abdominal ultrasound
• Seek euthanasia, the ultimate gift, if you cannot provide pain management and other palliative (end of life) care.

Be Blackie's voice, be her advocate. She is beyond the help of homeopathic extracts, oils, or special diet. She needs nutrients. Period. She needs pain therapy. Period. Truly listen to her. And respond with the love and the care you've demonstrated for eight years. She needs your help. Not something from the drug store aisle at Whole Foods or even an eastern medicine vet. All good vets that practice eastern medicine, utilize the pain therapy of western medicine.

Acupuncture may be helpful, but is often contraindicated in cancer patients, as it can cause inflammatory response and mutation of cells at certain sites, unknown at the time of needle placement, only obvious afterwards, when the masses are blown up and angry.

 
Depending on IF it turns out to be what the think it is, which it could not be, the best thing I can advise is find some cannabis oil and treat her with it.

It has been proven time and time again to cure cancer of many different kinds.

However, I hope that the tests come back negative.

This is terrible advice. No hemp oil. No cannabis oil. Just. No. Wrong. Harmful. Not helpful. Do not administer this to your pets. Ever.

 
I use asparagus juice for kidneys. I add it in there food. It works fast. 

First, I juice 1 or 2 stems  in my juicer and then I give them a teaspoon in the wet food every other day.

You  hemp oil at most health food stores.

Wholefoods, Toonies, Trader Joes, I use Nutiva. At first add 4 drops to food. The hemp can make them nauseous if they haven't eaten so never give it on an empty stomach.
You can also rub some on the outside wherever the lump is three times a day.

Also, get your cat started on un flavored pedialyte. 

Also, poor advice. Asparagus and many other green vegetables are toxic to the urinary tract. This cat has renal disease. And compromised health with an abdominal mass. No hemp oil. Right here, recommending a "treatment" that can cause nausea, therein lies your own answer as to why that would be harmful to a reduced appetite, renal disease cat already. No pedialyte.

Pain therapy, yes. Even good ole vitamin P, ER/onc nurse speak for Prednisolone, may help with pain, appetite, reduce tumor size/girth, and general inflammation; to be considered by your vet alongside her current stage of renal disease, as corticosteroids may be contraindicated.

Good variety of food, protein and phosphorus and sodium concerns be damned, they don't matter in the face of a poor appetite and lethargy. She need nutrients. Salt free chicken and beef stock, directly into a bowl, not diluted, so she'll drink as much as possible. Dehydration is likely considering her lethargy and reduced appetite. She may need subcutaneous fluid therapy at a minimum, intravenous fluids and hospitalization at a maximum. Oh, and pain management. Lots of Pain control. Pain therapy. Pain management. Did I mention analgesia, pain meds, buprenorphine, gabapentin? Oh, well I meant to say pain management.

 

[boomstick]

Puck - I actually spoke to my vet and that's what we're going to do. She mentioned some steroid to help with her appetite too. I can't remember the names of the meds...I was in a haze. The vet didn't even ask for a X-ray since she could feel the mass so well it's horrible. A week ago, Blackie was totally fine.

 

[boomstick]

This type of cancer, at this stage, is not a good responder to chemo or radiation, sadly. By stage, it's obvious with a palpably large mass, she is in later stage neoplastic development, and likely has metastases, as abdominal masses spread their lil cancer cells everywhere. She needs palliative care, aka Pain Management, in the form of buprenorphine, to administer in her cheek pouch or under her tongue 2 to 3 times daily, and possibly compounded gabapentin suspension you can give orally 3 times daily, both for Pain.  She is in pain.  Without a doubt.

I treat renal cats and cancer cats every day. Blackie is no exception. You don't need to afford chemo. You need to ask your vet to fill a prescription for buprenorphine (aka Buprenex) syringes, or a volumetric bottle from which you can pull volume needed from adapter tip, and call in a prescription for compounded gabapentin to RoadRunner Pharmacy, 877-518-4589, https://www.roadrunnerpharmacy.com/vets/about-us/  or Veterinary Pharmacies of America, 877.838.7979, http://www.vetrxrx.com/vparx/indexer.aspx. I prefer VPA as they'll fill the most volume for the minimum price, which was $43.00 minimum per compounded med. The suspension is easiest for gaba, but they make chews, dissolvable tongue strips, exact dosed tabs/caps, transdermal gels, pastes, otic meds, etc.

You are Blackie's palliative care advocate. That your vet's "face fell" and she wants a second opinion to verify her "suspicions" are moot, but she has to cover her ass, so to speak; request the pain meds anyway, without another exam, as money is best vested in pain therapy, and potentially an ultrasound to confirm, not just another palpating of the abdomen. That doesn't tell them anything except something big and weird is in the belly.

She needs to be fed whatever she will eat at this point. Any groceries are good groceries. Hold back on gross meds that will discourage appetite due to bitterness, like sucralfate (Carafate), metronidazole (Flagyl), no tramadol (Ultracet), and antihistamines. Food, pain meds, and B vitamin/iron/potassium supplements are your prioritized oral meds right now. Even the binders need to wait on the back burner, as they test horribly, and will reduce palatability of any food she does show interest in.

Good Luck with Blackie, and, please, keep us posted as to her progression, be it negative or positive.  Euthanasia is not a wrong answer here. Keeping her comfortable until that point is your only option; no pain meds is not an option.

Lethargy is a sign of pain. So is reduced appetite/joy of eating. She needs pain management. Cats don't say "hey out of a scale of one to ten, I'm an eleven." They show you. Like she is. Reduced activity. Reduced appetite. Reduced Blackie. Help her feel better. Get her whatever she wants to eat, as low protein nor low phosphorus are priority in the face of diminished appetite.

You came here seeking help. Advice. You've gotten:

• Seek Pain Management
• Seek abdominal ultrasound
• Seek euthanasia, the ultimate gift, if you cannot provide pain management and other palliative (end of life) care.

Be Blackie's voice, be her advocate. She is beyond the help of homeopathic extracts, oils, or special diet. She needs nutrients. Period. She needs pain therapy. Period. Truly listen to her. And respond with the love and the care you've demonstrated for eight years. She needs your help. Not something from the drug store aisle at Whole Foods or even an eastern medicine vet. All good vets that practice eastern medicine, utilize the pain therapy of western medicine.

Acupuncture may be helpful, but is often contraindicated in cancer patients, as it can cause inflammatory response and mutation of cells at certain sites, unknown at the time of needle placement, only obvious afterwards, when the masses are blown up and angry.

This is terrible advice. No hemp oil. No cannabis oil. Just. No. Wrong. Harmful. Not helpful. Do not administer this to your pets. Ever.




Also, poor advice. Asparagus and many other green vegetables are toxic to the urinary tract. This cat has renal disease. And compromised health with an abdominal mass. No hemp oil. Right here, recommending a "treatment" that can cause nausea, therein lies your own answer as to why that would be harmful to a reduced appetite, renal disease cat already. No pedialyte.

Pain therapy, yes. Even good ole vitamin P, ER/onc nurse speak for Prednisolone, may help with pain, appetite, reduce tumor size/girth, and general inflammation; to be considered by your vet alongside her current stage of renal disease, as corticosteroids may be contraindicated.

Good variety of food, protein and phosphorus and sodium concerns be damned, they don't matter in the face of a poor appetite and lethargy. She need nutrients. Salt free chicken and beef stock, directly into a bowl, not diluted, so she'll drink as much as possible. Dehydration is likely considering her lethargy and reduced appetite. She may need subcutaneous fluid therapy at a minimum, intravenous fluids and hospitalization at a maximum. Oh, and pain management. Lots of Pain control. Pain therapy. Pain management. Did I mention analgesia, pain meds, buprenorphine, gabapentin? Oh, well I meant to say pain management.

Yeah...I asked my vet if I should keep her on her low phosphorous diet and she said no, let her have whatever she wants. Fortunately she is still eating and asking for food...and still enjoys her old favorites.

 

[puck]

Puck - I actually spoke to my vet and that's what we're going to do. She mentioned some steroid to help with her appetite too. I can't remember the names of the meds...I was in a haze. The vet didn't even ask for a X-ray since she could feel the mass so well

it's horrible. A week ago, Blackie was totally fine.

Not only steroid, aka prednisolone. Discuss buprenorphine and gabapentin with your vet also. She is in pain. Pancreatic, stomach, splenic, liver, and intestinal cancer is uber painful, 10 out of 10, minimum.  I am the voice for my babies, even when vets think they've prescribed enough pain control. I tell them, "No, but he's eating slower, he's lethargic, he's not Puck! This isn't right. What else can we give, how much more, what synergistic combo are we thinking here?" I work with a great team of vets, but as their thoughts may be limited to a single plane sometimes, I get other outside vets to double check my babies all the time, think of a different approach, try a higher dose of one med, and lower dose of another. On a vet nurse's wee salary. You can get her the help she needs. Just ask, and if that doesn't yield pain management, demand a prescription for your Blackie baby. Corticosteroids shouldn't be the only thing the doctor recommended.

Yes, it's a lot of information. It's intimidating, and makes your mind feel like it's gonna shatter trying to balance emotion with logic. You have to pull it together for your baby girl. 

Get the pred (on the government $4 list at most human pharmacies per 30 count of tablets) called in by your vet to a pharmacy, and get your vet to fill a buprenorphine Rx; if they don't carry it, then they can call that one into RoadRunner for "hospital use" then dispense it to you under a licensed DVM number, with directions to draw from a volumetric bottle or administer predrawn syringes.

Or use a hospital that does carry buprenorphine, just switch your gears so it's not so difficult to get her what she needs. Gabapentin should only be compounded for cats, if they go this route also, as the human suspension has ingredients toxic to cats. Even a local compounding pharmacy can make you tabs, caps, chews, suspension, etc appropriately dosed from the vet's written or called in Rx.  Treating pain gives them a new lease on life. So many eat better, get around better, seek their people again, from a lethargic, recumbent state in pain.

 

[prince meow]

Boomstick,

I wanted to say hello to you and your little one.

I will be seeing the holistic vet monday. I will ask him for more information regarding Blackie.

I know you're recieving a lot of information from people and it can all get confusing. I also know you are there for him every step of the way.

Nothing matters more then that. Are there any questions that you would like me to ask him?

 

[ldg]

Boomstick, I'm so sorry for this terribly sad news. :heart2:


In the spring/summer of 2011, my cat Lazlo was found to have a "massive" mass in his stomach. It was inoperable, as the mass was fused to his stomach wall. I appreciate Puck's advice and experience, but based on my experience and the information provided by our oncologist, Dr. Craig Clifford (we saw him when he was a Red Bank, but this is who he is: http://hopevs.com/our-doctors/oncology/dr-craig-clifford/ ), I have to chime in here. According to Dr. Craig - a renowned veterinary oncologist - the most common cancer in the GI tract is lymphoma. This is not surprising as the most common cancer in cats is lymphoma. So while I appreciate and value Puck's experience, I think it's best to mention the most likely form of cancer.

Boomstick, I know you said you can't afford chemo, and I'm so sorry. The prognosis for treatment of lymphoma is much better than the other forms of cancer - though really, there's no point in speculation. Hemangiosarcoma can be rather reliably diagnosed from ultrasound, and the other forms can be identified with some confidence sort of, but require a biopsy to be sure. In Lazlo, they were able to diagnose large cell lymphoma from a needle biopsy done at the time of his ultrasound. It is an aggressive cancer, and he was given four weeks to live without treatment.

I have two cats that have had cancer: Spooky has small cell intestinal lymphoma (under treatment); Lazlo had large cell, a mass in his stomach. He is in remission. (Knock wood. :cross: )

I don't know if only the cost of treatment has figured into your reaction to no chemo, but many people relate experiences of family or friends (or even themselves :heart2: ) to what a pet may go through with chemotherapy. This is not a basis on which to make a decision, as chemo in pets is managed entirely differently. In people, the primary consideration is length of life, thus people are given much higher relative doses of chemotherapeutic agents - these obviously have more toxic and higher rates of side-effects. In pets, it is all about quality of life, and under the care of someone that knows what they're doing, management is active, and treatment adjusted based on quality-of-life questions that should be covered at every appointment.

The literature indicates that chemo puts large cell lymphoma into remission about 60% of the time. Dr. Craig said that his experience indicates it is more like 50%. We were very fortunate, the chemo put our kitty into remission, and over three years later (knock wood), he remains in remission.

I also have to disagree that lethargy always equals pain. Having a massive mass in one's stomach can make a kitty not feel well - but it doesn't by definition mean pain. I wasn't experienced at seeing pain in cats prior to Lazlo's cancer - and while looking back I can see he was in pain going into it, once we began treatment and supporting therapy, I can also look back and see he wasn't in pain. I suspect that what was painful for him were the bleeding ulcers, which we treated with sucralfate. His nausea was treated with Cerenia, his appetite stimulated with mirtazipine, and to protect him from developing ulcers from the prednisolone, he was given famotidine (pepcid ac).

There are many things you can do to make your kitty more comfortable along the way. How tolerant she is of being medicated should be the most important factor. But please know that things like pred can be compounded into transdermal applications. Some meds are not as effective topically vs orally, but when you're facing a terminal prognosis, clearly the comfort and happiness of your kitty should be paramount. There are many approaches to managing this time with your baby. One of the best approaches, IMO, has a phrase associated with it coined by a member of this site, "Love and Cheese Danish." It was written up here: http://catcentric.org/2014/10/13/love-and-cheese-danish-a-compassionate-end-of-life-concept/

My heart goes with you as you navigate this difficult time.


P.S. If you want to read Lazlo's story as it unfolded, from diagnosis through treatment, it is here: http://www.thecatsite.com/t/234030/mega-massive-vibes-for-lazlo-urgent

 

[puck]

@boomstick and @LDG

Soft tissue sarcoma is a broad group of many specific tumors. Abdominal mass being palpable does not mean gastrointestinal mass, stomach mass, intestinal mass, or colon mass. When we palpate a mass in the abdomen, it could be a pancreatic mass, hepatic (liver) mass, splenic mass, etc. Adenocarcinoma, hemangiosarcoma, small cell lymphoma, large cell lymphoma, etc are all common amongst cats. Blackie and boomstick are at the point where diagnosing the specific mass is not feasible, either financially or for personal living/philosophy reasons.

Thus, chemotherapy is not an option either. And once a mass is palpated, is that large, has grown and cancer cells have multiplied and flourished that much, even surgical removal and chemo often only gain the patient and family 6 to 9 more months. I personally don't opt for chemo, before I was even in specialty services, as I saw what chemo did to my regular veterinary patients, to family members' pets, and to human family and friends. For a certain age of critter, for a certain type of responsive cancer, I support chemo. But, not when tumors are caught in late stage development. The remaining life of a creature shouldn't be hell on earth when we already know they are terminal, and invasive procedures and therapy will only gain them a few more months.

Lethargy doesn't always mean pain in all patients, but it is one of few obvious visible symptoms a cat isn't feeling well, and abdominal masses are very very very painful; it can mean low blood glucose, or pain caused by elevated liver values and inflamed liver due to hepatic lipidosis, or dehydration, or combo of all 3. Lethargy results when they're weak and painful. Weak and painful can occur because of a fever also. Many things make them achy and painful.

I do support palliative care and pain management. Please, @boomstick, review my posts about pain therapy you can get your vet to prescribe, so Blackie girl is at least comfortable and cozy with you at home. She needs this. Do not ignore her pain. I've had many cats presented to me after being "monitored at home" that are recumbent, flat out, dehydrated, hypoglycemic, and painful. Be it due to cancer, severe lung infection, fluid around their lungs/heart, fluid in the abdomen, renal disease, angry liver, angry pancreas, angry gallbladder etc. I exhaust all efforts with life-saving injections, supportive oxygen therapy, CPR, and even colloid/blood infusions, but usually, their brain and organs have already suffered permanent cell loss and damage. Most owners have to overcome heightened emotion to authorize euthanasia.

You can proactively prevent this state. Supportive care with diet, hydration, and pain therapy will make you the best in-home nurse possible for your cat, while she is in her final moments with you at home. If you can't provide this supportive care with the help of your vet, then euthanasia is the best possible option for both you and Blackie.

 

[ldg]

puck thank you for expanding the discussion. That's very helpful. Thinking back to the process of Lazlo's diagnosis, while his mass was described as "massive," the vet opted for x-ray because she "thought" she felt something - it wasn't large enough to be sure. The x-ray showed all his organs squished and distorted. They actually thought he had spleenic hemangiosarcoma based on x-ray. I'm just thankful we were encouraged to pursue diagnostics and at least see the oncologist. We understood the statistics, but thankfully we've also beaten them.

It is our experience with Lazlo, however, that has resulted in our including a whole-body x-ray in all of our cats at all annual or semi-annual check ups. We also have blood pressure checked in all cats at check-ups. Cancer is common enough and often not visible in blood work, I really don't understand why vets don't include imaging routinely as part of the senior exam.

***********************************

boomstick , you've gotten wonderful advice on how to make Blackie as comfortable as possible. Having just recently and suddenly lost a beloved kitty, my heart goes out to you. :heart2: Right now each day, each moment is a gift. Blackie will hang on as long as she can for you. Kitties already live in dimensions beyond those we can perceive, IMO, so leaving their bodies is not the same for them as it seems to us. But they love and worry about us. I realize they're hard-wired not to display pain, illness, and weakness if possible. But I also think that often they try to hide it from us, to protect us.

Enjoy the best you can these precious moments. :heart2: :rub:

 

[boomstick]

Thank you so much to you and everyone. My vet actually gave her a shot of antibiotics the other day which helped a lot. Her fever is gone and her appetite came back more. She's also not quite as lethargic. She still meows for food and eats it all, so the vet us guessing she must've had an infection in addition to everything else.

I'm working closely with my vet as far as medications and painkillers go. When the time comes I will inquire about having her euthanized at home. I'm willing to pay a lot extra for this. It's the last thing I can do for her.

Thank you everyone who read and responded, I wish I had found this board years ago!

 

[prince meow]

boomstick

I'm so happy to hear Blackie is eating well again.

One of my cats is currently on an antibiotic, his veterinarian also suggested that he take a probiotic as well. (Which he takes 3 hours later so it doesn't interfere with the antibiotic.)

Both have made a huge difference in his heath.

It definitely worth asking Blackies vetinarian about.

All the best to both of you.