Enlarged Spleen?

[fionasmom]

That is great news and you must be so relieved!

 

[Jabzilla]

I am, I'm so very relieved! <3 <3 <3 Rocket is back home now with a whole kit of medications. She has mirtazapine, cerenia, ondansetron, gabapentin, and proviable. I gave her the proviable paste, mirtazapine, and ondansetron about an hour or so ago, but still haven't been able to get her to eat anything. Her gabapentin is due in 30 min, so hopefully she will eat after that. Rocket came out when she heard me open the treat bag, but wouldn't eat any of them. She hasn't eaten her dinner either, so I've put it away for now.

Today also came with a new problem, pancreatitis now. The vet said she saw inflammation in her pancreas during this morning's in hospital ultrasound, so Rocket's diagnosis is pancreatitis with enteritis.

 

[fionasmom]

I did wonder about pancreatitis and all of the medications which you have at home were the same ones that my GSD with recurrent pancreatitis was on. It can take a while for them to get an appetite when all of this is going on.

 

[Jabzilla]

I did wonder about pancreatitis and all of the medications which you have at home were the same ones that my GSD with recurrent pancreatitis was on. It can take a while for them to get an appetite when all of this is going on.

How long did it take for your cat to recover from their bought of pancreatitis? Rocket is eating, but in small amounts rather than a full meals worth. I'm feeding her more often to make sure she gets a full days worth of food. Now that she's eating, she's been able to get S Boulardii with each small meal which has stopped her soft poop. I've been giving her Gabapentin every 8 hours or so, rather than waiting for 12 hours between doses. I figure I'll do that until she seems more like herself. There has been improvement though. She comes out and asks for food on her own, she walks around and hangs out in the open rather than sleeping in the kitty cube all day. Rocket was even doing a sploot last night while I ate dinner. She's going to have a recheck w/ the internal med specialist in a few weeks along with an ultrasound.

 

[fionasmom]

Once we started the meds, the recovery was fairly quick and within a day there was improvement. Eating in small amounts is not unusual at first and I would keep trying to get small meals in when you can.

 

[Jabzilla]

Once we started the meds, the recovery was fairly quick and within a day there was improvement. Eating in small amounts is not unusual at first and I would keep trying to get small meals in when you can.

Excellent, it sounds like Rocket is on the path to recovery then. I'm working from home too, so I can give her some food whenever she asks and at the usual meal times.

 

[Jabzilla]

I spoke too soon. Rocket barely ate today despite having gotten her multiple medications, so we’re back at the hospital. I’ll report back when I have info. The Mirtazapine is making the insides of her ears red, which I’m guessing isn’t normal. I told the technician who took her into the back.

 

[silent meowlook]

She probably is having a reaction to the transdermal gel.

 

[Jabzilla]

She probably is having a reaction to the transdermal gel.

The technician said Rocket has a fever, her temperature is 39.8 C. She echoed what you said, and added the Mirtazapine could be causing the fever due to her possibly having a reaction to it. She told me the vet wants to do a point of care ultrasound to make sure there aren’t any effusions. I’ll update again here when I have more info. I haven’t seen the vet yet, just the technician.

 

[Jabzilla]

Okay, Rocket is going to stay at the hospital tonight. I figured the team here has a better chance of getting her to eat and they can watch & respond to her fever. Tomorrow they’ll try to have her seen by the internal med specialist to figure out why Rocket was improving and then suddenly went backwards today. They’re going to switch her to oral Mirtazapine since her ears are clearly irritated. I also said they could do the chest x ray since she’s here, for the b lines. The free fluid is no longer floating around in her abdomen at least.

I asked if her pancreas and intestines were the same, better, or worse, but the vet said her ultrasound machine wasn’t good enough to look at those. I appreciated her honesty and she said the specialist would be able to see them since she has better equipment and experience with such things.

 

[silent meowlook]

I hope everything goes well.

 

[Jabzilla]

Alrighty, Rocket has had her ultrasound and chest x ray. The x ray showed a pattern consistent with mild fibrosis and they said it could be the beginning of feline asthma or it could be something she's always had. The ultrasound showed severe inflammation in the junction where the small intestine connects to the large intestine. The lymph node that sits there is reactive as well. They've taken some FNA samples and sent them out for testing. As of right now, it's either going to be IBD or lymphoma. Rocket was eating well in hospital yesterday but today she hasn't wanted to eat at all. They're going to try to get her to eat on her own, but if she still refuses, they'll place a feeding tube. The test results from the FNA should come back in 24-48 hours.

 

[Jabzilla]

I also wanted to add that Rocket has lost more weight. On her paperwork for today, it says she’s now 4.5kg. Her fever still keeps coming and going as well. The state of her pancreas wasn’t mentioned in the ultrasound report either.

 

[silent meowlook]

I am so sorry for what you both are going through.

My cat has intestinal lymphoma and I have been treating her for over 3 years. One of the specialist I used to work for would say “If your a cat and you have to get cancer, lymphoma is the best kind to have, since it responds so well to treatment.”

 

[Jabzilla]

I am so sorry for what you both are going through.

My cat has intestinal lymphoma and I have been treating her for over 3 years. One of the specialist I used to work for would say “If your a cat and you have to get cancer, lymphoma is the best kind to have, since it responds so well to treatment.”

Thank you Silent Meowlook. I am comforted by having seen so many posts here about lymphoma and that cats respond well to treatment for it. So I am glad it’s not an immediate death sentence. Does your cat have a fluctuating fever as well? The doctors aren’t currently sure why that’s still happening.

I got a brief update on Rocket this morning. Her pancreas wasn’t commented upon during the ultrasound as being remarkable so I guess the pancreatitis is suddenly gone? I know pancreatitis is healable but for it to suddenly be completely back to normal so quickly sounds odd. Rocket’s spleen has been consistently abnormal looking. The team finally got her to eat around 10pm, but she didn’t want to eat again at 1am. They’re offering food every 4 hours. Her WBC is mildly elevated and her protein and albumin are 27.6.

Are all of the things in these updates similar to what your lymphoma kitty has gone through?

 

[silent meowlook]

Hi. See if you can get a copy of her most recent bloodwork and post it.

No, my cat has not experienced a fever. She does occasionally have pancreatitis flare ups, but no fever.

I’m not sure why they wouldn’t have mentioned the pancreas, but some times it is not easy to visualize with ultrasound.

 

[Jabzilla]

I’m very sad to report that Rocket’s cytology results came back positive for cancer. The vet said she has carcinoma. She was just leaving and didn’t have a chance to meet with the internal med specialist to talk about what to do going forward. Their evening vet is going to try to do so before the specialist leaves for the day. I haven’t heard back from them though, so there’s a chance I won’t get more information until sometime tomorrow. The vet said her team was unable to get Rocket to eat all day. Hopefully the evening team will be more successful. She mentioned the possibility of surgery, but said that would mean a life time of diarrhea due to the inflammation being at the junction between the small and large intestine.

I don’t know what to do to proceed since I don’t have any more info beyond that. I really hope the specialist will have a plan that will help Rocket out. I can ask for a copy of the most recent blood work when I finally hear back from them.

 

[silent meowlook]

Hi. I am sorry for that diagnosis. Always ask that they email you the lab report for your files.

Do you know if they said adenocarcinoma?

I am sorry.

 

[stephanietx]

I have been following, but not commenting very much. I'm so very sorry for this diagnosis, but it was in the back of my mind. I didn't want to throw it out there to cause you to panic. This is pretty much how my RB kitty, Hannah, was feeling before being diagnosed. She was worse than your Rocket, though. Again, I'm so very sorry that you're having to walk this path and that the doctor couldn't give you a treatment plan and you've been left hanging.

 

[Jabzilla]

Thank you Silent Meowlook and Stephanietx. I finally got to talk to an overnight vet. Rocket still isn’t eating and continues to have a fever. They said the next step for her would be to see an oncologist. Unfortunately there isn’t one near where I live and I don’t have a car. She also confirmed that it’s adenocarcinoma and it has spread to at least one lymph node. I highly suspect it’s in her spleen as well since it’s abnormally shaped.

After lots of tears, the resulting stuffed nose and headache, I’m heavily leaning towards doing an at home euthanasia. The bill is already multiple thousands of dollars and I don’t see Rocket making any kind of significant recovery after having a major survey performed, despite only being 7, and estimated prognosis from the vet I spoke to said maybe one year survival. She also said since it’s metastatic, there’s a high chance of the cancer reoccurring even if it’s all removed with surgery.

I’m planning on picking her up tomorrow and bringing her home to say goodbye over the weekend. That way she can be comfortable and her brother Cosmos can see her too, as he has been clearly upset by her sudden absence.