Another 'possible lymphoma' thread - Feeby

[MissClouseau]

Hi. Thanks. The internist is insistent that she cannot put odds on either IBD or lymphoma.

I did find out about a test from the Lymphoma forum I joined (PARR assay - PCR for Antigen Receptor Rearrangements that was developed to detect clonally expanded lymphocyte populations, as it would seem Feeby has). This test is run on the tissue that was retrieved from Feeby via fine needle aspiration during her ultrasound. When I asked why the test was not done, the internal med vet said that that the pathologist did not deem it necessary - and that was the end of that discussion.

I believe that if I am not ready to commit to one of her 4 recommendations - 1.) steroids in case it is IBD, 2.) chemo in case it is lymphoma, 3.) biopsy, or 4.) another ultrasound in a few months - then, she no longer considers herself to have a role in Feeby's care. And she is probably right about that. So, once I wrap my head around all of this information, I will be going back to Feeby's regular vet to see what her take is on all of this.

My impression is that cancer in digestive organs do not get better without treatment but rather leads to more symptoms in a relatively short time.

Feeby has lost about two pounds since a year ago (from 13.1 to 11.09), but most of that was lost early on in that timeline, and shortly after she went on H-T meds.

You know that cats also lose muscle mass as they age and that shows on the scale too. I will add this article here in case you haven't seen. CPD article: Weight loss considerations in the older cat

At Feeby's age, it would be very unusual for her to not lose some weight even without any health issue like hyperthyroidism or IBD.

 

[FeebysOwner]

You know that cats also lose muscle mass as they age and that shows on the scale too. At Feeby's age, it would be very unusual for her to not lose some weight even without any health issue like hyperthyroidism or IBD.

I didn't mean to infer that some of her weight loss isn't likely tied to aging in general - that is more or less a 'given'. But her weight has been relatively stable since being on H-T meds, until more recently. The fact that she now needs an appetite stimulant to help her maintain weight, I tend to think there is something else besides general aging involved. Could it be 1.) the need for an increased dosage of H-T meds, 2.) an escalation in her CKD, 3.) possible IBD/lymphoma, or 4.) something else? At this time nothing has been determined. Other than inappetence and weight loss, she is relatively symptom-free. That makes any of the above conditions - or a combination - a possibility, especially considering nothing in the ultrasounds/FNA cytology can be deemed anything other than 'inconclusive'.

She is due for another round of blood work, which could help to reveal an escalation in her thyroid level and/or kidney disease. If there are other blood tests the vet wants, that is fine too. And another ultrasound in a few months should help to clarify if there is progression that might better point to IBD/lymphoma. As I have been advised, treating her right now specifically for IBD or lymphoma, without a biopsy or a follow-up ultrasound, is nothing more than a shot in the dark. I was also told that using either steroids or chemo at this time would severely compromise the results of any further testing in search of confirming/ruling out IBD/lymphoma.

The good news - if there is such a thing - is that the most common form of lymphoma in cats is small cell which tends to be less aggressive. This also means that another ultrasound might reveal some sort of progression before she would actually start to demonstrate IBD/lymphoma symptoms other than inappetence and weight loss. To me this also means that I can likely afford to perform more testing before having to choose either steroids or chemo.