Chemo Without Biopsy For Lymphoma? Having Reservations.

[ifwewerebirds]

Baby Lilly has had all kinds of blood work ran and two ultrasounds. The specialist is fairly certain she has SCL due to ultrasounds and the fact that she isn't responding well to treatment for IBD. We opted to not do the biopsy because she had such a tough time recovering from anesthesia when her tube was placed (now out).

Her blood work isn't terrible. Lymphocytes are a little low, but over all WBC is normal. She has low potassium and folic acid. Creatinin and Monocytes a little low as well. All values out of range are only out of range just slightly.

However, her diarrhea has been constant for about a month despite being on Metro the whole time and other supportive meds. She's doing okay today, but it was a rough week.

I'm really scared to put her on Chemo, but also know if it is SCL, even though it's slow moving we need to do it soon.

I'm SO TORN. What are y'all's thoughts on this? Should we get a second opinion?

 

[Kieka]

It wouldn't hurt to get a second opinion. Sometimes a new pair of eyes and different perspective can come up with something different. Sometimes they agree but then you have a very solid feeling about the direction to go.

Crossing all my fingers and toes that she gets a little stronger each day.

 

[babiesmom5]

I am so sorry about your kitty. Having been down the difficult road with SCL, I will give you my opinions for what they are worth.

The good news is that Small Cell Lymphoma IS treatable...IF you get to it in early stages. Without treatment, it is usually fatal in 6-8 weeks. It is not pretty.

Standard treatment for SCL is Prednisolone, plus chemo (Leukeran/Chlorambucil). Cats tolerate Leukeran very well. I have one cat now who has been on Leukeran for a year. She tolerates it very well. I would not hesitate at all to at least try Leukeran.

Cats being treated with SCL often go into remission lasting several years. I know one Vet whose cat lasted 5 years with it and actually passed from something else.

You say the treatment for IBD is not working. Is that Prednisolone? When Pred no longer works, that is a pretty good sign it has crossed over to SCL. Pred does slow it down to a degree, but certainly does not stop it.

My SCL cat had low folic acid levels. She was prescribed a folic acid supplement.
I can tell you though that my SCL kitty's bloodwork, like yours, was not terrible. With SCL, bloodwork is not usually too off like it is with the Leukemia's.

I think your specialist is correct in his assessment. I would have gotten the biopsy to confirm diagnosis, but you have to proceed on assumption now.

I would consult with a vet Oncologist who can best explain your options for treatment...and the sooner the better.

As for the diarrhea, my SCL kitty had "explosive" diarrhea which was stopped in a few days with Proviable paste followed by Proviable probiotic capsules. Ask your vet.

I wish you and your kitty all the best, but time is off the essence. Do not wait.

 

[ifwewerebirds]

If it is SCL, I'm pretty sure it's early. They just did xray and the works last week and it hasn't appeared to diffuse or cross over yet. She is currently on a folic acid supplement and Budesonide along other supportive medications. She is on the Proviable, but for a while she wouldn't take it. Since Monday, she's had 3.5 doses.