Suggested Lymphoma 11 yr old male

[daftcat75]

Just a pic of Roo a few years back vs last week.
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Also some lab work.

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Unfortunately lymphoma doesn’t show up in bloodwork. Not directly. You might see elevated white cells and dehydration. But that can mean lots of things. Hopefully his UTI will clear soon so he can get his ultrasound. That’s the next step. If they can do a needle biopsy, that’s not invasive like endoscopy or surgical biopsy. You might ask about that option when you schedule the ultrasound.

 

[daftcat75]

October 2018 (battled through pancreatitis and first round of IBD well managed - 9 lbs)

November 2019 (Rough year with dental issues, FORLs, Just had her remaining teeth extracted a few days before this picture. Lymphoma would start presenting as liquid stools and weight loss the next month. - 7 lbs.)

July 2020 (A couple weeks before she passed. We had finally reached remission. But too little too late for her. 4 lbs. )

A video from about the same time.
View media item 423667

 

[kmbishop111]

October 2018 (battled through pancreatitis and first round of IBD well managed - 9 lbs)
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November 2019 (Rough year with dental issues, FORLs, Just had her remaining teeth extracted a few days before this picture. Lymphoma would start presenting as liquid stools and weight loss the next month. - 7 lbs.)
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July 2020 (A couple weeks before she passed. We had finally reached remission. But too little too late for her. 4 lbs. )
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A video from about the same time.
View media item 423667

What an absolute beautiful little gal!! Im so sorry.

 

[kmbishop111]

I believe I've narrowed down the culprit causing the tummy discomfort. Soon after I gave Roo his Veraflox dosage this am, same gurgling, going to the bathroom w loose stools etc. No vomitting, yet. BUT he is actually drinking his water afterward. (Maybe trying to get the nasty taste out of his mouth.)

Poor boy. Im wondering if the benefits of the strong meds for the UTI outweigh the sickness kts causing my boy.

The Vet Clinic Im using has a group come in on Tuesdays each week specifically for Ultrasounds of this type. So it will be next Tuesday before his appt.

 

[daftcat75]

I believe I've narrowed down the culprit causing the tummy discomfort. Soon after I gave Roo his Veraflox dosage this am, same gurgling, going to the bathroom w loose stools etc. No vomitting, yet. BUT he is actually drinking his water afterward. (Maybe trying to get the nasty taste out of his mouth.)

Poor boy. Im wondering if the benefits of the strong meds for the UTI outweigh the sickness kts causing my boy.

The Vet Clinic Im using has a group come in on Tuesdays each week specifically for Ultrasounds of this type. So it will be next Tuesday before his appt.

Long-term good health outweighs short-term distress. The UTI could get worse if you discontinue the antibiotics too soon. Finish the course as prescribed. The vet can prescribe Cerenia if the vomiting returns.

Look into saccharomyces boulardii for controlling the antibiotic runs on the other end. It’s a yeast-based probiotic. It won’t be killed by the antibiotics. The Jarrow brand is the gold standard as it also has a beneficial pre-biotic called MOS. You should be able to find it online, in a vitamin store, or in pharmacies where they keep their human probiotics. You can start with half a capsule twice a day. There’s no ceiling. Krista took a whole capsule (emptied into her food) twice a day when she was fighting off a clostridium infection in her gut.

 

[kmbishop111]

Long-term good health outweighs short-term distress. The UTI could get worse if you discontinue the antibiotics too soon. Finish the course as prescribed. The vet can prescribe Cerenia if the vomiting returns.

Look into saccharomyces boulardii for controlling the antibiotic runs on the other end. It’s a yeast-based probiotic. It won’t be killed by the antibiotics. The Jarrow brand is the gold standard as it also has a beneficial pre-biotic called MOS. You should be able to find it online, in a vitamin store, or in pharmacies where they keep their human probiotics. You can start with half a capsule twice a day. There’s no ceiling. Krista took a whole capsule (emptied into her food) twice a day when she was fighting off a clostridium infection in her gut.

I've found the Jarrows brand online but will have to order. This am and a few minutes ago he's had the runs directly after eating. His poor tummy. Im going to see what I can find local as far as Probiotics to get him some relief.

His appetite is still great! Im thinking of questions for my Vet. Since he most likely has IBD, it sounds like its going to be very hard to distinguish from Lymphoma. I'm still having Ultrasound done, but this sounds like no definitive answers is a great possibility.

What exactly does the Prednisone do? Im trying not to get overwhelmed but its been a tough couple of weeks for Roo and I. Thank you for your help in guiding us thru these uncertain waters!

 

[daftcat75]

I've found the Jarrows brand online but will have to order. This am and a few minutes ago he's had the runs directly after eating. His poor tummy. Im going to see what I can find local as far as Probiotics to get him some relief.

His appetite is still great! Im thinking of questions for my Vet. Since he most likely has IBD, it sounds like its going to be very hard to distinguish from Lymphoma. I'm still having Ultrasound done, but this sounds like no definitive answers is a great possibility.

What exactly does the Prednisone do? Im trying not to get overwhelmed but its been a tough couple of weeks for Roo and I. Thank you for your help in guiding us thru these uncertain waters!

Regular probiotics probably won't work here as he's also taking an antibiotic for the UTI. That's likely the cause of his runny poops. Antibiotics will kill both the bad and the good bacteria. The s. boulardii, being a yeast, is going to survive the antibiotics. I don't know the exact mechanism for how it works. But it's what you take or give for both antibiotics diarrhea as well as traveler's diarrhea.

However...

Krista's lymphoma started to present as liquid stools. I had thought that maybe she had a recurrence of the clostridium infection. But I paid for the poop PCR and it came back negative. Combined with the weight loss and the lack of response to prednisilone, I convinced my vet's boss (my vet didn't want to proceed without a biopsy confirmation) that adding chemo to her medicine regime would be less risk than putting her through a surgical biopsy.

The ultrasound, despite its potential for inconclusive results, is still an important step here. Small cell lymphoma and IBD are indistinguishable on ultrasound. However, other types of cancers including those that involve other organs or have a mass/tumor growth can be seen on the ultrasound. In that sense, an ambiguous diagnosis such as "diffuse thickening consistent with small cell lymphoma or IBD" is still better than multi-organ involvement and mass(es) observed.

It also suggests a few more options. If you get that "SCL or IBD" diagnosis, you may luck out and they can get enough cells from a needle biopsy. But usually they need to do either an endoscopy or a surgical biopsy. An endoscopy isn't pleasant. But at least it doesn't come with a recovery period. It does have its limits though.

I would say because of his age and his weight loss, he's probably not a great candidate for the surgical biopsy. In this case, you can discuss (like I did) with your vet a, "first one, then the other" approach. You could start with the assumption of IBD and a course of steroids (prednisilone) for its treatment. The steroids will reduce inflammation and lower the immune response that's at the heart of both IBD and lymphoma. If he's still reactive (butt and gut issues) and still losing weight, then you would consider adding a chemotherapy drug to his medicine regime. If you can, I would look for an internal medicine specialist to help you through this. They have more experience with both IBD and lymphoma than your general vet. They will also likely be more versed in the latest research and treatments. For example, one chemo regime is every three days. While another is a larger dose but only once every two weeks. They've been shown to have similar efficacy. And obviously one is easier than the other for both the cat and the guardian.

In the end, it was actually what I thought was cleverness on my part---wrapping her pred pill halves in fish flakes so she would pill herself--that prevented her from reaching remission for so long. Fish flakes were a reactive food for her. I discussed this with my vet, referring to it as our devil's bargain, and he could not tell me one way or another whether the pred/leukeran could/would suppress the reaction to the fish flakes. Ultimately, it did not. It was like mixing a small amount of gasoline into the water that's supposed to put out the fire. I'm hoping that a specialist would correct the next person who tried this devil's bargain. When you have identified what Roo cannot have, don't even give him "just a little." Cross it off and don't look back. That's the one lesson I've learned with Krista (too little too late) that I wish to pass off here.

The other lesson I would want to pass along is any medicine that has to be given regularly for longer than a couple of weeks, you should look into having it compounded into a formulation that's easy for both you and the cat, e.g. flavored liquids or transdermal gel.

One compounding pharmacy I worked with that was very responsive with excellent customer service and fast shipping is Wedgewood.
Veterinary Pharmacy

 

[kmbishop111]

Okay, so I just talked to my Vet. (Again were personal friends so she understands my zaniness and late night freak outs) lol She said there is a compounding pharmacy that can make the Pred tuna or salmon flavored and sees no reason to get that started after tx for UTI.

 

[daftcat75]

Okay, so I just talked to my Vet. (Again were personal friends so she understands my zaniness and late night freak outs) lol She said there is a compounding pharmacy that can make the Pred tuna or salmon flavored and sees no reason to get that started after tx for UTI.

You’ll want to do ultrasound before steroids. Otherwise you can get a false negative (or a rosier picture than reality) after the steroids have started to reduce inflammation.

 

[kmbishop111]

Ok I feel much better going into this knowledge wise. Then I look down at my Roo and know I have to be on my A game for him!!

 

[kmbishop111]

Ultrasound scheduled for tomorrow, advised he may be sedated for procedure. He's an older gentleman so that worries me a bit. But hopefully we get some answers. Any prayers, good vibes, well wishes appreciated for my precious boy!!

 

[fionasmom]

It is not uncommon to sedate if the cat will not allow the procedure. Jamie has been sedated for them and has done fine. If your cat is calm, he may not need sedation. Please post an update!

 

[daftcat75]

He'll probably be sedated because they have to shave his belly and put that cold gel on it. My Krista was being sedated regularly (because that’s the only way the vets would see her) in her last year. She was 15/16. She seemed no worse for it each time I brought her home

This is one of the funniest cat things I’ve ever seen though. A pregnant cat reacting to her ultrasound.

 

[kmbishop111]

I gave him Gabapentin before visit so they did not have to sedate. He had just enough food in GI Tract that theu couldn't reveal anything in small intestine. However he has minerilization in bladder? And an enlarged Adrenal Gland, which neither Dr had ever seen before in a cat.

So we repeat the Ultrasound and Owner of the practice is going to consult with my Vet and figure out where to go from here.

Im exhausted just from the stress. lol

 

[fionasmom]

Of course you are. AT least they did not have to sedate him since you were concerned about that. Maybe that will be the case with the next one as well. Mineralization of the bladder is a general term that could mean calcium deposits, or something similar, but I would follow up on it. Cushing's Disease and Addison's Disease which are not uncommon in dogs ( I have had two dogs with Cushing's) are very uncommon in cats. It is very possible that your vet has not seen this before. Remember that a mass can also be a benign nothing, so try not to panic just at the thought of a mass on the adrenal.

 

[kmbishop111]

Of course you are. AT least they did not have to sedate him since you were concerned about that. Maybe that will be the case with the next one as well. Mineralization of the bladder is a general term that could mean calcium deposits, or something similar, but I would follow up on it. Cushing's Disease and Addison's Disease which are not uncommon in dogs ( I have had two dogs with Cushing's) are very uncommon in cats. It is very possible that your vet has not seen this before. Remember that a mass can also be a benign nothing, so try not to panic just at the thought of a mass on the adrenal.

The Ultrasound Dr, Practice Owner, nor my Vet have seen in a cat. He doesn't have that Cushing's appearance, but here we are. I'm starting to wonder if this could be related to the Toxic Mold apt we lived in for a few years. It wrecked havoc on my son and I, why not my pets?

Roo is doing much better after finishing antibiotics. Whew. Now we wait for the 2nd Ultrasound and go from there.

 

[fionasmom]

For as much as I know about Cushing's in dogs, I don't know how many of the same signs present in a cat. Toxic mold....that must have been a nightmare and I don't blame you for being suspicious about its long term effects.

 

[kmbishop111]

Took Roo to the Vet today. It has been 1 1/2 months since this began. He has lost 4 oz in 1 month so even tho hes not gaining, he holding his own.

Tney took blood for the GI Panel 2 w spec fPl, it should be back in 5-7 days.

 

[kmbishop111]

I just received pre-results from the GI Panel 2 w spec fPl and talked to Roo's Vet. She said he is positive for Pancreatitis, EPI, and IBD. Im overwhelmed right now. I know the meds she said he needed but no prescriptions yet as Im guessing its pre-results. Pancreazyme, Tyloson, Prednisolone and B12. Can anyone give advice on best and most economical place to get tnese filled? Or any advice on what to expect from here foreward? Thank you!

 

[fionasmom]

I am sorry that you are faced with all those results at one time and it has to be overwhelming. I have never had to use those meds but have been faced with looking for more economical sources. Check Chewy for one and places like Diamondback in AZ. I have used both of those for dogs. Chewy has been very conscientious even during the worst of the pandemic and we never had a hitch with getting the meds....it is not the same as when they suddenly say, "opps! Don't have that food anymore."

The 6 Best Places to Buy Pet Medication Online in 2021

If you google "pet meds online" other sources will come up. Just checked and Diamondback is now Wedgewood but at same location and looks the same to me. They do have tylosin but I did not check or compare prices with other vendors.