Difficult Choice Between Leukeran And Prednisone

Jojo&Tutu

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My cat is losing weight eating good with decent bloodwork considering her medical conditions but not absorbing food well. She has pancreatic lipidosis (pancreatitis) and a worsening case of inflammatory bowel disease. Also occasional inflammatory liver. She had a rare benign liver tumor removed in 2016 and I131 radioactive iodine treatment for a thyroid tumor a year ago. She is 16 and a tiny Siamese Balinese cat. She has trace glucose in her urine could be influenced by her getting pumpkin added into her cat food. She is at risk for diabetes if on prednisone. She also has had a couple episodes of a lack of coagulation in her blood that puts her at risk for a bleeding disorder if in leukeran. My vet could scope her intestine to see if she has lymphoma or not and if so it would definitively require leukeran, or she can just be put on leukeran or she can just be put on prednisone. She is low potassium taking potassium supplements that can also reduce effectiveness of steroids such as prednisone and budesonide. She is currently is on the steroid budesonide that is not working well enough. Ultrasound showed further thickening of her intestinal lining. The prednisone might help the pancreatitis. Either way my vet feels we have to do something or her condition could become worse and more difficult to treat. What should I do?
 

neely

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First, let me say that I'm so sorry for all your cat's health issues. :hugs: At the grand old age of 16 you have been a very dedicated and diligent cat parent looking after her ailments. I'm not a vet so don't have a specific answer for you but if you trust your vet talk to them and ask if the benefits outweigh the risks. Or you can always get a second opinion for peace of mind.

Once again, I'm sorry your cat is going through this and wish you the best of luck. Please keep us posted on her progress. :alright:
 

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Hi. I can only offer my support and well wishes. The one thing that did come to mind is if you have any vet universities nearby that might be have some insight with studies they have done, or at a minimum provide a second opinion about the best option for your little girl. :vibes:
 
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Jojo&Tutu

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Hi. I can only offer my support and well wishes. The one thing that did come to mind is if you have any vet universities nearby that might be have some insight with studies they have done, or at a minimum provide a second opinion about the best option for your little girl. :vibes:
My internal medicine vet is a former UC Davis professor vet. I have thought hard about what to do. Tutu’s weight has stabilized though she eats more often to maintain it. Other than the weight loss no other new symptoms. She has had IBD for all of her16 years. I have a close friend who has four cats three with intestinal lymphoma on prednisolone and leukeran. They are doing well. I won’t be doing endoscopy on the advice of my vet. I will try the change from budesonide to prednisolone first and if she doesn’t gain a bit of weight back and if not doing better I will add in the Leukeran. She has also had a stubborn urinaryh tract infection and hoping that the change in antibiotic helped fully resolve it. She cannot get urine drawn for urinalysis without going back on the antibiotic. She seems hungrier in the morning wants a few breakfasts. I’m hoping the prednisolone helps. It might even help her inflammatory pancreas a bit. I believe firmly that all the smart meters and excess harmonics and radio frequency are causing these medical problems for animals and people. Tutu eats Just Juicy Venison and is doing well on it. I add a teaspoon of baby food pumpkin for her constipation. Her food only has a couple pieces of carrots per cans nothing much else but the meat and vitamins. No carrageenan no guar gum no xanthan gum - these add inflammation to your cat and no green peas no chick peas -my IBD cat is sensitive to these foods - so might your IBD cat be sensitive too. Though my cat has kidney function decline it is handled by sub q fluids every other day as the food has to be dictated by her IBD. At least her weight has stabilized for now though she is a very thin cat.
 
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FeebysOwner

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Thanks for the update! It sounds like you and the vet have got a plan and are starting to stabilize Tutu - that is what counts the most! Hope she can gain some weight with the prednisolone!!
 
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Jojo&Tutu

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Thanks for the update! It sounds like you and the vet have got a plan and are starting to stabilize Tutu - that is what counts the most! Hope she can gain some weight with the prednisolone!!
Thanks me too!!!
She is my heart and soul so I hope she gets better soon
 

daftcat75

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If she’s eating well, then that’s half the battle with pancreatitis. Because she’s older, has IBD, and pancreatitis, that’s three strikes against her digestion. You’ll need to feed her more than you think which could mean extra meals. My Krista is 9 lbs and eats nearly 300 calories to maintain or gain. She also has IBD and a couple bouts with pancreatitis.

If she’s not on B-12 replacement, she’s going to have an exceedingly difficult time regaining weight. If she’s not taking weekly B-12 subcutaneous shots, I would add those before mucking with the other drugs.
 

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I agree that keeping up the weight is the biggest battle - I had a cat with presumed intestinal lymphoma (or IBD) that was diagnosed after a weight loss (he had just turned 14 at that time). My vet had him on both prednisolone and leukeran (or, we got the generic chlorambucil as it was less expensive), and then that was supported with cerenia and mirtazapine (both to help his appetite).

For the next three years, that was enough to help him gain weight and keep him stable. The last 8 or 9 months were pretty rough - he started getting frequent UTIs (likely from the pred) and electrolyte imbalances (added potassium and d-mannose to all the other meds).

But the leukeran and prednisolone did buy him three fairly good years. Given that my vet had told me that the average survival time with the leukeran/pred would be 18 - 24 months, he actually lived for 3.5 years, it was helpful in his case. When I finally had to say goodbye, it wasn't from the intestinal lymphoma - he'd developed sarcoma in his jaw.

Also neither the leukeran nor the prednisolone were all that expensive (the cerenia, on the other hand... yikes!).
 
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Jojo&Tutu

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There is a new B12 Med not an injection and Texas AM tested it with IBD cats is safe for them. Called Cobaliquin -is chewable chicken flavored but no whole protein. I give my cat that daily. I still can’t believe she has intestinal lymphoma with her blood looking good and she only has weight loss issues but I guess that is possibly it. I am going to consult a second internal medicine vet by phone to see what she says. Will do what they advise. Starting with prednisolone first and adding in leukeran if needed.
 
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Jojo&Tutu

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There is a new B12 Med not an injection and Texas AM tested it with IBD cats is safe for them. Called Cobaliquin -is chewable chicken flavored but no whole protein. I give my cat that daily. I still can’t believe she has intestinal lymphoma with her blood looking good and she only has weight loss issues but I guess that is possibly it. I am going to consult a second internal medicine vet by phone to see what she says. Will do what they advise. Starting with prednisolone first and adding in leukeran if needed.

Update: Tutu is doing much better. The prednisolone made her much worse. Cornell oncology vet and U of Wisconsin oncology vet both said it wouldn’t hurt to lower her steroid Budesonide to see if that was the problem. My internal medicine vet didn’t like my consulting other vets and suggested that if I wanted to consult others maybe I should go elsewhere so after fifteen years with her I went elsewhere and am glad I did. The new vet suggested an intestinal antibiotic Tylosin or a probiotic. I tried Tylosin first but her stools were soft and bloated. So after a week or ten days I switched to Proviable a probiotic. She is small so I only use half or two thirds s capsule mixed into her food. Her stools are soft not bloated and no longer hard little rocks and I can lower the amount of pumpkin I added in to help soften her stools. Right now her weight though a little lower than normal is continuing to be stable. All along her problem was too high of Budesonide steroid. She might be on the verge of lymphoma but I am buying her time before going on Leukeran. Leukeran can cause blood issues though supposedly well tolerated by cats. It also does break DNA. I am glad I followed my instincts as she was so hyper with fully dilated eyes and I just thought she was on too high a steroid. The new internal medicine vets recommendations help control the amount of ecoli bacteria in her stool which also might be helping her avoid the repeat urinary tract infections she was having. Hoping she continues to improve.
 
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