*Questions about possible kidney cancer*

[Tabby1177]

My kitty is 18 years old. About a month and a half ago, he went to see the vet for a health exam and had his blood work done.
Results came back and my vet informed me that he has kidney disease. My cat’s blood work also showed a high level of globulins (an image of the blood work is attached).

Blood pressure test also showed he has high blood pressure (he was put on medication for that).

Ultrasound of his kidney showed his kidneys are small with no separation between cortex and medulla.
My vet is suspicious that my cat has kidney cancer/lymphoma because of the high level of globulins in his bloodwork. Because of this suspicion, the vet suggested a fine needle aspiration/cytology of my cat’s kidneys. We brought him in again and samples were successfully taken from both of the kidneys. The result showed that there are lymphocytes present in the samples, but they are heterogeneous and not homogeneous.

Apparently if it was cancer, the lymphocytes would be more homogeneous. But this is could also mean the beginning of cancer. And I was advised it is not normal to have lymphocytes in the kidneys.
Cytology report attached at end of this message.

My vet has suggested that we do one of two tests next:

1. Protein electrophoresis - which would help to more definitively differentiate between inflammation caused by cancer, versus inflammation caused by a non-cancer source
2. A re-testing of blood globulin - however, my vet thinks that it would be highly unlikely for blood globulin to drop when it was high recently (the initial test was done about a month and a half ago).

I am wondering what it is I should do next. Also wondering about what I can do to support my kitty and his kidney health. Any insight, suggestions, or advice would be greatly appreciated.

 

[FeebysOwner]

Hi. Sorry your kitty is having these issues. I would go ahead and have the SPE done - BUT also ask if the tissue that was used for the FNA cytology has been retained, as they could use it to also do the PARR Assay, which is a more in-depth analysis of the FNA cytology. My 18+ yo cat, Feeby, had a similar report from her FNA, which essentially was inconclusive. They did the PARR Assay which confirmed lymphoma, but it was her intestinal lymph nodes that were analyzed to determine intestinal lymphoma - not kidney.

Feeby also has kidney disease, Stage 3 (and high BP, as well as hyperthyroidism and arthritis). I follow a lot of protocols and treatments discussed on this web site: Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat (felinecrf.org). It is very comprehensive and can feel intimidating, but I promise you will not regret reading it. You can first go through the sections that interest you most and then work on from there.

 

[Tabby1177]

Hi. Sorry your kitty is having these issues.

Hi there, first off thank you so much for your reply and the information. Thank you for your advice, I was leaning toward the SPE, I think I will go ahead with that. I will ask the vet if they kept the tissue (hopefully they did).

I think I am in a bit of shock, and am finding things pretty confusing. It’s hard to think of kitty possibly having lymphoma, even though I know he is elderly. I’m sure it’s startling for many cat parents to hear.

Am I understanding this correctly - lymphocytes in the kidneys mean there is cancer or some other source of inflammation. My vet seems pretty convinced it is cancer. I’m wondering what other common causes of lymphocytes in kidneys are, or if other causes are not very common and it is likely to be cancer.

Thank you so much for the link for Tanya’s guide. It looks super comprehensive and helpful. I will try to read the basics first and then branch off to the other sections from there.

May I ask if Feeby is on any treatment for lymphoma, and if so, what that treatment is?

 

[FeebysOwner]

lymphocytes in the kidneys mean there is cancer or some other source of inflammation. My vet seems pretty convinced it is cancer... May I ask if Feeby is on any treatment for lymphoma, and if so, what that treatment is?

As far as I know it is generally from either inflammation or cancer, or perhaps a combination of both. I am not knowledgeable enough to know if a high globulin count points more toward cancer over inflammation - I wasn't under the impression that was the case.

Feeby is not yet on any treatment for her lymphoma. The oncologist recommended chlorambucil, but I don't believe that chlorambucil is the chemo protocol for kidney cancer. A lot of cats with cancer are also given Prednisolone (steroid) in addition to chemo, but Feeby's oncologist is against using it because of her high BP and the possibility it could lead to additional heart issues, especially in a cat of her age.

I probably can't do justice for you regarding the kidney cancer, I was mostly reaching out because of the kidney disease. There is a support forum indirectly affiliated with Tanya's web site that you might consider joining once you have a chance to collect some questions by reading through that site. I just don't know how many of the cat lovers on that site are also dealing with kidney cancer, although I suspect there has to be some. [email protected] | Home. They may also know of another group that is more focused on kidney cancer.

I did a search on this site for other threads related to kidney cancer, and only found a couple of more recent ones -
Most Likely Kidney Cancer | TheCatSite
Kidney cancer and nephrectomy - any of you with experience to share? | TheCatSite

 

[FeebysOwner]

Also, another group you might be interested in that likely has other members who are dealing with kidney cancer. Not all of them are all 'technically' inclined, but they are willing to share their experiences and treatment protocols.
Feline Lymphoma Support Group | Facebook

 

[silent meowlook]

Hi. From what I read, it sounds like there maybe wasn’t the best sample obtained due to cytolysis which is the disruption of cells due to an external influence. I could be wrong.

How does your cat feel?

If it was my cat and I wanted to seek further care, I would get a referral to an oncologist, as it is a very complicated part of medicine and you want someone with extra schooling in that subject.

When I worked for an oncologist we did see a cat with renal lymphoma that did okay on chemotherapy but it was injectable and three different types given iv for about 4 months at a time. First weekly along with blood tests each visit. Then the amount was reduced to bi weekly and then once a month. The cat went into remission briefly but then relapsed. Rescue chemo was given and again she was managed. I knew another cat with it that spent a year with a feeding tube and she got many chemo treatments done. Once the renal lymphoma was in remission she wound up with a tumor in her stomach. Thus, the feeding tube.

Both these cats were younger at about 12 or 13.
If it was my cat, at 18 years, I would do whatever I could to make her happy for now. I don’t think I would pursue chemo at this time because it is stressful with all the visits. Although it does help allot of cats, it is very expensive, but that sometimes doesn’t matter.

I wouldn’t put my cat through it because she hates to go to the vet and I would worry about her remaining time here being unhappy, if she was 18.

My cat does have lymphoma but it is intestinal so treated with oral chemotherapy.

You might want to see a holistic vet. One that treats with ozone and other treatments that are non invasive. I don’t have personal experience but I have heard good things.

Whatever you chose to do, I wish you and your kitty the best.

 

[Tabby1177]

As far as I know it is generally from either inflammation or cancer, or perhaps a combination of both. I am not knowledgeable enough to know if a high globulin count points more toward cancer over inflammation - I wasn't under the impression that was the case.

Regarding globulin, thank you for your thoughts. I am going to ask for additional clarification from my vet so I can better wrap my head around the situation. I am seeing the vet tomorrow, so I’m going to write down some questions.


Thank you very much for all the resources and search results. And for providing me with advice during this confusing time, I really appreciate it!!

 

[Tabby1177]

Whatever you chose to do, I wish you and your kitty the best.

Hi there,

Thank you so much for your reply. For some reason, the notification for your reply ending up in my spam and I didn’t see your message until today when I happened to be checking this older post. So sorry for the delay in replying to your message.


My cat is eating and drinking well, seems happy, and has been able to maintain a steady weight so far.



Many thanks for sharing your experiences and knowledge with feline oncology. It does sound very complex.



My kitty had serum protein electrophoresis done and my vet believes he has renal lymphoma. My new post is here:



* Prednisolone for kidney/renal lymphoma *



I am now trying to figure out if I should I should start prednisolone or chlorambucil for my kitty.



I actually have the same thoughts about chemo for my cat. Because my cat is quite old now at 18, I just want him to live the rest of his life happily as possible. He gets extremely stressed going to the vet, and even for simple visits, he acts depressed and traumatized for a couple of days after. My vet has told me how intensive chemo will be, and I know it will be super stressful for him especially at his new old age and due to his intense, innate anxiety at the vet.



Thankfully, the vet has said this tends to be a slower moving cancer and should not cause much pain/discomfort until the end, so I want him to spend the rest of his life as comfortable as possible, and will make I give him any palliative meds and care as necessary.



Thank you for letting me know about ozone treatment. I have seen holistic vets for previous kitties I’ve had on the past, I will do more research and look into this.



Anyway, I appreciate your thoughts very much. Thanks so much for taking the time to write such an informative and helpful reply.