Finally, a diagnosis ... but not good

[allmykitties]

One of my cats, Domino (approaching 11 this coming spring) had been losing weight and having intermittent diarrhea (sometimes it is normal, but sometimes it's very liquid, sometimes it's just mushy with solid bits ...). His stool exams were normal, his bloodwork was almost all normal (he had high glucose, but only three points above the top of the reference range). But you could tell something just wasn't quite right, because he seemed to be just wasting away. His appetite is normal, he doesn't vomit, and his behavior is the same as it's always been.

But, finally, we got a diagnosis as to what is wrong, and it's gastric lymphoma. I'm taking a little time to take that in, figure out what I can do (chemotherapy prices are just kind of right out, especially this year after my washing machine and furnace both required replacement). He also has a heart murmur that was detected before all of these newer symptoms, but seemed to be in the 'innocent' category, but makes the vet concerned about using steroids.

Previously, he always had an odd reaction when he got both his vaccines at the same time--if they were separated by a week and put in different locations, there'd only be a tiny lump you had to find by searching in the fur vs if he got them at the same time, it'd be a lump that looked like a half a pingpong ball got stuffed under his fur (not that it bothered him, but it kind of bothered us and was easily avoided by splitting his vaccines) and chronic goopy eyes (waxed and waned but never entirely gone). He had been trapped by the rescue that I adopted him from along with Autumn and TV (Autumn probably being the mother of the other two--she had all her adult teeth when they were trapped, but TV & Domino were in a mixed baby/adult teeth stage that put them around 4-5 months--it was believed that because of the remote location that this had been a "dump job"), they were all desperately underweight then, and when he was finally trapped it was found that he had a spiral fracture in one hind leg. I adopted them in 2014.

So now I am caught in this 'what can I do' and 'what should I do'. He is not my oldest cat (that would be Circe, who will be 15 in February, and Autumn is an unknown number of months older than TV & Domino.

 

[silent meowlook]

Hi. I am sorry for the diagnosis. It depends if it’s large cell or small cell lymphoma as small cell lymphoma cats can live for years after diagnosis with proper treatment.

The chemotherapy is usually Chlorambucil which is a pill given every other day. Of course there are different protocols. Prednisolone is also used. Pred is very inexpensive and if you order Chlorambucil from Wedgewood pharmacy it is also very inexpensive. I just paid around $100 for a bottle of 60.

 

[FeebysOwner]

How was the diagnosis made? Any chance this is a viral condition flaring up? It isn't impossible, but out of the ordinary for eating not to be impacted as well as BMs - with either lymphoma or IBD. I trust they also checked Domino for hyperthyroidism.

If this is truly gastric lymphoma (or maybe even IBD), you might ask about Budesonide (as opposed to Prednisolone); as I understand it, this med doesn't pose diabetes issues, nor does it have the same potential effect on the heart, as it primarily is focused on the digestive tract. Worth a question to your vet.

Chlorambucil, as mentioned above, can have varying treatment options - many vets are going to pulse dosing, which entails treatment every other week in many cases. You can call around to pharmacies - nation wide - to find the best prices, but to do so you will have to know the dosage and frequency. In addition to Wedgewood, I have heard Stokes in NJ is reasonable, efficient, and reliable.

 

[lovewilbur]

I have a cat with gastric lymphoma. The chemo and steroids put his cancer into remission. He was doing a lot better after treatment and he was eating more. I've seen some cats (online posts) live for years with lymphoma (if treated). Our cat has other issues that have popped up, unfortunately. The steroids do have risks if used long term. I think they taper down meds if the cats cancer is doing well. The treatment does get expensive. We've had to do a scope, ultrasounds, meds, check ups for meds etc.

 

[allmykitties]

Yes, the first tests we had done were a normal panel, where thyroid was also checked. Everything was pretty much in range, the vet did not think that 3 points above the top for glucose was significant. I'd kind of hoped it would be one of those two things, since they're high in the treatability range, but there was something that just in the back of my head was "this isn't good". We tried B12 injections but that didn't seem to make a lot of difference. So this was a panel that included TK1, and that was the source of diagnosis. He's, at this point, lost 4 pounds since last January (11 pounds then). He has gotten pickier about his wet food, but he does have a huge interest in the dry food.

 

[Furballsmom]

Previously, he always had an odd reaction when he got both his vaccines at the same time

More and more vets are offsetting the schedule of rabies and the other vaccine, so that they aren't given even in the same year. But I'm not clear what you were thinking by mentioning this -- you're thinking he was having serious health issues waiting in the wings all this time?

Can you find high calorie foods for him that are safe for cats?

There might be some helpful ideas here;
Any Good Tips To Get Your Cats To Eat? Share Them Here!

 

[allmykitties]

More and more vets are offsetting the schedule of rabies and the other vaccine, so that they aren't given even in the same year. But I'm not clear what you were thinking by mentioning this -- you're thinking he was having serious health issues waiting in the wings all this time?

I suppose it's kind of a spitballing .. was there a connection? I don't know, haven't asked the vet (this is a new vet, my prior vet retired so he was already on the split vaccine regime when she started caring for my cats). It might not be at all related, but I'm just still kind of trying to think things through. He's been with me since April 2014.

I have been giving him either senior cat formulated foods (actually a little higher calorie than kitten, in wet food) or kitten food with delectables on the top of that, just to try to get his calorie intake boosted. I'm not sure, maybe he is eating less of it than I think, but he's frequently in the dishes where the dry food is.

 

[Furballsmom]

Can you separate him when you're feeding him to see what is actually happening?

Feed more frequent smaller meals, try warming the food, and he might also like freezedried treats.

Wellness core chicken, turkey and chicken liver has 101 kcals per 3 oz can.

You could also add Royal Canin mother and babycat although I haven't done the math to get the kcals for a 3 oz can but if he eats it, that's half the battle.

In other words, try different foods, warmed a little if that helps, and keep looking for other high calorie foods that he might be interested in.

Also, take a look at that link above, there are some great ideas there.

 

[silent meowlook]

Diet is important with cats that have intestinal lymphoma. Usually you want a novel protein but of course they do have to eat.

If it was my cat, I would do Prednisolone and Chlorambucil, and find a novel protein diet he will eat. I would also add probiotics to food and Cerenia on the days he has the Chlorambucil.

I am not familiar with the TK1 is that a blood test?

 

[Meowmee]

i am so sorry about your kitty.

The higher tk1 levels can show cancer or inflammatory conditions. He could have ibd as well. My Wizard had that but had had ibd first for a long time. We never had tk1 tested as I recall.

Feline thymidine kinase 1: molecular characterization and evaluation of its serum form as a diagnostic biomarker - BMC Veterinary Research

Wizard was treated with prednisone and chlorambucil. Unfortunately when he started the treatment for that I think it was too late although it didn’t seem to help him about it first. He had had crf for a year or so before.