Help! Kitty with intestinal lymphoma won't eat!

[krashballz]

We just found out that our 14 yr old kitty has probable lymphoma in his small intestine. He's on 5mg of prednisone a day, and at the moment, 8mg of cerenia for nausea & 125mg of metronidazole for his severe diarrhea. He's always been a picky eater, but now I just can't get him to eat enough of anything! I've tried baby food, every kind of canned food they sell at the stores, people food...nothing works. I sprinkle FortiFlora on the food- it worked at first, but now he acts like I've poisoned the food. He won't touch dry food. I need to give him high protein, low carb, preferably gluten free foods, but would give him ANYTHING if he'd eat it at this point. Does anyone know of ANYTHING I can try? I really don't want to add another pill (appetite stimulant) to his "program" if I don't have to. He's been taking the current ones with Pill Pockets, but he's starting to catch on, & he's now just eating around the pills, so pill time is about to get difficult. Sorry for the long post, but I'm frantic and I'm terrified for my baby.

 

[vball91]

I am so sorry to hear of your kitty's lymphoma. Have you looked into syringe feeding? For cats who are sick and won't eat, it can be a lifesaver until they are feeling better and eating on their own. Another option is to have a feeding tube put in. Here are some helpful links.

http://www.thecatsite.com/t/266161/help-kitty-with-intestinal-lymphoma-wont-eat#post_3422682

http://www.catinfo.org/?link=feedingtubes

 

[krashballz]

I have thought about syringe feeding, and I think that's what it'll come down to. He's not the most cooperative kitty and he's so frail, I'm afraid I'll hurt him accidentally. He used to be such a big kitty- 22lbs- now he's so tiny and only 9lbs. This is breaking my heart.

 

[mrsgreenjeens]

We just found out that our 14 yr old kitty has probable lymphoma in his small intestine. He's on 5mg of prednisone a day, and at the moment, 8mg of cerenia for nausea & 125mg of metronidazole for his severe diarrhea. He's always been a picky eater, but now I just can't get him to eat enough of anything! I've tried baby food, every kind of canned food they sell at the stores, people food...nothing works. I sprinkle FortiFlora on the food- it worked at first, but now he acts like I've poisoned the food. He won't touch dry food. I need to give him high protein, low carb, preferably gluten free foods, but would give him ANYTHING if he'd eat it at this point. Does anyone know of ANYTHING I can try? I really don't want to add another pill (appetite stimulant) to his "program" if I don't have to. He's been taking the current ones with Pill Pockets, but he's starting to catch on, & he's now just eating around the pills, so pill time is about to get difficult. Sorry for the long post, but I'm frantic and I'm terrified for my baby.

I truly hate to say it, but maybe he's trying to tell you that he's had enough

. 

I had an old guy who was diagnosed with kidney disease and went from 13 lbs down to 6.  His appetite went from pretty hearty to nothing, and I tried every trick in the book to get him to eat.  I also always promised him that I would let him go when he had had enough, he just needed to let me know when that was.  So...every time he completely rejected his food, I would ask him if he was telling me he was ready to leave me.  He would them immediately start eating as his way of telling me "no!".  One day, though, he turned his back on me when I was begging him to eat.  That was a totally different reaction from him that I had ever gotten before.  So I looked him right in the eyes and asked him once again if he was ready to go to the bridge.  This time he stared right at me and started purring so loud it knocked my socks off.  I knew then that he was ready.  And even though it broke my heart, I told him I would keep my promise, and I let him go.  He purred even at the Vet's office

Now I am only telling you this because your boy is old, he is sick, and probably will not get better

.  You have said he has nausea and severe diarrhea.  That doesn't sound like a very good quality of life.  Now, if that is temporary due to something or another, that is quite another story.  Here is a Quality of Life Scale to measure how you feel he is really doing:  http://www.hilstvet.com/quality-of-life-scale-pets/  Maybe it will be helpful to you.

I know you are frantic, and terrified for him.  Believe me, I do.  I've been there, and now I have another one with a chronic illness, so am about to face this again, although my little girl cat isn't near end stage yet, thankfully.   My thoughts and prayers are with you and your little one

 

[ldg]

I'm so, so sorry. It's devastating to get news like that, we've been there.

Our kitty had large cell lymphoma. Here's a thread where we sought ideas for how to get him eating: http://www.thecatsite.com/t/235692/food-to-entice-cat-with-smell-problem-to-eat

In the end, his main problem was nausea. The cerenia really helped him, though we did have to get him over some humps with assist-feeding with a syringe.

But we were treating him for the cancer, and he wasn't overly stressing about all the vet trips. The difference is that we had hope that he might go into remission (which we were very fortunate, he did). Syringe-feeding or feeding tubes are really meant for use - as mrsgreenjeens points out - when the thinking is it will be temporary. :heart2:

Intestinal lymphoma is often small cell, though, which can be treated with leukeran. I assume the vet doesn't want to prescribe it without a biopsy?

At this point, I wouldn't worry one bit about what you're feeding him. A TCS member, Momofmany, calls this "treatment" of terminally ill pets "Love and Cheese Danish," and the explanation is here: http://www.thecatsite.com/t/228159/the-mackerel-update-thread-3/90#post_3032680

It sounds like his "cheese danish" isn't food right now though.

to you, and vibes for your kitty. :heart2:

 

[krashballz]

Thank you so much for the comforting words. This is my first time going through this. I know we aren't the only ones to ever deal with this, but it really helps to hear it. Thanks so much for sharing stories of your kitties.
Mrsgreenjeens, the quality of life scale really does help me put Krash's health in perspective. I got a 56 out of 80, so it's not too bad. As a worrisome mommy( & 1st time with a sick baby), I'm having a hard time telling the difference between a bad day and "this is the end." His doctor told me when he stops doing his 3 favorite things, I'll know it's about time. And I promised him as soon as he tells me, then I won't make him fight anymore. I'm trying to be realistic about everything (i.e. his age, statistics, etc.), but honestly, my gut feeling is that this is temporary. Thanks for the link to ideas to get him eating again. I'm going to try warming up his food tomorrow morning.
LDG, He's seen 2 vets and one specialist so far. They've all said based on the ultrasound and cytology that it's 99.9% positively small cell. They haven't done a biopsy though. I wonder, is that absolutely necessary if he has all the other symptoms and tests? He has an appointment with an oncologist in 2 days so I'll talk to her about it. He's seen an internal medicine specialist already, and he did mention Leukeran. He seems to think with treatment, Krash could go into remission. So I'm holding onto hope and trying to be as positive for him as I possibly can. He's got a pretty good attitude about everything so far. It's like he knows we're just trying to make him feel better.
PS- believe me, he's getting his "cheese Danish" Krash is the kind of kitty that gets what he wants, and I've never been happier to oblige. The world is his if he wants it

 

[mrsgreenjeens]

That's GREAT that he scored so high on the quality of life scale test!  So...  have you tried Fancy Feast?  I know it doesn't fit the parameters you want, but to most cats, it's appealing, and the CLASSICS are actually grain free and low carb.  They have a couple of new CLASSICS out there, with cheese.  Also, one that my TWO pickies will eat (although I HATE to feed it because it is not grain free) is the Fancy Feast Mornings Egg Souffle.  They've got a couple different ones. 

Additionally, have you picked up any of the 100% chicken or turkey or beef or whatever protein you like freeze dried treats.  They make wonderful toppers!  Wholelife and Purebites are the brands that immediately come to mind.  Wholelife crushes up into a powder as fine as baby powder, and Purebites has a completely different texture, but all my cats love both of these, so I always keep both on hand, in many different proteins.  I use them as treats as well as toppers. 

Parmesan Cheese (from the green can) is another good topper, and it doesn't take much!  I had to use this this morning on one of mine, and boy did it work

Here is a food chart that shows various canned foods and their % of protein, fat, carbs and calories which you might find helpful.  It doesn't talk about gluten, however:  http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf

Keep us posted on what's happening, especially after his next Vet appt.

 

[krashballz]

I never thought about sprinkling Parmesan cheese on his food. What a great idea! He might like the surprise of something different that I haven't tried yet instead of the same things over & over! Pretty much the only food I've been able to get him to eat has been Fancy Feast. My mom has a Bengal with IBD that gets classic Fancy Feast, so I was aware they were gluten free. Today I warmed it up for a few seconds in the microwave, and he ate like a champ! I'm so excited! He even had an almost normal poop which hasn't happened in over 6 weeks. So overall, I'd chalk today up as a good day for Krash
I'm going to get the soufflé Fancy Feast for him when I go get more food tomorrow. You're right, it's not what I'm looking for, but maybe it's what he wants. Thanks for the link to the chart. I wish they labeled cat food like they do people food. It gets so confusing when I have to have something so specific.
But I'm determined as long as he's in it, I'm in it with him and for him. I'm so glad I found The Cat Site and people that care. I hope your little guys are doing alright too

 

[krashballz]

Holy crow! This chart shows every kind of food. What a great source of information! Thank you so much!

 

[dan32]

I've just been through this recently with a 5yo with large cell lymphoma.  I did have some success with using the appetite stimulant Cyproheptadine made up into a topical cream that I could just apply to his ear without a lot of fuss.  Within 15 minutes of applying the Cypro, he was at the bowl eating.  A miracle!

It might not be a bad idea to have some kind of appetite stimulant and/or anti-nausea meds around anyway if you go the Leukeran route as not all kitties tolerate that so well.  Of course having them eat on their own is the best, appetitie stimulated eating second and syringe feeding only in a dire emergency - at least in my book.

 

[krashballz]

I will definitely talk to Krash's doctor about the cyproheptadine when I take him in tomorrow. It would be a blessing to not have to give him ANOTHER pill. I didn't know topical appetite stimulants existed.
I think he may need anti-nausea pills with whatever route we take. He seems to be pretty dizzy a lot of the time. I appreciate your feedback and advice. Thank you!
How did you treat your kitty?

 

[dan32]

I also had Cerenia (anti-nausea) made up into a chicken flavored suspension.  They could not make up the Cerenia into a topical cream, but the suspension wasn't too bad to administer.  I would just draw it up into a syringe that came with the medicine and squirt it into the side of his mouth, rather than wrestle with pills.  Kinney was also getting prednisone (steroid)  in a chicken flavored suspension on a daily basis. On days when he got both the prednisone and the Cerenia, I would draw them both up into the same syringe and just push them both in at once.  He would have been virtually impossible to pill.  He hated being handled.

There are two main appetite stimulants: Cyproheptadine (an antihistamine) and Mirtazapine (an anti-depressant).  Cypro is given daily and Mirt only every few days.  I had horrible experiences with Mirtazapine making my guys crazy and howling, but some people on here like it.  I personally had the better luck with Cypro.  Just so you know - the vets seem to favor one or the other.

This is a dissertation from Tanya's CRF pages on appetite stimulants.  http://www.felinecrf.org/persuading_cat_to_eat.htm   The website focuses on kidney disease, but the info on getting cats to eat is relevant anyway.

You might do some advance research prior to your vet visit and locate any nearby compounding pharmacies in your area as some vets are not aware of the abilities of these pharmacies.  Most will do next-day mail-order if you can't pick-up from them directly due to distance.  I found it was worth the hassle for the ease of administration.

Kinney unfortunately went down rather quickly from his lymphoma despite my and the medical community's best efforts, but the Cypro did jump start his eating multiple times.  A typical approach to small cell lymphoma is prednisone + Leukeran and the prednisone also does wonders for their appetites.  You can try the search bar up top and search for "Leukeran" and there are some longer posts with people chiming in on their experiences with it - good and bad.

 

[krashballz]

Oh my gosh, yes! I didn't even know those were options. What a relief to think that I might not have to give him pills several times a day. He loves being held, but seems to know when it's pill time and turns into a snarling, angry beast lol. He won't let anyone but me even attempt to give him pills. I'm going away for 4 days in a couple of weeks, and I'm scared to leave him. So I need to make his daily doses as easy as possible for my husband to give him. The Pill Pockets worked so well until he figured out that the pills were in there. Now, when I give him one, he just stares at me like he knows what I'm doing and he's not falling for it.
He's been on 5mg of prednisone daily for 3 weeks now. The vet wants to switch him to prednisolone when his current bottle runs out. So I'll be doing some research on the differences/benefits of those meds too.
I'm really sorry about your Kinney. I'm sure he fought a good fight.

 

[denice]

Prednisolone is a much better option.  The liver converts prednisone into a substance like prednisolone.  The liver has to work harder to get the same medicine when prednisone is used.  Prednisolone being more bioavailable means he is actually getting more medicine with the same dosage.

 

[krashballz]

I took Krash to the oncologist today. She has prescribed Leukeran on a 4 day treatment. He'll get 2 pills a day for 3 days, 1 pill the 4th day and not have to take them again for 17 days. She said that he might need an injection of vincristine to "kickstart" the chemo if the pill isn't working after 2 weeks. It's a hard decision to make- whether or not to put my baby through this, not knowing if it will help or make him feel worse...His doctors all seem to think we can get him into remission. I know Krash better than anyone else in the world. I feel like he knows I'm trying to help him feel better. And he's a strong kitty, I know he can do this. He still has so much life in him. I promise him I won't make him do it any longer if he doesn't want to- And I intend to keep that promise. This is not about me. It's about trying to give him the best life I possibly can, right up to the very end. I love this cat more than I've loved anything in my life. I can't have kids, so he is my kid.

I'm scared to death to start this, but more scared to not start. I'm excited to think that this might make my cat feel better and happier, and even more scared that it will not. So tomorrow I'll give him his first 2 doses, pray to God and keep my fingers crossed. 

Thank you all for your help and advice, and mostly just for caring. I'm sure I'll have plenty more questions in the near future lol

 

[denice]

There is a very high remission rate with leukeran.  Remissions can also last for years.

 

[gizmocat]

My cat lived 3 1/2 years after intestinal surgery for large cell malignant lymphoma. She was so far along that had we not operated, she would have had a blocked intestine from the tumor. She was happy and reasonably healthy until early this year. the cancer did eventually return, and it spread to her lymph nodes, making it inoperable. If you can operate, I recommend surgery. If not, your vets' medications may help for a while.But if your cat is not eating, he may be trying to tell you something. I am sorry and sympathize with you.

 

[denice]

I don't think there is a surgical option with small cell lymphoma.  There is no growth to remove it's a high number of inflammatory cells in the lining of the intestines.  That's why it is so hard to differentiate between IBD and small cell lymphoma.  It's a matter of how the inflammatory cells are clumped together and how many there are.  When we had the same question with my kitty I didn't get a biopsy done, we just treated for IBD and he has been good for almost 3 years now.

 

[krashballz]

How did you treat him for IBD? I know. Lot if the treatments are similar to that of small cell lymphoma. The oncologist said that there is still a tiny chance it's IBD- obviously they can't say without a biopsy. She said that even if it turned out to be IBD, the Leukeran is still a viable treatment for that. Does that sound right? I've done some reading up on Leukeran, but haven't seen anything about it being used to treat IBD. Maybe I just need to keep reading.
She also called today and said to increase his prednisone dosage to 10mg a day instead of 5. I switched him over to only canned food that is gluten free as soon as there was a concern that it was IBD or lymphoma. It hasn't really seemed to make much of a difference. He still has tummy troubles pretty bad. Even with metronidazole and Cerenia.

 

[steve smith]

Our cat had Lymphoma and we took her to a vet oncologist and he put her on Lumusteen . Its pill form and she went once every 5 weeks and she responded well for a year . She was only 5 years old so much younger . the treatments were not that expensive .