Charlotte Might Have Lymphoma

[rhinuh]

Hello all!

I'm new to this site-- after perusing quite a few posts I saw about cat health, I decided to create a profile and start a thread with the hope that I may find some help, for both my cat and myself.

I adopted Charlotte over a year ago from ASPCA; she's a maine coon mix and she's the love of my life. She's three years old, and when I adopted her, they had tested for feline leukemia and she tested negative.

She's usually a very perky, vocal, energetic, snuggly kitty. Everything started to go downhill last week-- I had noticed she was acting pretty lethargic and maybe losing a bit of weight. I had to head home for thanksgiving, so I entrusted her care to a close friend of mine, who is very good with animals. I asked her to keep a lookout for Charlotte, seeing as she had been acting a little funny. My friend messaged me Friday evening to let me know Charlotte was even more lethargic-- not playing with her favorite toys, no meows, no greetings at the door. She also noticed that Charlotte's breathing was a little labored and that she wasn't eating, so we both agreed that the best option was to take her to an after hours vet.

There, the vet noticed that Charlotte was in respiratory distress and put her on oxygen. They diagnosed her with congestive heart failure, and stabilized her overnight. I brought Charlotte home Saturday afternoon with orders to put Charlotte on Lasix, 12.5 mg twice a day to help drain the fluid from her lungs. Mind you, Charlotte hadn't eaten since Friday morning either...come Sunday, she still hadn't eaten (though she had been drinking a lot because of the Lasix) and was still extremely lethargic, so I decided to take her back to the vet.

There, the vet decided to re-do the x-rays, which showed that Charlotte's lungs hadn't really lost any of the infiltrates, though her breathing was much better than it was on Friday. So we decided to do some blood work, which ended up showing that Charlotte had a white blood cell count of 64,000-- a cause for concern, the vet decided to do a feline leukemia test, for which Charlotte tested positive.

At this point, the vet basically tells me that there are roads to pursue, but that they'd be very expensive and probably wouldn't provide a good quality of life. The vet wasn't super clear about this...so I decided to call another vet, who had worked with Charlotte on Friday, to get her opinion-- she said the same thing: that Charlotte's prognosis was really poor, and that her quality of life wasn't likely to be great. I was devastated-- my cat is only THREE years old. I didn't understand how euthanasia could be the only reasonable outcome after all of this. It took just a few days for my sweet kitty to fall so ill.

I decided to take Charlotte home, and per the vet's suggestion, I took her off of the Lasix and put her onto an appetite stimulant (mirtazapine 15mg every 48 hours). I called a few cat friends and people who had worked in a cat rescue shelter with me years ago-- we all agreed that I should take Charlotte to another vet to get a second opinion. Ended up getting a referral from the first vet to the clinic at the University of Minnesota. We went today and got another exam, and the vet consulted a cardiologist and they agreed to do an echo-cardiogram. Turns out, it was NOT Charlotte's heart-- there's nothing wrong with her heart right now, and the respiratory distress on Friday was NOT from congestive heart failure. So...here comes the tough part. The vet seems to think that Charlotte is suffering from mediastinal lymphoma. We have another appointment on Wednesday with the medicinal unit to go over her bloodwork and do a few more exams to try and get a firm diagnosis, then to talk about treatment plans. This vet sent me home with an antibiotic (just in case she has an infection and that's what is causing the infiltrates), as well as maropitant 16mg to try and help the appetite.

Where we are now: Charlotte is still not very interested in eating, even with all the appetite supplements. The vet mentioned that the antibiotic could worsen her appetite even more, and if that happens to take her off the antibiotic...but I've only given her one dose. Should I go forward with the other three doses? Or take her off of it? I'm worried about her not eating...but also worried that if she has an infection, taking her off the antibiotic could worsen her health. Anyone have any advice on appetites for super sick kitties?

Also-- has anyone had a super young kitty who suffered from lymphoma? If so, what are some ways you coped? And any estimates on what her treatment would be like?

Sorry for the novel, I'm just so desperate and heartbroken. Charlotte is my world-- I call her "mon petite oiseau" or "my little bird" because she chirps like a bird whenever you'd speak to her. Or, she used to...she doesn't do much talking anymore.

If anyone has words of wisdom, please share. They'd be most welcome!

 

[susanm9006]

I do not have any medical insights nor any words of wisdom that will help deal with the crushing pain of a sudden serious illness in such a young cat. I have been there with a wonderful two year old rescue many years ago and it is still painful. Prayers for you and Charlotte.

 

[rhinuh]

I do not have any medical insights nor any words of wisdom that will help deal with the crushing pain of a sudden serious illness in such a young cat. I have been there with a wonderful two year old rescue many years ago and it is still painful. Prayers for you and Charlotte.

Thank you. I appreciate the prayers-- seems like that's all that's keeping us going right now until we have an answer.

 

[computerbagel]

I've read these forums for a long time, but was finally prompted to join when I read your post, as I'm currently experiencing a similar situation with my young 4.5 year old cat. Unfortunately (and honestly, unbelievably), we are nearing the end of our story with her. It truthfully still shocks me to type this, but my husband and I are preparing to help her over the Rainbow Bridge tomorrow. Her decline has been incredibly quick -- we were told she likely had large cell GI lymphoma just a little over three weeks ago -- but I wanted to share a bit more of our story and offer any assistance and support I can, as I know how incredibly difficult this situation is.

Our beautiful girl MeeMee (that's her in my avatar picture!) has been with us since September of 2016, when she came to us as a badly-neglected stray. Dumped in a park by her owner, she had horrible flea allergy dermatitis and was severely underweight. We treated her and fattened her up in no time, and she adapted beautifully to our household and became a wonderful "big sister" to our two younger cats, Ducky and Goose. We had an incredible year with her, and honestly pinched ourselves at how lucky we were to have found her. We still feel incredibly lucky -- she is a remarkable little girl!

In mid-September of this year, she had her annual checkup and everything indicated that she was a perfectly healthy (if not slightly too well-fed) four year old cat. My husband and I took a ten day anniversary trip at the beginning of October, and when we returned I immediately noticed something was off. I noticed what seemed like a bit of weight loss and lack of appetite, and at first we chalked it up to stress and a disruption in her schedule. After a week or so had passed and she hadn't returned to normal, it was clear something else was going on. She was lethargic and noticeably less interested in food, even after we tried a number of exotic and enticing new treats (and this is a cat who loves to eat!)

We took her to our regular vet twice before the end of October for exams and tests. He confirmed that she had lost over a pound in the six weeks since her last vet visit -- not good. There was also big red flag on her blood work -- her protein levels were out of wack, with high total protein but very low albumin. Of course, this set my alarm bells off like crazy and I started researching -- she seemed "too old" for FIP and "too young" for cancer, I thought. X-rays and urinalysis both came back clean, so we scheduled an appointment with a specialist for an ultrasound. In the meantime, MeeMee started taking mirtazapine, and her appetite rebounded. We transitioned her to an easy-to-digest grain-free wet food, and she was eating it happily.

On November 8th, we took her in for her ultrasound. While we were guarded in our hopes, and understood she was battling something serious, we were unprepared for the prognosis we were given. MeeMee had extreme thickening along significant portions of her intestines and colon (four times the normal thickness in some places), along with serious changes and degradation in the layers of those organs. The doctor told us, straight out, that her prognosis was very poor. He indicated that his findings pointed pretty definitively to lymphoma, so I of course jumped in with questions about IBD and small-cell lymphoma in the hopes of getting some feedback that this might be treatable. He was very direct in his response to me: the location, size, and character of these thickened portions essentially ruled out those out as possibilities. Surgery was not a possibility, and the amount of infiltration that had already occurred indicated that the cancer wouldn't respond to chemotherapy. We talked through the value of doing an endoscopy and biopsy to confirm, but the doctor was very clear that MeeMee's prognosis would still be incredibly poor -- we were looking at 1-2 months survival time regardless of intervention. Even if this turned out to be a different kind of cancer, it was incredibly aggressive and would still be terminal. I asked him what he would do if MeeMee was his cat, and he told me that he would begin palliative care. We left the office with prednisolone, sub-q Vitamin B, and a huge hole in our hearts. I couldn't make myself comfortable with the decision not to intervene -- it felt so wrong, so impossible to me.

We immediately made a follow-up appointment with our regular vet, just to get a second opinion and peace of mind. He essentially seconded all of the specialty vet's findings. I came with a battery of questions about the CHOP protocol and other chemo options, but, as with the other vet, I asked him to be honest with me as to whether he would head down that road if MeeMee was his cat. When I heard the "no" from him -- the second "no" I had heard -- I knew I had my (incredibly painful) answer. We spent the rest of our appointment talking through the palliative care process. While I was still completely devastated after that appointment, I started to feel a tiny bit more at peace. In my head, that "1-2 month" figure kept dancing around. "We'll get two months," I told myself, "maybe more. Who knows! She's so young."

The prednisolone, combined with her appetite stimulant, worked really well for the first few weeks. I told myself over and over again that she would make it to Christmas (silly, I know), that we would celebrate together and have that final memory of the holidays with our three young healthy cats. If I'm being totally honest with myself, I started noticing a decline late last week, but I kept seeing these bright spots: "Look, she ate all her dinner!" "Look, she's rolling over on her back!" "Look, she hopped on the bed and wants to cuddle!" While all of that was -- and is -- true, it was also becoming increasingly apparent that she was uncomfortable. For the past few days, I've watched her struggle with constipation. I've seen her grow increasingly listless, and I know that she spends more time hunching in "breadloaf" position or hiding under the bed than she does relaxing or lounging with our other two cats. She seems more like one of my parent's elderly cats than she does the bright young cat she was before. Last night and this morning, I noticed her third eyelids were starting to show intermittently. This morning, I held her and asked her if she was hurting, and if she was tired of this. She looked directly into my eyes and I saw, I knew, that she was in pain. It rocked me to my core. We're at the end of the road. This is real. I can't fix this.

After two agonizing conversations with my husband, we called the vet this morning and talked through the symptoms we were seeing. As background, I watched my parents struggle with the decision to euthanize our 17 year old cat, Inky, this summer. She also had an aggressive form of cancer, and her decline was quick, awful, and traumatic for our family. Their vet told them candidly that Inky had probably suffered for a few days longer than necessary, and I know that that has haunted my parents ever since. I do not want to put MeeMee in that position. Our vet confirmed that the symptoms we were seeing indicated that MeeMee was on the decline, and that further intervention would only postpone the inevitable -- likely with a considerably reduced quality of life. After a lot of tears, we set an appointment to help her over the Rainbow Bridge tomorrow afternoon.

As I sit here typing, tears streaming, I still can't quite believe it. I still feel the urge to ask questions, to research, to see if there's something else we might try, to wait it out and see if there's not another temporary rebound. MeeMee is unlike any cat I've ever met, and has always been my shadow. She has always woken me up with her beautiful trills, curled up on my lap the moment I sat down, followed me from room to room with her adorable chirps, luxuriated in any and all cuddles, and has brought me toys while I slept. Even last night, she curled up on my legs and slept like a log there all night. All cats are special, but some are really your particular brand of special -- that's MeeMee, for me. I feel crushed and robbed of the chance to enjoy a long and happy life with her, but I also know that she isn't thinking that way. She just knows that she feels really bad. She came to us suffering terribly, likely because of neglect at the hands of a previous owner, but she has shown us boundless love, trust, and devotion. I am so grateful for her! Now I know we've got to show her that same kind of impossible love with this final decision, even though it's killing me.

I apologize for the length of my post, particularly since I know it's such a bummer. This is incredibly raw for me right now, and I debated whether or not to post at all, but this all sort of flowed out all at once. Know that I am thinking of you and Charlotte, and hoping that your story has a happier ending than mine. I am happy to talk more about my experience, and I'm also happy to listen. Just know that I understand how badly you're hurting right now, and how scary this is. I am really, really pulling for Charlotte!

 

[rhinuh]

I've read these forums for a long time, but was finally prompted to join when I read your post, as I'm currently experiencing a similar situation with my young 4.5 year old cat. Unfortunately (and honestly, unbelievably), we are nearing the end of our story with her. It truthfully still shocks me to type this, but my husband and I are preparing to help her over the Rainbow Bridge tomorrow. Her decline has been incredibly quick -- we were told she likely had large cell GI lymphoma just a little over three weeks ago -- but I wanted to share a bit more of our story and offer any assistance and support I can, as I know how incredibly difficult this situation is.

Our beautiful girl MeeMee (that's her in my avatar picture!) has been with us since September of 2016, when she came to us as a badly-neglected stray. Dumped in a park by her owner, she had horrible flea allergy dermatitis and was severely underweight. We treated her and fattened her up in no time, and she adapted beautifully to our household and became a wonderful "big sister" to our two younger cats, Ducky and Goose. We had an incredible year with her, and honestly pinched ourselves at how lucky we were to have found her. We still feel incredibly lucky -- she is a remarkable little girl!

In mid-September of this year, she had her annual checkup and everything indicated that she was a perfectly healthy (if not slightly too well-fed) four year old cat. My husband and I took a ten day anniversary trip at the beginning of October, and when we returned I immediately noticed something was off. I noticed what seemed like a bit of weight loss and lack of appetite, and at first we chalked it up to stress and a disruption in her schedule. After a week or so had passed and she hadn't returned to normal, it was clear something else was going on. She was lethargic and noticeably less interested in food, even after we tried a number of exotic and enticing new treats (and this is a cat who loves to eat!)

We took her to our regular vet twice before the end of October for exams and tests. He confirmed that she had lost over a pound in the six weeks since her last vet visit -- not good. There was also big red flag on her blood work -- her protein levels were out of wack, with high total protein but very low albumin. Of course, this set my alarm bells off like crazy and I started researching -- she seemed "too old" for FIP and "too young" for cancer, I thought. X-rays and urinalysis both came back clean, so we scheduled an appointment with a specialist for an ultrasound. In the meantime, MeeMee started taking mirtazapine, and her appetite rebounded. We transitioned her to an easy-to-digest grain-free wet food, and she was eating it happily.

On November 8th, we took her in for her ultrasound. While we were guarded in our hopes, and understood she was battling something serious, we were unprepared for the prognosis we were given. MeeMee had extreme thickening along significant portions of her intestines and colon (four times the normal thickness in some places), along with serious changes and degradation in the layers of those organs. The doctor told us, straight out, that her prognosis was very poor. He indicated that his findings pointed pretty definitively to lymphoma, so I of course jumped in with questions about IBD and small-cell lymphoma in the hopes of getting some feedback that this might be treatable. He was very direct in his response to me: the location, size, and character of these thickened portions essentially ruled out those out as possibilities. Surgery was not a possibility, and the amount of infiltration that had already occurred indicated that the cancer wouldn't respond to chemotherapy. We talked through the value of doing an endoscopy and biopsy to confirm, but the doctor was very clear that MeeMee's prognosis would still be incredibly poor -- we were looking at 1-2 months survival time regardless of intervention. Even if this turned out to be a different kind of cancer, it was incredibly aggressive and would still be terminal. I asked him what he would do if MeeMee was his cat, and he told me that he would begin palliative care. We left the office with prednisolone, sub-q Vitamin B, and a huge hole in our hearts. I couldn't make myself comfortable with the decision not to intervene -- it felt so wrong, so impossible to me.

We immediately made a follow-up appointment with our regular vet, just to get a second opinion and peace of mind. He essentially seconded all of the specialty vet's findings. I came with a battery of questions about the CHOP protocol and other chemo options, but, as with the other vet, I asked him to be honest with me as to whether he would head down that road if MeeMee was his cat. When I heard the "no" from him -- the second "no" I had heard -- I knew I had my (incredibly painful) answer. We spent the rest of our appointment talking through the palliative care process. While I was still completely devastated after that appointment, I started to feel a tiny bit more at peace. In my head, that "1-2 month" figure kept dancing around. "We'll get two months," I told myself, "maybe more. Who knows! She's so young."

The prednisolone, combined with her appetite stimulant, worked really well for the first few weeks. I told myself over and over again that she would make it to Christmas (silly, I know), that we would celebrate together and have that final memory of the holidays with our three young healthy cats. If I'm being totally honest with myself, I started noticing a decline late last week, but I kept seeing these bright spots: "Look, she ate all her dinner!" "Look, she's rolling over on her back!" "Look, she hopped on the bed and wants to cuddle!" While all of that was -- and is -- true, it was also becoming increasingly apparent that she was uncomfortable. For the past few days, I've watched her struggle with constipation. I've seen her grow increasingly listless, and I know that she spends more time hunching in "breadloaf" position or hiding under the bed than she does relaxing or lounging with our other two cats. She seems more like one of my parent's elderly cats than she does the bright young cat she was before. Last night and this morning, I noticed her third eyelids were starting to show intermittently. This morning, I held her and asked her if she was hurting, and if she was tired of this. She looked directly into my eyes and I saw, I knew, that she was in pain. It rocked me to my core. We're at the end of the road. This is real. I can't fix this.

After two agonizing conversations with my husband, we called the vet this morning and talked through the symptoms we were seeing. As background, I watched my parents struggle with the decision to euthanize our 17 year old cat, Inky, this summer. She also had an aggressive form of cancer, and her decline was quick, awful, and traumatic for our family. Their vet told them candidly that Inky had probably suffered for a few days longer than necessary, and I know that that has haunted my parents ever since. I do not want to put MeeMee in that position. Our vet confirmed that the symptoms we were seeing indicated that MeeMee was on the decline, and that further intervention would only postpone the inevitable -- likely with a considerably reduced quality of life. After a lot of tears, we set an appointment to help her over the Rainbow Bridge tomorrow afternoon.

As I sit here typing, tears streaming, I still can't quite believe it. I still feel the urge to ask questions, to research, to see if there's something else we might try, to wait it out and see if there's not another temporary rebound. MeeMee is unlike any cat I've ever met, and has always been my shadow. She has always woken me up with her beautiful trills, curled up on my lap the moment I sat down, followed me from room to room with her adorable chirps, luxuriated in any and all cuddles, and has brought me toys while I slept. Even last night, she curled up on my legs and slept like a log there all night. All cats are special, but some are really your particular brand of special -- that's MeeMee, for me. I feel crushed and robbed of the chance to enjoy a long and happy life with her, but I also know that she isn't thinking that way. She just knows that she feels really bad. She came to us suffering terribly, likely because of neglect at the hands of a previous owner, but she has shown us boundless love, trust, and devotion. I am so grateful for her! Now I know we've got to show her that same kind of impossible love with this final decision, even though it's killing me.

I apologize for the length of my post, particularly since I know it's such a bummer. This is incredibly raw for me right now, and I debated whether or not to post at all, but this all sort of flowed out all at once. Know that I am thinking of you and Charlotte, and hoping that your story has a happier ending than mine. I am happy to talk more about my experience, and I'm also happy to listen. Just know that I understand how badly you're hurting right now, and how scary this is. I am really, really pulling for Charlotte!

Thank you for sharing your story with me. It's helpful to know that there are other stories like Charlotte's-- I'm so sorry to hear about your sweet cat. I do understand the pain you're feeling-- try to understand that you've given her such a wonderful life, and that she absolutely knows it. I'm sorry that your journey with her is ending, but I'm sure she feels your love for her and that the decision to ease her pain is the right one.

Charlotte and I had another appointment with internal medicine today-- we're waiting on a call about her blood work. Probably going give us either: 1) A diagnosis of lymphoma or 2) She has some kind of wicked awful infection. Our vet today seemed to think it's most likely lymphoma. I suppose we'll have to see what stage it's in and take steps from there.

Thank you for reaching out-- I'm happy to be a support and I'm grateful for your offer to be one as well. Cat moms, especially moms of sick kitties, have to stick together some how. <3

 

[Shar371]

Sadly, I also have a story similar to this... My Midnight was, like MeeMee, 4.5 years old. However, we never did find out what got her. I have some theories, but nothing more.

She'd had prolapsed third eyelids for several months, which hadn't responded to antibiotic treatments. I bounced vets after the first said "It's normal, deal with it". We won't talk about the second. The third, treating without the benefit of Midnight's records (we had evacuated during Hurricane Harvey, and in our haste, I'd left them behind), took one look at her and ran an ELISA test... Came back as a strong positive for FeLV. She opted to not reconfirm with the IFA because Midnight was already stressed (and an avowed and combative vet-hater, to boot). That was September 1 of this year, and I promptly decided this was the new primary vet for Midnight. I boned up on my FeLV knowledge, boohooed (2-3 year lifespan? With a prognosis of anywhere from months to years? OMG!) Advice point # 1, if this ever, ever becomes a sticking point, have them do the blood draw and send to the proper lab to confirm.

Fast forward; I noticed that she had eaten about half her food on 10/29, and nothing at all on 10/30. We were back to the vet for some help on 10/31. She gave Midnight a Covenia shot, some B12, and introduced me to baby food for cats... Midnight ate half a jar, then retreated to her offered carrier. I was told that she should start eating right away, but I might need to forcefeed her. After another 12 hours without eating, I called the vet back, and they basically said that they could do nothing more for me... they referred me to an animal hospital they liked.

Long story short, after going to that animal hospital four times, two trips to a specialist, and a final trip to an emergency vet on the night of 11/10, that final ER vet said she "probably" had some variety of bone cancer that hadn't shown up on the x-rays or ultrasounds, and I should euthanize her. My post on that whole ordeal is here, as it was going on. Similar symptoms to start... lethargy, not eating, elevated white blood count (strong left shift, which means high neutrophils, high bands, low segments, low eosphils, low basophils... basically, an inflammatory response, which indicates either cancer or infection).

They went through the same rigmarole... Mirtazapine, antibiotics (she reacted very badly to the first, Orbax, so they discontinued... for days... until I demanded something be done. Then I demanded a certain, feline-only antibiotic (Zenequil) based on advice from a vet tech friend, and a feeding tube...More on that in a moment). In all of that, they never placed a feeding tube (I started asking for one starting on 11/6, at first the animal hospital and then at the specialist), and the latter two places both advised me to NOT syringe feed/force feed Midnight.

My problem is, in the two weeks since her death on 11/12 (two weeks after she stopped eating entirely...right on schedule for a healthy weight cat to starve to death, I'm told), I've done a lot of research. TL;DR: At the time of the final blood draw, where the ER vet said she had "cancer for sure" and a "very poor prognosis"...it can't be proven with the lab work performed (white blood count can do crazy things in response to an infection, or in response to steroids, which were also in her mix by that time. Platelets and red blood cells also tend to drop with hepatic lipidosis, I've found). What I /can/ say is that what ultimately took Midnight down was NOT cancer... Cancer doesn't kill the way she died (Seizures, laboured breathing, wasting by dropping 2+lbs/~22% in two weeks... and she was a healthy-weight cat to start).

I also think that Midnight's FeLV status might (and this is a very big "MIGHT") have had something to do with the vets all refusing to put their best foot forward. As soon as the conversation entered her FeLV status, they would indicate that it didn't matter what else was going on, she was destined to have a short lifespan anyhow, and this might be the disease manifesting. Through the various other tests (FNA, Ultrasound, X-rays) run, there were no swollen lymph nodes, tumors, indications of FIP, samples indicative of cancer in her liver or spleen, etc. found. Her heart and lungs were healthy, as were every other observable organ (the only place not covered by the exam was her head). The only indications that things were amiss were her bloodwork, a "bright" liver (indicative of hepatic lipidosis, which, for a cat who hadn't eaten in 10 days by that point, no kidding), a "heterogenous spleen" (Again, samples normal), and a healed rib fracture (that I had to find out about from discharge paperwork and demanding the films, not from the vet).

My best advice to you is that, if Charlotte still isn't eating by tomorrow night, find a vet Friday that will either place a feeding tube, or advise you on syringe feeding. I'm volunteering for a shelter now, and I've seen a few cats bounce back after syringe feeding, so I'm a believer. It isn't going to cure cancer, or FeLV, or any other underlying issue, but it might give Charlotte her best shot of fighting through whatever /is/ going on. My understanding is that the worse that could happen by keeping her on antibiotics is that you can feed into the antibiotic-resistant strains of infection... but if Charlotte is FeLV+, then those antibiotics are probably doing well by her, so long as her liver/kidneys/etc. can process them. The antibiotics probably will make her feel nauseous (they do the same for humans), so maybe you can get an anti-nausea shot (Cerenia?). Be leery of steroids with an FeLV+ cat, since they can help fuel certain infections. They also didn't work as appetite stimulants for Midnight, but they made her crazy thirsty, and she was too proud to pee outside her litterbox, no matter how cruddy she felt, so I watched the poor girl struggling to get into the litterbox, and glower at me when I tried to help (Ms. Independent to the end). That mirtazapine dose seems awfully high...and if she's on a different appetite stimulant, I'd double check to see if she should be on both, or just the new one. I'm guessing you've tried all the usual tricks to get her to eat... heating some wet food, trying the recovery food, baby food, tuna juice, pumpkin, etc. so I won't bore you to death with all that stuff.

Best of luck getting your little bird chirping again :-) Keep us posted! It seems wacky to have my fingers crossed for an infection, but, knock on wood, here's hoping it's a treatable infection!

ComputerBagel, much love to you, your husband, and to MeeMee. I know this is the hardest decision to come to with a loved one, and how much it tears at you. Know you aren't alone. If you need a shoulder to lean on, don't hesitate to reach out, and please share stories of MeeMee with us on the forums when you're ready.

 

[rhinuh]

Sadly, I also have a story similar to this... My Midnight was, like MeeMee, 4.5 years old. However, we never did find out what got her. I have some theories, but nothing more.

She'd had prolapsed third eyelids for several months, which hadn't responded to antibiotic treatments. I bounced vets after the first said "It's normal, deal with it". We won't talk about the second. The third, treating without the benefit of Midnight's records (we had evacuated during Hurricane Harvey, and in our haste, I'd left them behind), took one look at her and ran an ELISA test... Came back as a strong positive for FeLV. She opted to not reconfirm with the IFA because Midnight was already stressed (and an avowed and combative vet-hater, to boot). That was September 1 of this year, and I promptly decided this was the new primary vet for Midnight. I boned up on my FeLV knowledge, boohooed (2-3 year lifespan? With a prognosis of anywhere from months to years? OMG!) Advice point # 1, if this ever, ever becomes a sticking point, have them do the blood draw and send to the proper lab to confirm.

Fast forward; I noticed that she had eaten about half her food on 10/29, and nothing at all on 10/30. We were back to the vet for some help on 10/31. She gave Midnight a Covenia shot, some B12, and introduced me to baby food for cats... Midnight ate half a jar, then retreated to her offered carrier. I was told that she should start eating right away, but I might need to forcefeed her. After another 12 hours without eating, I called the vet back, and they basically said that they could do nothing more for me... they referred me to an animal hospital they liked.

Long story short, after going to that animal hospital four times, two trips to a specialist, and a final trip to an emergency vet on the night of 11/10, that final ER vet said she "probably" had some variety of bone cancer that hadn't shown up on the x-rays or ultrasounds, and I should euthanize her. My post on that whole ordeal is here, as it was going on. Similar symptoms to start... lethargy, not eating, elevated white blood count (strong left shift, which means high neutrophils, high bands, low segments, low eosphils, low basophils... basically, an inflammatory response, which indicates either cancer or infection).

They went through the same rigmarole... Mirtazapine, antibiotics (she reacted very badly to the first, Orbax, so they discontinued... for days... until I demanded something be done. Then I demanded a certain, feline-only antibiotic (Zenequil) based on advice from a vet tech friend, and a feeding tube...More on that in a moment). In all of that, they never placed a feeding tube (I started asking for one starting on 11/6, at first the animal hospital and then at the specialist), and the latter two places both advised me to NOT syringe feed/force feed Midnight.

My problem is, in the two weeks since her death on 11/12 (two weeks after she stopped eating entirely...right on schedule for a healthy weight cat to starve to death, I'm told), I've done a lot of research. TL;DR: At the time of the final blood draw, where the ER vet said she had "cancer for sure" and a "very poor prognosis"...it can't be proven with the lab work performed (white blood count can do crazy things in response to an infection, or in response to steroids, which were also in her mix by that time. Platelets and red blood cells also tend to drop with hepatic lipidosis, I've found). What I /can/ say is that what ultimately took Midnight down was NOT cancer... Cancer doesn't kill the way she died (Seizures, laboured breathing, wasting by dropping 2+lbs/~22% in two weeks... and she was a healthy-weight cat to start).

I also think that Midnight's FeLV status might (and this is a very big "MIGHT") have had something to do with the vets all refusing to put their best foot forward. As soon as the conversation entered her FeLV status, they would indicate that it didn't matter what else was going on, she was destined to have a short lifespan anyhow, and this might be the disease manifesting. Through the various other tests (FNA, Ultrasound, X-rays) run, there were no swollen lymph nodes, tumors, indications of FIP, samples indicative of cancer in her liver or spleen, etc. found. Her heart and lungs were healthy, as were every other observable organ (the only place not covered by the exam was her head). The only indications that things were amiss were her bloodwork, a "bright" liver (indicative of hepatic lipidosis, which, for a cat who hadn't eaten in 10 days by that point, no kidding), a "heterogenous spleen" (Again, samples normal), and a healed rib fracture (that I had to find out about from discharge paperwork and demanding the films, not from the vet).

My best advice to you is that, if Charlotte still isn't eating by tomorrow night, find a vet Friday that will either place a feeding tube, or advise you on syringe feeding. I'm volunteering for a shelter now, and I've seen a few cats bounce back after syringe feeding, so I'm a believer. It isn't going to cure cancer, or FeLV, or any other underlying issue, but it might give Charlotte her best shot of fighting through whatever /is/ going on. My understanding is that the worse that could happen by keeping her on antibiotics is that you can feed into the antibiotic-resistant strains of infection... but if Charlotte is FeLV+, then those antibiotics are probably doing well by her, so long as her liver/kidneys/etc. can process them. The antibiotics probably will make her feel nauseous (they do the same for humans), so maybe you can get an anti-nausea shot (Cerenia?). Be leery of steroids with an FeLV+ cat, since they can help fuel certain infections. They also didn't work as appetite stimulants for Midnight, but they made her crazy thirsty, and she was too proud to pee outside her litterbox, no matter how cruddy she felt, so I watched the poor girl struggling to get into the litterbox, and glower at me when I tried to help (Ms. Independent to the end). That mirtazapine dose seems awfully high...and if she's on a different appetite stimulant, I'd double check to see if she should be on both, or just the new one. I'm guessing you've tried all the usual tricks to get her to eat... heating some wet food, trying the recovery food, baby food, tuna juice, pumpkin, etc. so I won't bore you to death with all that stuff.

Best of luck getting your little bird chirping again :-) Keep us posted! It seems wacky to have my fingers crossed for an infection, but, knock on wood, here's hoping it's a treatable infection!

ComputerBagel, much love to you, your husband, and to MeeMee. I know this is the hardest decision to come to with a loved one, and how much it tears at you. Know you aren't alone. If you need a shoulder to lean on, don't hesitate to reach out, and please share stories of MeeMee with us on the forums when you're ready.

I'm SO happy you shared your story about Midnight. I felt the exact same way after leaving the vet on Sunday-- threw things at me like "a poor prognosis" and implied that her FeLV status was basically a death sentence. To update, Charlotte and I got back from the vet today, who did more extensive blood work (and basically implied that the first vet didn't do a thorough enough exam) and had it examined by a staff pathologist at the U. She came back basically a 100% for bone marrow cancer. The vet called me and gave me options: send the blood off to an external lab with results in a week to figure out exactly what strain of bone marrow cancer we're looking at, so I can sit down with an oncologist and discuss treatment plans and a prognosis. For either strain it could be (lymphoid or myeloid) it's not good. He said something about a 30-50% chance of response from chemo, and even if she went into remission, it would- at best -be 6 to 8 months before she would develop the cancer again.

So, not great news. I wish it were an infection-- but at this point, Charlotte and I are taking it day by day. We'll make an appointment with our primary vet for a checkup in two weeks, and get an appointment to sit down with an oncologist. I'm feeling closer to closure at this point-- there's a name to it, and there's a fight to be had.

I'm sorry about your Midnight. From the sound of it, her symptoms seem strikingly similar to Charlotte's. I'll take your advice on the feeding-- I have a friend/former supervisor from my days working at a cat shelter, and perhaps he'll have some words about syringe feeding.

Thank you for the support, and I hope I can provide as much in the future.

 

[Shar371]

Oh, Rhinuh, I'm so sorry. I wish it were better news. But you're right...There's a name, there's a fight, and your Charlotte is in good hands with you. All my best to you both.

 

[computerbagel]

Oh, I’m so sorry to hear this update. Know that Charlotte is so lucky to have you as a mom! I think you are exactly right about taking this day by day— after all, that is exactly how our kitties approach the world. Know that I am here to lend support and a sympathetic ear as you navigate this process with your girl.

Shar371, I am so sorry to hear about Midnight. Your love for her— and how hard you fought for her—are so clearly visible in your post. I know how awful it feels to lose such a young, vibrant cat so young — and I’m sorry that you had to deal with so much frustration and uncertainty along the way.

Thanks to both of you for your kind words of support about MeeMee. Yesterday was our last day with her, and I spent the whole day cuddling with her, giving her her favorite treats, and telling her stories about all of our favorite memories before we took her in for her last appointment at 3:30. Right now, my heart keeps finding new ways to break— everything is so different without her!— but in time, I do want to share her story on the forums. She was a very special girl. It is so nice to talk to fellow cat parents who understand! Thanks to both of you so, so much.

 

[rhinuh]

Hearing about MeeMee absolutely breaks my heart. Please let us know what we can do to help-- I know she must have loved being with you for the last part of her life, and that she felt completely and totally at home. You did the best thing by her, I'm sure.

Shar371-- thank you also for your support. It's so comforting to have other cat parents to talk to. I did start syringe feeding Charlotte, and that has seemed to help her appetite on top of the stimulants. She's closer to acting herself, which makes me both joyful and heartbroken, because I know the cancer inside of her will take her from me sooner rather than later. But I'm happy to say that she seems more comfortable as we wait for an appointment with an oncologist. Fingers crossed we get in very, very soon.

Thank you both for your support-- I genuinely can't explain how helpful it has been. It's comforting to know there's a place to come to where people understand my love and devotion to Charlotte. I'm sure she feels the love too!

 

[computerbagel]

Rhinuh, we will be keeping fingers and paws crossed that you are able to get an appointment soon! The waiting is the worst.

And I know how bittersweet it is to see her acting better while still knowing she is sick. One thing that helped me and kept me from losing my mind was to try and see the situation from MeeMee’s perspective, which really boiled down to how she felt in the present moment. If she is feeling good and acting like herself, Charlotte isn’t worried or thinking about the future or wondering when things might change. She’s just happy because she feels good, so she is having a good day. I spent a lot of time reminding myself to stay in the present moment with MeeMee, because those good days are so very precious. MeeMee never quite returned to the cat she was before, but she developed a “new normal” where it was clear she was happy and enjoying herself. I wish you and Charlotte many, many good days!

 

[rhinuh]

That's wonderful advice, computerbagel. Charlotte has been having some wonderful days so far-- she's eating again, using her scratching post, following me around and "chirping" again.

It seems that, at least for now, my little bird is feeling better. I'll keep all of you updated on her situation as it progresses-- for now, we're playing the waiting game.

 

[rhinuh]

We have happy updates!

So, Charlotte is a miracle cat-- we had her re-check yesterday, and the vet had informed me that if her scans are once again inconclusive, there's only one more test they can perform (sending her blood out to a lab at Cornell, which was apparently the only lab that could do the test) before there's nothing else they could do for her. All the vets were convinced we were leaning towards acute myeloid leukemia, and these re-checks would confirm it and we'd head into oncology.

However, the vet called me back this evening...and Charlotte's counts are all completely normal. Normal white blood cell count, normal lung scans, normal heart scan. I asked the vet what on earth could have happened-- two options: it's a phasic cancer, or it was an aggressive inflammatory infection. The antibiotics seemed to have cleared it up in the last two weeks, so the vet is leaning towards an infection.

So, next steps: she still has FeLV and her anemia seems to be worsening, so we're staying on antiobiotics for another week and getting her anemia checked again next week. But for now...all is well with little bird.

Thank you all for your support, and for your thoughts and prayers. Charlotte and I appreciate it and feel it!

 

[Antonio65]

I didn't step into this thread because I had nothing to contribute with, but this is a great news!!!
I'm so happy for you. Hopefully you will deal with her issue greatly!

 

[Shar371]

I'm so glad Charlotte is doing well, and is responding to treatments! Hearing that she's chirping is really wonderful news.