WWYD? Possible lymphoma, advice needed

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chai love

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I have a 1.5 year old kitty that developed diarrhea over the summer. I took her to her vet when it first started but blood work and x-ray revealed nothing unusual. For awhile she had diarrhea on and off so I changed her food a few times in hopes it was just her food not agreeing with her. It didn't work. She slowly stopped eating her dry food and began only eating wet food. After some time, she started eating less and less of her wet food. She's now done to just licking off the gravy. She's also been urinating and defecating outside her litter box on occasion. She's still affectionate and doesn't seem entirely unhappy but she doesn't play anymore and has been spending more and more time alone.

Fast forward to this week at her vet appointment. I took her in because her diarrhea went from occasional to having only diarrhea (and it's completely liquid). She went from 10 lbs. in May to now 6 lbs. I can easily feel her spine and hip bones. Her vet palpated her abdomen and said her intestines were completely hard so he did an x-ray which came back showing her intestines in a haze. He said that more than likely this is GI lymphoma even though she's very young. He recommended euthanasia or exploratory surgery. We cannot afford the surgery unfortunately. In a panic, I took her to another vet that works with an internal medicine specialist for a second opinion. They did a CBC, x-ray, and abdominal ultrasound. Her albumin was so low the doctor was surprised she isn't full of fluid and her ultrasound revealed a severely thickened lower small intestine and colon along with two large masses, one of which they believe to be a very enlarged lymph node (2.5 cm). The IM vet diagnosed her with lymphoma but said there's a possibility of a severe infiltrative infection like FIP. They gave her a prognosis of poor to grave. Once again I was told exploratory surgery could be done for biopsy or an endoscopy could be done but because of the location of her supposed cancer, surgery is the better option. The doctor also told me that euthanizing her would also be an option for her case.

Today she is scheduled for euthanasia but after not sleeping and barely eating, I have realized I cannot go through with it. I lost a kitty two years ago to a short battle with FIP and I cannot lose another kitty so soon. At her appointment today I'm going to bring up the possibility of doing a colonoscopy with biopsy so we can know for sure it's cancer and not something more easily treatable like IBD. Depending on the cost of the biopsy, I'd like to have it done. We cannot afford cancer treatment nor can we really afford something like major surgery (we've already been paying for her vet bills with a credit card). We're expecting our third child very soon and my husband will be changing careers next year (lower pay) so digging ourselves further into debt is not an option. Our kitty means so much to us, but I have to be realistic about what we can and cannot afford.

What would you do in this situation (taking her age, prognosis, and our financial situation into consideration)? Would you choose to euthanize or go further into debt having more testing done? Please keep in mind that euthanasia is NOT the easy solution for us and that this is a horrible decision we have been faced with. We love her very, very much.
 

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@chai love...I am so sorry that you are going through this with your 1.5 year old cat. 

How did the Vet visit go yesterday?

Did you opt for the colonoscopy?

For me, the decision would come done to 'quality of life' for my animals.

If they are suffering, no longer able to do the things that they loved doing, and there was no realistic hope for improvement, then the decision to euthanize would be the hardest but kindest thing to do.

Even before they would start suffering, based on the prognosis, then I would opt for euthanasia.

But everyone is different, and the decision is such a personal one, so no one can really tell you when you are ready.

Do please be kind to yourself, and take care of yourself, by eating and sleeping when you can.

Our cats would not want us to suffer, and know how much we love them.

They come into our lives for various reasons, and we are so lucky to have them for however long, or short their lives are.

It's not fair when their lives are short, but somehow there is so much meaning found, no matter how much time they are with us.

What is your cat's name?

Sending you vibes of Strength for what you are going through.
 
 
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chai love

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Thank you for your kind words. Her name is Jinga Belle. :) Her regular vet wasn't there so we spoke with the one who was filling in. I let her go over all of the lab results, ultrasound report, etc and she gave me the same answer: that the prognosis is poor and is most likely cancer or FIP. I asked her if there was any chance at all that it could be a severe form of IBD and she said that while it would be unusual in this case, it's not impossible. The vet said for peace of mind that we did everything possible and just to rule out a possible bacterial/fungal/parasitic infection, she's put her on prednisolone and flagyl. Jinga will be on it through the weekend and she said if there's any improvement at all then we'll continue her on meds while changing her over to an appropriate IBD diet. She did warn us though that if it is IBD and it's already this bad so early on in Jinga's life, then it's probably going to progress into something worse like lymphoma. If there's no improvement then I will know we did what we could. Given the location of her masses and the severity of her inflammation, doing abdominal surgery would be better in terms of proper diagnosis than an endoscopy/colonoscopy. The doctor said that if she were to open Jinga up and confirm it is indeed cancer or FIP, that she would not wake her from anesthesia because she wouldn't live long anyway. I don't want to put her through the pain of surgery and she's already so frail that I'm afraid just putting her under would kill her. She has been eating a little more than usual today and is actually wanting to be a part of our activities rather than hiding all day so fingers crossed the meds are helping. She goes back to the vet on Monday so we'll see what happens. At this point I'm preparing for the worst but hoping for the best. 
 

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I think what you are doing is really wise.

By giving her the steroid and antibiotic, hopefully any inflammation and any infection will diminish, and that you'll see an improvement in Jinga Belle. (beautiful name :)

I do hope the meds work fast, and Jinga continues to eat more, as well.

I don't think I would risk any surgery, either, just to confirm a disease, where you might lose her during the procedure.

The prednisolone is one of the meds they give to cats with lymphoma, anyhow, and to cats with IBD,...so by giving her this med, you are already doing treatment.

I'm so glad that she is eating a little more, and wanting to hang out, rather than hide.

All you can do is be with her, when she wants to be, and like you said hope for the best.

I'll be hoping for the best, too, and hoping that this weekend brings some improvement.

Many continued Health vibes are being sent for Jinga Belle,


and continued strength for you and all your family.
 
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chai love

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Thank you so much. At her appointment yesterday the vet found that her intestines are not as thickened and her belly is soft instead of hard like it was before. So the medications seem to be working. :) Whether it's IBD or lymphoma, her vet suggested she be on a high calorie, high protein, low to no carb diet. I've found some grain free canned foods she likes and she's actually eating really well, even asking for seconds! She has a follow-up in two weeks so I hope she continues to improve.
 

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I have nothing to add, except for (((Hugs)) for you and Jinga!!
 

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What we did in a similar situation was to have the exploratory surgery because there was nothing to lose. I did not have a surgeon that told us he would not wake her up, and don't think I would have gone through with it under those circumstances. Cindy had a large mass in her abdomen and couldn't get a diagnosis of what it was for sure although they suspected cancer. She was losing so much weight that surgery was the only option and I was at peace knowing that if didn't make it through the surgery (naturally), it was meant to be.

In your situation, I don't think I would have the colonoscopy. That was one of the options offered to us but was told it was iffy if it could actually find anything or not.

Have you tried Royal Canin Recovery RS canned food?  it is  high calorie and nutrient dense, and very tasty to cats.  Not cheap though, and have to has a script to get it.

I hope your kitty keeps improving.
 

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Thank you so much. At her appointment yesterday the vet found that her intestines are not as thickened and her belly is soft instead of hard like it was before. So the medications seem to be working. :) Whether it's IBD or lymphoma, her vet suggested she be on a high calorie, high protein, low to no carb diet. I've found some grain free canned foods she likes and she's actually eating really well, even asking for seconds! She has a follow-up in two weeks so I hope she continues to improve.
What an excellent update.
  I'll take any small improvement, but Jinga eating,... to me, is big time excellent. 

It's probably the prednisolone, which is supposed to make a cat hungry.

But maybe it's the antibiotic making her feel better, or the combination of the two.

Good that you found some food that Jinga Belle likes.


Continued Healing vibes being sent, and as @Artiemom and @Mysty8723 already mentioned, more hugs, and hopeful thoughts of continued improvement. 
 
 
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chai love

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Thank you for all the support. :)

Exploratory surgery just isn't option for us as we simply can't afford it. Even if money wasn't the issue, I wouldn't want to put her through it considering how frail she is.

She's eating less canned food now and is back to mostly just licking the gravy off like she was before she went on prednisolone. She is at least eating more dry food which is something she hasn't done in a long time. I haven't tried the Royal Canin food yet as her vet wanted to just start her off on meds then go from there and decide what diet she needs. I do have a friend with an IBD kitty and he was crazy for that brand of canned food. I could see if she has any cans to spare for Jinga to try. For the past week and a half I've been feeding her grain free wet food and a high protein grain free dry food (nature's variety instinct). Last night she defecated on a pillow in our bedroom and it was bloody diarrhea. It wasn't just a drop of blood either, it was quite a bit. I've noticed that she doesn't always use her litter box and lately has been favoring our bedroom and our youngest's bedroom. Just when I thought she was on her way to getting better, we experience a setback. Her next appointment is on Halloween so we'll see what the vet says about all this.
 
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Oh, no. I was hoping that Jinga Belle was on an upturn, and would continue this way.

Can you place another litter box, inside your bedroom, just in case she cannot make it to her own litterbox.

I wonder if her intestines are just so irritated, and gaseous, and then the diarrhea is explosive, so she does not make it in time, to her own box.

With IBD, from what I've read, it is so difficult to find a 'Limited Ingredient Diets' (LID) cat food, which is also a new protein, that the cat has not tried, yet.

If she is allergic, or bothered by any of the cat food ingredients, then the 'flare-ups' happen.

There are some LID brands of cat food, with novel proteins such as duck, venison, lamb, etc, that may help Jinga out, but I don' t have any experience with IBD, so would not be very helpful, in where to begin.

I really hope that Jinga continues to eat, and that you find something that works.

With her diarrhea, I wonder if adding some sort of probiotic, or fibre would help her.

Don't know if pure pumpkin, would make the diarrhea worse or better.

There are various threads on TCS (the Cat Site) which may help in finding some foods, if you do a general "Search" for 'ibd food for cats', you come up with various threads:

http://www.thecatsite.com/newsearch?search=IBD+food+for+cats

and this specific thread has some useful info: http://www.thecatsite.com/t/265847/good-commercial-foods-for-ibd-cats

It even mentions that some IBD cats do well on Fancy Feast.

At this point, dry or wet, I would just give her whatever she wants to eat.

Sending more health vibes for Jinga.


So hoping she improves, well before Halloween.
 

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Have you tired the NV food line of "PRIDE" ?  My guy has IBD and will eat the Pride Rabbit. It contains rabbit and pork.. 

Wishing you well.. and ((hugs))...
 
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chai love

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Thank you everyone.

She had blood in her stool again yesterday so to err on the side of caution, I called her vet to see what they wanted me to do. They had me come in right away to check her. Unfortunately after palpating her abdomen, the vet could tell the masses have grown since her last visit. Her gums were white so now she's extremely anemic. She has also lost weight since her last appointment. He basically told me that at this point the signs point overwhelmingly to it being cancer and not IBD. Really all he said he could do for her are a few comfort measures like a shot of steroids and a B12 injection. At this point I feel like we've done what we can. The prednisolone was basically a last resort and as badly as I wanted it to help her, it's not. My husband thinks it's time to let her go and as much as it pains me to admit it, I think it is too. Her quality of life has declined greatly over these past few months. She's very withdrawn, prefers not to be petted (she's usually very affectionate and big on sitting in laps), no longer plays or sits in the window (one of her favorite things) and is down to eating nothing but the gravy in her canned food. Her zest for life is just gone and it saddens me so much that she's so ill at such a young age.
 
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chai love

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Oh to answer the question about her litter box. We have two, one of which is in our bedroom. It seems like she's seeking out other places to defecate because she'll be near our bedroom but will pass it by and will go off down the hall into our son's bedroom instead to use the bathroom. When she pooed on the pillow in our bedroom yesterday, the pillow was near her litter box. I'm not sure if she's confused or if she's so ill that it doesn't matter to her where she goes as long as she gets a bit of relief.
 

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She does sound like she is extremely ill, and very much in pain, now. 


The steroid shot would ease some of the pain, but it does not sound like it can counter all of it.

Sending prayers for Jinga, you and your family. 
 
 
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chai love

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Thank you. It's so hard to see her unwell. We've always just wanted her to be happy and healthy. 
 

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Very unfair, because she is so young. 

Do you have any other cats or animals, that can ease your grief, even in some small amount.

It will not change what is happening to Jinga Belle, but it may help with your sadness, a little.

I wish things were different. And these little companions of ours did not have to go through all this pain. 
 
 
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Our only other fur baby is our dog Dolly that we've had for about 6 years. She's good friends with Jinga. :) Jinga loves to rub up against her and groom what I refer to as "her puppy." All of this has made me really appreciate how healthy our pup has been.
 

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Jinga has her own dog,..."her puppy,"...6 year old Dolly,...that just brought tears to my eyes.
So amazing how certain cats and dogs get along.

All you can do is tell Jinga how much you love her, and all the things you want to say.

You did everything you could, but cancer takes over too quickly.

Letting Go is sometimes the only choice we are left with. 
 
  
  
  
 
 
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chai love

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We let Jinga go peacefully today. After speaking with the vet, our options were to have her remain on meds the rest of her life (with her diarrhea likely never going away) or having her put to sleep before things get too bad for her and while she still has her dignity. The sedative made her yell out as we were warned it stings a bit but she quickly settled down and over several minutes, drifted quietly off to sleep while my arms were wrapped around her. We cried, told her how much she's loved and how much she means to our family, and gave her kisses. The vet tech cried along with us as she's been there for us through Jinga's journey. After the vet gave her the final shot, Jinga went with peace. We stayed with her for a bit afterward. Her ashes will be returned to us so she can reside in the urn with our FIP angel kitty. Our hearts are broken but we feel this was the nicest gesture we could offer her. 

Here she is just a couple of months ago....she was still herself then (left) and as a baby (right)

      
Jinga and her puppy

 

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@chai love...I am so sorry for your loss of Jinga Belle.

With the tumour masses growing, and losing more than 4lbs in 5 months, I don't think her body was able to absorb enough nutrients, and the diarrhea didn't help with that either.

Being surrounded by her family at the end, she'd know all the love from you all.

Actually, I think that our cats continue their journey's elsewhere, and their essence never dies.

May she be playing at the Bridge,or in Heaven, being whole and healthy again.

May your hearts also heal with time.

Thank you for posting the beautiful photos of Jinga. So sweet.

Especially the one where she's sleeping on her back, with those front paws curled, and back paws in the air.

And the one with Dolly, 'her puppy', sleeping right next to her on the sofa. Adorable.

Run like the Wind, Jinga, 
and look down on your family, from time to time, especially that dog of yours, even though it looks like she's a well behaved pup.
 
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