Chlorambucil and vomiting

[HowieF]

My cat was throwing up about once a month back in 2017 (now 2021) and my original vet had no idea, even with x-rays and blood work, what the problem was. Finally got referred to a specialty hospital where I've been ever since (original vet no longer in business). Before that, the frequency became every two weeks or so. The vet there ran an ultrasound and has been doing blood work. Thinks the cat (now 14 years old) has IBS or Lymphoma but, based on time-frames, decided it was more likely IBS. Without spending an exorbitant amount of money (I am retired) the specialty vet decided we should go with 10 mls of prednisolone daily and she had been on that until this year (2021).. Then her vomiting got worse, becoming a semi-weekly event. The part that bothered me was the cat was in distress for about 12 hours twice a week. The vet raised her dosage to 1.5 ml once per day and that made the cat's recovery time a lot shorter. So, now, he has her on 1.5 ml twice a day and she is no longer throwing up but is putting on a lot more weight so I have to watch how much she is eating. He also ordered Chlorambucil 6 mg one pill every two weeks for four pills total. Just the bag it came in "Chemotherapy" has me very nervous. The vet did suggest another ultra-sound, and a surgical biopsy but couldn't give me a feeling that it would solve anything as to exactly why she is throwing up and I'm in a financial "hole" at the moment. So, I'm hoping that if you have been through this medication, could you or anyone give me an idea what to expect? It sounds like she will not be feeling well for about 24 hours but are there any dangers? Anything to watch out for? I have a call into the vet but I hope that someone who has been through this could give me more personal insight. Thank you all..

 

[Mamanyt1953]

I do not have experience with it, but just did some reading. It seems to me that NOT giving the medication would be far more risky than giving it. I did find this article. Remember, while the medication sounds somewhat terrifying, not treating is far more so! It does give a list of possible side effects that require your vet's attention, so that should help you somewhat.

Chlorambucil for Veterinary Use

 

[daftcat75]

It's likely IBD. If she is able to maintain or gain weight, it's not likely lymphoma. Not yet. But it can become lymphoma if it's not brought under control.

It's my experience that IBD/lymphoma always have a food component to it. Some irritant caused inflammation which changes the porosity of the intestines allowing partially digested or undigested food proteins to escape into the bloodstream. When this happens, the immune system recognizes those proteins that should not be in the bloodstream as foreign and builds an immune memory. It's basically a learned allergy. Medicine helps by suppressing the immune response. But if you're still feeding the original irritant and the learned allergen, it's like trying to put out the fire while still pouring gasoline into her. My Krista did not achieve remission until all her trigger foods were identified and eliminated from her diet. Sadly, this would not last long as her suppressed immune system was not able to fight off a bladder infection.

If you're feeding her dry food, transition her to an all wet food diet. That's the first thing you need to do. There's just too many irritating ingredients in dry food. Now the bad news. Whatever proteins she's been eating for the last couple of years, you will probably have to avoid them now. Probably chicken and fish. Those are the most common. Unfortunately, it's very difficult to find single protein foods that don't have hidden no-no ingredients. For example, if you're trying to avoid fish, you might buy a turkey food only to find chicken ingredients on the label. Rawz is the gold standard food for conducting food trials with IBD cats. It's also hard to find and not cheap. Rawz, especially the rabbit, has also been subject to many shortages over the past year or so. When you find a flavor she'll eat and it seems to agree with her, stock up and hoard as much as you can afford at a time.

Where to Buy | RAWZ

I recommend the turkey or the rabbit pates. Start with the turkey because that's easier to find and give that a month or two. If the turkey doesn't help, try the rabbit.

If you can find a pork or beef-based food that doesn't have chicken or fish ingredients, that might work too. Unfortunately, my Krista never cared much for beef or pork. The vet may also have a hydrolyzed protein prescription food. Hydrolyzed protein means it's been broken down so it doesn't look like chicken to the immune system anymore. This may be easier to get than Rawz but it might also be more expensive. It's also not very popular with many cats.

I'm not a vet and far be it for me to contradict a vet's advice. But I don't think chemo is necessary yet until she starts losing weight while eating a normal or more than normal amount of food. I would discuss this with your vet. The pred however absolutely needs to be given according to the vet's instructions. Changing the dosage without a vet's guidance can be very harmful. But hopefully, the food will cool the fire and you can work with the vet to taper the pred dosage down.

 

[fionasmom]

I am also wondering with a weight gain if you cat does not have lymphoma but IBD. In that case, she would not actually need the chlorambucil.....but I am guessing at this and not telling you to make a decision based on my opinion.

Chelsea is on chlorambucil, without having done the biopsies, but she had a very noticeable weight loss and was on pred initially. If you do need to give the chlorambucil, wear gloves when you handle it if your concerns are for yourself. Chelsea has tolerated it well, and most animals respond to chemo much better than humans in terms of side effects.

I have been giving Cushing's medication to my dog for 6 years and it is considered to be chemotherapeutic. Funny....just this last order from Chewy had a big sticker that cautioned me not to touch it with bare hands. He also received immunotherapy for another condition 3 years ago and had absolutely no side effects aside from enjoying a ride in the car to and from the hospital.