IBD on to the next chapter, where do we go from here, part 2 - It's time to learn options/treatments

In my last thread I mentioned Krissy slowly losing weight but remained her usual self.

I don't think that is the case anymore, it appears to me that she may have lymphoma now.......ugh, those dreaded words.

Without getting in to how I am tormented with this, can't sleep, etc I need to stick with the real questions, stay focused.

I spoke with the vet yesterday who agrees she has likely crossed the turning point and is showing early lymphoma signs, no vomiting, no diarrhea, only loss of appetite and weight loss, which apparently is the first sign.

Unfortunately I assumed I would see her revert to vomiting as her IBD caused, but not be able to get uinder control, to me, that would mean she has advanced in to lymphoma, but not so.

She still has times where she acts fine, but for the most part, she sleeps so much, acts 'under the weather', much less interested in eating.

Now the vet I spoke to is not Krissy's original vet I was first dealing with, I felt a lack of experience with IBD in her generally speaking, but remember the vet who came in to do her ultrasound is exceptionally great and considered as the best in her profession, so I felt confident in the ultrasound results.

So if my next step is to get an ultrasound I will go through her former vet again so I get that excellent vet to perform it, then her recommendation for treatment I will give to her new vet, well that was the plan but she told me about a current cat she is treating for lymphoma now, that includes 60 days straight of chlorambucil/leukeran.

But reviewing other sites for treatment, that might be overkill.

I do not care to put Krissy through a biopsy, so am hoping the ultrasound will show the vet clearly what we are dealing with, is that unrealistic?

I've read treatments of other names of chemo, and like 4 days on, 21 days off, etc.

Anyone else have a story of their cat and what the treatment was and outcome by chance?

I need to get on this now that I am convinced she is there.

Thanks.

I'm bumping this up for you, since no one has responded.  I guess the real question would be, Small or Large Cell Lymphoma.  And, of course, you don't know, because you don't really know if it's Lymphoma at all.  I'm not sure if there is truly a way to know without a biopsy.

Here, maybe this thread will help on small cell:  http://www.thecatsite.com/t/302330/lymphoma-diagnosis#post_3794192

And, you remember LDG's Lazlo, right?  He had large cell,and had treatment and lived much longer than anyone ever imagined.  His thread is extremely long, but just search Lazlo and you'll find it. 

mrsgreenjeens said:

 
I'm bumping this up for you, since no one has responded.  I guess the real question would be, Small or Large Cell Lymphoma.  And, of course, you don't know, because you don't really know if it's Lymphoma at all.  I'm not sure if there is truly a way to know without a biopsy.

Here, maybe this thread will help on small cell:  http://www.thecatsite.com/t/302330/lymphoma-diagnosis#post_3794192

And, you remember LDG's Lazlo, right?  He had large cell,and had treatment and lived much longer than anyone ever imagined.  His thread is extremely long, but just search Lazlo and you'll find it. 

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Thanks so much.

I'd like to assume it's small cell since 89% is small, so a great chance it would be.

Large scares me....

A little over a year ago Patches started loosing weight slowly with no vomiting.  The vet redid the ultrasound, blood work including folate, b12 levels, and the test that is sent out for pancreatitis.  Nothing showed up.  She increased his pred dose from 2 1/2 mgs per day to 5 mg per day.  He regained the weight that he lost and has maintained his weight.  IBD can be progressive without being small cell lymphoma.  Large cell lymphoma will usually show up on an ultrasound as a recognizable growth.  I think the only way to diagnose small cell lymphoma is with a biopsy.

I have seen different ways of giving the chemo for small cell lymphoma but it usually does include some kind of cycling regimen.  When it is cycled it is given in conjunction with a steroid.  I have seen different ways  of giving it though which I think means it is still a 'work in progress' as far as treatment protocol.

Yes lymphoma is diagnosed via biopsy. If you want to get a biopsy then its recommend that you don't give pred until after the biopsy. Its been noted that it would affect the results of the test. There is a group on yahoo I have been a member of since 2012. Lymphoma feline discussion group on yahoo. There is also a group on Facebook who is a part of the yahoo group. Feline intestinal lymphoma. Very good people in there. Also look up pulse dosing for leukeron (sp?). Often its given every two weeks one large dose. Prior to this dose they recommend: sub fluids/cerenia for the day before. Day of and two days after chemo is given. An appetite stimulant can be added on as well.

I've followed a sweet lady of Kelly H whose cat is in remission from large cell lymphoma. I remember when they were getting treatment. He's three years in remission now. Feel free to ask her any questions. She's also an ICU nurse and knows her meds. She's who I learned my cat nursing from.

Ibs is such a hard thing to treat. So many variables. Sending you hugs and vibes

Thanks so much for the input!

I'm not sure just why I feel the need to figure out the details and preferences of treatment prior to seeing the vet. Maybe it's due to my knowledge of cat/kitten care, and the vets I use in my rescue know this, and I don't necessarily agree with what they tell me to do, for instance to euthanize a cat who is hopeless, I decline, only to make the cat well and healthy again and getting it adopted for a new life, as they have seen happen many times.

Maybe because vets vary such a great deal, and this issue I am lacking knowledge on what works best.

For instance, a vet I use in my rescue and I spoke the other day about Krissy, I asked what amt of experience she has with this, she told me she recently had a patient who was confirmed to have small cell, she treated DAILY for 60 days straight on leukeran.......I mean wow, overkill or what?! 

I have read some vets say one pill every 2-3 days, I have read one a day for 4 days, then wait 3 weeks and repeat, so which is the best for results and easiest on her?

Maybe I should find an expert oncologist?

I agree that I will likely have to allow a biopsy, but can't do the surgical type, I just can't, endoscope or needle aspiration, well okay I guess if I must.

One good thing is, Krissy's IBD has been controlled by diet only, no drugs, so she should respond well to prednisolone now when given with leukeran.

I feel your pain. Boy do I feel it.

My boy Bandit, almost 17 has been dealing with many mystery ailments. Pancreatitis for start, but the symptoms did not seem to abate. The vet said the only thing we had not tested for was small intestinal lymphoma. And I won't test for it given his age and his loathing for needles. My vet did say there was one type that responded very well to chemo--the small cell (please don't quote me on that), but for my needs, even if he did have that, the outlook for life span with treatment is 2 yrs. Bandit is already old and I won't put him through that type of testing (ultrasound and needle biopsy). He is being managed on prednisone and pepcid ac and is doing very well (aside from developing horner's syndrome which is likely un-related). 

But I would do what you feel you need to--we know our kitties well enough to know what they need in regards to testing. If Bandit were younger, I'd have already been to the clinic that does the ultrasound and biopsy because he was such a strong kitty---but he's aged almost over night and while he's not frail and continues to show slow, steady improvement, I don't want him stressed.

Best of luck with your kitty!!! I do hope the results come out that the condition is treatable. My vet said kitties don't lose their fur in chemo--just their whiskers. Odd huh?

I don't know about that-I know cats who had small cell and lived long lives. They often passed from something other than their condition. check out that lymphoma site and ask folks to tell you how they beat small cell. ultrasound is the most LEAST invasive method. I strongly recommend getting at least an abdominal ultrasound=it is good for keeping track of organ illness/health etc etc. plus if something happens 6 or more months down the road you will be glad that you have that baseline to compare off. But don't use just any old vet. Find one who specializes in IBS/Cancer like an internal medicine vet who knows how to read the ultrasound. That is just my uneducated recommendation. Pred helps for small cell. it also helps for IBS. as long as your cat is eating/drinking/poo/pee and responding to you then keep on doing what you are doing. Just remember when they get old they will have a few bad days..just like we do. So if you have a day where they slow down eating, don't feel discouraged..just do the best you can. Cats are one of the most resilient animals I have had the pleasure of working with.

darkhorse321 said:

 
I feel your pain. Boy do I feel it.

My boy Bandit, almost 17 has been dealing with many mystery ailments. Pancreatitis for start, but the symptoms did not seem to abate. The vet said the only thing we had not tested for was small intestinal lymphoma. And I won't test for it given his age and his loathing for needles. My vet did say there was one type that responded very well to chemo--the small cell (please don't quote me on that), but for my needs, even if he did have that, the outlook for life span with treatment is 2 yrs. Bandit is already old and I won't put him through that type of testing (ultrasound and needle biopsy). He is being managed on prednisone and pepcid ac and is doing very well (aside from developing horner's syndrome which is likely un-related). 

But I would do what you feel you need to--we know our kitties well enough to know what they need in regards to testing. If Bandit were younger, I'd have already been to the clinic that does the ultrasound and biopsy because he was such a strong kitty---but he's aged almost over night and while he's not frail and continues to show slow, steady improvement, I don't want him stressed.

Best of luck with your kitty!!! I do hope the results come out that the condition is treatable. My vet said kitties don't lose their fur in chemo--just their whiskers. Odd huh?

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When Krissy was diagnosed with IBD, it was via ultrasound, and she also had pancreatitis, thickened intestinal wall, enlarged lymph nodes, this was 2 yrs back.

But the vet who performed the ultrasound is exceptional and in comments said she did not suspect lymphoma at this time.

Se Krissy has had no needles, or meds, and has been nice and stable for 2 yrs, with the exception of a couple of very short flare-ups during this period.

I have heard and read all over the net, most cats, like nearly all cats respond very well to the therapy meds. It just is uncertain how long it is in remission, but even so, are given another type of med and goes right back in to remission.

Problem is, vet must know what they are dealing with, whether small cell or large, as treatment and outcome varies a great deal among the 2.

This is the only type of cancer in cats that responds so well to med therapy.

If Krissy were 17, and healthy as she is now at 14 1/2, I would do the same as I am about to now.

Why not buy him another couple years or more when the meds are well tolerated?

It is a personal choice of course, just as others choose to have exploratory, etc that is not for me.

foxxycat said:

 
I don't know about that-I know cats who had small cell and lived long lives. They often passed from something other than their condition. check out that lymphoma site and ask folks to tell you how they beat small cell. ultrasound is the most LEAST invasive method. I strongly recommend getting at least an abdominal ultrasound=it is good for keeping track of organ illness/health etc etc. plus if something happens 6 or more months down the road you will be glad that you have that baseline to compare off. But don't use just any old vet. Find one who specializes in IBS/Cancer like an internal medicine vet who knows how to read the ultrasound. That is just my uneducated recommendation. Pred helps for small cell. it also helps for IBS. as long as your cat is eating/drinking/poo/pee and responding to you then keep on doing what you are doing. Just remember when they get old they will have a few bad days..just like we do. So if you have a day where they slow down eating, don't feel discouraged..just do the best you can. Cats are one of the most resilient animals I have had the pleasure of working with.

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I would love to hear what the treatments were, as mentioned before, I am trying to get educated on the treatment protocol and the best outcomes, whether it is a pill once every 2 weeks, daily, or pulsing/4 pills, 3 weeks without, repeat, etc.

Krissy sees the vet at 4 today..........