Mystery illness, Possibly Lymphoma, Not Eating

[Furballsmom]

I told my brother I was tempted to take the pills myself! Everyone in the household is thrilled that he seems comfortable and happy.

LOL, what a wonderful update!

 

[RussellsMom]

I spoke too soon: Danno was fine overnight and early this morning, but later in the morning and for the rest of the day he's clearly in discomfort. He's still somewhat frisky—clawing the stair carpet and running up the stairs agilely—and he ate OK through the afternoon (not so in the evening), but he's sitting and lying down tenderly and in obvious discomfort.

I was making up a chart of everything that's happened since he got sick—behavior, eating, drinking, litter, vets, and meds—and I found the labwork that was done when the ultrasound and FNA were done last Friday. It was tacked on to the bottom of the cytology report (online, not on paper), and I must have missed scrolling down after the I read the cytology. It showed elevated BUN (46), which had not been elevated (28) in his test five days before, and elevated creatinine (3.0), where it had been very slightly elevated (2.2) five days before. How unfortunately familiar I am with such readings from when my beloved Story was diagnosed with CKD.

All that scared the hell out of me, but I’m trying to remind myself of the conviction of the oncologists who felt the best course of action at this point was to start treatment for GI lymphoma right away.

The thing that’s eating at me most tonight is that the regular vet—not the oncologist—we saw this Wednesday gave us a few cans of A/D because he wasn’t eating. She did say to feed sparingly because it’s very high in protein. He’s been enjoying the A/D Wednesday, Thursday, and today (less than a full can total). When I saw those kidney values, I felt terrified that maybe the reason he’s painful today is because I overdosed him on protein with the A/D in my zeal to get him to eat and in my then-ignorance of his elevated kidney values.

Can anyone talk me down from that catastrophic thought? Any thoughts about A/D and painful kidneys?

 

[silent meowlook]

Hi. It is fine to feed a cat with kidney disease protein. In fact they need it. So, your feeding the A/D did not cause his kidney values to rise.
That being said, that is quite a rise in Creatnine in a short amount of time. What changed in his lifefrom the first bloodwork to the most recent?

 

[RussellsMom]

The first bloodwork was done on Monday, 8 January, which was 3 days after his suddenly falling ill. The second labs were done on Friday, 12 January. The only thing different was that he'd been severely ill for a full week by the time of the second labs, plus the stress of two ER visits. He ate wet food in that week, for the first time in his life - could that have impacted the numbers so much?

Last week, he was so severely ill - I think I haven't quite described it properly in my previous posts. He was almost 100% of the time in his cat bed, shuddering, not looking up but looking inward (is how I'd describe it), not responding to us, licking only food that was brought to him, crawling to the water bowl. Once he fell onto the water bowl and knocked it over but he couldn't move away, he just lay in the puddle. And once he crept into his litter box and just lay in it. His haunches and back legs were very weak, wobbly and emaciated. He was suddenly, profoundly altered and impaired that week. Like most of you, I have been around dying cats and I felt certain he was dying. Since the first dose of chemo he's been dramatically more himself, even today, which hasn't been great.

One curious finding in the exam was this: "Abnormal body conformation: is obese with a large fat pad but has muscle wasting dorsally." He's actually a bit scrawny, with sharp hip, spine, and shoulder bones. He has a little pot belly with hardly any fur on it (the rest of his fur is normal, pleasant and soft). I had noticed his hind quarters getting very thin and slightly bowed about 6 months ago, but when I asked my brother about it he said he hadn't noticed. -?

 

[iPappy]

The first bloodwork was done on Monday, 8 January, which was 3 days after his suddenly falling ill. The second labs were done on Friday, 12 January. The only thing different was that he'd been severely ill for a full week by the time of the second labs, plus the stress of two ER visits. He ate wet food in that week, for the first time in his life - could that have impacted the numbers so much?

Last week, he was so severely ill - I think I haven't quite described it properly in my previous posts. He was almost 100% of the time in his cat bed, shuddering, not looking up but looking inward (is how I'd describe it), not responding to us, licking only food that was brought to him, crawling to the water bowl. Once he fell onto the water bowl and knocked it over but he couldn't move away, he just lay in the puddle. And once he crept into his litter box and just lay in it. His haunches and back legs were very weak, wobbly and emaciated. He was suddenly, profoundly altered and impaired that week. Like most of you, I have been around dying cats and I felt certain he was dying. Since the first dose of chemo he's been dramatically more himself, even today, which hasn't been great.

One curious finding in the exam was this: "Abnormal body conformation: is obese with a large fat pad but has muscle wasting dorsally." He's actually a bit scrawny, with sharp hip, spine, and shoulder bones. He has a little pot belly with hardly any fur on it (the rest of his fur is normal, pleasant and soft). I had noticed his hind quarters getting very thin and slightly bowed about 6 months ago, but when I asked my brother about it he said he hadn't noticed. -?

Was he unable to drink, and dehydrated during those labs? I would wonder if dehydration from being so sick for a week would shoot those numbers up. (I'm not a vet, and I don't know much about kidney disease in cats but it's just a thought.)

 

[RussellsMom]

It's possible. The ultrasound did show his kidneys were inflamed. The cytology "confirmed" a "suspected" diagnosis (I used quotation marks because those two words are odd together) of GI lymphoma. Renal involvement is suspected by the doctor, but there was no mention of renal cancer. I almost don't want to ask to look too much further, if that makes sense, but just proceed with this treatment.

Danno had diarrhea twice this morning. He seems rather better since then - talkative and more comfortable. Not where we were two days ago - such a high! - but not as low as yesterday. Maybe it's just a case of "There are good days and bad days." I so appreciate everyone's help and kindness.

 

[iPappy]

From the not eating, to the chemo, to the increase in appetite diarrhea is not surprising to me. Just keep a close watch on it because you don't want it to go on for too long! Make sure you let the vets know about this next time you talk to them.

 

[RussellsMom]

Hi all: A little update and a little plea for good wishes today. Danno's been doing really well the past few days. He has a lot of his normal character and behaviors back. He's eating amazingly well. Today he's so playful, energetic and comfy, but we have to bundle him into his carrier in a few minutes to take him to the oncologist for his one-week labwork. How I wish I didn't have to stress him out! But it's obviously necessary. I know you can all relate. So my little plea for good vibes for Danno, that his labwork goes well. I'm very nervous about it. Thanks for the help and hand-holding!

 

[FeebysOwner]

 

[fionasmom]

 

[RussellsMom]

Thank you!! We're back home and Danno is so upset - he's hiding under the bed. They took blood from his neck. How awful! I wish I'd been prepared for that - I assumed they'd take it from his leg.

He's come out now, for a bit of cuddling.

THE GOOD NEWS is that they felt his abdominal mass was noticeably smaller. White blood cells were fine; red were slightly lowered, but not so much that they were concerned today.

Back next week for second dose of chemo. Thank you so much for your well wishes!

 

[daftcat75]

I wonder if they can prescribe gabapentin for him that you give him before a vet visit so he's more relaxed seeing as it sounds like you're going to be doing more of these visits for awhile.

 

[RussellsMom]

URGENT QUESTION: Is it OK to crush prednisolone? This is the first day I haven't been able to pill Danno. Can I crush the pill and put it in some food? Thanks

 

[daftcat75]

URGENT QUESTION: Is it OK to crush prednisolone? This is the first day I haven't been able to pill Danno. Can I crush the pill and put it in some food? Thanks

I think so. My IM let me cut it with a pill cutter. I don't know why crushing it would be any different. I don't know if he'll eat it in food unless you can supervise him eating it mixed in a small amount of food or treat until he's taken the whole dose. Personally, I would simply crush it in a spoon, add a little water, and then syringe up your makeshift suspension and shoot that into him. Over and done with and no begging to eat altered food. Sadly, this is how I have to "pill" Betty with ondansetron and gabapentin twice a day. The gabapentin is already a liquid dose. But I crush up the quarter pill of ondansetron in a spoon (I use a plastic measuring spoon and the plastic coated ended of a capsule filling spatula because metal on metal seems to make pill fragments launch airborne across the kitchen.) I also use a short squat 3 mL syringe to re-uptake her 1 mL measured dose. This type of syringe pops the dose into her in one clean go whereas the 1 mL syringe often sticks halfway and then I have to chase her down for another half dose.

Didn't you get pred mini-melts? Or is that another thread I'm on?

 

[iPappy]

Thank you!! We're back home and Danno is so upset - he's hiding under the bed. They took blood from his neck. How awful! I wish I'd been prepared for that - I assumed they'd take it from his leg.

He's come out now, for a bit of cuddling.

THE GOOD NEWS is that they felt his abdominal mass was noticeably smaller. White blood cells were fine; red were slightly lowered, but not so much that they were concerned today.

Back next week for second dose of chemo. Thank you so much for your well wishes!

This is a great check up! I'm sorry he's upset though. Gabapentin as daftcat75 suggested might be a good idea if this is something that has to be done often. I'm glad Danno has been eating and getting stronger so this will just be a slight upset to his routine.
I've had vets take blood from my dog and my cats necks. It's upsetting to see at first, but I think there's less resistance because in order to get blood from a leg, they sometimes need a tourniquet (something a lot of them hate), and they have to hold/restrain the leg either by the elbow, paw, etc. (something else most of them hate.) The neck veins are also a lot larger and sometimes, especially with cats, finding those tiny veins in the legs can be hard, leading to them having to be poked more often.
If they take blood again in the near future, try to remember this if it helps.
I'm so glad the mass has shrank!! This is such awesome news!

 

[white shadow]

...They took blood from his neck. How awful! I wish I'd been prepared for that - I assumed they'd take it from his leg......

Hi RussellsMom - One of my cats once got a needlestick injury....from which he never recovered. I've read other similar accounts.

You can put an end to this now.

Two points for next contact with those folks:

1. NO NECK BLOOD DRAWS from now on
2. Insist on entries in chart/file paper/digital of NO NECK BLOOD DRAWS

No matter what. Never. (and, yes, the gabapentin: the night before and 3 hours pre-visit)

That's it! Will keep watching.
.

 

[IndyJones]

Complications from a jugular blood draw are fortunatly extremely rare. Like you have a better chance of being hit by lightning rare. Usualy if any bruising is most common.

Kabuto has a jugular blood draw twice a year for his thyroid. He bit the vet once but she couldn't get the vein.

They typicaly do take blood from the jugular in cats and small dogs because their veins are so tiny.

 

[RussellsMom]

Scary stuff, guys, but thank you for letting me know it's not an uncommon procedure. I've cared for sick cats before, but I don't remember blood draws from the neck. white shadow (sorry, I don't know how to link to names), I'm so, so sorry for your boy's terrible injury and I'll consult with my brother about adding "no neck blood draws" to Danno's papers. I'll also do it for my Russell (who already has "no Convenia" and "no Metacam" on his carrier, eliciting many eye rolls in the back room, I'm sure. Oh well).

I did finally manage to pill Danno, but he really struggled and I felt terrible having to wrestle with him a bit (of course I was very gentle, but I had to try several times. I took breaks between to keep his stress down) after the day he'd had. daftcat75, yes, we did get medi-melts, and oddly they were the ones I was having trouble with. He kept spitting them out. The regular tablets, even though they're larger than the melts, I had no trouble at all giving him. I'm not sure if it was the pills themselves or that he'd had a bit of a shocking afternoon and just wanted to rest.

 

[RussellsMom]

By the way, the prednisolone medi-melts from Wedgewood say "chicken flavor" but they smell strongly of marshmallow to me. Not unpleasant to my nose, but I can't imagine a cat would eat something that smells like that. Could they have mixed them up? And if so, could they have gotten other parts of the prescription wrong - like the medication itself???

 

[FeebysOwner]

By the way, the prednisolone medi-melts from Wedgewood say "chicken flavor" but they smell strongly of marshmallow to me. Not unpleasant to my nose, but I can't imagine a cat would eat something that smells like that. Could they have mixed them up? And if so, could they have gotten other parts of the prescription wrong - like the medication itself???

Call Wedgwood and ask. I have found them to be very willing to answer questions about their meds. You can probably even look up some details about the med on their web site - Veterinary Pharmacy for Compounded Pet Medications (wedgewoodpharmacy.com).