Large cell lymphoma in intestines, kidney, and bladder

My cat Blue will be 9 in August. 2 months ago he started losing weight so I took him to the vet 2 weeks ago on May 24th when he also seemed to be struggling to go to the bathroom. He normally weighs 12lbs and at the first vet visit weighed in just under 8lbs. After running bloodwork, having an oncologist do an ultrasound, and aspirate they found he has large cell lymphoma in his intestines, kidney, and bladder. The week I brought him in he was thin and having bathroom issues but was in good spirits and still playful and alert. When he was diagnosed May 28th I opted to do the prednisone. He gets very stressed going to the vet and car sick. The vet agreed he was so stressed he had dandruff and they had to sedate him for most of the tests but that it was my choice in the end to do chemo or not. Keeping quality of life in mind I chose the prednisone and began it immediately. Since the last day at the vet he seems depressed without much improvement.
I question myself every day if this was the right choice. In the past week that he's had the prednisone he's been up and down but mostly down. This weekend he's definitely deteriorating quickly. He seems depressed, he is barely eating or drinking, he's constantly in and out of the little box but not really going, he hides a lot which is very uncharacteristic, he's very lethargic, very thin, but can still walk around and jump up on the bed. I know everyone says you just know...
I did not expect this to be so hard from the first week. I can tell he's unhappy and I can't bare the thought of him suffering but I also don't want to let him go prematurely. Is he in a lot of pain? Am I being selfish for keeping him alive? Am I being paranoid and giving up too soon? This is breaking my heart. He is like my child and I feel like I'm so stressed and crazy about this I don't know if I'm making the best choices. How do I know when it's time?

and Welcome to TCS.

I'm so sorry that you and your kitty are dealing with this and know that we care. I personally cannot offer any words of wisdom regarding his diagnosis but there are several people here that have personal experience and will be better able to advise regarding treatment etc.

You sound like a loving guardian and you ultimately know your kitty the best, trust yourself in this, I know it's hard.

Is your cat able to eat, drink and use the litter box still?

He uses the litter box very frequently and eats very little. He usually has a few bites of wet food at night and I've barely seen him drink water. I'm going to reach out to our vet tomorrow and try to see if there's anything I can do to make him eat and drink at least. Thank you.

BluesMom07 said:

He uses the litter box very frequently and eats very little. He usually has a few bites of wet food at night and I've barely seen him drink water. I'm going to reach out to our vet tomorrow and try to see if there's anything I can do to make him eat and drink at least. Thank you.

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If you are going to be talking to your vet tomorrow, you need to ask him to prescribe some Buprenex for pain.  I think alleviating suffering is what we all want when our little ones are going through something like this.  It's so hard to tell when a cat is in pain, but I can pretty much assure you that he is.  The prednisone should help with inflammation and swelling, but it also suppresses his immune system and has other side effects, such as behavioral changes.  It normally increases the appetite, as well as increasing thirst and urination.  Also, if he is taking oral prednisone, it's thought that prednisolone is the superior oral version of this drug. Sometimes a cat's liver is unable to convert oral prednisone into the bioactive form, prednisolone.  

You can probably still choose chemo if you've changed your mind, since it's only been two weeks since you went to the vet.  There are several cat parents on this site whose cats are going through chemo right now and seem to be handling it well.  I would definitely talk to the vet tomorrow and get something for pain and discuss the prognosis if you choose chemo.  I know it's such a hard decision and my heart breaks for anyone trying to decide how to best help their baby, but the very least you must do is make him comfortable, and Buprenex will do that.  You will both be in my prayers.  Hugs, sweetie.

If you just want a little more time with him, getting the buprenex will help because it will ease his pain.  We have another cat on here who has a different kind of cancer, and he has hung on a long time.  We are expecting him to go at any time because he has already lived a couple of months longer than the vet gave him initially, and he is on the buprenex twice a day and has been through most of his end stage illness and it still is keeping him comfortable.  It is a very long thread, which she never expected it to be, but you may want to drop in towards the end and see how comfortable Simon is despite the fact he has an inoperable tumor in his mouth and is wasting away.  He has been so loved by his family, especially his human mom, and it's so obvious in this thread.  It may help you, or you can send her a private message, I'm sure she will answer you, if you have questions about hospice care for your cat. 

http://www.thecatsite.com/t/316100/...hare-with-you-simons-journey/330#post_4027516

Considering your cat's disease has already metastasized to kidney and bladder, I wouldn't consider chemo if he were my cat because although it might stop further spread, it won't repair the damage that already exists.  I'm not sure about blood test results, but it sounds like his kidneys are already failing, and chemo might make that worse.  You will have to talk to your vet about it.  I've known several people who wished they had never done it and would not do it again, but hindsight is 20-20. 

Common signs of pain include decreased appetite, reclusive behavior, dilated pupils, tail swishing, body tensing, difficulty sleeping, depression, and sometimes aggression i.e. grumpiness, not wanting to be handled or even petted.  If you read any of Simon's thread above, even now that he's in end stage and can't even stand anymore in the past couple of days, he is relaxed and even eats and drinks still (with help) and is not grumpy at all, because the pain medicine is working.  It's a really touch time for you and your cat, but if you put his comfort first and become willing to go along with his process, whatever it is, you will be more peaceful and comfortable with your choices.  We will all be here to support you.

Thank you all so much for all the information, advice, and kind words. I called the vet and am waiting to hear back. I had given him Brupenex 2 weeks ago when he first was diagnosed and I didn't see a huge change but he did seem a little more comfortable so perhaps that'll be good for him. He has been showing signs of pain... Very lethargic, swishing tail, dialated eyes, hiding, depression, and he refused to eat last night and this morning... He is still affectionate and sits next to my bed waiting for me to pick up him and waits at the end of the bed to have me put in down so he can go to the little box. He's not cleaning himself so I've been trying to clean the little that's caked in his paws with a warm wet towel. I am hoping the vet tells me there is more I can do. I don't want to do chemo regularly as going to the vet makes him incredibly stressed and he gets sick in the car even in his best health. It's breaking my heart to watch him struggle as his poor little body is so frail and deteriorating so fast. I've been taking time off work as much as I can but I feel terrible whenever I have to leave him. I guess I'm just waiting to hear from the vet now. I do truly appreciate the support. Thank you.

Sweetie, if he hasn't eaten in almost two weeks, if he isn't grooming, if he's hiding, then he is trying to let you know that his quality of life is gone.  This is each pet parent's individual choice and only you know the right choice to make.  I have never owned a cat who enjoyed being put in a carrier and taken to the vet, but that's part of it.  I've had some that were just as stressed by a vet visit as he is, that yowled in the car the entire way to the vet, but they never did that on the way home.  I believe cats are incredibly intelligent and know when they are getting help..  Are you syringe feeding him at all?  Giving him unflavored Pedialyte?  Anything?  If he's getting no nutrition, his behavior has changed dramatically and he seems to be in pain, you have to love him enough to help him if his little body is shutting down.  I know it's incredibly difficult.  We are here for you.  I am assuming that's Blue's picture as your avatar.  I looked at that sweet face and saw how utterly adorable he is.  Please don't let him suffer.  Is there a vet who makes house calls in your area?  Your boy needs help, honey.  Maybe a different vet could give you a second opinion and offer him something other than prednisone.  Blue deserves better than that.   I'll be praying for you both.

I am so sorry for the diagnosis. This is so Heart breaking. Some kitties have reactions to the pred. What dose is your kitty on? I ask because sometimes heart issues don't become known until after pred has been given for a time. Another member had her kitty on pred and it was excalibrating congestive heart failure-they were able to slow it down but sometimes its not noticeable except when their behavior changes. Her kitty wanted to be alone and didn't eat. And purred really loud and snuggled more than usual. So I would look into this for an ultrasound on the heart-too bad that they didn't do this while they did the organ ultrasound-wouldn't have had to stress out the kitty much more than usual.

I only wish that more vets would do an ultrasound on the heart prior to doing longterm pred. Of course I understand not being able to do the tests without sedating-that in itself is heartbreaking on its own. It is true that pred changes their personalities sometimes. You could also let them know that maybe they could try a different steroid-there are other classes of steroids that may work better without the side effects. dexamethasone is another  type of steroid-sometimes it can be switched but maybe you can ask the vet.

I only wish we could get rid of cancer. As far as eating-let them eat whatever you can get into them. baby food ham is a big hit in my home when they are ill. you can try the other flavors--in my house they love fish and turkey and ham. you can also try Kentucky fried chicken classic fried chicken with no bones/skin-warmed up-this may help perk up the appetite. The babyfood should have no onions or garlic but usually the ones in the grocery store sold by Gerbers and Beechnut don't have anything added other than cornstarch. And the old tuna water trick is another one. I believe someone posted this method in other threads-they took a can of tuna and added to a jar with water and shook it up-let it sit in the **** for a bit for it to break apart and serve the "juice" on their wet food to help entice eating. chicken broth can be used-no onion/garlic. at this point anything to help the eating or... the unthinkable next step that we all struggle with. Sending you hugs and hope.

Sadly, I spoke with the vet and after talking things through with her, I made the decision to put my baby down. I feel awful about it but he was clearly in a lot pain so I chose to end his suffering. I know he is in a better place although it hurts my heart to come home and not see his little face waiting for me to cuddle him and give him kisses. Thank you all for yor support. This was the hardest decision I've had to make and I know my Blue is in heaven now. Here are some pictures of my handsome little guy before the lymphoma. He was such a smart, affectionate, sweet, and loving cat. I miss him so much already.

Oh

BluesMom07 said:

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• bluesmom07
• Jun 8, 2016

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• bluesmom07
• Jun 8, 2016

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• bluesmom07
• Jun 8, 2016

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• bluesmom07
• Jun 8, 2016

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• bluesmom07
• Jun 8, 2016

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Oh, sweetheart, I am SO sorry.  I was very much afraid of this.  I am very very proud of you because I know the love and the courage it takes to make that most difficult decision.  Beautiful little Blue is not in pain any longer, he's happy and healthy and whole, and yes, I agree with you that he is in heaven.  You are very brave, just as he was.  Sending you a huge hug and much love.  I know you miss him so much and I know there is a hole in your heart with Blue's name on it.  I hate that loving costs us this kind of pain.  You will be in my prayers, honey.  You were a wonderful mom to this gorgeous little boy.  Sending you a PM.

to you! I'm sorry that Blue is gone & I know your heart is broken but I hope that you hold strong to the fact that you gave the ultimate kindness to your beloved companion!

Thank you so much for coming back on here to tell us about your decision to let Blue go to his next life (sometimes people go away and we never know, always wonder...)  I believe you did the right thing for Blue, and while it is breaking your heart now, you will feel better about it over time because you spared him any additional suffering.  You did see all the signs of pain in him and you recognized that he was no longer happy to be in his body, so you set him free of it.  We all know you would have saved him if you could have, but it wasn't meant to be.  He will join Simon at the Rainbow Bridge and wait for you to come get him when it's your time to cross over.  As badly as it hurts now, you can take comfort in not worrying about him when you are away from home.  I would have done the same thing, and in fact have done so in the past many times.  Those are lovely pictures of him.  When you are ready, you should post a tribute to him in our Crossing The Bridge forum, and include all those pictures and share the story of his life.  I'm glad you came here, and that you got the support you needed to make that hard decision.  It was best for Blue, and he's free now.

So very sorry to read this news.  On behalf of the TCS Team, we offer our condolences for the loss of your sweet baby.  We'll close the thread now as is our custom, out of respect for your loss.  Please feel free to post a tribute to your boy Blue in our Crossing the Bridge forum:  http://www.thecatsite.com/f/19/crossing-the-bridge