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My cat is having an ultrasound tomorrow with fine needle aspiration. The vet is concerned about GI lymphoma.
- Thread starter Pat N
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Hi. I have read numerous posts on this site about members whose cats have undergone a fine needle aspiration (FNA) - and had no issues or problems associated with the procedure. Most FNAs can be done without sedation, so that is a plus as there is no recovery time involved.
Please keep us posted and share with us whatever you wish - good news and/or bad, or anything in between. The members on this site are wonderful people and we will all 'be here for you' regardless of the outcome.
Sending wishes and hopes that your vet does NOT find it to be lymphoma. If they do, please know that there are treatment options, and depending on the type of lymphoma it might be, there are cures!!
Please keep us posted and share with us whatever you wish - good news and/or bad, or anything in between. The members on this site are wonderful people and we will all 'be here for you' regardless of the outcome.
Sending wishes and hopes that your vet does NOT find it to be lymphoma. If they do, please know that there are treatment options, and depending on the type of lymphoma it might be, there are cures!!
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- #3
Thank you so much for answering my question.
My cat, Rachel, is my heart. She was a feral kitten who would get on my roof and meow for help getting down. I came to her rescue and found her to be adorable. I wasn't thinking of having cats as pets again. She was about 7 months old when I found her unable to walk. She had fallen from a tree and hit a wire fence on the way down. That's when she broke her leg and dislocated her hip. That's when she became part of the family - indoor only kitty.. She also was spayed twice because an ovarian remnant was left behind after first spay. She's 8 years old now. She receives acupuncture for arthritis pain every month. In the last 3 months her personality has changed. She's recently had several episodes of vomiting. Blood tests show severe inflammation. She's had so many experiences with vet visits that she puts up a fuss when she has an appointment. I think the vet is going to sedate her for tomorrow's procedure.
I have followed the Site for sometime now and I think the community is awesome. I'm sure I will need support. I'll post vet's diagnosis and recommendations in the next few days. I don't think I can put Rachel through chemo given all her other problems.
My cat, Rachel, is my heart. She was a feral kitten who would get on my roof and meow for help getting down. I came to her rescue and found her to be adorable. I wasn't thinking of having cats as pets again. She was about 7 months old when I found her unable to walk. She had fallen from a tree and hit a wire fence on the way down. That's when she broke her leg and dislocated her hip. That's when she became part of the family - indoor only kitty.. She also was spayed twice because an ovarian remnant was left behind after first spay. She's 8 years old now. She receives acupuncture for arthritis pain every month. In the last 3 months her personality has changed. She's recently had several episodes of vomiting. Blood tests show severe inflammation. She's had so many experiences with vet visits that she puts up a fuss when she has an appointment. I think the vet is going to sedate her for tomorrow's procedure.
I have followed the Site for sometime now and I think the community is awesome. I'm sure I will need support. I'll post vet's diagnosis and recommendations in the next few days. I don't think I can put Rachel through chemo given all her other problems.
Wow! Poor baby has been through a lot! Even with sedation, which is usually less 'drugging' involved than anesthesia, she should be fine. Maybe a little 'woozy' when she comes home.
It is a possibility that she could have IBS, which is also treatable. And, you would be amazed to read previous posts (if you haven't already) about chemo treatment being much easier on cats than it is people - although I realize that she might need to be making vet trips for it.
Have you ever considered trying cat calming products on Rachel before a vet visit, things like Bach Rescue Remedy which are drops you rub into a cat's ear to help calm them before a vet visit? There are other similar products as well. Maybe the vet would even prescribed a small dose of something like Gabapentin, which other members have used as a calming agent before a vet appt.
Keeping Feeby's 'fingers' crossed for Rachel - and you!
It is a possibility that she could have IBS, which is also treatable. And, you would be amazed to read previous posts (if you haven't already) about chemo treatment being much easier on cats than it is people - although I realize that she might need to be making vet trips for it.
Have you ever considered trying cat calming products on Rachel before a vet visit, things like Bach Rescue Remedy which are drops you rub into a cat's ear to help calm them before a vet visit? There are other similar products as well. Maybe the vet would even prescribed a small dose of something like Gabapentin, which other members have used as a calming agent before a vet appt.
Keeping Feeby's 'fingers' crossed for Rachel - and you!
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- #5
I so appreciate having this conversation with you.
I hope it is IBD but don't think it is because of the way described what she saw in a partial ultrasound yesterday.
Rachel has been taking gabapentin for pain and anxiety caused by her arthritis but she had two recent episodes of vomiting and lethargy so her vet says stop giving it to her. Thanks for the suggestion though. I will try the Bach Rescue Remedy.
I hope it is IBD but don't think it is because of the way described what she saw in a partial ultrasound yesterday.
Rachel has been taking gabapentin for pain and anxiety caused by her arthritis but she had two recent episodes of vomiting and lethargy so her vet says stop giving it to her. Thanks for the suggestion though. I will try the Bach Rescue Remedy.
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Chemo is not as bad in cats as it is in people. Most cats experience mild and few side effects if any at all. I never noticed any side effects to the chemo itself in my Krista. I mean nothing that I could separate from what she was already going through. It halted the weight loss and gave her much improvement in quality of life, and probably another six more months than she would have had without it. Of course, chemo does have some risks like it will suppress the immune system and marrow production. So there may be history here that might preclude her that you haven't shared. But I would certainly discuss the chemo option, preferably with an oncologist, before dismissing it based on human preconceptions and experiences.
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- #7
Hi daftcat75. Thank you for your thoughts on the chemo issue. I know I'm ahead of myself a bit but want to be prepared for discussion with Rachel's vet. Would Rachel have to have a biopsy to be eligible for chemo or would the FNA info be enough? Would she have to travel to an oncologist office? If she were on chemo could she be around the 2 other cats in the family? Good to know Krista benefitted from her chemo. So many things to consider!
daftcat75
has an amazing story of his care for Krista. I can only add my own experiences with intestinal lymphoma to try to answer a few of your questions.For the most part, in order to receive chemo a biopsy might be needed. My vet told me that the first step is the US, then the FNA, and then the biopsy because the FNA is often not conclusive. If it were to be conclusive, then chemo would be done without the surgical biopsy. At least according to how my vet would have handled it. Chelsea is now 10 1/2 and while indoor only was a feral rescue who has been imminently difficult to handle for most of her life....unsafe even. As she aged, she softened a little which meant that I could pick her up with one arm, but if I raised the other arm she clawed me.....so when it was apparent that she probably had intestinal lymphoma I declined all invasive tests intending to just keep her comfortable. On the advice of
daftcat75
I requested that the vet begin leukeran/chlorambucil without the tests which she agreed to. Chelsea has been on it for several months and has not had any issues with it. It does not require isolation from other household members. Incidentally, I have a dog who had 6 rounds of immunotherapy at a somewhat advanced age for another condition and each time walked out of the office and came home acting as if he had just been on a visit to the dog park...no issues at all.I do recommend that you find an oncologist....my dog has one; Chelsea does not because I did not do any of the required testing.
I have had several FNA, granted I am a little bigger than a cat, but basically they were uneventful and I drove myself to and from most of them.
Rachel sounds like a little sweetheart and so lucky to have found you.
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- #9
Thank you Fionna'smom.
It's good to know that Chelsea didn't have to be isolated. You have helped me to at least consider Leukeran.
I don't know what's happening to Rachel right now. After her recent vet visits she's been given fluids and Cerenia and by the next day she's eating and perky. Today she has eaten a very small amount of food and is very lethargic. This is worrisome because she's never been like this. I called the vet and told them I didn't know if sedation for the FNA tomorrow would be too much for system since she hasn't eaten and is not too responsive this afternoon. They said she should come in tomorrow and the vets will assess this new situation. Lymphoma can't take them that fast can it?
Thanks again for the information and your kind words.
It's good to know that Chelsea didn't have to be isolated. You have helped me to at least consider Leukeran.
I don't know what's happening to Rachel right now. After her recent vet visits she's been given fluids and Cerenia and by the next day she's eating and perky. Today she has eaten a very small amount of food and is very lethargic. This is worrisome because she's never been like this. I called the vet and told them I didn't know if sedation for the FNA tomorrow would be too much for system since she hasn't eaten and is not too responsive this afternoon. They said she should come in tomorrow and the vets will assess this new situation. Lymphoma can't take them that fast can it?
Thanks again for the information and your kind words.
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I believe both Chelsea and Krista were suspected small cell lymphoma. This has a diffuse thickening appearance in ultrasound rather than a mass. This is likely what makes FNA inconclusive as the lack of cancer cells in the aspirate doesn't rule it out. If the vet suspects small cell lymphoma from the previous ultrasound, then yes, leukeran can be tried. In this case, you simply have to convince your vet that the diagnosis, the surgical biopsy, is riskier than the drug. However, if your vet isn't certain what type of lymphoma it might be, then he might not be willing to try leukeran if another would be more appropriate. I would ask your vet to put several options at the top of a sheet of paper and the risks underneath each: a) doing nothing, b) steroids only, c) steroids plus chemo, d) surgical biopsy, and e) chemo option B without the biopsy (in case leukeran may not be the best option depending on the type of cancer they suspect.) You might be able to put together an "informed consent" game plan, e.g. "I understand the risks of skipping the biopsy. Let's try our conservative options before our invasive options."
A helpful video from a vet explaining the difference between high grade (large cell)/low grade (small cell):
You can also subscribe and post questions to this support group. They don't reply as quickly as we do here because most people are getting a single daily digest email. But they are very knowledgeable, perhaps more so than the folks here.
Felinelymphomasupport groups.io Group
A helpful video from a vet explaining the difference between high grade (large cell)/low grade (small cell):
You can also subscribe and post questions to this support group. They don't reply as quickly as we do here because most people are getting a single daily digest email. But they are very knowledgeable, perhaps more so than the folks here.
Felinelymphomasupport groups.io Group
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- #11
Thank you daftcat75.
Your suggestions make so much sense. I watched the video and I will check into the support group.
Rachel has not eaten since yesterday morning and it was a very small amount. Of course, I can't feed her this morning because of FNA procedure with sedation. She sleeps most of the time but does come into the living room and screened in patio. She has gone down so fast. She's had so many physical exams and blood work since November. There was inflammation for sure but not one clinic or the UCD Teaching Hospital thought there was really serious issues until Jan. 2. I really don't anticipate good news this morning and if she is failing this fast I don't want to put her through extended chemo sessions. I sincerely hope the vet can get nutrients into her asap. Rachel's holistic vet is standing by in case Rachel can be helped with acupuncture or laser therapy or herbs.
Thank you again. Having this connection with you and others on The Cat Site is keeping me from going off the deep end.
Your suggestions make so much sense. I watched the video and I will check into the support group.
Rachel has not eaten since yesterday morning and it was a very small amount. Of course, I can't feed her this morning because of FNA procedure with sedation. She sleeps most of the time but does come into the living room and screened in patio. She has gone down so fast. She's had so many physical exams and blood work since November. There was inflammation for sure but not one clinic or the UCD Teaching Hospital thought there was really serious issues until Jan. 2. I really don't anticipate good news this morning and if she is failing this fast I don't want to put her through extended chemo sessions. I sincerely hope the vet can get nutrients into her asap. Rachel's holistic vet is standing by in case Rachel can be helped with acupuncture or laser therapy or herbs.
Thank you again. Having this connection with you and others on The Cat Site is keeping me from going off the deep end.
Please let us know what happens...sending good thoughts to you and Rachel.
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- #13
Thank you and the others who have been supportive.
A FNA was not done because the vet who is credited with being excellent at doing ultrasound said there was no mass and nothing prominent to aspirate. He said she had very thickened intestinal walls but no prominent lymph nodes. He said it appears that this is chronic situation. He said it is consistent with IBD. In discussing lymphoma possibilities he said the ultrasound showed nothing consistent with large cell lymphoma. He said a biopsy could be done. At this point I'm not going down that road.
Because Rachel had only eaten such a small amount of food over the last few days he kept her overnight, gave iv fluids and Cerenia. I brought her food over to see if she would eat. This morning I was told by the tech caring for her she is bright and did eat some of the food. I will speak to the doctor later this morning for further update, diagnosis and treatment plan.
Thanks again.
A FNA was not done because the vet who is credited with being excellent at doing ultrasound said there was no mass and nothing prominent to aspirate. He said she had very thickened intestinal walls but no prominent lymph nodes. He said it appears that this is chronic situation. He said it is consistent with IBD. In discussing lymphoma possibilities he said the ultrasound showed nothing consistent with large cell lymphoma. He said a biopsy could be done. At this point I'm not going down that road.
Because Rachel had only eaten such a small amount of food over the last few days he kept her overnight, gave iv fluids and Cerenia. I brought her food over to see if she would eat. This morning I was told by the tech caring for her she is bright and did eat some of the food. I will speak to the doctor later this morning for further update, diagnosis and treatment plan.
Thanks again.
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- #14
Rachel did not have FNA because vet doing ultrasound found no masses or prominent lymph nodes to aspirate. He said he believes this is a chronic condition and consistent with IBD. He kept her over night on iv fluids and Cerenia. I took her food over to the clinic last night and this morning the tech caring for her said she is bright and did eat some of the food. I will hear more from the vet later this morning. He said a biopsy could be done if I wanted it.
I appreciate your comments on leukeran and "informed consent" and your a), b), c), etc. Thanks so much for your support and information.
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That’s good news that there’s no mass and it’s not large cell lymphoma. However, without a biopsy, you can’t rule out small cell lymphoma. And to be honest, a number of people believe that IBD and small cell lymphoma are different stages of the same condition. The rule of thumb that I would discuss with your vet is that if you can stabilize her weight loss, if she can maintain or gain weight, it is probably not (yet) lymphoma. But if you feed her normal or more than normal amounts of food and she continues to lose weight, that is a hallmark of cancer.
Work with the vet to get her eating again with probably appetite stimulants, anti-nausea (Cerenia), and possibly steroids to get some initial control over the inflammation. Once she's eating again, you can monitor her weight. I wouldn't weigh her anymore frequently than once a week. Also talk to your vet about B-12 shots. These are critical to her short-term and long-term treatment for IBD/lymphoma.
If you have access and can afford it, I recommend putting together her treatment plan with an internal medicine specialist. You'll want a specialist because they can and will schedule the follow-ups to monitor the treatment but also for the side-effects of the treatment medications (usually steroids.) My biggest regret with Krista's treatment was not getting her a specialist for her IBD/lymphoma. I felt my regular vets were just out of their depth there.
Work with the vet to get her eating again with probably appetite stimulants, anti-nausea (Cerenia), and possibly steroids to get some initial control over the inflammation. Once she's eating again, you can monitor her weight. I wouldn't weigh her anymore frequently than once a week. Also talk to your vet about B-12 shots. These are critical to her short-term and long-term treatment for IBD/lymphoma.
If you have access and can afford it, I recommend putting together her treatment plan with an internal medicine specialist. You'll want a specialist because they can and will schedule the follow-ups to monitor the treatment but also for the side-effects of the treatment medications (usually steroids.) My biggest regret with Krista's treatment was not getting her a specialist for her IBD/lymphoma. I felt my regular vets were just out of their depth there.
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- #16
Thanks again for everything.
Rachel hasn't lost weight. It's been within the last 2-3 months that she has had intermittent vomiting. She has always dealt with pain because of her injuries as a kitten but now I'm wondering if a lot of her overgrooming, especially abdomen is pain from IBD. She has been given B12 injections by her acupuncturist but maybe not as often as she should. I'm still waiting for a call from the vet this morning with an update. Will ask the vet for information about specialist he may have worked with.
What food did you get for your kitties? Have you heard anything about Nom Nom? Male cat in the family has IBD. There was some discussion about small cell lymphoma. Diet change was the first recommendation in his treatment plan as was prednisolone. His symptoms (vomiting, diarrhea) disappeared. Pred was stopped about 6 months ago and he is doing fine. Pretty sure now it's not small cell lymphoma.
Rachel hasn't lost weight. It's been within the last 2-3 months that she has had intermittent vomiting. She has always dealt with pain because of her injuries as a kitten but now I'm wondering if a lot of her overgrooming, especially abdomen is pain from IBD. She has been given B12 injections by her acupuncturist but maybe not as often as she should. I'm still waiting for a call from the vet this morning with an update. Will ask the vet for information about specialist he may have worked with.
What food did you get for your kitties? Have you heard anything about Nom Nom? Male cat in the family has IBD. There was some discussion about small cell lymphoma. Diet change was the first recommendation in his treatment plan as was prednisolone. His symptoms (vomiting, diarrhea) disappeared. Pred was stopped about 6 months ago and he is doing fine. Pretty sure now it's not small cell lymphoma.
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I liked Rawz or homemade raw for Krista. Until it was lymphoma and I couldn't trust whether raw would be appropriate with an immuno-suppressed cat (because of the chemo.) Rawz can be difficult to find, subject to shortages/outages, and terribly expensive. But it's second to none on recipe quality especially when trying to rule out trigger ingredients. Their single protein pates are specifically and only those proteins. No chicken ingredients hiding in the turkey or rabbit recipes.
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Where to Buy | RAWZ
I have seen the shredded textures at more mainstream stores. But the pates, and these are the better foods, I have only seen at independent pet food stores. Rawz doesn't distribute the pates to chains.
I have heard that they will send you samples if you write them. And most resellers will issue refunds if you buy a case and your cat doesn't like them.
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I would vote on treatment for lymphoma. I went through this with 2 of my cats. First cat was not eating - not for a week and I nearly had her euthanized. Thickened intestines. Diagnosis was lymphoma or IBD. Local vet said pancreatitis. Treated with steroids and she recovered. Still with me at age 15.
2nd cat, age 10, suddenly stopped eating. Took him to internal medicine specialist. Diagnosis was IBD or lymphoma. Started on chlorambucil and prednisolone. I did not want to biopsy or do invasive testing. He went into remission for 8 months. Took him in to the vet in September and was told everything looked fine on the ultrasound except for some kidney disease started and to not be surprised if his kidney values go up. Little did I know that slight kidney disease was actually metastasized cancer- he acted fine until he stopped eating in December and by then his kidneys were gone and he passed in 5 days.
The specialist said we could taper his prednisolone because he was in remission - I had been hoping it was just IBD. I don't know if tapering the meds lead to his death, as it is possible the cancer would have returned regardless. I have so many regrets, but I was trying my best and hoping for several more years, in which case those meds could worsen kidney disease and tapering them made sense.
A mass can grow in as little as 4 weeks. And we don't know it wasn't large cell or even what type of cancer it was. And cancer can always become resistant to the drugs used to treat it...there are no good answers. Or the chemo drug he is on can allow a second cancer to multiply.
I would want to assume that this is cancer and that aggressive treatment is warranted. Because if you are wrong and just treat with steroids you might get 4-6 weeks. And you have limited time once they stop eating.
2nd cat, age 10, suddenly stopped eating. Took him to internal medicine specialist. Diagnosis was IBD or lymphoma. Started on chlorambucil and prednisolone. I did not want to biopsy or do invasive testing. He went into remission for 8 months. Took him in to the vet in September and was told everything looked fine on the ultrasound except for some kidney disease started and to not be surprised if his kidney values go up. Little did I know that slight kidney disease was actually metastasized cancer- he acted fine until he stopped eating in December and by then his kidneys were gone and he passed in 5 days.
The specialist said we could taper his prednisolone because he was in remission - I had been hoping it was just IBD. I don't know if tapering the meds lead to his death, as it is possible the cancer would have returned regardless. I have so many regrets, but I was trying my best and hoping for several more years, in which case those meds could worsen kidney disease and tapering them made sense.
A mass can grow in as little as 4 weeks. And we don't know it wasn't large cell or even what type of cancer it was. And cancer can always become resistant to the drugs used to treat it...there are no good answers. Or the chemo drug he is on can allow a second cancer to multiply.
I would want to assume that this is cancer and that aggressive treatment is warranted. Because if you are wrong and just treat with steroids you might get 4-6 weeks. And you have limited time once they stop eating.
