GI Lymphoma in Stomach

[harri804]

Hello,

My 12 yo neutered male was just diagnosed with suspect lymphoma in his stomach. He'd been having problems vomiting lately which ultimately resulted in an ultrasound. He's also had some weight loss but this was originally attributed to his still fairly recent diagnosis of hyperthyroidism. The internist said his stomach is severely thickened and he has several enlarged lymph nodes in his abdomen. She sent off a thymidine kinase test to confirm lymphoma (his lymphocytes, oddly enough, were normal as of a week ago when a massive blood panel was done). I have zero experience with lymphoma and the vet didn't want to get into too many details until the blood test comes back. He was started on prednisone in the meantime. However, the vet was not too optimistic on survival time when I did press her for details. She said chemo could be given in the form of either a pill or IV (both with prednisone) and she knew a couple of cats who survived 18 months but most were 6 months to a year. She estimated he has maybe 3 weeks left without chemo. According to her, his stomach wall will continue to thicken until it prevents food from entering his intestines. I was wondering if anyone has any experience with stomach-based lymphoma? What I've read online is much more optimistic than what she told me, but everything online is about lymphoma in the intestines and not the stomach so now I'm torn. He gets very stressed at the vet so treatment is going to be difficult (quality of life).

 

[klunick]

Never had that issue before. If cost isn't an issue for you, it never hurts to at least try chemo. If he seems to be getting a better quality of life, keep at it. If not, then you will have to think about the alternative. You know your baby best and will make the right decision for him.

 

[harri804]

Never had that issue before. If cost isn't an issue for you, it never hurts to at least try chemo. If he seems to be getting a better quality of life, keep at it. If not, then you will have to think about the alternative. You know your baby best and will make the right decision for him.

I think I'm going to try the pill form of chemo with him as long as he doesn't lose his mind over having to go in for more frequent blood checks. I'm mostly just startled with the difference in reported mean survival times online, from reputable sources, with what my vet told me. So that's why I'm trying to see if anyone else has some experience with GI lymphoma in the stomach. I'm obviously going to talk to the vet more once the lab work comes back, but sometimes it helps to talk to other people who have gone through it....

 

[FeebysOwner]

Hi. I have no experience with this either. But, I did find an article that infers GI lymphoma of the stomach is pretty much the same as that of the intestines. The key is which kind: small cell or lymphocytic, or large cell or lymphoblastic. Small cell, or low grade, forms of the disease are typically considered easier to treat than large cell, or high grade varieties. If it is small cell, the article states that chemo can be very effective - regardless of where it is in the digestive tract. See link to the article below. I have also heard of IBD being in the stomach, not always just in the intestines (another link for IBD below as well).

There are members on this site who have treated their cats with chemo, and most do surprisingly well on it - compared with humans.
Also, you might want to see about in-home visits for the frequent blood checks - I would have to believe that would be less stressful on your cat than going to the vet each and every time.

Gastrointestinal Lymphoma in Cats
https://vcahospitals.com/know-your-pet/inflammatory-bowel-disease-in-cats

 

[TheSpacePope]

You may ask about fluids and nausea medication. Both have been super helpful with my cat's lymphoma. And while he was also given "weeks" to live, he's been hanging on for months now and seems happy to be here. I take him into the vet twice a week for fluids....because he won't allow me to do it at home...and he takes half a nausea pill in his food once a day.

 

[daftcat75]

Don't hesitate to try chemo based on human experiences with it. Cats tolerate chemo much better often having mild if any side effects. I think the TK blood test is useful for ruling lymphoma in. But a negative result doesn't necessarily rule it out.

Ask your vet to discuss the options with you.

1. Pred only. What does "not working" look like and at what point do we consider...
2. Pred + chemo. What are the risks here? (should be fewer than pred only.)
3. Doing nothing. Not a good option.
4. Any other options?

My Krista has GI lymphoma. Or "suspected" anyway. We didn't do the blood test or the biopsy. But since pred alone wasn't working, I went over my vet's head to her boss because she didn't want to prescribe chemo without a cancer diagnosis. The owner and founder of the practice discussed the options above with me, and in our case, a further option of a biopsy which we both agreed she wasn't a good candidate for considering her weight loss and inability to put any lost weight back on. Ultimately, we agreed that the cancer diagnosis (the biopsy) was riskier than the chemo drug. Within one or two doses, her liquid stools she had for months cleared right up. She still hasn't regained weight. But that's my fault. I kept wrapping her nightly pred pill in fish flakes to get her to take it. Turns out the fish flakes were an inflammatory trigger. I had to discontinue that and switch her to transdermal pred for another reason (different thread.) But when I switched out the fish flakes, her poop nonsense (inflammation-mediated constipation) cleared right up. I have to call my vet up. But I think we're about ready to taper the steroids to a lower dose and keep the chemo which has fewer long-term side effects than steroids.

As for medicating your cat, you have options if you get the medicine compounded. For Krista, I give her a prednisilone "wet willy" transdermal in the ear each night. For the chemo, she gets that as a super-concentrated anchovy-flavored liquid. I mix it in a small amount of food and just enough salmon oil get her to clean that mini-medicine meal. We started at twice a week. But we've been able to switch to a larger dose once every two weeks now as maintenance.

The compounding pharmacy I use:
Veterinary Pharmacy

I don't know when or how this will ultimately end for Krista. But for now, she seems to be enjoying a remission. We'll enjoy that together for as long as it lasts.

 

[fionasmom]

Chelsea has intestinal lymphoma and was on pred only when daftcat75 encouraged me to ask the vet for leukeran/chlorambucil without doing any of the invasive testing. So far, so good .She is a former feral who is very hard to handle despite having been inside for 10 years, in fact, almost unsafe to handle but we have been getting through this and I am glad that I gave it a try.

 

[cataholic07]

If its cancer you do have to do both chemo/pred. Finding out what grade it is would be a good idea as well. My first cat had GI lymphoma in her intestines, it was small cell but had the potential of turning into large cell. We chose to do treatment, it was daily chemo/pred at a low dose which isnt the norm.. but she went into remission in two weeks. We had 7 months with her before we had to euthanize her as her cancer not only returned but was in both lungs. If we had opted to do no treatment we would have had had maybe a few weeks with her maybe a month if we pushed it and did hardcore palliative care. She had 4 months or so where she seemed perfectly happy so I don't regret giving her the treatment... even though by the end she even feared me because she did not like her meds. I think I would have preferred the more normal route of every few weeks going once for chemo treatment at a vet. We did do monthly vet check up with an at home vet for her b12 shot, continued daily medication including chemo but super low dosage and to weigh her to make sure her weight wasn't going down. Its why we were shocked she was so sick at the end, in a span of 2 weeks she went downhill extremely quickly. But some cats who have had small cell lymphoma can live many years, it was just unfortunate that my cats cancer turned high grade at the end

 

[harri804]

Thanks all for the replies. He's slowly going downhill despite the steroids - much more restless, not sleeping as much, shallow breathing, bloated rib cage, and lots of diarrhea (new). He's still bright and alert, though, especially if he thinks he's getting fed. He has to eat 8+ times a day because he starts vomiting if he goes more than 2-3 hours without food. I'm mixing water in his canned food to help with hydration. Unfortunately the specialist is out of the office until Tuesday so any talks of chemo have to wait until then - they were supposed to call me by the end of this week with results and I hadn't heard anything. The specialty clinic won't do anything (and I mean anything) until the specialist is back. My regular vet feels the same way. May not be taking any other current or future cats to either facility in the future. I'm thinking chemo will be a moot point at this rate I feel like other than a visit to an emergency vet for...I don't even know what they would be willing to do apart from pain meds. He's not dehydrated, yet. No vet I've talked to is willing to adjust his pred dosage without consent from the specialist. This is just utterly frustrating - I'm NOT someone who is willing to wait for their cat to be vocalizing in pain or constantly dry heaving before deciding they're in enough discomfort. The fact he can't even get comfy enough to sleep for several hours is upsetting enough. So I feel like I'm coming up on a euthanasia decision before even getting to really discuss treatment.

 

[FeebysOwner]

He's still bright and alert, though, especially if he thinks he's getting fed.

I am so sorry, but the above comment that you made would be my guide - if I were you. Feed him when he needs to be fed/when he wants to be fed, and deal with the diarrhea. Alert and eating are two very good things. If he was in that much pain, he wouldn't be eating at all. Give his stomach food, even if it means nothing in the end - just to get him through until Tuesday. (And, then yes, after this ordeal is over, get another vet - another day, another time).

 

[daftcat75]

The "can't even get comfy enough to sleep for several hours" is likely a side effect of the steroids. And the diarrhea is probably the lymphoma. It could clear up quickly with chemo.

If he still wants to eat, feed him. That's one less thing to worry about until Tuesday.

 

[cataholic07]

If you are really worried bring him to the emergency vet. In fact, if breathing is an issue I'd say do it for sure and get an xray done. If there is alot of fluid around the lungs they will have to drain it.

 

[rootb33r]

My kitty was diagnosed with lymphoma earlier this year. Chemo + Steroids gave me another 3 months with her which I don't regret. It slowed the cancer but unfortunately did not stop or reverse it.

I miss her every day, but I don't regret that we did chemo. For a while she actually got quite a bit better and was back to her sassy self and that alone was worth it. It also made me realize just how badly she had likely been feeling before, and when the chemo stopped working it made it a little easier to put her to sleep because the difference was night and day.

I'm so very sorry your kitty has lymphoma.

In case it helps, the chemo we went with that seemed the best option was called the 'CHOP' prototocol. It's 3 types of chemo drugs + prednisolone and is supposed to be most effective against large-cell lymphoma.