Experiences With Lomustine For Lymphoma?

[claired]

Hi,

I only seem to end up on this site when things are bad, so here I am again...

I have a 14 year old cat who has been diagnosed with "intermediate to high grade" lymphoma. Right now, he's still eating but throwing up about once a day and seeming otherwise a bit off. We visited the oncologist today for a consultation. He has a mass in his intestines and enlarged lymph nodes.

They tell us untreated, life expectancy is 4-6 weeks, and our options are just prednisone to ease symptoms for the duration, maybe extending life 2 months or so, or chemotherapy. The vet also said about 60-70% of cats respond to this treatment, which can give him up to 6-9 months.

The chemotherapy treatment they outlined would be to give him Lomustine every 4 weeks. Their plan includes a dose of oral sedation, a vet visit charge, the chemo drug and blood tests, and comes to around $400 per treatment for however long he has.

I am feeling really torn because I can probably financially make this work, but I'd be lying if I said it weren't going to be a strain. It's essentially what my family is able to save on a monthly basis, on average. But he's our furbaby. My husband and I have only been together a year longer than we've had Guy, and I'd like to say I'd do anything for him. That said, I fear that I am being selfish and desperate by wanting to put him through first chemo treatment, till his health continues to fail, and then prednisone and more decline.

Has anyone else had experience with this drug in their cat, and did you feel like it was worth the cost for what it was able to do?

 

[silkenpaw]

I haven't had your exact experience, but here are some things to think about:
Is your cat in good physical condition? No major weight loss? If so, I might be inclined to go with the chemo, for at least an initial treatment.

Of course, you have to think of the drug side effects. In people it's nausea and vomiting, I don't know about cats. Are you going to make his life a misery just to buy him a bit more of it?

Here's what happened with my cat with intestinal lymphoma. She was initially treated with prednisolone and Leukeran (chlorambucil) but she progressed (slowly, it took over a year). By the time we gave her more chemotherapy (CHOP) she needed a feeding tube and was obviously ill and very thin. She got through one cycle of CHOP but continued to get sicker and we finally euthanized her last week. If I had it to do over again, I don't think I would have dragged it out for all of us. The chemo did not make her violently ill but she seemed more tired after each dose.

It's a tough decision each of us ultimately has to make for himself or his animal. Find out as much as you can about the side effects and then decide.

 

[Mamanyt1953]

I have been very, very lucky so far. I have not had to deal with this. But many of our members have, and cats do not (or only very rarely) have the kind of reactions to chemo that humans do. They do fine with it.

That said, only you can decide what is best for your family, and especially for your cat. This may help you with your decision:

The Feline Quality of Life Scale Helps You Determine If It's Time to Say Goodbye to Your Cat | Catster

Regardless, you will not be alone on this journey. We will be with you.

 

[claired]

The vet also outlined the CHOP protocol but that sounds so very intense, requiring weekly visits that I think would really stress my buddy out.

I think I might be leaning towards trying the chemo as long as it is only requiring monthly visits. I just really worry that doing "really well" on chemo is still not doing all that well overall. I really wish we could do it without having to bring him in at all, but they want blood work before each time. (During his ultrasound, he bit the guy doing the samples so badly that he is actually "quarantined" for 10 days, despite having up to date vaccinations...14 years and no criminal record till now...)

I really appreciate the support. This decision has me and my husband questioning our judgement every time we think we have come to a conclusion.

 

[Plumeria]

Hi, my baby had 1 dose of Lomustine (and 1 Elspar) before he was put to sleep, so I didn't get an extensive experience with it. But as you said, the CHOP protocal is intense and I wouldn't recommend it for cats that are older, shy, anxious, hates carriers, traveling in cars, vet, and being handled by strangers. Leroy was very anxious, and I suspect being taken to the animal hospital, on top of getting dosed with aggressive drugs, accelerated his decline. His body did not respond to either of the chemo drugs. If you're just doing Lomustine once a month, hopefully it is not as intense. The chemo is only worth it if your cat's body responds to it, and isn't too psychologically damaging to your cat. So if you try 1 dose and it doesn't work due to one reason or another, I would stop and just use prednisolone and holistic supplements.

Main side effects are nausea, lack of appetite, vomiting, diarrhea. If you do choose chemo, make the oncologist prescribe anti-nausea meds and appetite stimulant on DAY 1 of chemo. Your kitty may coast through it and not need them, but in case he does, you want to treat him immediately, rather than risk having him skip a meal or two until you can pick up the prescriptions. FYI my Leroy lost his appetite as soon as the chemo started. I would also ask the oncologist how long the drug will remain in his body after each dose and what the windows of the side effects would be - would it start a few hours after the dose is given? 2-3 days later? How long would it last? etc.

 

[Mamanyt1953]

I really appreciate the support. This decision has me and my husband questioning our judgement every time we think we have come to a conclusion.

It always does. Always. But remember this...so long as you act in your cat's best interests, given the information that is available to you, you have done everything you can for your cat. No matter which route you take. Guy knows he is loved. He lives, breathes and has his being in that love, and he returns it full measure. The quality of the time he has left with you physcally is far more important that the length of that time. One question you should ALWAYS ask your vet is, "If he were your cat, what would you do?"