Chemo? Parr Test? Immediate Information Needed Thank You

[SharkyandCinnamon]

If you missed my last post, I have a 4-5 year old tabby male who was recently diagnosed with large cell lymphoma via a fluid analysis. His blood was fine. His urine was fine. No masses showed up in any scan. He is not experiencing any symptoms as far as I know(except prior to the fluid draining, he had pleural effusion in his lung(s.)

So I just got back from the oncologist, where they recommended immediate and aggressive chemotherapy ASAP. I didn't start today because they also suggested something called a PARR test, which would/should/could alleviate any doubt I had about the diagnosis. I just felt a bit off starting today when he is asymptomatic and none of the other tests have showed anything. Was that stupid?

Also, the PARR test is 780 dollars. That's the big one. I CAN do it but it will cut into chemo money significantly. Is it worth it to go forward with this exorbitantly priced test or should I just take the oncologist's word for it, based on the original fluid analysis? I really have NO idea what to do and am just about losing it and any advice would be so so so helpful. Thank you in advance.

 

[Antonio65]

The PARR test (I think it's spelled this way) is the same thing that the vet asked me to do today. If you have read much post I had to take a sample of fluid to the university for a test, now I remember the name. They didn't mention any over the roof price, so I reckon it is something affordable.
I should have the report tomorrow. This could clarify some things and rule out others.

I wouldn't agree to start off with the chemo without any clear diagnosis. Of course 780 dollars is lots of money. I really don't know... Is there any other test that can be done?

 

[Antonio65]

We are cross-posting each other
I think that vet prices in US are crazy!!! How can a chemo course be so expensive?
Given the high costs for the chemo I'd go with the PARR test. This way, if it shows nothing, you'll save thousands. If it shows something it will about 1/8 of the chemo bill.
I would do it!

 

[Kieka]

I'd agree with the test first. I did chemo and we are talking in the several thousand range (mine wasn't in doubt though due to biopsy and physical lump visible). The $799 to verify you even need the chemo since you are questioning it will be worth it if it turns out the diagnosis is wrong. If it is right, will the test help in determining a better treatment option?

 

[SharkyandCinnamon]

You guys are right and I made an appointment for saturday for the test. i just can't go through with chemo, the stress on him and myself, without being absolutely iron clad 100 percent sure it is necessary. Even IF I get a positive diagnosis I'm not 100 percent sure yet because people keep telling me "think of quality of life" and there is the money to factor in (I don't have it) but if I didn't do everything in my power to help him I'd never forgive myself.

Yes and vet prices are outrageous. It's such a huge bummer and an under-discussed part of American life. I guess we can't talk about animal health care before we get people health care straight.

 

[Kieka]

I know the pain of problems in animal health care and it is absolutely depressing. Costs, knowledge, and quality of actual care all are major issues.

As to the, is chemo worth it aspect. I did chemo; my cat had treatments for 6 months. Having gone through it here are my thoughts and whys. Of my current two I would do it for Link; assuming it was early enough and the type of cancer had at least a 50% chance of responding well. He has the temperament to take the appointments and driving for it. He would take his medications and he is smart enough that when he isn't feeling well he doesn't fight you (but he does fight once he feels better). Medications for nausea and pain management are key and cats do handle the side effects well. Rocket, no. I don't love her any less but she would handle it poorly and her quality of life would be too impacted to make it worth even trying. I have enough trouble with monthly flea medication and annual check ups. I can't even image the impact regular visits would have on her mentally and behaviorally. She is very emotional and has gotten sick from stress; so I seriously doubt she would make improvements just because of the psychological aspect. And even if she physically responded she would not come out of it with the same level of sanity she has now.

You can't let anyone else make the decision for you. It has to be something you really look at your cat and everything involved to decide. If he does have it then 100% agree that immediate treatment even if asymptomatic is vital should you decide to go for it.

 

[SharkyandCinnamon]

Yeah agreed. Sharky is pretty tough in some ways and sensitive in others. I still haven't worked out how he would take to it. Complicating situations is I cannot afford chemo at the oncologist's office, which comes in at like 7k for 6 months. I found a mobile pet van that administers chemo but it is in really inconvenient places and he'd have to be alone with them all day. I wouldn't be able to stay there. So ugh. No perfect solution here. How did your cat turn out when you did chemo before? Thanks for the response!

 

[Kieka]

Yeah agreed. Sharky is pretty tough in some ways and sensitive in others. I still haven't worked out how he would take to it. Complicating situations is I cannot afford chemo at the oncologist's office, which comes in at like 7k for 6 months. I found a mobile pet van that administers chemo but it is in really inconvenient places and he'd have to be alone with them all day. I wouldn't be able to stay there. So ugh. No perfect solution here. How did your cat turn out when you did chemo before? Thanks for the response!

My cat was 9 or 10 when I notoced a lump on his neck. I insisted on a biopsy as the inital vet said it was an abscess. It was about the size of a pencil eraser but I know abscesses and it wasn't. Sadly, I was right.

We started with surgery to remove the existing mass. Then did chemo once a week for (and I realize Imistyped earlier) 4 months driving an hour to a specialist and waiting. From that first appointment to his first chemo was 2 weeks. I paid half and split it with my Mom it was a little over $1k per session. That included MRIs and all medications.

They rechecked him at the end of treatment and the cancer had returned to the same site. It was barely visible on the scan but it was back. We scheduled surgery for 5 days later. But when they went into surgery the cancer had latched onto his artery. There was no way to remove it without him bleeding out and it had likely already started spreading through that main blood flow.

So they closed him up with only remov8ng a little on the edge. I cherish every single moment of his last 2 months.

I am not going to lie, knowing the outcome a small part of me regrets the stress and likely discomfort of the chemo. If I knew what I know now I probably wouldn't have done it. But hindsight is 20/20 and I think the questions of could I have done more and what if I had just tried would have haunted me more. As it is, I know I did everything and gave him every chance to survive. I was lucky that my Mom split the cost and I had recently graduated college. Since I had worked my way through school and already budgeted to save $500 every two weeks; it was easy to continue that. With CareCredit I was able to pay towards it during treatment and pay if off before the 6 month period with the deffered financing.

Cancer sucks and there will never be any right answer. You can do nothing and wonder if you had just tried. You can do everything and wonder if you just made things worse. No matter what you do keep in mind that when all is said and done you are the only one who can decide or judge your choices so make the choice you can live with.

 

[SharkyandCinnamon]

That story is heartbreaking. At least you got that final two months. The funny part is Sharky doesn't even like me that much! I think he loves me but doesn't "like" me. He's an independent soul which i love about him a lot. I'm learning throughout this ordeal that...we need to give ourselves a break. It sounds like you did so, so, so much for your cat and, if karma exists, you are sure to not come back as a bug. I'm realizing the same. In my heart of hearts I'm so terrified of not doing enough but I get the sense from friends and family that I've already gone past what many of them would do.

I have crap credit from when I was young and ridiculously stupid so CareCredit isn't in my personal future but I'm going to ask my dad to co-apply with me tomorrow. And I'm getting that test on Saturday, despite the expense. Then comes the decision. Today he seems a bit ...lethargic but he just ate from both bowls and that always makes me really happy. You be a hog! He was scratching up the chair and I was encouraging him. There's a first time for everything.

Also, if/when there comes a time when treatment will not work or if I cannot afford it and the end is coming and it is steroids only time, he gets to go back outside whenever he wants. He comes from the outside and getting back there is his purest passion but its too risky, this neighborhood alpha used to beat him up(I captured him and defanged him via having him fixed.) But it is really the greatest gift I can think of to give him while he still has energy.

Cancer is so gross and horrible. I'm glad you had some good years with that cat.

This picture is just like 2 months ago. His usual routine trying to claw his way to freedom.

 

[Kitten70]

How was the large cell lymphoma diagnosed in your cat? I thought the only diagnosis is through a biopsy, correct me anybody if I am wrong please. We did the PARR test for ours and came out inconclusive, sometimes they can't tell if lymphoma is present or not from the analysis. In his case the lymph nodes were enlarged and that was the only diagnosis we got. Sadly, 3 weeks later he died. I would not start chemo without knowing for sure if he has large cell or not, but that is a personal decision you have to make after you know a little bit more. And yes, I agree with you, give him lots of freedom, that's what we did with ours, at the end they are the ultimate decision makers.

 

[Antonio65]

Hi SharkyandCinnamon , I had the report for that special test I told you about.
It wasn't the PARR test, it was a flow cytometry. The lab vet told me that this test is a little more advanced than PARR, even though this doesn't mean that it is better. The two tests are complementary, one helps the other.
I haven't paid for it yet, the vet told that it might cost about 120 euro.
So I asked the vet what the cost of a PARR test is and he told me that it should be between 80 and 100 euro, that is about 8 times less than you have been asked for the same test.
That is so unfair!!!
People should be able to pay for pet health and care, prices and bills like those you have in US are absolutely crazy and not helpful. Why are some vets so greedy and heartless?

 

[chicy724]

How was the large cell lymphoma diagnosed in your cat? I thought the only diagnosis is through a biopsy, correct me anybody if I am wrong please. We did the PARR test for ours and came out inconclusive, sometimes they can't tell if lymphoma is present or not from the analysis. In his case the lymph nodes were enlarged and that was the only diagnosis we got. Sadly, 3 weeks later he died. I would not start chemo without knowing for sure if he has large cell or not, but that is a personal decision you have to make after you know a little bit more. And yes, I agree with you, give him lots of freedom, that's what we did with ours, at the end they are the ultimate decision makers.

Hello,
This is a really old post but I just came across this and it sounds familiar.
Our sweet kitty is awaiting results from the PARR test, and we will decide if we do biopsy or not depending on the results.

Reading that your kitty died 3 weeks later really scares me. May I ask what his condition was at that time?

Maybe I shouldn't wait. Maybe I should just ask for medication now.

 

[Kitten70]

His condition was not good but it wasn't that bad, not that we thought he was going to be gone so soon. He had lost some weight and was having some episodes of diahrrea. But otherwise he was his old himself going out, jumping into things, eating normal... He had had also some kind of respiratory issues that none of the vets were able to diagnose, he was on antibiotics (which probably caused the diahrrea). I would suggest to wait and see if the PARR results tell you something. If your cat is in good health they can still do a biopsy to know for sure. Once they start on prenisolone a biopsy could be inconclusive. Please someone chime in to verify this, it is what I remember from our conversations with the vets.

 

[chicy724]

You are right- we weren't able to start the prednisolone because of the chance we will need biopsy.
The surgery for that is very invasive. She is 13 years old, and really, really, really not feeling well despite anti-nausea medications.

But she is just miserable. She won't eat.
Even with Cerenia yesterday, Zofran this morning- she wouldn't eat.

It's almost time for her next dose of Cerenia.. but if she was feeling less nauseous after the Zofran this AM as she was already on Cerenia, she should have eaten.

She turns her nose up at about everything. Licks juices off things, maybe eats a few treats; she has a buffet of options. She will sniff it, and not eat.

This is why I am just thinking maybe we should just start treatments. She will just get worse and be miserable.. and now I am worried after reading your post that she could lose her life in-between.

 

[Plumeria]

Hello,
This is a really old post but I just came across this and it sounds familiar.
Our sweet kitty is awaiting results from the PARR test, and we will decide if we do biopsy or not depending on the results.

Reading that your kitty died 3 weeks later really scares me. May I ask what his condition was at that time?

Maybe I shouldn't wait. Maybe I should just ask for medication now.

Hi, my cat didn’t get a PARR test but he was diagnosed with large cell lymphoma in the intestines through biopsy. At the time, he was already multicentric, but we didn’t know until after his biopsy/intestinal resection surgery. The lymphoma was also in his brain. Giving him chemo was the biggest mistake. Not only was it ineffective, but it hit him hard and caused him to decline rapidly. I brought up his temperament not being right for chemo, but the oncologist brushed it off saying coming to/from the animal hospital for treatments was not too stressful for cats My Leroy died 3 weeks after diagnosis. The chemo definitely did more harm than good. As others have said, it depends on if the cancer is caught early and you really have to consider your cat and determine if s/he can handle it.

 

[Plumeria]

I wanted to add that Leroy was showing the following symptoms at the time of diagnosis - lethargy, paralyzed jaw, drooling, weight loss. I would try giving your cat turmeric, bloodroot,...can’t think of others right now, but if you can find these supplements I would try.

 

[Plumeria]

Sorry forgot to add diarreah as another of his symptoms.

 

[Kitten70]

Kitty was picky about eating too, but he would still eat. Have you tried B12 shots? Those can boost the immune system, I remember Kitty reacted very well to those.
You could start treatment I guess and see if she improves, that will tell you too if it is lymphoma or not. It's a shame that there is no real diagnosis for this type of disease, yet it seems to be so common in cats nowadays.
I wish the best for your cat, don't give up, she knows you are trying hard to help her. You'll be in my thoughts. Keep us posted.

 

[Plumeria]

I apologize for posting multiple times. I was replying from work earlier and kept getting interrupted. Have you tried appetite stimulant? If Cerenia and Zofran aren’t doing the trick, I would try Pepcid AC, especially if your cat hasn’t eaten in days. I would be aggressive and try different medicine if the current one isn’t working. Are you syringe feeding? I would give your cat turmeric, or better yet Curcumin supplements, because not only is it anti-cancer, anti-tumor, it also works for allergies, diabetes, liver disease, and more, for just in case your cat is suffering from something other than lymphoma. Once your cat starts chemo in the future, she likely won’t be able to take Curcumin because it’s an antioxidant. So I would try now and see if it makes a difference for her. Here’s a thread about Curcumin feeding and dosage for cats. Anyone have experience with giving Tumeric to their ailing fur babies?

 

[chicy724]

I have thought about turmeric. I had just started looking it up the other day so thank you for that link!

She has mirtazapine as an appetite stimulant, but the other day when we gave it to her, I think her nausea was out of control so it didn't do anything.

I have not syringe fed yet. I was planning to tonight. We can give her the mirtazapine tonight around 10pm.. I am hoping that will kick in and help.
She has licked juices off of food and ate a bunch of treats (we are trying everything we can!), and we left her a kitty buffet with tons of options. So far it's juices and treats..

I have debated syringe feeding until after mirtazapine. I wonder if I syringe feed then the mirtazapine kicks in, and she feels hungrier, eats, then feels sick.. if it would be too much and throw us backward again.