Suspected IBD or Lymphoma... is surgery worth it?

[Margot Lane]

For Oscar and Tyleete: it really does help to feed your cats small portions if you are struggling w/ small cell lymphoma and chlorambucil. My vet said divvy up the portions of canned catfood into four & it really helps the poo not go kerflooey (highly scientific word!). Don’t give into his or her yelling about “wanting more now!” Wait a bit. Your kitty litter box will thank you.

 

[Margot Lane]

Arrg. Another small suggestion to those struggling to stabilize their lymphoma cat: if the cat food you’re using works, stock in a lot of it. Mine ran out, couldn’t get more for a couple weeks and the next best thing triggered him. Fortunately more is on the way but my cat gave me a look today: “What were you THINKing? Where’s the good stuff?”

 

[Margot Lane]

Another small update in case your cat needs a urine test: it truly is painless for the cat, so don’t worry there!

 

[Margot Lane]

Heya! Thought I’d check in on Oscar again! Any news about his health? Mine seems stable, but pawing at my face for snacks all night so I might do a test run with me in in the guest room! Hope you’re well.

 

[rockitorknockit]

Rather than start a new thread, I figured I'd update here.

Oscar is not doing as well as I hoped at this point.

Chemo is continuing.
We are very gradually lowering the steroids.
His thyroid medication, which he was on previously, is the same.
His poop has never once changed from the frequent soft bombs (literally nothing seems to be influencing that).

But now he's starting to vomit about once a night, and has lost half a pound.

The internal medicine specialist had no insightful updates for me. This is just how it can go, from my understanding. He may have lots of time, or maybe not as much as we had hoped.

Behavior-wise, he's mostly himself. Loves to be by me, purring lots. Asks me to feed him every couple of hours... but only nibbles. But he will wake me from sleep if he doesn't get that nibble. He always eats a bit more when I love on him while he does - he's always purred and loved to be rubbed while eating. I do it as often as I can just to encourage more eating and less weight loss. I wake up multiple times a night to do it. He's been caught playing with his favorite toy, a felt carrot, multiple times recently. He spends most of his time lying in the various cat beds I've set up for him around our living room, walking to his favorite water bowl, or coming over to us if we are eating something interesting on the couch.

He squats and looks like he could be nauseous sometimes, but I could also be completely making it up. I don't know what is me being attuned to him and what is me having OCD. I always say he just looks puny, even if he is reacting to me totally normally. I've given him cerenia the past two nights and NO VOMIT! But now wondering if it is truly safe to give to him nightly? Does it not cause more inappetence? With that + the lower steroid, really worried about more weight loss. And doesn't cerenia have possible heart side effects? Which I would be really worried about with his heart condition. And how much should he really be taking, if he's only about 9 pounds now? Anyone have thoughts on this?

He gets another chemo dosage tomorrow (he gets one every two weeks). I am scared about seeing him dip after the dosage (he usually acts like he feels crappy for a couple of days).

All of this has been absolutely nightmareish. This is my angel, my boy, my son, one of the most precious loved ones I have ever had. He and my wife are the things that matter most to me in this world. I know you all know what this feels like. I cannot imagine life without him. I wonder if he's suffering and I can't tell. I wonder if I am making the right decisions. I am shocked by how small he is now. He was 16 pounds at his heaviest (a few years ago), 13 at his most steady/stable. Now he's 9. But we still call him Big Boy.

So, I guess I am wondering what you all think regarding the cerenia?
Also wondering what water consumption is like with these illnesses? He is obsessed with drinking water. He has been for ages, long before these diagnoses. Is that a common part of this? I think he just likes water but the meds maybe make him drink even more.
Also wondering what suggestions people have for gooey eyes? A little cream of some kind I could put on the corners of his eyes would be ideal, since they're a little irritated from watering. (He's always had some sort of allergy-type watery eye thing off and on.)
Should I be asking the vet for something to increase his appetite yet?

He doesn't have another vet appointment until mid-April-ish, unless of course something changes.

Thanks if you read this far. Oscar is currently sitting next to me watching my wife unpack a sewing machine. She says he looks happy and relaxed. I wish so bad I could read his little mind.

 

[rockitorknockit]

Here we are, recently, on his favorite blanket ever (real men love pink).

 

[Margot Lane]

It’s so weird you and I are going through the same thing w our cats yet mine now has great poop and never barfed! He did drink a lot in the beginning but now like you I give him lots of little wet meals instead of one big one…seems to make it go through him more easily. One difference between us is my vet said not to lower the pred., and for us that has worked. As of today it will be a year since the diagnosis, and at the time I thought I’d only see him for a few days! So this time is precious. The pumpkin and quail seem just fine for him: diet as you know is a huge factor. The only other difference between us is Zorro gets a chemo pill every third day. Have you tried a second opinion w another vet or do you like yours? Very glad you chimed in again and good to see that great orange boy (and you).

 

[Margot Lane]

Also if you do want more sleep it really really helps to get a cat mate cat feeder. He is now trained to the sound of it and leaps off the bed for his 2 nightly feeds! Getting a solid night’s sleep can help you in “being there” for him (and you!) during the day.

 

[babiesmom5]

I am so sorry your kitty is having these issues. In my opinion, with the vomiting and weight loss, I would not be tapering the steroid. Steroid helps decrease inflammation...a cause of vomiting and keeps the appetite up. I would ask about an appetite stimulant like Mirataz which is a gel you put on the pinta of the ear. My vet said Cerenia could be given daily, but I have found Odonsetron, better for nausea prevention. My (IBD) cat gets this each evening and no vomiting. You might want to get a second vet opinion.

 

[Margot Lane]

SO glad you wrote this, as I was thinking it, but did not wish to impose. I agree: don’t taper the steroid. I’ve talked to 2 vets about my Zorro and they both said the same thing.

 

[babiesmom5]

My long time Internal Medicine Vet believes you give the dosage of steroid necessary to control the symptoms; inflammation, nausea, vomiting for quality of life of the cat. I agree, as do your two vets.

 

[rockitorknockit]

The vomiting began while he was still on the higher dosage of steroid. We are tapering him lower but not off. I'm wondering if her thought process was that the high dosage is not controlling vomiting or stool, and therefore it's basically an over medication for no reason? I'm just guessing. The cerenia has certainly stopped the vomiting this week, it seems, as I'm giving it every evening. This morning I gave him chemo as well, and he's actually up quacking (he doesn't "meow" really lol) and snacking next to me as we speak. But I'll be keeping a close eye on how he does tonight and tomorrow.

I've also emailed the internal med specialist to see some of her thoughts. I appreciate y'alls input so much. Thank you for reading and replying. I have never heard of this other anti-neausa medicine you mentioned, but an appetite stimulant was one of the questions I asked in my email.

 

[rockitorknockit]

Also wondering if his heart condition is part of the decision to lower his steroid dosage. Sounds like I should ask her for more clarity on that.

 

[babiesmom5]

Yes, the heart condition could have been a factor in lowering the steroid dosage. You might want to ask your vet if Budesonide may be appropriate. It is a glucocorticoid alternative to Prednisolone for the management of cats who cannot tolerate Prednisolone. Budesonide supposedly carries less risk for development of diabetes and complications with heart disease.

Ondansetron is commonly known by the brand name Zofran for treatment of nausea, vomiting. But if Cerenia seems to work in the evenings, I would stay with that. You might want to ask your vet if you should have Zofran on hand just in case Cerenia doesn't. In the event Cerenia is not effective, my vet has advised Zofran which, (in my opinion) quells the nausea/vomiting a little faster and better. I keep both on hand.

 

[Margot Lane]

Sorry to hear about the heart condition. I was going to say it was such a RELIEF, that moment Zorro stopped having the runs! Not only for his health, but for his dignity too, he just hated it, and I think it contributed to his drinking a lot of water as well, which he doesn’t anymore.I wonder if Cerenia would allow him to up the pred, it really has made a huge difference in his life. I almost sing w/ joy when I clean out the litter box now.

 

[rockitorknockit]

Yes, the heart condition could have been a factor in lowering the steroid dosage. You might want to ask your vet if Budesonide may be appropriate. It is a glucocorticoid alternative to Prednisolone for the management of cats who cannot tolerate Prednisolone. Budesonide supposedly carries less risk for development of diabetes and complications with heart disease.

Ondansetron is commonly known by the brand name Zofran for treatment of nausea, vomiting. But if Cerenia seems to work in the evenings, I would stay with that. You might want to ask your vet if you should have Zofran on hand just in case Cerenia doesn't. In the event Cerenia is not effective, my vet has advised Zofran which, (in my opinion) quells the nausea/vomiting a little faster and better. I keep both on hand.

I think I may ask my vets about both the alternative steroid and Zofran (which I've taken the people version of myself, it is a wonder drug).
This morning is day 2 post chemo dosing which is always, for whatever reason, the day Oscar seems to be the most puny and sick.
But I'm also just wondering if he's spending a lot more time miserably nauseous than I realized.
He's definitely not vomitted even once since I began giving the cerenia nightly, but he still meatloafs and drools a bit/drinks nonstop, fairly regularly. And he just seems "pickier" about his food in general. Is it possible zofran would work better?
This morning I woke up and realized he had not disturbed me in the night for food, which is unusual. I got up and gave him his medicine, which he gobbled up without hesitation luckily. But then I observed him being super picky about eating his normal food. I coaxed him into eating a little with love. Then he sat looking incredibly nauseous for a short while (crouched awkwardly, squinty eyed, heartbreakingly tiny). Then the wave seemed to pass a bit, he sat up and washed his face, walked around a bit, and is now sleeping his usual bed he sleeps in all day.
Do these conditions come with pain? Realizing now the doctor has never mentioned either way to me.
I've just been a crying anxious mess since yesterday worrying about him again. I know I can't stop the inevitable, and worrying solves nothing. I have OCD and it's really difficult not to obsess and panic. I want so much to be making the right decisions to keep him comfortable. It's all really hard.
Yesterday we were able to get a little antibiotic ointment for his watery/gunky eyes, so that is a relief at least.
Truly wondering if the chemo is causing most of his misery and its worth it to keep going with it, or if things would be worse without it. I guess there is no real way to know.
He really seemed to be doing okay for a couple of weeks and now he's just seemed to feel crappy since his last vet visit.
Thanks, everyone, for your input. Planning to spend some time today just researching on this forum and online about possible ways to help him. Maybe go get him a fancy new good supplement I can trick him into eating, like pumpkin or bone broth. Also going to see if I can find a traveling vet around here that would come see him at home, for a second opinion maybe and also in preparation for what may one day have to happen. Appreciate any tips you guys can continue to share.

 

[daftcat75]

Chemo is supposed to be well tolerated in cats. I only saw my Krista sleep more on dosing days. I didn’t see any other side effects. There are two dosing protocols. The larger dose every two weeks or a smaller dose every third day (which is really annoying to keep track of—a twice a week schedule is also acceptable.) If you think the two week dose may be hard on him, ask your vet if you can try the twice a week protocol instead. The dose will have to be lowered and recalculated by your vet.

Budesonide and zofran sound like great suggestions.

Low tech suggestion: is his food bowl on the ground? If it isn’t already, can you elevate it a few inches (a textbook or two) so that he doesn’t have to bend over to eat. That can cause acid reflux. It seems to be helping my Betty have less gas after eating. I think she just ends up swallowing more air when she has to bend over to pick up the food. Back to Krista, Optagest digestive enzymes also seemed to help her that last year. Not promising a miracle here. But it couldn’t hurt to try them. That’s probably why they are sold in sample packets as well as bottles. She seemed a little less uncomfortable and her stools a little better. You won’t be trading meds for digestive enzymes. But they might give him just that extra little helping hand he could use right now.

 

[Margot Lane]

Everything in me is yelling: “increase the pred, fa chrisskakes!!!!’ but, I guess i can’t, b/c of the heart condition.(But I’m I’m still yelling anyway). Please for me can you just at least ask your vet if that is possible w any other kind of med to protect his heart? Or just ask what is the safest largest daily amt you can give him? I only say this b/c it has helped Zorro so much.

 

[rockitorknockit]

Update!

Thank you guys so much for the recent suggestions. Per daftcat, I have now moved to only feeding him in lifted bowls. He has been slowly improving since the weekend. He's no longer sitting around looking like he'd rather die, but is actually up, open eyed, a little more normal. Still not eating as much, though.

After an absolute nightmare of back and forth phone calls with asshole vet techs and front desk people, I was finally able to get the internal medicine people to understand that I wanted to discuss possibly changing the chemo protocol, adding Zofran, and a few other things (including his steroid dosing and how his thyroid might be doing). All of this resulted in taking him into the vet today to be checked first.

The visit (which was with his actual internal medicine specialist doctor) went as good as I could have possibly hoped, and way better than I expected. She said he'd gained 5 ounces, his intestinal thickening had lessened, and he had no swollen lymph nodes. She said he looked really good and she was surprised based on how he was last visit and what I described from the weekend (which was REALLY bad). She sent out some blood work, and assuming it comes back as expected, we will determine whether or not to change the chemo protocol or just add Zofran around the next dosing. All in all, I was over the moon leaving this visit. I'm feeling much more confident now that his dip over the weekend was just related to the chemo, but it was so amazingly reassuring to hear her literally say, "This means the medicine is helping."

On a side-note, today has been absolutely absurd. After taking Oscar to the vet, my wife and I returned home to find out other cat, Barney, was literally covered in poop. Like, his entire back-end, the entire bathroom floor, everything. Poop literally everywhere. We ended up having to bathe him TWICE and clean everything. We ended up taking him to the vet, of course. So I've been driving to and from vets and pharmacies ALL DAY!!! The last TWELVE HOURS! The diagnosis for Barney so far is "Shrug, he must have eaten something bad." Fecal testing was clean, physical exam was fine. But we're going to give him some gentle food, probiotics, and medicine over the next few days to see how he does. What a ridiculous household I have right now.

 

[Margot Lane]

You OK?