My Cat Charlie - Pancreatitis? Lost alot of weight and Little appetite

  • Thread Starter Thread Starter
  • #102

miguel99nyc

TCS Member
Thread starter
Adult Cat
Joined
Sep 19, 2016
Messages
296
Reaction score
125
Hello everyone,

So it seems that the teeth grinding issue as what Im being told on this other site, its a result of being nausous - which makes in a way sense and probably the reason why Charlie wouldn't go near the other foods he used to like so much. So, by either giving Zofran or Cerenia would clear that part up temporarily as to his teeth grinding and possibly resume eating his other foods.

But as far as his ultrasound report, they are thinking its most likely Large Cell lymphoma...but they are also suggesting either to do a specific ultrasound redone for that mass area - because it didnt specify the thickness of the intestine nor location which was strange, but otherwise they too recommend doing the surgical biopsy. They said that a new ultrasound would just delay it only to confirm what type of biopsy should be done whether endoscopy or surgical. They are saying based of Charlies bloodwork he should be fine during anasthesia and that the surgery should go well. Only thing is that since he is on prednisolone, he should be off of it for at least a week or two prior to the procedure.

My only thing is that aside from lets say if that surgery goes well, and if its large cell lymphoma, I'm not really going to probably pursue it any further because that may be more impossible to come back from or go into remission. and somehow, if I elect to NOT go through biopsy, I shouldnt be tapering off the prednisolone and if anything, remain on the same dosage at at least 5mg daily..

Again just totally scared of going through such biopsy, wish there was another way around it but doesn't seem like it. At the same time, seems now im getting like somewhat totally different answers here as to, what dosage to give him for pred if I keep him on that and to the point of actually suggesting to go through with the surgical biopsy.
 

daftcat75

TCS Member
Top Cat
Joined
Sep 7, 2018
Messages
7,124
Reaction score
12,436
Always clear the steroids dose and schedule with a vet. Do not just take the word of an internet stranger or Dr. Google.

Next time you talk to vet, ask about Cerenia or Zofran. The nausea isn’t going to clear up until you treat the underlying condition. Which is still TBD without the biopsy. You’ll need to work out the mirtazapine dose and whether Cerenia or Zofran is more effective for restoring his appetite. If you work this out, you may be able to taper him off the steroids if he doesn’t seem to need them. With vet’s guidance! Tapering him off the steroids is the first step if you wanted to seek the biopsy.

If you suspect it is cancer and one you cannot or don’t intend to treat, then I would discuss with 2nd vet or specialist about stabilizing his eating and monitoring his weight. Buy a baby scale from Amazon for $60 and weigh him once a week.
 
  • Thread Starter Thread Starter
  • #104

miguel99nyc

TCS Member
Thread starter
Adult Cat
Joined
Sep 19, 2016
Messages
296
Reaction score
125
I actually contacted my primary vet earlier today about the surgical biopsy - he mentioned to me the possible complications but has said it is very unlikely that any of it would occur. Let alone, based of his last blood test, all his organs were normal he said. He explained how the IV fluids have dextrose/sugar to give him energy so he said Charlie would be fine without eating for 2-3 days.

The thing that got to me today though was that I was watching Youtube videos of actual surgical biopsies, DAMN that looks intense. Whether or not it was to find cancer/lymphoma or something else but the way they go inside the organs and open up the cat is absurd. LIterally cut open in half and the cut islike the size of an adult hand! Don't think with that many stitches I may go through with such procedure...its not even about the money now, that surgery looks insane. Even I saw the Organs themselves some got stitched. I cant even imagine the pain Charlie would be in after.

Another thing is my vet DID NOT answer my question if I went with him to do the biopsy, how long to be off prednisolone. He didnt respond at all. either he missed it or...who knows. But I know he has to be off it at least a week prior to procedure per 2nd vet. He did say grinding of his teeth may mean dental cavity/issues but would need dental xrays apparently (Which i thought he did take that..).

The way Im thinking about this is if i have Charlie on prednisolone weakest dosage per 2nd vet, and then say in few weeks he doesnt get any worse, I wonder then and only then I may consider either re-utlrasound or just biopsy then because he should technically be getting worse if it was large cell lymphoma (as some think it may be based off that other lympoma site). let alone, mass isnt usually involved with SCL or IBD. It could mean possibly his mass is something else.

I will ask the primary vet if I should go that route - hold off on biopsy see if he gets any worse and in mean time have him on pred and/or if not needed, taper it off and just give him mirtazpine and cerenia. Question though, is cerenia safe enough to be given every day? And if he survives on that, just cerenia and mirtazpine, then that might give clue that prednisolone isnt really needed since it didnt help that much out. Thats when id reconsider maybe doing new blood, and ultarsound. Thats what 2nd vet told me, in all likelyhood the internal medicine may ask for their own bloodwork and ultrasound to see what they are dealing with and prehaps suggest a route for medications.

THe only positive thing i see of charlie is that he still eats, but otherwise just sleeps most of the day without hiding...but physically he doesnt seem to be getting any worse as of yet.
 

Rowen

TCS Member
Young Cat
Joined
Aug 22, 2020
Messages
79
Reaction score
130
Location
Rogers Park Chicago
I actually contacted my primary vet earlier today about the surgical biopsy - he mentioned to me the possible complications but has said it is very unlikely that any of it would occur. Let alone, based of his last blood test, all his organs were normal he said. He explained how the IV fluids have dextrose/sugar to give him energy so he said Charlie would be fine without eating for 2-3 days.

The thing that got to me today though was that I was watching Youtube videos of actual surgical biopsies, DAMN that looks intense. Whether or not it was to find cancer/lymphoma or something else but the way they go inside the organs and open up the cat is absurd. LIterally cut open in half and the cut islike the size of an adult hand! Don't think with that many stitches I may go through with such procedure...its not even about the money now, that surgery looks insane. Even I saw the Organs themselves some got stitched. I cant even imagine the pain Charlie would be in after.

Another thing is my vet DID NOT answer my question if I went with him to do the biopsy, how long to be off prednisolone. He didnt respond at all. either he missed it or...who knows. But I know he has to be off it at least a week prior to procedure per 2nd vet. He did say grinding of his teeth may mean dental cavity/issues but would need dental xrays apparently (Which i thought he did take that..).

The way Im thinking about this is if i have Charlie on prednisolone weakest dosage per 2nd vet, and then say in few weeks he doesnt get any worse, I wonder then and only then I may consider either re-utlrasound or just biopsy then because he should technically be getting worse if it was large cell lymphoma (as some think it may be based off that other lympoma site). let alone, mass isnt usually involved with SCL or IBD. It could mean possibly his mass is something else.

I will ask the primary vet if I should go that route - hold off on biopsy see if he gets any worse and in mean time have him on pred and/or if not needed, taper it off and just give him mirtazpine and cerenia. Question though, is cerenia safe enough to be given every day? And if he survives on that, just cerenia and mirtazpine, then that might give clue that prednisolone isnt really needed since it didnt help that much out. Thats when id reconsider maybe doing new blood, and ultarsound. Thats what 2nd vet told me, in all likelyhood the internal medicine may ask for their own bloodwork and ultrasound to see what they are dealing with and prehaps suggest a route for medications.

THe only positive thing i see of charlie is that he still eats, but otherwise just sleeps most of the day without hiding...but physically he doesnt seem to be getting any worse as of yet.
I would make sure he doesn't have problems with teeth first because that infection can lead to other things and weaken his system. My cat was eating but ended up having to have 4 teeth removed that were decaying.
 

daftcat75

TCS Member
Top Cat
Joined
Sep 7, 2018
Messages
7,124
Reaction score
12,436
I second that. And teeth can change in an instant. Your cat won’t cry out if he breaks a tooth. So even if he’s had a dental recently, I recommend getting him new mouth xrays.
 
  • Thread Starter Thread Starter
  • #107

miguel99nyc

TCS Member
Thread starter
Adult Cat
Joined
Sep 19, 2016
Messages
296
Reaction score
125
I second that. And teeth can change in an instant. Your cat won’t cry out if he breaks a tooth. So even if he’s had a dental recently, I recommend getting him new mouth xrays.
Thats probably one thing I didnt say...

He's had broken teeth or a broken tooth( I think) + dental disease for..long time now, since maybe ayear ago or so, but despite my vet saying (it isnt important for now - not the reason he isnt eating) last year during his pancreatitis bout, and now, perhaps it got worse as well and hes in pain. But that mouth pain won't really explain his weight loss or mass inside bowel...

Our 2nd vet did also say he has dental disease but it wasn't the main cause for hi appetite. My primary vet did say grinding teeth can be cavity/dental issue so he said he can take dental xrays aswell if he came for the procedure biopsy. The only thing is...his dental costs was estimated to be $1,500 last year as he needed a tooth extraction...and insurance won't cover it because I dont have it as an option. I could wait for it to ADD the insurance so its covered BUT, then every prexisting condition prior to this renewal of insurance would NOT be covered so this cancer/mass treatment going forward would not be covered as it would be deemed prexisting. So its a complicated...but I definitely think his teeth is having some issue as well, especially since he doesnt want to chew dry food.

Im on my way to get Cerenia and 1mg Mirtazapine to help him out as he had thrown up this morning - primarily liquid with like a brownish color tint it, but was alot of water. Of course he didnt want to eat maybe an hour after...but about 2-3 hours after he resumed eating again. Im assuming also this Cerenia is something that works...same day I guess rather then him needing to take say 3-5days worth of Cerenia before his nauseous wears off?
 
Last edited:

Rowen

TCS Member
Young Cat
Joined
Aug 22, 2020
Messages
79
Reaction score
130
Location
Rogers Park Chicago
Thats probably one thing I didnt say...

He's had broken teeth or a broken tooth( I think) + dental disease for..long time now, since maybe ayear ago or so, but despite my vet saying (it isnt important for now - not the reason he isnt eating) last year during his pancreatitis bout, and now, perhaps it got worse as well and hes in pain. But that mouth pain won't really explain his weight loss or mass inside bowel...

Our 2nd vet did also say he has dental disease but it wasn't the main cause for hi appetite. My primary vet did say grinding teeth can be cavity/dental issue so he said he can take dental xrays aswell if he came for the procedure biopsy. The only thing is...his dental costs was estimated to be $1,500 last year as he needed a tooth extraction...and insurance won't cover it because I dont have it as an option. I could wait for it to ADD the insurance so its covered BUT, then every prexisting condition prior to this renewal of insurance would NOT be covered so this cancer/mass treatment going forward would not be covered as it would be deemed prexisting. So its a complicated...but I definitely think his teeth is having some issue as well, especially since he doesnt want to chew dry food.

Im on my way to get Cerenia and 1mg Mirtazapine to help him out as he had thrown up this morning - primarily liquid with like a brownish color tint it, but was alot of water. Of course he didnt want to eat maybe an hour after...but about 2-3 hours after he resumed eating again. Im assuming also this Cerenia is something that works...same day I guess rather then him needing to take say 3-5days worth of Cerenia before his nauseous wears off?
[/QUOTE
I was lucky enough to have a vet that I would email with questions and she would respond when Gems issues started- something I really would recommend since now we can't go into the office, something I wish I would have done in the end. ( I had changed vets to one closer) I have a thread - from my first vet and then invoices from my second- so heres what happened-
Sept 24 2018- found dental disease during visit-blood work good- Gem was at 9lbs. Made appointment for Nov 20 extractions.
Nov 6th 2018 Throwing up dry food( Science Diet) Eating wet and drinking water no problem. Nov 7th okay with dry but asked about diet change- vet didnt think it was needed...as long as she wasnt vomiting. I mentioned that maybe it was teeth related vet said its possible-Gem was still eating-
Nov 20 2018 Gems weight is at 8 1/2 lbs-4 teeth pulled ( she was in stage 3 periodontal disease)the vet gave her Convienia which I later found out stays in their system for up to 2 mos and can cause appetite loss- I can't say no to this enough-Vet seemed to think giving her dry food was ok I didnt agree.
Dec 12 2018- Gem not eating enough shaking head occasionally very concerned.
March 3 2019- took Gem to emergency vet because she had bloody stool- and diarrhea for one of the first times in her life-she had lost a pound. She wasnt vomiting and was eating only wet food, pretty sure she was on Wellness turkey pate. Her pancreatitus snap test was abnormal, low white blood cell count, ropey intestines,muscle wasting, slight heart murmer(in normal range) thyroid, liver and kidneys fine- and remained fine throughout the whole time she was sick. Given probiotics and something for potential parasites-suggested abdominal ultrasound.
March 11 2019 - new stool sample no parasites-
March 12 2019- new vet- weight loss concerns-although she was eating. Gem was at 6.4 lbs-has her blood work redone as requested by emergency vet because sometimes there are false readings- within normal range.
June 17, 2019- Gems weight- 6.4- Edd Senior blood panel- exam
Oct 28, 2019- Gems weight 6.1- Edd Senior blood panel- exam
Feb 3, 2020- Gems weight 6.4 regular exam
April 11, 2020 Gems weight- 5 lbs- Edd Senior blood panel exam- mirtazapine- only used a couple of times because she started eating- was given a hypoallergetic dry food which Gem didnt eat- but she would not eat her wet food anymore- so I got her Royal Canin for digestive issues which she did eat. I didnt like but I was between a rock and hard place because she had to eat something.
June 26 2020= Gems weight 5 lbs- back to original vet because everything was booked at new- 3rd eye showing- . Given b12 shot
check up.
Got her back on wet food- but will only eat Tiki Cat Ahi Tuna- eating up to 9 oz'es a day.
July 20the 2020- Gems weight up to 6lbs- eyes are running and she had stumbled after jumping out of litter box- and seemed to be falling sideways while she walked so had her eyes checked- heart murmer a little louder- kidney values thyroid ok-vet said the eyes running could be a herpes virus flair up which all cats can get. Now I wonder why I had tests done again, and know that the falling over could have been heart related.
Aug 5th 2020- Gems weight 6 lbs- took her in because her breathing was labored- thought because of the previous possible herpes virus diagnosis it was a respiratory infection. She had eaten through the night - had been with us on the couch the night before- I had just gotten her a new bed the day before that she had jumped up on- the morning I was to take her in I thought I we'd be coming home with antibiotics.I'm in Chicago and we are still standing outside- so gave her to the tech and was then told by the vet after exam that she had fluid all around her lungs and that she could die during procedure.That it would be recurring. So I had to decide to euthanize her. She died from the sedative they gave her to calm her down. Of course the worse day of my life.
In the end it was gi lymphoma - this is what the new vet had said. That the cancer makes the heart weak and it can no longer pump. My original vet who I stopped using because she gave no dietary input- said that she had biopsied a cat who had no other symptoms but weight loss and it was gi lymphoma. She also suspected heart disease. I liked both the vets but they came up short in terms of really giving any information throughout- and never talked about the impact of diet- and Science Diet- which is what they all seem to offer and is crap.
Gem was still playful up until the last month-still with us as usual- never had any other symptoms aside from weight loss no matter how much she ate- except for the first few months when it all started- and thats why I kept thinking she'd get better.
For Gem-I really think it all started with her teeth-infection-no matter what else you're treating if they aren't dealt with they cause disease-and make any disease you're going to treat more difficult because of- so they have to be taken just as seriously. I think the damage was done- from the way things went. I wish I had known about this forum during this, thats why I'm giving you this info. I hope it gives you some insight. And if your vet is not offering information thats helping you I would try another- if theres one that only deals with cats thats what I would try-
 
  • Thread Starter Thread Starter
  • #109

miguel99nyc

TCS Member
Thread starter
Adult Cat
Joined
Sep 19, 2016
Messages
296
Reaction score
125
Thank you so much for that, I hear you on that, about clearing up the dental part. I did hear how it can lead to other diseases too. I'm just more concerned now about the mass if anything, so still considering doing the biopsy but seeing that Youtube video of an example, how they play around with the organs was rather disgusting. Granted, I don't believe they will do same by like taking out all the intestines to find that mass (hope not) and then re-insert the organ and stitch the organ up from where the sample is taken off...Its a very disgusting video to see - Id throw up knowing they did that to my cat...

I do feel somewhat safe considering on the estimate - they wrote - he'd have Fluid Therapy for 3 days, Therapy Analgesic, Therapy Antibiotic, then gets sent home with an Elizabethan collar and clavamox drops 15ml. So in a way with all those treatments, it kind of feels the vet would approach this with alot of care/attention and approach it safely with these therapies provided in clinic.

I just gave my cat Cerenia because he sat for a moment like half hurled up and half sitting up and just staring endlessly in one direction - we thought he was about to throw up again. But he just shook it off I gues, walked around and wanted food. But I placed into his mouth the Cerenia and now he is resting. The question I forgot ot ask is while he is on Prednisolone, can be he be on both or does one interact with the other? I also got the 1mg mirtazapine but will await to see how he feels first.
 

daftcat75

TCS Member
Top Cat
Joined
Sep 7, 2018
Messages
7,124
Reaction score
12,436
Thank you so much for that, I hear you on that, about clearing up the dental part. I did hear how it can lead to other diseases too. I'm just more concerned now about the mass if anything, so still considering doing the biopsy but seeing that Youtube video of an example, how they play around with the organs was rather disgusting. Granted, I don't believe they will do same by like taking out all the intestines to find that mass (hope not) and then re-insert the organ and stitch the organ up from where the sample is taken off...Its a very disgusting video to see - Id throw up knowing they did that to my cat...

I do feel somewhat safe considering on the estimate - they wrote - he'd have Fluid Therapy for 3 days, Therapy Analgesic, Therapy Antibiotic, then gets sent home with an Elizabethan collar and clavamox drops 15ml. So in a way with all those treatments, it kind of feels the vet would approach this with alot of care/attention and approach it safely with these therapies provided in clinic.

I just gave my cat Cerenia because he sat for a moment like half hurled up and half sitting up and just staring endlessly in one direction - we thought he was about to throw up again. But he just shook it off I gues, walked around and wanted food. But I placed into his mouth the Cerenia and now he is resting. The question I forgot ot ask is while he is on Prednisolone, can be he be on both or does one interact with the other? I also got the 1mg mirtazapine but will await to see how he feels first.
My thoughts on this (and these are only the thoughts of an internet stranger who had a cat with a different cancer):

1. You can't do anything about the mass until you've finished the pred course. I would finish the pred course as originally prescribed except instead of the 2.5 every other day until you run out, ask what the off-ramp looks like. Probably 2.5 every other day for a week and then you can stop. But I never got Krista off steroids so I don't know this one. You clear this with a vet before you try to take him off the steroids.

2. While you're waiting out the steroids course, buy a baby scale and weigh him once a week. Don't weigh him any more frequently.

3. Make a plan for the teeth. If those become infected, that can become a bigger problem than the mass.

4. If you finish the pred and he hasn't lost any weight, that mass is probably not cancer. You can still monitor his weight for how many more weeks he needs to be off pred before they could do the biopsy. If after the pred and the wash out period, his weight is still stable, it's even more likely it's not cancer. You could still opt for biopsy to figure out what it might be. But it might be better to shift focus to the teeth.

5. If you continue to have trouble with his eating after mirtazapine and cerenia, there may be a pain component involved. You can ask about a short course of buprenorphine to test that theory out. If he eats with the bupe, you can deduce that he has pain. But you don't know if that's his teeth or the mass. But bupe can also suppress appetite. So if he doesn't eat on the bupe, you can't rule out pain.

6. The teeth will need to be addressed regardless of the nature of the mass. Plan for this as soon as it can be done.

And yes, you can administer mirtazapine, cerenia, and prednisilone all at once. But don't add CBD to this. If you were ever considering CBD, wait until he's off the steroids. There is an interaction there where the CBD can make the steroids slower to clear the liver.
 
Last edited:

Rowen

TCS Member
Young Cat
Joined
Aug 22, 2020
Messages
79
Reaction score
130
Location
Rogers Park Chicago
Thank you so much for that, I hear you on that, about clearing up the dental part. I did hear how it can lead to other diseases too. I'm just more concerned now about the mass if anything, so still considering doing the biopsy but seeing that Youtube video of an example, how they play around with the organs was rather disgusting. Granted, I don't believe they will do same by like taking out all the intestines to find that mass (hope not) and then re-insert the organ and stitch the organ up from where the sample is taken off...Its a very disgusting video to see - Id throw up knowing they did that to my cat...

I do feel somewhat safe considering on the estimate - they wrote - he'd have Fluid Therapy for 3 days, Therapy Analgesic, Therapy Antibiotic, then gets sent home with an Elizabethan collar and clavamox drops 15ml. So in a way with all those treatments, it kind of feels the vet would approach this with alot of care/attention and approach it safely with these therapies provided in clinic.

I just gave my cat Cerenia because he sat for a moment like half hurled up and half sitting up and just staring endlessly in one direction - we thought he was about to throw up again. But he just shook it off I gues, walked around and wanted food. But I placed into his mouth the Cerenia and now he is resting. The question I forgot ot ask is while he is on Prednisolone, can be he be on both or does one interact with the other? I also got the 1mg mirtazapine but will await to see how he feels first.
I know you have alot going on at once- and it is really important that he be able to eat and maintain weight while you decide.
 

daftcat75

TCS Member
Top Cat
Joined
Sep 7, 2018
Messages
7,124
Reaction score
12,436
If you're not already, I recommend starting a food journal for Charlie to track how much he's eating, what meds he's taking, how he's acting, and when he has episodes: throwing up, abnormal poop, not eating, crouching. Whatever is abnormal, track it!

I used a Google Sheet for this and explain it in this thread. You can use whatever works best for you including a plain old paper journal as long as you keep up with it.

Pet food/exercise tracking app?
 
  • Thread Starter Thread Starter
  • #113

miguel99nyc

TCS Member
Thread starter
Adult Cat
Joined
Sep 19, 2016
Messages
296
Reaction score
125
Yes definitely will. And seems like very good information there. I know you may not be an expert but any thoughtful such as that definitely helps! I too was thinking along those lines - the "hopeful" thinking. In that if he manages to still eat near normal amount AND maintain weight after at least pred regimen tapered off, then it could probably 50/50 rule out cancer, then even further as you said, without no pred and still manages to eat, maintain his weight still as well and probably resort to his mouth issue...though I'm sure him throwing up this morning was not related to his teeth but hoping at least Cerenia will help combat that for now. He hasn't thrown up food yet so I guess thats a good thing, only seems to be the water or maybe even acid? that he throws up. A week ago or so ago was hairball, and today was just water/liquid.

I'd say today so far he has eaten less unfortunately...but could just be a minor bump off day. I had given him Cerenia about 5 hours ago...thought he was going to eat alot for dinner but he didnt. Hope tomorrow turns him around - or it may explain he isn't really nauseous and maybe Cerenia may make him feel worse.
 

daftcat75

TCS Member
Top Cat
Joined
Sep 7, 2018
Messages
7,124
Reaction score
12,436
As long as he’s still eating something, I would give the Cerenia a chance over several doses or several days. But, in some cats, Cerenia depresses appetite. Zofran is an option there.

You can try to feed him smaller meals more often. If you’ve been feeding him twice a day, try adding a second breakfast and a second dinner. As cats get older, it’s harder for them to do two meals a day. Cats would normally hunt up to 10 times a day in the wild.
 
  • Thread Starter Thread Starter
  • #115

miguel99nyc

TCS Member
Thread starter
Adult Cat
Joined
Sep 19, 2016
Messages
296
Reaction score
125
Oh believe me, with Charlie in the past few weeks, he has been eating multiple times - smaller amounts throughout the day. He used to eat primarily morning one meal, then afternoon some dry food once, then dinner one meal. He was known to go back to his canned food on the floor left out after dinner or breakfast to eat up the rest or most of it. That is why I was never concerned in the past say month ago or so if he ate a little bit at first because he'd always go back on his own to eat again. But that week prior to sept 8th, it would progressively get worse, just ate veyr little or nothing then went to hiding or sleep like all day with no movement.

Just this morning I tried giving him a canned food that he wasn't too much of a fan of...he took literally two big bites but that was it and walked away. I was also wondering because Charlie slept last night more than the other days (its around the time I give him his Pred), i did not give it to him because we were outside as well so we said we wait until tonight to give rather early in morning to make it up. Now I was thinking maybe because he didnt have his pred last night (though I just gave it to him short while ago), that side effect of appetite increase from the pred was lacking from no pred last night. No, I am not freestyling it either he was just simply sleeping and I did not want to disturb his sleep, he seemed he was joyfully sleeping as his paws were up in the air and he was stretched out. So with tonight I'm going to keep up with it no matter what. Surely tomorrow he will be eating again bit more because of it possibly...but then to keep up with that appetite then woudl be mean he'd have to rely on it. There is the 1mg mirtazapine I may add in tomorrow as last resort if both todays Cerenia and tonights prednisolone doesn't really help for tomorrow see if thats boosts him up.

Another thing aside from chewing of food and grinding noise at times was that I don't know if its common with other cats...but since he eats now mostly his Pate, as he is chewing too, he tends to be like spitting out little chunks either back onto his plate or outside his plate. Well not spit out but its just the reflex he makes as he chews with his mouth open, some of that food comes out. I wish I could upload a video but it doesn't, just pictures it seems.
 
  • Thread Starter Thread Starter
  • #116

miguel99nyc

TCS Member
Thread starter
Adult Cat
Joined
Sep 19, 2016
Messages
296
Reaction score
125
Hello,

Just as an update - hoping to get some more insight tomorrow as I finally was able to make an appointment to a oncologist. Not really sure how that came about as I started off the conversation with the hospital to confirm that only way to see an oncologist or specialist was just through referrral - they said yes. However my story was that my current primary vet wouldn't give me that referral unless I did the biopsy. The guy on phone from hospital thought it was nuts that he couldn't get me the referral. So he helped me out and instead they contacted the vet directly and got all his results from testing previously done + all his medical records since the beginning.

Now hoping with that,plus the hospital mentioned the oncologist based off what he sees may request another blood or Ultrasound - the ultrasound possibly guiding in some better way since the past ultrasound performed wasn't too specific.

I had also thought of something as well. In all likelyhood I would proceed with the biopsy - I thought to myself, the mass itself - wondered if that would be something that goes away with medication or would need surgical removal? And if surgical removal is the only option - then it would mean he'd be opened up twice?? That thought would make me sick honestly because thats just too much. So I asked my primary vet if the mass would be removable? He said - If upon sampling the biopsy - the mass is deemed removable, then he could suggest it at that time (I guess he would call me?) but he mentioned it would involve intestinal anastamosis which he described as joining to ends of the good part of intestine together which is a very complicated procedure. That itself made me worried. Let alone - price wise he said would at least DOUBLE the current estimate for the biopsy. So what - we looking at $5k approx if not more for this...

But again Im hoping the oncologist will offer somewhat better info/thoughts instead this intense surgical route.

Another thing that kinda shook me bit is that when I made the ultrasound appointment with my primary vet weeks ago - I was kinda getting nervous and desparate and wanted it sooner but the "technician" only came to his office on thursdays. So back then I had to wait nearly a week to get the ultrasound. He said otherwise, i could go to one of these hospitals he recommends but warned me their costs for the ultrasound would be literally through the roof. When I asked the assistant of the hospital over the weekend - he told me the costs for ultrasound would be just around $400-$600... I paid $510 at my primary care office. So that means it was just all B.S what my primary vet said about his pricing compared to hospitals - that itself making me reconsider where/if I do this biopsy because perhaps it will be cheaper at a hospital with an actual surgeon? Then again as my family has said, any surgical procedures my cats when through was through that primary vet - albeit those were performed nearly 10 or so years ago as most recent...our vet is far older now. But then again this hospital Im going to overall hasn't the best reviews...but it was the only one that seemed accommodating and at least somewhat insightful over the phone.

Charlie has been doing alright - eating at times good one day and another day less been back and forth of late. have him on the 2.5mg pred after a week of 5mg, and as of today he would be on the 2.5mg every other day until he finishes...but I wonder if the 5mg was making him eat more. He definitely doesn't look worse but also not better either still unfortunately. His overall attitude is still somehwat the same as ever before.
 

daftcat75

TCS Member
Top Cat
Joined
Sep 7, 2018
Messages
7,124
Reaction score
12,436
It’s possible that the higher dose of pred made him eat more. But that’s not what pred should be used for. There are appetite stimulants that come with far less risk to his health than steroids. Besides. Any treatment course from here is going to require him to taper off steroids. Stick with the schedule and ask the oncologist when and how he would like Charlie off them and for how long before new diagnostics or procedures can be performed. If mirtazapine isn’t as effective as you’d like, there are other options. Don’t use steroids as an appetite stimulant.

If it were my cat, I would prefer a surgeon specialist doing the biopsy than a general vet. Even if the price is higher, the level of expertise and experience would be worth it. Your vet may be able to do the procedure just fine. But how many of those do you suppose he does in a year? Wouldn’t you want more practiced hands especially for the more intricate procedure if they remove the mass and rejoin the intestines?

Is his weight remaining stable?

Do you have a plan for the teeth yet? Whenever he is sedated next either for another ultrasound or a surgery, ask to have mouth Xrays added on.
 
  • Thread Starter Thread Starter
  • #118

miguel99nyc

TCS Member
Thread starter
Adult Cat
Joined
Sep 19, 2016
Messages
296
Reaction score
125
Hello,
Yes i agree - a surgeon specialist would be ideal for such situation, perhaps that is something Oncologist will suggest. As for his teeth, I do plan on getting those checked out. Primary vet did mention along with biopsy he can do xrays of his teeth as well while sedated so that made sense. He has still be grinding his teeth but not as much as in past weeks - don't know if that means anything. The only thing that gets me is that as of late - he would ENJOY a fresh canned food opened but once its in the fridge - later in day he would try to eat it. Sometimes its a hit or miss - he would eat it just fine and other days he won't want that cold food. Other times I warmed it up but it did nothing as well. That I can't tell if he is nauseaous but wouldn't make sense how the next day after or so he would eat that particular leftover food just fine -- cold or warm regardless. It's VERY tricky and confusing.

I haven't tried the mirtazapine yet but I planned on it starting it this week as he starts to taper off the prednisolone. Before I tried the 0.5mg of Mirtazapine but clearly didnt help him at all. Now I have 1mg of mirtazapine hoping that will help bit. Primary vet told me the standard dose is 2mg but said to try 1mg first and would be given 1 every 48 hours. I know, i too thought it was maybe the stronger side effect of the pred at 5mg making him eat... but his appetite has been back and forth literally - a day he eats so much and next day not so much, back and forth. But I am on that path of tapering him off since hes on it every other day as of today for another week or so. May do it even faster if Oncologist says thats ok - will follow his guidance/suggestions. This visit can mean everything tomorrow morning. As a precaution though, they said to fast him as of tonight again incase he will do the ultrasound tomorrow - if needed.

I haven't got the scale yet but he definitely did not lose much more weight if any, still feels the same if anything feels some bit more meat on his hind legs then before. Just ever so slight. The only thing I still notice is that he still produces each morning very little stool and its rather dark. I know vet said he does little stool only because he's eating less...but at times worries because he passes just a ball of stool at times or even smaller amount as if he's constipated - but I know that has to in all likelyhoood have to do with the mass inside unfortunately. It doesn't look Tarry though...as I read online. No red streaks and at times when he does it slightly larger amount - the consistency of it seems normal, just very dark brown.



It’s possible that the higher dose of pred made him eat more. But that’s not what pred should be used for. There are appetite stimulants that come with far less risk to his health than steroids. Besides. Any treatment course from here is going to require him to taper off steroids. Stick with the schedule and ask the oncologist when and how he would like Charlie off them and for how long before new diagnostics or procedures can be performed. If mirtazapine isn’t as effective as you’d like, there are other options. Don’t use steroids as an appetite stimulant.

If it were my cat, I would prefer a surgeon specialist doing the biopsy than a general vet. Even if the price is higher, the level of expertise and experience would be worth it. Your vet may be able to do the procedure just fine. But how many of those do you suppose he does in a year? Wouldn’t you want more practiced hands especially for the more intricate procedure if they remove the mass and rejoin the intestines?

Is his weight remaining stable?

Do you have a plan for the teeth yet? Whenever he is sedated next either for another ultrasound or a surgery, ask to have mouth Xrays added on.
 
  • Thread Starter Thread Starter
  • #119

miguel99nyc

TCS Member
Thread starter
Adult Cat
Joined
Sep 19, 2016
Messages
296
Reaction score
125
So a Quick update.

I had just dropped him off with oncologist. He seems amazing - and maybe beacuse he's a specialist he was able to go into more details. But firstly, upon physical examination he said he did feel the mass but it was smaller then what the initial ultrasound had listed. Whether or not that was the prednisolone he wasn't too sure he said. Then he felt another lump but he was certain it was just some small stool stuck inside. But amazing how he can feel the lump through physical examination but from the first primary vet visit on Sept 8th, he couldn't feel it...making me think more he did these separate days/testing just to get the money.

So he had suggested to do the ultrasound with the fine needle aspirate which he said was much less invasive, cheaper, then exploratory surgery. He thought going straight to surgery was too quick and intense to go about it from the get go. And that the ultrasound guided FNA would be best way to go. He did say of course being on prednislone, it may mask that mass/sample they would get but that isnt also 100% but he suggested we started with that option of doing the ultrasound with FNA. We would not the results in about few days and approach treatment that way. That is complete stark difference in which my primary vet was just suggesting all he can do is surgery to open up because he "doesn't know" where the mass is. This oncologist said that the ultrasound seems to have been performed by a practictioner...and that their ultrasound at hospital will be better because its done by certified radiologist. I guess there's the difference in terms of quality/results.

Then he went on to describe the possible three types of cancer ( either small cell lymphoma, large cell, or intestinal carcinoma) as he too thinks it IS cancer, though he said there's a slim chance its just Benign or it can all be IBD as his intestines is thickened base of last ultrasound. So it is very sad news to hear that he too feels its most likely cancer...but now I can only hope this FNA sample will reveal finally what he has and be given either chemotherapy or appropriate medication to get him back on his way.

The only slight concern...if anything - as he was weighed as well he did drop 0.1lbs? Sept 8th he was 7.8, Sept 17th he was 7.7, and now October 6th 7.6lbs...but he has also been fasted so he has no food in him since late last night + he released stool this morning prior to leaving home. So I don't know if that's considered being stable or dropping still. But not a real good sign either unfortunately.
 

daftcat75

TCS Member
Top Cat
Joined
Sep 7, 2018
Messages
7,124
Reaction score
12,436
This is why we recommend specialists. General vets can do a lot. But specialists can do it better. That’s their speciality!

0.2 lbs lost in 1 month is not at all alarming. It’s worth keeping track of it. But it’s not concerning yet. However. If it is cancer, it may be difficult for him to regain any weight he loses. So while I wouldn’t be concerned about 0.2 lbs now. I would want to be stingy about future weight loss. Once the weight loss starts, it’s going to be really difficult to stop it. That’s why I recommend monitoring it weekly with a baby scale. Baby scale is less stress and more accurate than stepping on the scale with him in your arms and subtracting your weight.
 
Top