Tortie with high grade/large cell lymphoma

[peanutbutter7]

Hello all!

My cat Peanut was diagnosed with large cell lymphoma almost 2 months ago now, after about 2, almost 3, months of daily vomiting (the vet thought at first that it was a protein intolerance or diet issue because she's only 7). I had a consult with the an oncologist who gave the grim prognosis. Unfortunately, Peanut isn't the best candidate for chemo because she really struggles with vet visits. She is terrified, often pees herself, and has to be sedated every time she's go there. The vet said with chemo options she'd likely have to go in weekly either for the chemo treatments or for blood work and monitoring, which I think is too much for Peanut and would downgrade her quality of life. She also said that with this progression of lymphoma chemo usually only buys around 6 months, and I'm not sure if spending those months going back and forth to the vet would make Peanut very happy. So, as of now, Peanut is just on steroids and cerenia which the vet said would give her a month or two. I'm happy to report that she's still doing decently well! She's still eating, although is very picky about what she eats, she's playing with her favorite toy, snuggly, watches birds, pretty normal things. Her vomiting has started increasing a little more to about once a day when her cerenia is wearing off, and it's almost time for her next dose.

Although over the past few days I'm running into a new problem, and she's started getting more restless. For the past few weeks her schedule has been:

• 10:00 am - she starts getting excited for her food, meowing/screaming at me, etc.
• 11:00 am - she gets fed, then spends the rest of the day sleeping, sometimes watching birds, following me around various places in the apartment so she can snuggle with me, but generally very content and quiet
• 10:00 pm - starts getting excited for food again
• 11:00 pm - she gets fed, and then will alternate between eating at sleeping for a while
• 4:00-5:00 am - she wakes me up because she's bored and snacky, and I will usually put some treats into a toy treat dispenser for her to bat around, then she goes back to sleep/bird watches as the sun goes up
• Repeat

But for the past few days she's been waking up more through out the day and meowing, scratching at doors, desperately trying to get into the bathroom for whatever reason, and she's been waking me up a few times throughout the night instead of just one. Last night, she was relentless until past 4:00 am and just wouldn't or couldn't sleep. I tried giving her extra food (I know not to give in, but I needed sleep), gave her her toys, anything that usually works, but she just kept waking me up. She eventually calmed down enough for me to sleep, and then at 9:00 am this morning the restlessness started again. The only thing that has been calming her down is by making her wear this Christmas sweater that I got her. Once that's on she just immediately wants to snuggle down.

I'm wondering about anyone else's experience with large cell/high grade lymphoma and end of life progression. Is this normal? Could it be side effects from the steroids?

If anyone has gone through this with their cats, what was the progression of the cancer like?

I appreciate any information!

 

[FeebysOwner]

Hi. I am sorry about Peanut's diagnosis. I would guess some of her behavior is due to the steroids. I don't have any direct experience with this, but just wanted to offer a couple of ideas you might consider pursuing. First, I know there are other members on this site who have administered chemo (pill form, I believe) at home. Is that a possible option? Two, in-home blood tests would reduce the number of vet visits required to help with Peanut's anxiety of going to the vet all the time. Maybe you could check into this as well?

Hopefully, members with first hand knowledge will soon see your post and offer their input.

 

[daftcat75]

That restlessness could definitely be the steroids. She'll get used to them some. But there will always be more of that restlessness than normal as long as she's on them.

I wouldn't normally suggest alternative treatments for something this serious. But since the traditional treatments have been ruled out by temperament and quality of life issues, what do you have to lose?

https://vitalityscience.com/could-fenbendazole-treat-cancer-in-dogs-and-cats/

 

[daftcat75]

I do chemo at home with an every other week (started at twice a week) concentrated oral oil suspension (chlorambucil) that I mix with a little food and some salmon oil. But Krista is in remission from small cell lymphoma (presented as liquid stools for months and weight loss.) Her stools are perfect now which is what makes me believe she's in remission.

I do not have experience with large cell/high grade. I imagine the chemotherapy protocol is different because it's a more aggressive cancer.

There is a Feline Lymphoma Support Group that isn't very active. But they are responsive. I got my question answered by several members within a couple days.

Felinelymphomasupport groups.io Group

 

[peanutbutter7]

Hi. I am sorry about Peanut's diagnosis. I would guess some of her behavior is due to the steroids. I don't have any direct experience with this, but just wanted to offer a couple of ideas you might consider pursuing. First, I know there are other members on this site who have administered chemo (pill form, I believe) at home. Is that a possible option? Two, in-home blood tests would reduce the number of vet visits required to help with Peanut's anxiety of going to the vet all the time. Maybe you could check into this as well?

Hopefully, members with first hand knowledge will soon see your post and offer their input.

Yes, I did look into these options, unfortunately, Peanut is not the most easy going cat and is extremely difficult to pill. Even with liquid medication she struggles and eventually holds a grudge and will start avoiding me. My vet and I talked about not wanting to do anything that damage my relationship with her especially if she has limited time. As much as I hate this reality as well, cost is also a concern with chemo.

But thank you for your response and input! I am hoping her behavior change is due to the steroids, and she will revert back to her regularly scheduled screaming!

 

[peanutbutter7]

I do chemo at home with an every other week (started at twice a week) concentrated oral oil suspension (chlorambucil) that I mix with a little food and some salmon oil. But Krista is in remission from small cell lymphoma (presented as liquid stools for months and weight loss.) Her stools are perfect now which is what makes me believe she's in remission.

I do not have experience with large cell/high grade. I imagine the chemotherapy protocol is different because it's a more aggressive cancer.

There is a Feline Lymphoma Support Group that isn't very active. But they are responsive. I got my question answered by several members within a couple days.

Felinelymphomasupport groups.io Group

I'm sorry about Krista, but I'm glad she's doing better!

And you're correct, the vet said with this type of cancer the best option would be the CHOP (?) protocol, but even then she wasn't hopeful especially with the stress it would put on Peanut.

Thank you so much for the support group info, I will definitely check that out!

 

[daftcat75]

Yes, I did look into these options, unfortunately, Peanut is not the most easy going cat and is extremely difficult to pill. Even with liquid medication she struggles and eventually holds a grudge and will start avoiding me. My vet and I talked about not wanting to do anything that damage my relationship with her especially if she has limited time. As much as I hate this reality as well, cost is also a concern with chemo.

But thank you for your response and input! I am hoping her behavior change is due to the steroids, and she will revert back to her regularly scheduled screaming!

Check with Wedgewood Pharmacy and your vet/onc.
Veterinary Pharmacy

Some chemotherapy medicines can be compounded into flavored liquids or even chew treats to make it easier on both the animal and the caregiver. Krista's chlorambucil is compounded as a concentrated anchovy flavored oil suspension. It's concentrated so I only have to mix 0.1 or 0.2 mL (the lower when we were dosing twice a week and the higher now at once every two weeks) with a bit of salmon oil into about a nickel's worth of food. She polishes this plate and then I can serve her a meal without any medicine mixed in. Her steroids, prednisilone, I have compounded as a transdermal gel. I give her a wet willy in the ear every night before dinner. She's still not crazy about it. But she'll usually sit still and let me do it anyway once I've caught up to her and gently squished her down into the "hold still for a second or two" position. Chemotherapy can make a huge difference with cats. And it's not nearly as destructive as chemo in people. They don't lose their fur and most cats will experience either no side effects or very mild side effects. Krista doesn't experience any side effects that I know of. Her energy level, appetite, and poops remain the same on dosing days as any day between doses. But if you're certain that chemo is not for her, then have a look at the experimental treatment I posted above. That sounds promising. If Krista's lymphoma ever fails to respond to traditional treatments, I'll give that a shot with her.

 

[daftcat75]

I'm sorry about Krista, but I'm glad she's doing better!

And you're correct, the vet said with this type of cancer the best option would be the CHOP (?) protocol, but even then she wasn't hopeful especially with the stress it would put on Peanut.

Thank you so much for the support group info, I will definitely check that out!

Chlorambucil and prednisilone can be compounded. But it looks like the other two drugs in CHOP (doxorubicin and vincristine) are coming up empty on Wedgewood.

Definitely post to the Feline Lymphoma support group. They will have more experience and knowledge about high grade lymphoma and CHOP.