experiences regarding possible lymphoma?

[KikiKami]

hello all,

today i took my cat kiki in to get seen for an uptick in vomiting over the last couple weeks. vet did basic bloodwork and an ultrasound, and sent out blood for another test that i forget the name of at this moment. she said it would help see if kiki is not able to absorb any vitamins, or something like that. i can send what its called in a little bit.

overall, given her clinical signs (vomit, slowly decreasing appetite, slowly losing weight), and based on the results of the ultrasound (thickened intestines?), the vet said the most likely culprits are either IBD or lymphoma, her guess is low-grade.

she told me i should consider a biopsy, which would be able to say if its lymphoma or not. there are some things i am considering about this, and i will of course discuss this with her next week, but i just need somewhere to bounce ideas off or at least just get my head on straight.

first, she did say that lymphoma is not curable, and with chemo treatment kiki could get 1-3 more good years before the cancer ultimately wins. the thing here is that the biopsy alone costs around 3500 (i asked for a ballpark), and while i didn't think in the moment to ask how much chemo costs, google ranges from 3000-5000, with a 50-70% remission rate (meaning she gets those 1-3 more years). thats just not feasible for me. thats at LEAST 6500 dollars all at once. i know it is wrong to get a cat without being able to pay vet bills but my god, i wouldnt even be able to pay that much for myself.

due to this experience, i am immediately getting my younger, healthy cat on pet insurance, but that doesn't help kiki. i'm just not sure i can even justify a biopsy if i don't see how id be able to pay for treatment, especially considering it only gives her a limited amount of time. if this was a situation where it would cure her and not be likely to return, it would be different.

is it wrong for me to not do the biopsy and pray that it is "just" ibd? the vet gave me steroids and told me i have to give that to her long term either way. this is manageable. this is easy. i can do that for years, as long as she has left. i just feel sad at the idea that there might be cancer inside of her slowly taking over.

the vet also strongly recommended a novel protein, limited ingredient diet. she gave me a prescription for rayne prescription food, which is very expensive but still manageable. it's not that i can't pay for medical care, it's just that cancer care is so ****ing expensive for such a bad prognosis. she also suggested stella and chewy rabbit raw food or instinct rabbit if the prescription is unfeasible.

the horrible thing about this is that kiki is the worst picky eater ive ever encountered in my life. i showed her the sample bag of rayne today and she acted like it didnt even register as food to her. i really want her on a good diet for her condition but i dont know how i can convince her to eat something she has already decided is bad. i also had been giving her liquid treats like churu and delectables to help her water intake, as she straight up doesn't drink water, so i guess i can't do that anymore. this whole situation is so stressful and i am just sad that i might lose my cat soon. any experiences or advice help.

 

[stephanietx]

How old is your kitty? My cat, who's 13 years old and has a history of gastrointestinal problems, was diagnosed with IBD in December by ultrasound. Honestly, he's probably had it his whole life, but the vets didn't diagnose it because of his age. When the vet did the ultrasound, she didn't see anything that would indicate lymphoma (no enlarged lymph nodes, liver looked great, spleen looked great, pancreas was enlarged, but he had a bout of pancreatitis recently), so she suggested we try food change, meds, and see how he does. If none of that worked, the next step is the biopsy. She noted some thickening of the intestines, but everything else looked good. Did your vet notice anything on the ultrasound that would indicate lymphoma? I personally would try the diet change and meds first and if that works, great! If it doesn't work after a period of time, then maybe consider the biopsy. Depending on her age, treatment may not even be the best option for her.

 

[KikiKami]

How old is your kitty? My cat, who's 13 years old and has a history of gastrointestinal problems, was diagnosed with IBD in December by ultrasound. Honestly, he's probably had it his whole life, but the vets didn't diagnose it because of his age. When the vet did the ultrasound, she didn't see anything that would indicate lymphoma (no enlarged lymph nodes, liver looked great, spleen looked great, pancreas was enlarged, but he had a bout of pancreatitis recently), so she suggested we try food change, meds, and see how he does. If none of that worked, the next step is the biopsy. She noted some thickening of the intestines, but everything else looked good. Did your vet notice anything on the ultrasound that would indicate lymphoma? I personally would try the diet change and meds first and if that works, great! If it doesn't work after a period of time, then maybe consider the biopsy. Depending on her age, treatment may not even be the best option for her.

kiki's age isnt actually known for sure. i got her from the pound, who estimated 4 years. however, they literally got her off the street while she was pregnant, so she could be any age really.

i know her pancreas looked good, her bloodwork was completely normal, but i just didn't think to ask about the other organs....the vet told me that the thickened intestines and her clinical signs indicate one or the other, so it would be best to do the biopsy to either rule it out or start treatment sooner rather than later. once i showed my hesitancy for that, she said she will send me home with steroids to be given long term to help with symptoms, and start the new diet. the medicine is prednisolone. however, she said she would reccomend i continue to consider biopsy. she really made it seem like that was the best option, which is why i have been so worried.

may i ask what diet your cat is on, if he is on one?

 

[stephanietx]

We tried Science Diet z/d, but that just gave him really bad diarrhea, so we put him back on Royal Canin Gastrointestinal and Instinct venison. I would like to switch him off the RC Gastro as I think it might be chicken based and that may be causing his issues, but everything else I've tried gives him really bad diarrhea.

Thickened intestines is the sign for IBD and can be diagnosed through ultrasound. If she didn't see anything else that would indicate lymphoma such as other organs inflamed, any fluid in the cavity, or enlarged lymph nodes, I would not worry about the biopsy at this time.

 

[silent meowlook]

Hi. My cat Cheetah was diagnosed via abdominal ultrasound. I didn’t want to do the biopsy, so we treated using the ultrasound as the diagnosis.

Cheetah eats the Royal Canin PR canned, which is a novel protein prescription diet. It runs about $100.00 for a case of 24 and she gets about a can a day.

She also gets Prednisolone and that is an inexpensive drug. I buy the largest amount I can to keep the cost down. Often you can get it less expensive through Chewy. I think it couldn’t run more than $30.00 a month and that’s a high estimate.

I also give her the chemotherapy drug Chlorambucil. I get it compounded from Wedgewood Pharmacy. She takes one tablet every other day. My last prescription was I think, $50.00 for 30 tablets. So, that’s a 2 month supply.

Other than those, I give an injection of Vitamin B12 once a month. I give 0.5ml., and the entire bottle is 100ml and I think I paid $20.00

I also have Cerenia on hand for nausea. It is expensive, costing about $60.00 for 4 tablets and she takes 1/4 of a tablet as needed for nausea.

With my cat, she needs SQ fluids to keep her hydrated. Buying one bag at a time is about $30.00 a bag, but I buy it in a case of 12, which lasts me a year, for $250.00. But if you ask for a prescription you can get it for about $100 a case. That’s if your cat even needs it and she may not.

I don’t give probiotics because they never seemed to make a difference in my cat.

My cat has been going like this since 2021. So far so good.

I hope this helps.

 

[KikiKami]

We tried Science Diet z/d, but that just gave him really bad diarrhea, so we put him back on Royal Canin Gastrointestinal and Instinct venison. I would like to switch him off the RC Gastro as I think it might be chicken based and that may be causing his issues, but everything else I've tried gives him really bad diarrhea.

Thickened intestines is the sign for IBD and can be diagnosed through ultrasound. If she didn't see anything else that would indicate lymphoma such as other organs inflamed, any fluid in the cavity, or enlarged lymph nodes, I would not worry about the biopsy at this time.

that's interesting.....i will ask the vet when they call next week if she saw anything else that made her think lymphoma. i'm not gonna lie, i was kind of startled so probably wasn't asking the best or most thoughtful questions in the moment. i think seeing how a diet change does might be my best course for now.

 

[KikiKami]

Hi. My cat Cheetah was diagnosed via abdominal ultrasound. I didn’t want to do the biopsy, so we treated using the ultrasound as the diagnosis.

Cheetah eats the Royal Canin PR canned, which is a novel protein prescription diet. It runs about $100.00 for a case of 24 and she gets about a can a day.

She also gets Prednisolone and that is an inexpensive drug. I buy the largest amount I can to keep the cost down. Often you can get it less expensive through Chewy. I think it couldn’t run more than $30.00 a month and that’s a high estimate.

I also give her the chemotherapy drug Chlorambucil. I get it compounded from Wedgewood Pharmacy. She takes one tablet every other day. My last prescription was I think, $50.00 for 30 tablets. So, that’s a 2 month supply.

Other than those, I give an injection of Vitamin B12 once a month. I give 0.5ml., and the entire bottle is 100ml and I think I paid $20.00

I also have Cerenia on hand for nausea. It is expensive, costing about $60.00 for 4 tablets and she takes 1/4 of a tablet as needed for nausea.

With my cat, she needs SQ fluids to keep her hydrated. Buying one bag at a time is about $30.00 a bag, but I buy it in a case of 12, which lasts me a year, for $250.00. But if you ask for a prescription you can get it for about $100 a case. That’s if your cat even needs it and she may not.

I don’t give probiotics because they never seemed to make a difference in my cat.

My cat has been going like this since 2021. So far so good.

I hope this helps.

hi, thanks for the reply. the vet also prescribed kiki prednisolone, she said it would help whether it was ibd or lymphoma. i will continue to give her this long term, assuming she does well on it in the coming weeks.

dis the chlorambucil seem to be the deciding factor in her continuing to do well? if kiki continues to decline, that option (treating without a biopsy) might be something i ask about. it would definitely put chemo treatment into the realm of possible rather than impossible (i can afford either the biopsy or the chemo, but not both...) the shots sound scary, im not sure if i could do that, but if i had to i would of course. i have no issues with providing long term medicine, and while it might be more expensive then surgery in the longer run, it's different because that is payments over the course of months and years, not a huge lump sum all at once, if that makes sense?

the vet recommended i stick to novel protein rabbit diets from now on. this is proving to be impossible, as kiki is abjectly refusing anything made with rabbits, dry, wet, and raw. i had no choice today but to give her chicken flavor today. i don't know if the vet fully understands that kiki would literally rather be hungry than eat something she doesn't like. a lot of people say a cat wont starve themselves, but she's done it before in the past when i tried to outlast her in giving her healthier options for food. i am going to have to discuss other food options with the vet, hoping she will approve royal canin or purina prescription diets as kiki enjoys some versions of those brands, and might be more likely to approve of that now. i am trying to do my own research as well, but the world of cat food is huge and kind of overwhelming when you suddenly can't just buy whatever says "complete and nutritional diet" on the label anymore.

 

[stephanietx]

Alternatives to rabbit food: venison, lamb, or beef. You can try duck or turkey, but since they are also considered fowl, they may not work (but they might!). Try to avoid fish, too.

 

[silent meowlook]

Hi. I would try duck or venison. Royal Canin makes both. It’s called PD or PV.
For small cell intestinal lymph, the treatment of choice is the Chlorambucil/Prednisolone protocol. Large cell lymphoma would be the kind that would use injectable chemotherapy.

 

[silent meowlook]

The thickening of the intestinal mucosal layer is what they would see with intestinal lymphoma. Also some enlarged lymph nodes in the abdomen as well.

 

[Mac and Cats]

I have some experience. Although, I don't know if it will really help you. In 2020 my late cat had suspected large cell lymphoma (the rapidly growing kind). We did not do a biopsy or fine needle aspirate. He had lost quite a bit of weight and he was put on Pred twice a day. I think he probably had IBD his whole life, but I didn't know that frequent vomiting was really a problem until later in his life. He would vomit pretty often and it was mostly undigested food, which we chalked up to him eating too fast. He was on the RC Gastrointestional for the last few years of his life up until his ultrasound. Right around when he was "diagnosed" I would just feed him whatever he would eat, which was mostly Royal Canin Mother and Babycat wet food. Sadly we said goodbye to him 3 months later. He was 17.

A couple years later, we had another cat with symptoms of not eating, who I rushed to the ER and we did an ultrasound and a fine needle aspirate. He had a disease that often gets mistaken for lymphoma prior to biopsy. I can't remember the name, but it was long and has only been recognized since something like 2017. They recommended a $6k surgery and we needed to decide very quickly. We really couldn't even afford the $2k we had already spent diagnosing this. He went down hill very quickly and we ended up saying goodbye to him. He was only 10. I really regret not trying the surgery and beat myself up about it to this day. I wake up in the middle of the night and it's the first thing I think about. But, I can't turn back time.

We now have a 15-ish year old cat with suspected IBD/small cell lymphoma. We did not do a biopsy because he didn't do well under anesthesia at his last dental. So we put him on 5mg of Pred daily for a month and then reduced to 2.5mg daily. He did pretty well on the Pred once a day for about 7-8 months and gained 3 or 4 pounds. His only symptom was not wanting to eat/being very picky about food. He had no vomiting or diarrhea issues except for once or twice right before I took him to urgent care (and a very small amount of both).

I recently took him in for another ultrasound because around 7 or 8 months of being on the Pred, he started becoming extremely picky and refusing food again, which as I said before was his only symptom previously. We also did not do a biopsy or a fine needle aspirate this time either. They recommended adding Chlorambucil and said he was a "good candidate". He has had 3 doses (2mg every other day) of Chlorambucil so far (yesterday was his third dose). I looked into 3 places and Wedgewood was the cheapest (unfortunately, I figured this out after ordering from another place which is much more expensive at $160 for a 2 month supply). Wedgewood came out to be $66.75 ($33.37/month) for a 2 month supply (30 tablets). Obviously, if we proceed, I will be ordering from Wedgewood next time. The plan is to keep him on Pred (5mg) once a day and Chlorambucil (2mg) every other day for 3 weeks. Then we will take him in for a blood test to test his white blood cell count and give him a B12 injection. They will also show me how to give the injection at home during this appointment, which I will then give him monthly. They are also recommending a hydrolyzed diet, but said that could wait for now. I'm very skeptical that he will even eat it as right now he will only eat gravy lovers fancy feast some days and other days I have to put 10 options out to get him to eat anything. I really hate giving him the appetite stimulant because he turns into a tiny monster (a loveable one, but still), but I do give it to him if needed as well as Cerenia.

So far, he's doing ok. He sleeps a lot and did have diarrhea yesterday and I had to give him a partial bath. I suspect the diarrhea is from the Chlorambucil. So, I added Proviable DC probiotic and hope that helps. It's hard to say if the sleeping is from his age, medication or the IBD/SCL or all of the above. I did give him the appetite stimulant yesterday and he ate a bunch, but followed me around and cried at me all day. I think next time I give it to him, I will give him only a half dose. I'm now looking into the prescription hydrolized and the RC PR and also the Rayne nutrition one. I just wish I could get samples locally, but I can only find the Hills option locally.

Did your vet tell you that it's best to do a biopsy prior to starting the pred? Did she say the ultrasound results aligned more with IBD/Small Cell Lymphoma or Large Cell Lymphoma?

I understand how overwhelming all of this is for sure. Especially if it is something you were not expecting and haven't been through before.

If it were me, I would probably opt to do the pred and ask about Chlorambucil. My current guy has eaten 3 cans of gravy lovers fancy feast today and taken a walkabout around the house, but has otherwise slept other than eating and using the bathroom once (it's 2pm). I gave him half a dose of Cerenia today and did not give him an appetite stimulant. Sorry if my answer is way too detailed. I'm just telling you this because I keep having questions of what to expect with my own guy and I can't rely on my past experiences because they were different. The problem is, I haven't found any cases on the internet that are exactly like his situation. So, it's hard for me to find anything that I can relate him to. Plus, every cat is different. So, we are just going day by day. He has started to come snuggle with me at night again, which he hasn't done in awhile. And he was even baking some bread the other day, which I haven't seen him do in months.

Have you started the Pred yet? How is she doing?

 

[KikiKami]

I have some experience. Although, I don't know if it will really help you. In 2020 my late cat had suspected large cell lymphoma (the rapidly growing kind). We did not do a biopsy or fine needle aspirate. He had lost quite a bit of weight and he was put on Pred twice a day. I think he probably had IBD his whole life, but I didn't know that frequent vomiting was really a problem until later in his life. He would vomit pretty often and it was mostly undigested food, which we chalked up to him eating too fast. He was on the RC Gastrointestional for the last few years of his life up until his ultrasound. Right around when he was "diagnosed" I would just feed him whatever he would eat, which was mostly Royal Canin Mother and Babycat wet food. Sadly we said goodbye to him 3 months later. He was 17.

A couple years later, we had another cat with symptoms of not eating, who I rushed to the ER and we did an ultrasound and a fine needle aspirate. He had a disease that often gets mistaken for lymphoma prior to biopsy. I can't remember the name, but it was long and has only been recognized since something like 2017. They recommended a $6k surgery and we needed to decide very quickly. We really couldn't even afford the $2k we had already spent diagnosing this. He went down hill very quickly and we ended up saying goodbye to him. He was only 10. I really regret not trying the surgery and beat myself up about it to this day. I wake up in the middle of the night and it's the first thing I think about. But, I can't turn back time.

We now have a 15-ish year old cat with suspected IBD/small cell lymphoma. We did not do a biopsy because he didn't do well under anesthesia at his last dental. So we put him on 5mg of Pred daily for a month and then reduced to 2.5mg daily. He did pretty well on the Pred once a day for about 7-8 months and gained 3 or 4 pounds. His only symptom was not wanting to eat/being very picky about food. He had no vomiting or diarrhea issues except for once or twice right before I took him to urgent care (and a very small amount of both).

I recently took him in for another ultrasound because around 7 or 8 months of being on the Pred, he started becoming extremely picky and refusing food again, which as I said before was his only symptom previously. We also did not do a biopsy or a fine needle aspirate this time either. They recommended adding Chlorambucil and said he was a "good candidate". He has had 3 doses (2mg every other day) of Chlorambucil so far (yesterday was his third dose). I looked into 3 places and Wedgewood was the cheapest (unfortunately, I figured this out after ordering from another place which is much more expensive at $160 for a 2 month supply). Wedgewood came out to be $66.75 ($33.37/month) for a 2 month supply (30 tablets). Obviously, if we proceed, I will be ordering from Wedgewood next time. The plan is to keep him on Pred (5mg) once a day and Chlorambucil (2mg) every other day for 3 weeks. Then we will take him in for a blood test to test his white blood cell count and give him a B12 injection. They will also show me how to give the injection at home during this appointment, which I will then give him monthly. They are also recommending a hydrolyzed diet, but said that could wait for now. I'm very skeptical that he will even eat it as right now he will only eat gravy lovers fancy feast some days and other days I have to put 10 options out to get him to eat anything. I really hate giving him the appetite stimulant because he turns into a tiny monster (a loveable one, but still), but I do give it to him if needed as well as Cerenia.

So far, he's doing ok. He sleeps a lot and did have diarrhea yesterday and I had to give him a partial bath. I suspect the diarrhea is from the Chlorambucil. So, I added Proviable DC probiotic and hope that helps. It's hard to say if the sleeping is from his age, medication or the IBD/SCL or all of the above. I did give him the appetite stimulant yesterday and he ate a bunch, but followed me around and cried at me all day. I think next time I give it to him, I will give him only a half dose. I'm now looking into the prescription hydrolized and the RC PR and also the Rayne nutrition one. I just wish I could get samples locally, but I can only find the Hills option locally.

Did your vet tell you that it's best to do a biopsy prior to starting the pred? Did she say the ultrasound results aligned more with IBD/Small Cell Lymphoma or Large Cell Lymphoma?

I understand how overwhelming all of this is for sure. Especially if it is something you were not expecting and haven't been through before.

If it were me, I would probably opt to do the pred and ask about Chlorambucil. My current guy has eaten 3 cans of gravy lovers fancy feast today and taken a walkabout around the house, but has otherwise slept other than eating and using the bathroom once (it's 2pm). I gave him half a dose of Cerenia today and did not give him an appetite stimulant. Sorry if my answer is way too detailed. I'm just telling you this because I keep having questions of what to expect with my own guy and I can't rely on my past experiences because they were different. The problem is, I haven't found any cases on the internet that are exactly like his situation. So, it's hard for me to find anything that I can relate him to. Plus, every cat is different. So, we are just going day by day. He has started to come snuggle with me at night again, which he hasn't done in awhile. And he was even baking some bread the other day, which I haven't seen him do in months.

Have you started the Pred yet? How is she doing?

hi all, sorry for disappearing and not responding to comments. last month after kiki started pred, she improved a lot. her eating was much better and she gained a tiny tiny tiny bit of weight back. i stopped coming on here cuz, to be completely honest, i was really hoping that would be the end of it.

since my last post, shes puked maybe 3 times total. once was a hairball, so idk if she puked due to the hairball or the hairball just came out cuz she was already puking.

she takes .5ml of liquid pred every day. it seems to be getting less effective, or shes going through a flare up or something. the last few days have been tough getting her to eat. its hard cuz she is still very playful and happy, she even runs over and seems eager when i am prepping food, but she only eats about half of it, when she deems it acceptable. she is so picky its so hard to even consider the vet reccomended diets. i already know she wont eat them, but i know i shouldnt just disregard vet suggestions.

im dreading this re-occurance of the extremely picky eating. i cant help but feel like shes just going to get worse and worse and im going to regret not having done the biopsy in the first place. the vet had told me the pred will have to stop for like 4 or 6 weeks (i dont fully remember which she said) if i decide to do the biopsy later, and i know that will just backslide kiki further. it just wasnt feasible for me in the moment. i am a student and i just wish this all started happening a year from now, when i will have a hospital job and be paid well. i know this isnt about me, but i also have my very important licensure exam coming up in april and i cant even focus to study because this recent episode of inappetite has me stressed out. i just wish i already knew what she has for sure.

i am thinking i will wait a few more days and see if she gets her appetite back. its happened in the past where she goes through a small period of little appetite then gets it back and eats a lot. if it continues, i will take her in again. im not sure what the vet can do besides tell me to get a biopsy again, but hopefully something.

this situation had me putting my younger cat (only 1 year old, no health issues) on pet insurance. i dont ever want to have cost be what stops me from seeking treatment and diagnoses ever again. this sucks so bad.

my vet also reccomended a novel protein hydrolyzed diet. she gave me a sample and kiki looked at me like i was ****ing stupid. i dont blame her, it looked gross. she hates pate, which a lot of novel diets are. she hates duck, she goes back and forth on rabbit and lamb, and thats all the "novels" ive been able to find. her most reliable flavors are beef, turkey, and chicken. i cut out fish entirely. i known poultry isnt good either but i honestly dont know what else im supposed to do, if she refuses to eat the same flavor two days in a row, or sometimes even two meals in a row. the only kibble she eats (i give kibble because she wont get enough calories with wet food only) is purina pro plan kitten chicken flavor. i let her try the sensitive stomach lamb version, she ate some of it. maybe i can transition her, but im not hopeful.

i guess i will know in the next few months if its cancer. this sounds bleak, but from everything ive read pred buys them like 6 months max then they decline and eventually need to be put down. i wish i could do more for her.

 

[silent meowlook]

Hi. Will your vet prescribe Chlorambucil for her. It is usually taken every other day and pred is given alternate days.I would try that.

The novel protein diets aren’t any good if she won’t eat them.
Feeding any canned food is better than feeding any dry food.

 

[KikiKami]

Hi. Will your vet prescribe Chlorambucil for her. It is usually taken every other day and pred is given alternate days.I would try that.

The novel protein diets aren’t any good if she won’t eat them.
Feeding any canned food is better than feeding any dry food.

probably not without a biopsy, but im definitely going to ask about it.

i do feed canned, but she wont eat enough of it alone to not start losing weight, even when she was at her healthiest. she's just not that excited by wet food, she genuinely likes her dry food. my other cat doesn't eat dry food at all, but i don't want to reduce kikis calories even further by denying her what she prefers

 

[silent meowlook]

It’s more important that she eat than not eat.

 

[di and bob]

I agree, give her what she wants to eat. I have given Prednisolone for over two years with no problems to a cat with agressive mouth cancer and he died from breaking his hip in a jump. You just do what you can......
i have two of my cats on 2.5mg of Pred right now. Both have leukemia and scarred lungs from surviving distemper years ago. The food I get them to eat is at Tractor Supply, Untamed, grain free, and it includes duck, with many other flavors. my cats didn't liek puree either, but they like this one.
Don't ever feel bad about not having the money to fight something that wins in the end. To me it prolongs the suffering and is not a cure. If it was I'd do it in a heartbeat. Just give that little girl the love and attention she wants and take it day by day, it's all you can do and it is enough........