Willy might have cancer / high-grade lymphoma Treatment thread

[tarasgirl06]

I don't know if vets are allowed to answer such a question or not, but I have asked it. With vets I know, the response is usually somewhere along the lines of yes, or a look that I know means probably not. It's a rough question to ask, and to be asked, but having their opinion is vital.
Another question I would ask about is the strength of these drugs, and if any cases that they're aware of that were close to Willy's were helped by them. I would also ask how quick acting they are, and if you should see long lasting improvement with one treatment, two, three, etc.

It doesn't hurt to ask, iPappy .

 

[cmshap]

I am unable to sleep yet tonight because Willy is constantly trying to scratch his left ear. I keep having to physically stop him.

I feel like it is only a matter of time before he makes himself bleed again. At what point should I draw the line?

I am not putting a collar on him in his final moments, because this isn't something thats going to heal, and he is terribly uncomfortable with wearing a collar, as I said before.

I don't really know what to do at this point. I doubt giving him something that stops typical itching sensation would apply in this scenario, as the irritation is from actively growing tumors. But maybe there's a med I can use? Another question for the vet tomorrow morning.

This illustrates why this situation is so difficult to judge. He spent time on my lap tonight, he was purring, he communicated with me, he ate and drank well, so his overall condition is okay... but then he's constantly feeling physical irritation and potentially damaging the tissue. If he starts bleeding again, what do I do?

Kwik suggested nail caps a while back. I never mentioned this, but I used them on him in the past, but they kept falling off. Like they'd start falling off within a day. I could possibly try those again, but he's not going to stop scratching.

For now, I took a small file, and rounded his nails as best I could, so that any sharp edges from clipping are also eliminated. I am planning to do this every day to make sure there are no edges.

 

[iPappy]

I would keep up with the filing if it helps, and maybe see if the vet has any other ideas. I have not used nail caps but I've seen cats with them on and the owners say they last about a month, though one or two might fall off within a day or so.
I hope you and Willy are both having a good day.

 

[IndyJones]

Claw caps do work but they look ugly imo. Makes cats look like they have massive hippogriff talons. The only real concern I have is the krazy glue used to stick them on. Cyanoacrylate is the technical term for it buth krazy glue and the adhesive included are of this class. That stuff burns if you get it on your skin.

Not easy to find but msds for soft paws adhesive

url=https://store.ryanspet.com/site/pdf/SPR24018msds.pdf

 

[Kwik]

I am unable to sleep yet tonight because Willy is constantly trying to scratch his left ear. I keep having to physically stop him.

I feel like it is only a matter of time before he makes himself bleed again. At what point should I draw the line?

I am not putting a collar on him in his final moments, because this isn't something thats going to heal, and he is terribly uncomfortable with wearing a collar, as I said before.

I don't really know what to do at this point. I doubt giving him something that stops typical itching sensation would apply in this scenario, as the irritation is from actively growing tumors. But maybe there's a med I can use? Another question for the vet tomorrow morning.

This illustrates why this situation is so difficult to judge. He spent time on my lap tonight, he was purring, he communicated with me, he ate and drank well, so his overall condition is okay... but then he's constantly feeling physical irritation and potentially damaging the tissue. If he starts bleeding again, what do I do?

Kwik suggested nail caps a while back. I never mentioned this, but I used them on him in the past, but they kept falling off. Like they'd start falling off within a day. I could possibly try those again, but he's not going to stop scratching.

For now, I took a small file, and rounded his nails as best I could, so that any sharp edges from clipping are also eliminated. I am planning to do this every day to make sure there are no edges.

I've used them with the teeniest amount of glue at the tip of the natural nail facing down to the ground and never got any on the skin in this manner,keeping the nail down as I pushed the cap up......ugly? Yep! But it worked,no amount I've ever filed worked as well as that rubbery plastic...still,it's difficult not to injure that delicate ear tissue

Praying for Willy

 

[cmshap]

Update: 14 days post-chemo (4th dose)...

Willy is still okay. But what is mostly bothering me is the constant irritation he is feeling on the tumor around his ear. Constant scratching, and shaking his head (very light shakes, but he's pretty much doing it every few minutes whenever he isn't sleeping).

I'm still waiting to hear from the vet about if there is anything I can give him to alleviate the discomfort.

I can't decide if the next level of treatment is worth it (there's a chance it would be impossible financially, anyway). They could get him in as early as next week, or his next previously scheduled appointment on 2/13. Instead of $700, It's going to be $1,200. What I want to know is, does this have even any legitimate chance of working? Did they ever treat another cat with LCL who cycled through multiple different chemo drugs like this and then achieved remission?

Even one anecdote would make me feel better about making a decision, in either direction.

I'm giving him almost double the prednisolone, as it might(?) be slowing the tumor growth. I have refills of the liquid prednisolone that I can get if I run out early.

(See the second pic I attached, where he is standing on my coffee table meowing at me. That one was from 3 days ago, and I feel like the mass doesn't protrude quite as far today as it did then... although judging this by eye is always very difficult.)

He still has a healthy appetite, and he is still partaking in his favorite pastime, shredding paper balls. (First pic with the paper shreds is from today.)

 

[iPappy]

I'm not sure how this type (LCL) works, but, do the vets feel his organs and lymph nodes are clear?

 

[fionasmom]

What I want to know is, does this have even any legitimate chance of working? Did they ever treat another cat with LCL who cycled through multiple different chemo drugs like this and then achieved remission?

There is absolutely nothing wrong with asking the vet this...and I don't mean to imply that some here may not have an answer for you. My cat vet would absolutely tell me, and has in the past, if she has serious doubts about proceeding with a treatment.

I have found that specialists and oncologist might have a slightly different mindset about continuing to try as that is essentially what they do. In that case, your second question is really to the point.

 

[cmshap]

Second update: 14 days post-chemo (4th dose)...

I got a quantitative answer from my oncologist... she ballparked about a 20% success rate. And after that, he would still have drug-resistant lymphoma, so the odds would keep going down as his lifespan continued.

I opted to keep my next chemo appointment on 2/13 and see what happens in the meantime. I could potentially move it up to next week, but paying for it next week would be extremely difficult. And I'm looking at 20% odds. While also knowing that just two weeks ago, Willy was given two brand new drugs that did not work.

I am making a gamble here that I think is in both my and Willy's best interests. If I got him treated next week, and it actually worked, despite the odds, I'm still looking at more and more expensive treatments after that, for a drug-resistant lymphoma, where additional drugs means more appointments and more trauma for him. But the odds of it working at all are still just 20%. So either way, I am putting him through more trauma.

So, I am keeping the 2/13 appointment for now, at which point we would administer the new meds. I am no vet, no scientist, no pharmacist, no expert... but this is what I am thinking...

If he makes it to the week of 2/13 and hasn't declined any further, or has even improved (by some miracle) I might go for the $1,200 treatment.

If he continues to decline, I am going to cancel the 2/13 appointment, and focus entirely on end-of-life comfort.

(Also, this pet hospital is very busy. I don't want to unnecessarily reserve an appointment that could be used for someone else's sick pet.)

If he continues to decline, I seriously do not see any value in continuing treatment, for either if us. I already mentioned that he gets extremely scared during chemo appointments. His appointments have been every 3-4 weeks so far, and the staff comments on how "sweet but scared" he is with every appointment. He gets over it quickly after getting home, but I always feel bad about putting him through that.

I also asked about comfort meds, so our oncologist sent in gabapentin to be compounded into a liquid form, like the prednisolone I'm currently using. It is to be used as a pain med, mainly, but could also be helpful in reducing the scratching of his ear. I am going to pick that up as soon as it is available.

 

[iPappy]

All things considered, it sounds like you've thought this out very well. I've read your above response several times and find myself nodding in agreement with a lot of what you are saying.
The gabapentin is a good idea. From what I understand, it also can act like an anti-anxiety medication which might be helpful for his next visit on the 13th.
I so wish they could talk, and Willy could tell you if his ear is itchy, or if it's pressure, etc. The fact that he's still eating and still shredding paper tells me he still feels good. I think back on the cats I have lost over the years and I can't think of one who was still playing when the time was approaching, they just didn't have the energy or strength.

 

[cmshap]

I'm not sure how this type (LCL) works, but, do the vets feel his organs and lymph nodes are clear?

I've been trying to get a complete copy of Willy's records from the hospital where he goes for oncology. They have weird hours (24/7 pet hospitals are rare around here, in Milwaukee, despite being a major US city... so hours are wonky where we go... like they are open all night on one night, and then close at 5:00pm another night). And all non-emergency requests are handled by leaving messages and waiting for replies.

I should have been seeking this out already, but I haven't until recently. I've only gotten full records from Willy's general vet (who did the biopsy surgery and initial diagnosis).

I think back on the cats I have lost over the years and I can't think of one who was still playing when the time was approaching, they just didn't have the energy or strength.

Willy has definitely lost interest in play, to some extent. He is not chasing and pouncing on paper balls anymore. But he will bat at them if I kick them past him, and then go and shred them.

But there has been no running and chasing for a while now. I mentioned he's not zoomed in a longer while, either. So I definitely take that as a sign that something is happening.

But he's also about 12 years old now (he was approximately 1 when found in 2013), and on drugs that could be tiring him out. He had more energy while on lomustine, and so his energy decline could be from being on two new chemo drugs now, or the cancer progressing, or aging, or probably all of the above.

 

[iPappy]

I would ask for a full copy of his records so you can review them in depth and help you come to a decision on how best to move forward. Getting Tags records was not difficult, but seeing his latest blood work results shocked me. It did help me decide on how I wanted to proceed.
Goofy was not nearly as playful in his last months, but I had no idea anything was wrong and assumed it was age. It's so hard to know when there are multiple potential factors to consider.

 

[cmshap]

Update: 15 days post-chemo (4th dose)...

I missed a voicemail from the local pharmacy yesterday, saying they were ready to move ahead with the liquid gabapentin. They texted me today because I hadn't responded, but not until a couple of hours before they closed for the weekend.

For some bizarre reason, the phone number that they make outgoing phone calls with does not match their main business number. And it even has an entirely different area code. I get a lot of spam calls and voicemails, and it registered as spam when I saw the strange area code.

I did manage to speak with someone there about 20 minutes before they closed, and was told it would be almost $115 for the gabapentin.

I wouldn't be able to get it until Monday, anyway, but that seems outrageous to me. At least I don't feel like I need to use gabapenton yet. Willy is still doing as okay as he was yesterday.

I may try to get it in powder or pill form, instead. I want him to be as comfortable as possible, but these costs are killing me already. As I said before, I'm not in the most stable type of job to afford all of this, and this situation is actually making me seek a change sooner rather than later. I don't expect to change my income soon enough to affect Willy's care, but I am of course going to have another cat after him (he turned me into a cat guy), and I don't want to face this kind of medical situation again when I have trouble affording it. And I definitely want to look at pet insurance next time.

As far as Willy goes... still eating, still following me with his tail straight up, still being very vocal towards me, still occasionally shredding paper, but also still sleeping a lot, and still not running/pouncing/doing more energetic things.

 

[tarasgirl06]

Update: 15 days post-chemo (4th dose)...

I missed a voicemail from the local pharmacy yesterday, saying they were ready to move ahead with the liquid gabapentin. They texted me today because I hadn't responded, but not until a couple of hours before they closed for the weekend.

For some bizarre reason, the phone number that they make outgoing phone calls with does not match their main business number. And it even has an entirely different area code. I get a lot of spam calls and voicemails, and it registered as spam when I saw the strange area code.

I did manage to speak with someone there about 20 minutes before they closed, and was told it would be almost $115 for the gabapentin.

I wouldn't be able to get it until Monday, anyway, but that seems outrageous to me. At least I don't feel like I need to use gabapenton yet. Willy is still doing as okay as he was yesterday.

I may try to get it in powder or pill form, instead. I want him to be as comfortable as possible, but these costs are killing me already. As I said before, I'm not in the most stable type of job to afford all of this, and this situation is actually making me seek a change sooner rather than later. I don't expect to change my income soon enough to affect Willy's care, but I am of course going to have another cat after him (he turned me into a cat guy), and I don't want to face this kind of medical situation again when I have trouble affording it. And I definitely want to look at pet insurance next time.

As far as Willy goes... still eating, still following me with his tail straight up, still being very vocal towards me, still occasionally shredding paper, but also still sleeping a lot, and still not running/pouncing/doing more energetic things.

I hope you're able to get the gaba next week, and I certainly empathize bigtime about the terrible costs incurred when caring for our loved ones. It shouldn't be that way. But it is. So I hope and pray that it all works out for you both.
And I am so happy that you are now a certified cat guy! *Once you go CAT, you never go back.*
You've probably looked into Care Credit, but in case you haven't, it might be helpful. I haven't had it so can't say one way or the other. Maybe some other posters have experience with it and can give you some helpful feedback on it.
The phone number thing is maddening. I have my phone set up so any unrecognized number can leave voicemail, but does not ring. I'm in the L.A. area so I also get hordes of spam calls. Don't want/can't use and most are flagged and reported.

 

[iPappy]

I have never had pet insurance, and would prefer not to go that route, but if I did I would be very careful reading all the fine print to make absolutely sure I understood what the coverage was, and what it included. I've heard of some really good plans and some really good companies out there, and some not so great companies (the same can be said for human health insurance.)
That cost does seem high to me, but I'm not sure what the typical rates in Wisconsin are compared to Ohio. How long do they feel one bottle of the Gabapentin will last him? Some people have said it has a VERY mild sedative effect, so if you do use it, keep your notes going; if Willy's activity level decreases after using it you'll be able to know if it's due to the medicine.
We've actually gotten spam calls from numbers that match our own. If that isn't crazy I don't know what is. If I don't recognize a number, I don't answer it. I've told a few people to text me vs. calling because I refuse to answer a phone call from an unknown number.

 

[carrie640]

I completely feel all of this. Lucy was diagnosed with oral cancer...technically, last week, but this has been an ongoing issue since October. I did not even know cancer was a suspect..I thought she just needed a dental extraction. So, it was absolutely crazy. Thinking back, I should've questioned more. I mean, the way she was acting seems pretty extreme for a bad tooth. I do believe her original vet knew all along, but did not, for whatever reason, tell us. That's another story. But, Lucy is on 50mgs of Gabapentin and also on Metacam. She is twitching and sometimes it's very frequent. She also gets these "jolts/shocks/tremors" (as if someone snuck up on your and said, "BOO!" and you would jump. Yesterday, I timed them. anywhere from 9-20 seconds apart. Sometimes she goes a long time none. Sometimes they don't stop. I don't know if they hurt. I did not opt for a biopsy. The doctor told me she is sure that is what it is. Lucy is almost 20. I could never ever put her through all of that treatment and I don't know if this type is even an option. Pre-extractions, her eyes were normal. Post-extractions, her third eye-lid on the cancer side is half closed..all the time. What would cause this with just an extraction?

Anyway...I am sorry you and Willy are dealing with this. And thank you for posting about your experiences (I learn a lot by tese kinds of things!).

 

[Mac and Cats]

Update: 15 days post-chemo (4th dose)...

I missed a voicemail from the local pharmacy yesterday, saying they were ready to move ahead with the liquid gabapentin. They texted me today because I hadn't responded, but not until a couple of hours before they closed for the weekend.

For some bizarre reason, the phone number that they make outgoing phone calls with does not match their main business number. And it even has an entirely different area code. I get a lot of spam calls and voicemails, and it registered as spam when I saw the strange area code.

I did manage to speak with someone there about 20 minutes before they closed, and was told it would be almost $115 for the gabapentin.

I wouldn't be able to get it until Monday, anyway, but that seems outrageous to me. At least I don't feel like I need to use gabapenton yet. Willy is still doing as okay as he was yesterday.

I may try to get it in powder or pill form, instead. I want him to be as comfortable as possible, but these costs are killing me already. As I said before, I'm not in the most stable type of job to afford all of this, and this situation is actually making me seek a change sooner rather than later. I don't expect to change my income soon enough to affect Willy's care, but I am of course going to have another cat after him (he turned me into a cat guy), and I don't want to face this kind of medical situation again when I have trouble affording it. And I definitely want to look at pet insurance next time.

As far as Willy goes... still eating, still following me with his tail straight up, still being very vocal towards me, still occasionally shredding paper, but also still sleeping a lot, and still not running/pouncing/doing more energetic things.

We get the capsule form for 100mg at Costco, 60 pills and it's $9.79 (I just picked it up today). I wish you lived near and I'd give you some bottles of compounded chicken vanilla butternut squash flavor. My cats cant stand the liquid and I have most of a bottle and part of another.

What compounding pharmacy are you getting these from? I priced out three for Chlorambucil the other day and Wedgewood came out the cheapest. $66.75 for 30 pills. The one our vet recommended was $160! I did order from that one for the first round but I will not be ordering from them in the future.

EDIT: I just checked our Wedgewood history since I thought I had ordered the liquid gaba from them before. One bottle was $66.75. The last time I ordered it was back in May of 2022, so that price may have changed. The pills are easier for us anyway and 60 pills for under $10 is a much better deal.

EDIT 2: You also do not need to be a member of Costco to use their prescription services. You do save a couple bucks if you are though.

 

[Mac and Cats]

I hope you're able to get the gaba next week, and I certainly empathize bigtime about the terrible costs incurred when caring for our loved ones. It shouldn't be that way. But it is. So I hope and pray that it all works out for you both.
And I am so happy that you are now a certified cat guy! *Once you go CAT, you never go back.*
You've probably looked into Care Credit, but in case you haven't, it might be helpful. I haven't had it so can't say one way or the other. Maybe some other posters have experience with it and can give you some helpful feedback on it.
The phone number thing is maddening. I have my phone set up so any unrecognized number can leave voicemail, but does not ring. I'm in the L.A. area so I also get hordes of spam calls. Don't want/can't use and most are flagged and reported.

I do have care credit. I got it when we lost our other cat. It has been helpful as of late. You get 6 months to pay off whatever charge you do, but you have to make sure you pay it off within that time or it charges you back interest. It's been really helpful to us as of late to us since we've had 3 animals that have needed vet care recently. I think it's for sure worth getting prior to you actually needing it.

 

[carrie640]

That is a LOT of money for Gabapentin! We got capsules (100mg) at Walgreen's for cheap (even cheaper with a GoodRX coupon!). Lucy couldn't tolerate the full 100 so we use half a capsule a day.

 

[cmshap]

Second update: 15 days post-chemo (4th dose)...

Late evening...

Thanks everyone who has been replying and contributing to this thread. I am reading everything you post. But I've been too busy to reply to everything as of today, but I appreciate all the responses.

Another unfortunate, but not unsurprising turn of events has happened...

Willy has stopped eating the Delecatbles squeeze treats, as well as the chicken-flavored prednisolone. At least, he has stopped as of today. Maybe he will start eating them again.

I have tried feeding him 3 different brand-new tubes of Delectables paste treats throughout the day today, with prednisolone dripped on top of it (which is what he has been willingly lapping up before today). But today, he only sniffed at it and then started digging around his dish.

Whenever he starts digging like that, I know he is never going to eat anything that is on that dish. He "buries" it and then walks away, without eating it, and if he ever returns later, he repeats the same behavior. He seems to want to bury it instead of eat it.

I then tried giving him about 6-7 Temptations dry treats, with a droplet of prednisolone on top of each one (this method has worked before). Before serving, I thoroughly washed his dish and surrounding mat, so there are no smells of old food anywhere, at least that my human nose can detect... but I really cleaned thoroughly.

Yet he still refused to eat any of the dry treats, and started digging around them just like with the paste treats (the liquid prednisolone is chicken-flavored, so probably smells similar to when I dripped it onto the Delectables squeeze treat).

I've wasted several doses of this liquid prednisolone since obtaining it, which was supposed to last a month. And it was expensive. And now, I am going to have to force-feed today's dose to Willy.

This is so stressful, which is why I am seriously looking into euthanasia options now, vs. waiting much longer. I am trying so hard to give him a good life for as long as he wants to live it. But parts of this process involve making him hurt and resent me, while I am only trying to help him out of love. It is so hard to deal with.

(Edit: I don't mean I am looking into euthanizing him right now, but rather that I want to know exactly how I can seek these services at a moment's notice, when I feel like it is time.)

I gave him a dose of Mirataz in both ears (double dose) about 20 minutes ago, hoping that he gets hungry enough to eat the Delectables treats again. And that tube of Mirataz keeps getting smaller, so refilling it is another expensive purchase, if I need it.

If that doesn't make him eat it, I won't waste more of the drug, and instead force it into his mouth. After which point he will likely hide in the closet from me again.

(Edit: Note that Willy definitely does not have a general appetite problem. He is still eating his Hills ONC dry kibble food readily, and always wants more.

His issue with wet food, and any other non-dry food/treats, has persisted for years, and I still fail to understand it. He's gone from eating it, to resoundly reject it, repeatedly.)