Mega massive vibes for Lazlo urgent

[darkmavis]

I'm still thinking of you all and sending mega vibes to Lazlo...

 

[captiva]

I'm sorry it's cancer, Laurie

I'm keeping you, Gary and Lazlo in my thoughts and prayers. It's so tough getting that news. I'm glad that you are both keeping his quality of life in mind, too.

 

[ldg]

This is nuts. Thankfully Laz is asleep, but there's some very hungry kitties at home. 4miles from our exit and we're dead stop. Gary talked to truck driver behind us. There's 2 accidents between us and exit. Both are fatality accidents. An entire family died in one. We could be here hours. At least 5 ambulances have gone past in breakdown lane.

 

[violet]

I'm so sorry. Any chance you can get off by going on the breakdown lane and taking the nearest exit that way?

 

[violet]

PS: and taking the back roads home, I mean?

 

[momto4kitties]

Oh No, that is awful Laurie

I hope you can get home soon. I also feel sad about the people in the accident. I hope you get home soon and safe.

 

[ldg]

We're home! We debated about the breakdown lane. We carry oxygen tanks for Gary, and one is empty and one is getting low. (Oxygen is a powerful vasoconstrictor delivered at high flow rates, it's used for his medication situation, not for emphesema or breathing or something). We debated... we're pretty sure getting caught in a breakdown lane re: accident is a suspension fine. He decided to plead low oxygen. We went for it. We only got a mile before a fourth lane opened up because of a hill, so he just pulled in line up there. Thank goodness - another ambulance went by right after that.

I think we were there 1 1/2 hours. Thankfully Lazlo just slept.

Got the kitties fed.

And I think Doc was right (feline oncologist specialist) - Lazlo's problem isn't his appetite, it's that he feels nauseous all the time because of the cancer in his tummy. He gave him an injection of Cerenia, an anti-nausea med, and sent me home with cerenia pills.

We got home - and the other kitties hadn't eaten since this morning!!!!! (We put food out dry food for them to free feed if we're going to be gone all day. We had no idea we were going to be gone all day).

I called everyone for dinner basically the minute I walked in the door, and Lazlo started MEOWING. I mean - like he hasn't in a long time.

He ate a 1/2 can of c/d in one go. I gave him a little more after a few minutes, and he ate... maybe another 1/8 of a can.

It's been about 20 minutes / 1/2 hour since they ate (I think), and he just popped in here MEOWING. I gave him some kibble. He just ate a handful.

So... I know this doesn't really mean anything, because Doc said that if he's going to have issue with the chemo, it's usually after 2-3 days. But we'll know by Tuesday, when his next treatment would be. I'll explain in next post.

Oh - and Violet, thank you so much for the info! But Lazlo's problem is that his blood is too thin. He wasn't producing enough platelets, so his blood wouldn't clot, which is why even if surgery was an option, it wasn't an option. The herb was to help boost his platelet production.

 

[ldg]

Ok, I just lost the entire post, and it was long and detailed and almost done LOL. BUT, it was for a good cause. Lazlo came in meowing again for more kibble.

 

[violet]

So very sorry about that. Not fair after the day you had.

Anyway, just wanted to say, so glad you're home and that Lazlo has anti-nausea medication that seems to work.
Many, many prayers for a good weekend for all of you.

 

[momto4kitties]

I'm glad you are home

I hope Lazlo responds to his treatment, lost of good vibes

 

[carolina]

Laurie, what a day!
So glad Lazlo started chemo - 50/50 chances that he beats is a chance that would keep my hopes up for sure.... I would fight for it no doubt about it

And yes, when I discussed with my vet about chemo, he said the same thing - cats take it much better than humans - it is not as bad at all.... We do have such a huge, huge trauma of it, and we see our friends going through such horrible things when they go through chemo, we immediately think our babies will go through the same...
Fantastic news that he is eating well too - Cerenia is a great drug for nausea - the injection works SO fast - it has been great for Bugsy as well.
I have all my fingers and toes crossed for Lazlo to beat this - I will never lose hope.... One day at a time is a day closer every day for him to get all better

 

[ldg]

Let's start over. I want to get this out before I forget LOL.

First of all, I really liked this doctor. What a kind, gentle, wonderful person. Also so upfront and honest, not "salesy." Obviously our vet knows what she's doing in recommending this guy.

Gary and I both love that he became a vet 12 years ago and got his specialist certificate - whatever it is - in feline oncology 10 years ago. (We were in the room for a while before he came in and we read all the stuff hanging on the wall). It means he's young enough to be current (and we assume he is anyway because he specializes) - but has been practicing long enough to have a lot of experience.

The first thing he did was talk to us about lymphosarcoma. Then he talked about Lazlo specifically.

Lymphosarcoma is a cancer of the white blood cells, and is the most common cancer in cats. This we knew. What we didn't know is that there are two types. He explained it like this. When the lymphocytes are "born" in the bone marrow, they're large. As they mature, they shrink. The most common form (85%) of lymphosarcoma is the "large cell" type. The rarer form (15%) is the "small cell" lymphosarcoma.

The large cell lymphosarcoma is aggressive (and most often found in the gastrointestinal tract, though not limited to it).

The small cell sarcoma is not aggressive, and is almost always treatable.

Large cell lymphosarcoma based on the literature goes into remission in about 60% of cats. In his experience, it is more like 50%. It is very aggressive.

Lazlo has the large cell type lymphosarcoma (aggressive).

The good news is that his hematocrit is now 32%. The problem is that he's had two depo shots in the last month (one just Wednesday). Depo can decrease the effectiveness of chemo.

The other good news is that the tumor is in his stomach and in his stomach only. It can be a real problem if in the intestines or colon (causes blockage and requires surgery, which is often a problem because of anemia, potential infection, recovery, &etc.). The bad news (which we knew) is that it's large. The problem with that is that it has penetrated much of the lining of his stomach wall, so if we pursue chemo, we can't try to kill it too fast, or it'll leave his stomach wall too thin and risk rupture. So he has to put Lazlo on a schedule that would kill the cancer, but allow his stomach wall to repair along the way.

At this point we asked about the quality of life issues. He explained that in his experience, even though literature says only 5% - 10% of kitties experience problems with the chemo, you have to consider (as Violet already pointed out) how stressful it is for the cat to DO the chemo. He did go on to explain, however, that the relative doses in proportion to body size in treating cats is smaller than doses in treating humans, so while in humans, chemotherapy means QOL issues about 90% of the time (if not more), in cats in HIS experience it's about 15% of the time (not the 5% - 10% according to the literature on the subject). Also, while toxicity is a huge concern in humans (and the major cause of QOL issues), in cats because of the dose relative to body size, it is almost a non-issue.

Lazlo is very thin - but his blood work is improving rapidly. So far he doesn't mind being pilled and syringe fed... so we'll just have to see.

Prednisone is part of the overall treatment, but Lazlo just had the depo shot. Because of the size of the tumor and how aggressive the cancer is, he recommended starting chemo today... and we'll see how he responds (not the cancer so much as how he feels) and decide how to proceed from there.

So that's what we decided to do. Lazlo didn't stress on the drive down there. Now that we know where it is, we know a better way to get there that should take about 1/2 hour off the trip, so it'd be 1.5 hours. He practices every-other-Tuesday in an office that as it turns out is (depending on traffice) 45 minutes to 1 hour from here, so manageable.

So in treating Lazlo. He does not want to use just one chemo. He wants to rotate weekly. He generally gives four weekly treatments, then skips treatment the fifth week, then evaluates where things stand and decide how to proceed.

Today Lazlo was treated with Elspar (Asparaginase) via IM. (He was also given a shot of the anti-nausea medication, Cerenia). Elspar kills ONLY the cancer, not all growing cells (which most chemotherapies do). Normally with a tumor as large as Lazlo's, he combine the Elspar with VinBlastine... but he doesn't want to kill it too fast because of how much of the stomach wall lining it's penetrated.

So we scheduled an appt for treatment Tuesday in the office that's closer to us. And based on how Lazlo reacts between now and Tuesday, we'll decide whether or not to proceed.

And obviously we discussed the herbal meds he's on. Doc is fine with the platelet-builder and the blood-builder, but does NOT want us to start him on curcumin (tumeric) as it interferes with chemotherapy.

So IF we proceed, here's the schedule he outlined:

"Week 1, cont'd:" Tuesday, Aug 2: Office that's closer for VinBlastine via IV.
Week 2: Cytoxan (IV) at farther-away office (he practices in the closer office only every-other week).
Week 3: VinBlastine (IV)
Week 4: Adriamycin (IV)

Lazlo is to continue the 10mg pepcid a/c 1x per day (antacid - we give in evening)
The one chinese herbal (blood builder) 2x per day
The other chinese herbal (platelet builder) 1x per day
4mg Cerenia (oral) 1x per day in AM (anti-nausea med)
15mg Mirtazapine (appetite stimulant) every three days (morning).
And he'll start 5mg prednisone 1x per day probably next Tuesday.

Syringe feed him if necessary.

Re-evauate everything we're doing if necessary. Depends on Lazlo, and how he's feeling.

******************
One last comment here (for now LOL). I told him that I found it very odd that Lazlo not only didn't seem to mind the syringe feeding, but almost seemed to enjoy it. He said this is because the poor guy has probably felt nauseous for months. We chalked up initial weight loss to the switch off of free-feeding to timed all wet meals - and it just happened to coincide with the development of his cancer (or we would have not blamed it on the food change

). But he's hungry - that's why he licks at the food. But he feels sick, which is why he doesn't eat more. So he probably doesn't mind the syringe feeding, because it makes him feel better having some food in his tummy, even though he doesn't feel like eating on his own.

We may find he doesn't need the appetite stimulant - the pepcid a/c and anti-nausea meds may be enough. But he doesn't want us to find out yet, as he seems to be responding well to the stimulant. Obviously we'd all love to see Laz gaining some weight without throwing up.

 

[carolina]

Sounds like he is really a great doctor! And of course you guys..... no words!

 

[ldg]

Ummm.... a question I should have asked him but didn't. How much is it OK to feed Lazlo? If the space in his tummy is so small, how much food fits in there or how fast does he digest it?

He keeps asking for more food - and I keep giving it to him. He hasn't thrown up (yet, knock wood).

Do I need to worry about him eating too much?

 

[carolina]

Originally Posted by LDG

Ummm.... a question I should have asked him but didn't. How much is it OK to feed Lazlo? If the space in his tummy is so small, how much food fits in there or how fast does he digest it?

He keeps asking for more food - and I keep giving it to him. He hasn't thrown up (yet, knock wood).

Do I need to worry about him eating too much?

I am not a vet, so take this with a grain of salt... I would probably feed him often and smaller meals a day, but keep feeding him. My understanding is that they do have a fast digestion - the food doesn't sit on their tummies for more than 2 hours or so.... I would also feed him lower fiber foods (doesn't bulk on his tummy with water) and more digestible proteins - probably lots of higher protein wet food, and stay away from kibble is a good idea. I wouldn't be scared of him throwing up - it is just that his stomach walls are so thin and this tumor is massive.... My understanding also is that those foods, A/D and Maximum recovery (??) are highly digestible - so you'd be fine that route too...

 

[violet]

Do I need to worry about him eating too much?

I would think so. I wouldn't give him all he wants right now. I think I would wait a few hours (at least a couple of hours) to make sure he can keep his food down before giving him any more. And I would give food in small amounts but often if he can keep it down.

Laurie, you're truly blessed with this doctor, he sounds like everything a loving cat parent could hope for. Most importantly, kind and caring. From what you're sharing, he will do his very best to help Lazlo without putting him in any danger from the treatments.

I will be praying very hard for the treatments to work.

 

[ldg]

Sound advice, thanks Carolina.

When he had the xray in Jan, I remember his vet saying his tummy should be empty because the meal was more than 2 hours before the xray.

But he's asking for food like every 15 - 20 minutes.

Good thing the fridge isn't very far away from the bedroom. I did keep giving him kibble, but I'll get out of bed.

I'm just happy he WANTS to eat!

 

[calvin&i]

Laurie, glad you liked the oncologist. I sincerely hope that the chemo does it's job with minimal side effect.

glad that laz is eating. Keeping our fingers crossed and sending tons of your way

 

[ldg]

Originally Posted by Violet

I would think so. I wouldn't give him all he wants right now. I think I would wait a few hours (at least a couple of hours) to make sure he can keep his food down before giving him any more. And I would give food in small amounts but often if he can keep it down.

Laurie, you're truly blessed with this doctor, he sounds like everything a loving cat parent could hope for. Most importantly, kind and caring. From what you're sharing, he will do his very best to help Lazlo without putting him in any danger from the treatments.

I will be praying very hard for the treatments to work.

Well, it's pretty much too late for that Violet!

I just fed him some every time he asked for food. He's been eating the Before Grain Chicken dry food. But... they ate dinner (wet food) around 8:00 (1.5 hours late!), and I've been giving him the kibble since.

But it is time for ... well... I call all their meals "dinner" because that's the term they know LOL. It's time for a wet food meal again, and if he keeps asking for food (because he just walks up and meows in my ear - it's too cute), since the fridge is about 8 feet away from the bedroom in the RV, and the microwave is right next to it, I'll go heat him up a little a/d every other time he asks for food instead of just continuing to feed him kibble between wet food meals.

He's kept it all down, so whatever's going on... I guess it's good.

 

[carolina]

Go Lazlo, go Lazlo!!! I love it! and yep, they are just too cute for words!!!

and the sound of them asking for food when they are sick and need to put on weight after being force-fed.... cute-to-the-max!