Willy might have cancer / high-grade lymphoma Treatment thread

[cmshap]

Update: 26 days post-chemo (3rd dose)...

The pet hospital where I take Willy for oncology seems to be quite busy right now, and so they weren't able to squeeze him in earlier than Thursday this week. But I did speak to an oncology department tech who confirmed with the doctor that I can continue doing what I'm doing, if I feel it is helping. But she did also reiterate that basically any course of action at this point carries some risk, which I understand.

So his next appointment is in about 28 hours from the time I am writing this post.

As far as Willy, there hasn't really been any more dramatic tumor shrinkage, but it's staying at a static size at this point, which is also good. And he's continuing to behave like his normal self.

Really the only difference in behavior is that he no longer zooms. All throughout his life, he was a zoomer, and even during the first month or two of chemotherapy, he got a zoom urge about once a day. I haven't seen that in a while.

But as long as he still feels like playing I know he is feeling okay enough. And he has turned back into being a permanent fixture on my lap.

 

[IndyJones]

Could the tumer be affecting his vestibular system? Maybe he feels too unbalanced to run laps.

 

[cmshap]

Could the tumer be affecting his vestibular system? Maybe he feels too unbalanced to run laps.

He doesn't seem off-balance when playing and jumping.

I also keep having to remind myself that we have no idea what's going on inside his body. He hasn't had any kind of scan to reveal internal tumors. I'm sure such a thing would be way out of my budget, anyway.

But no signs of pain, at all yet; with the exception of his ears, if I brush them wrong or with too much pressure. At least I think that gives him pain, as he immediately meows with a lower pitch that sounds like a cat version of "ouch!"

Otherwise, he still shakes his head often, but not as often as a week ago. And he isn't trying to scratch the inside of his ears anymore (he was previously really trying to reach inside of his ears with his rear claws to scratch, which was my biggest immediate concern at the time -- as when this all started, his ears were bleeding and infected from scratching at the insides).

 

[cmshap]

I actually got him to play for a while tonight... longer than he is normally willing to.

Of course, he then proceeded to steal my chair again for the majority of the night.

(I have those extra cushions/pillows on that chair because the lining is worn out, and I haven't gotten around to reupholstering it yet -- which I have determined to do as a DIY project because I don't want to pay for it. The pillows make it more appealing to him.)

 

[catloverfromwayback]

I actually got him to play for a while tonight... longer than he is normally willing to.

Of course, he then proceeded to steal my chair again for the majority of the night.

(I have those extra cushions/pillows on that chair because the lining is worn out, and I haven't gotten around to reupholstering it yet -- which I have determined to do as a DIY project because I don't want to pay for it. The pillows make it more appealing to him.)

Your chair, humaine? Your chair?

 

[cmshap]

Your chair, humaine? Your chair?

Honestly, since his cancer diagnosis, I mostly let him do whatever he wants. He can take my chair if he wants to. He gets infinite passes at this point, as far as I am concerned.

Edit: In fact, I just yielded him the chair. He got up for a while to go eat, and I sat down in the chair. Upon returning to the living room, he paced around his cave bed, while looking at me and meowing. Like "this is unsatisfactory."

He loves the cave bed, but it's nearer to my windows, and in Wisconsin this week it's been around 0° F for days, with a negative wind chill for a while (I know it's been much colder in other areas of the Midwest, but surprisingly it's been "only" 0-1°F here in WI). So he probably doesn't like sleeping that close to windows. I'll have to try relocating the bed.

I got up from my chair and he immediately and fully occupied it again within 5 seconds.

Attached is a pic of Willy relaxing by the radiator while it was at full heat. It's way too hot in here when I leave the valve open all day, so I have to juggle it on/off. But Willy loves when it's on.

 

[catloverfromwayback]

Honestly, since his cancer diagnosis, I mostly let him do whatever he wants. He can take my chair if he wants to. He gets infinite passes at this point, as far as I am concerned.

Which is as it should be with our ofurlords, in good health or not!

 

[IndyJones]

Honestly, since his cancer diagnosis, I mostly let him do whatever he wants. He can take my chair if he wants to. He gets infinite passes at this point, as far as I am concerned.

Edit: In fact, I just yielded him the chair. He got up for a while to go eat, and I sat down in the chair. Upon returning to the living room, he paced around his cave bed, while looking at me and meowing. Like "this is unsatisfactory."

He loves the cave bed, but it's nearer to my windows, and in Wisconsin this week it's been around 0° F for days, with a negative wind chill for a while (I know it's been much colder in other areas of the Midwest, but surprisingly it's been "only" 0-1°F here in WI). So he probably doesn't like sleeping that close to windows. I'll have to try relocating the bed.

I got up from my chair and he immediately and fully occupied it again within 5 seconds.

Attached is a pic of Willy relaxing by the radiator while it was at full heat. It's way too hot in here when I leave the valve open all day, so I have to juggle it on/off. But Willy loves when it's on.

Its been cold here as well, not that we Canadians aren't used to it, Kabuto was sleeping on my head lastnight i do think the older cats just like older people feel the cold. Its been in the -10°~-20° c range lately here.

 

[cmshap]

Update: 27 days post-chemo (3rd dose)...

Unfortunately, between yesterday and today, there was a little bit of tumor growth. At least, it feels like it.

One of the things that makes this so hard to read is that the tumors change shape. Like I said before, what happens during growth is smaller nodules forming on/around the surface, and so the tumor can become smaller in terms of surface area under his skin, but larger in terms of outward protrusion.

Our oncologist takes measurements of all the masses, so she will be able to tell me what's actually going on when I take him in tomorrow.

I can't help but obsess over this... I am constantly having huge swings of emotions. Whenever I see a change in the positive direction, I get hopeful, and whenever I see a change in the negative direction, I worry that this treatment is ultimately not going to work well enough.

Also, everything that's going on medically is highly confusing to me. I really observed the prednisolone working again after I started administering it over the last 5 days, but then I see change in the opposite direction.

I really feel like the ideal treatment would be chemo doses every 3 weeks, because week 4 in between doses is when everything starts getting worse. But as I said before, our oncologist found his white cell count to be a little bit low at the end of week 3, and concluded that 3-week intervals would not be possible.

However, that did not stop her from continuing to administer chemo at that time (the interval between the 2nd and 3rd doses was 3 weeks due to the holidays). Which confuses me. If it was okay to do it at that time, isn't there a possibility that we could continue to do it that way? Even if it carried more risk, would it be a possible informed decision that I could make?

These are questions for our oncologist, but I'm wondering if any of you have thoughts on this.

 

[tarasgirl06]

Update: 27 days post-chemo (3rd dose)...

Unfortunately, between yesterday and today, there was a little bit of tumor growth. At least, it feels like it.

One of the things that makes this so hard to read is that the tumors change shape. Like I said before, what happens during growth is smaller nodules forming on/around the surface, and so the tumor can become smaller in terms of surface area under his skin, but larger in terms of outward protrusion.

Our oncologist takes measurements of all the masses, so she will be able to tell me what's actually going on when I take him in tomorrow.

I can't help but obsess over this... I am constantly having huge swings of emotions. Whenever I see a change in the positive direction, I get hopeful, and whenever I see a change in the negative direction, I worry that this treatment is ultimately not going to work well enough.

Also, everything that's going on medically is highly confusing to me. I really observed the prednisolone working again after I started administering it over the last 5 days, but then I see change in the opposite direction.

I really feel like the ideal treatment would be chemo doses every 3 weeks, because week 4 in between doses is when everything starts getting worse. But as I said before, our oncologist found his white cell count to be a little bit low at the end of week 3, and concluded that 3-week intervals would not be possible.

However, that did not stop her from continuing to administer chemo at that time (the interval between the 2nd and 3rd doses was 3 weeks due to the holidays). Which confuses me. If it was okay to do it at that time, isn't there a possibility that we could continue to do it that way? Even if it carried more risk, would it be a possible informed decision that I could make?

These are questions for our oncologist, but I'm wondering if any of you have thoughts on this.

None, except that it is essential to bear in mind that each living being is a unique individual and each medicine will have differing effects on each individual as a result. No medical "mastermind" can possibly tell what that effect will be. But absolutely, note each question down and ask the oncologist/care team. Never feel you can't or shouldn't.
*PRAYERS* continually for Willy!

 

[cmshap]

Of course, he then proceeded to steal my chair again for the majority of the night.

He is now King of the Chair.

 

[tarasgirl06]

He is now King of the Chair.

*As well he should be.*

 

[silent meowlook]

Hi. His WBC count might have been at the lower end of normal and the oncologist felt it was ok to do one time at the three week interval but not on a regular basis.

Trust me, you do not want his WBC to bottom out from the chemo. I have seen it before and it is a gruesome death.

If the oncologist wants to wait, wait. You can also ask for a copy of his lab work each time he has it done. It is a good idea to have a copy of all his medical records in case something were to happen and you have to take him to the ER.

 

[fionasmom]

 

[cmshap]

Update: Day of 4th chemo dose

We got back from Willy's 4th appointment a couple of hours ago.

Takeaways:

1. All bloodwork was considered good. There were no issues that could get in the way of continuing chemotherapy.
   
   
2. His weight was stable. Actually, he gained 0.25 lbs since his last appointment a month ago.
   
   
3. All in all, in terms of side effects, Willy has done exceptionally well.
   
   
4. His facial tumor measured "much larger" than at the time of his last appointment. Other smaller tumors are about the same size.
   
   
5. The likeliest explanation is that his lymphoma has become resistant to lomustine. So the best course of action was to try different chemotherapy drugs, or stop treatment and focus on quality-of-life care.
   
   
6. I opted to try different drugs. Rather than lomustine, this time, Willy was administered vincristine sulfate, 1 mg/mL (0.18 mL), and cyclophosphamide, 50 mg.
   
   
7. It is unknown yet if Willy's lymphoma is just lomustine-resistant, or generally drug-resistant. Only time will tell.
   
   
8. Given everything I explained about how I've been administering prednisolone at home (see post #549 and subsequent posts), it was determined to be better for me to continue administering it at home. So the methylprednisolone injection was not done this time, and I will be dosing him with his daily pred from now on.
   
   
9. Given that I have trouble pilling him, our oncologist ordered a liquid compounded form. It's been sent to a local veterinary pharmacy, who should be giving me a call so I can choose a flavor that I think Willy will find appealing. I should be able to pick it up in a few days. In the meantime, I will continue with pills.
   
   
10. This next month is going to be critical. If he improves, we will continue with chemotherapy. If he continues to decline, it will likely be time to stop treatment and just focus on his end-of-life care.

Here is is after getting home. Something about these appointments makes him hungry afterward, so he polished off a meal right away.

 

[tarasgirl06]

Update: Day of 4th chemo dose

We got back from Willy's 4th appointment a couple of hours ago.

Takeaways:

1. All bloodwork was considered good. There were no issues that could get in the way of continuing chemotherapy.
   
   
2. His weight was stable. Actually, he gained 0.25 lbs since his last appointment a month ago.
   
   
3. All in all, in terms of side effects, Willy has done exceptionally well.
   
   
4. His facial tumor measured "much larger" than at the time of his last appointment. Other smaller tumors are about the same size.
   
   
5. The likeliest explanation is that his lymphoma has become resistant to lomustine. So the best course of action was to try different chemotherapy drugs, or stop treatment and focus on quality-of-life care.
   
   
6. I opted to try different drugs. Rather than lomustine, this time, Willy was administered vincristine sulfate, 1 mg/mL (0.18 mL), and cyclophosphamide, 50 mg.
   
   
7. It is unknown yet if Willy's lymphoma is just lomustine-resistant, or generally drug-resistant. Only time will tell.
   
   
8. Given everything I explained about how I've been administering prednisolone at home (see post #549 and subsequent posts), it was determined to be better for me to continue administering it at home. So the methylprednisolone injection was not done this time, and I will be dosing him with his daily pred from now on.
   
   
9. Given that I have trouble pilling him, our oncologist ordered a liquid compounded form. It's been sent to a local veterinary pharmacy, who should be giving me a call so I can choose a flavor that I think Willy will find appealing. I should be able to pick it up in a few days. In the meantime, I will continue with pills.
   
   
10. This next month is going to be critical. If he improves, we will continue with chemotherapy. If he continues to decline, it will likely be time to stop treatment and just focus on his end-of-life care.

Here is is after getting home. Something about these appointments makes him hungry afterward, so he polished off a meal right away.

Willy looks wide-eyed and kittenish here! So glad his appetite is good post-visit and praying the change in treatment will be very successful. #s 1-3 are very good and hopeful results! Also, hoping that you're able to choose a flavor he likes a lot.

 

[cmshap]

Willy looks wide-eyed and kittenish here! So glad his appetite is good post-visit and praying the change in treatment will be very successful. #s 1-3 are very good and hopeful results! Also, hoping that you're able to choose a flavor he likes a lot.

I'm a little nervous about giving him liquid medicine, but not as nervous about pilling him. As I said before, pilling is difficult to do by myself, and I end up causing him pain if I apply pressure in the wrong spot while holding his head -- like near his ear.

Liquid meds are easier, but he has still fought me in the past when giving them (the only times I've given liquid meds were buprenorphine after surgical procedures).

But those painkillers were probably foul-tasting, so maybe he will learn to tolerate a flavored medicine better

Plus, unlike the buprenorphine, I don't have to focus on buccal administration. With the liquid prednisolone, I will just have to squirt it anywhere in his mouth.

Here he is again, out cold probably for the night. After every chemo appointment in the past, he came home, ate a meal, then went to sleep for the rest of the day. I don't know what chemotherapy feels like, but I can imagine it's exhausting.

 

[tarasgirl06]

I'm a little nervous about giving him liquid medicine, but not as nervous about pilling him. As I said before, pilling is difficult to do by myself, and I end up causing him pain if I apply pressure in the wrong spot while holding his head -- like near his ear.

Liquid meds are easier, but he has still fought me in the past when giving them (the only times I've given liquid meds were buprenorphine after surgical procedures).

But those painkillers were probably foul-tasting, so maybe he will learn to tolerate a flavored medicine better

Plus, unlike the buprenorphine, I don't have to focus on buccal administration. With the liquid prednisolone, I will just have to squirt it anywhere in his mouth.

Here he is again, out cold probably for the night. After every chemo appointment in the past, he came home, ate a meal, then went to sleep for the rest of the day. I don't know what chemotherapy feels like, but I can imagine it's exhausting.

Yes, I imagine it must be. A good rest has got to be beneficial as well as comfortable for Willy right now. He knows he's safe and loved.

 

[IndyJones]

You could put the liquid in a bowl of churu or some other tube treat (squeeze it into a bowl and mix it up). Might work easier if you are concerned about him choking on the liquid.

 

[cmshap]

You could put the liquid in a bowl of churu or some other tube treat (squeeze it into a bowl and mix it up). Might work easier if you are concerned about him choking on the liquid.

Unfortunately, he refuses to eat any non-dry food or treat, as I mentioned in one of my previous posts...

AND, he refuses to eat all wet food, stews, broths, pastes, etc.

I don't really get why, because I had him on a 90% wet food diet for a long time at one point. But now he won't even eat the squeeze-tube treats (any flavor).

I'm not worried about choking. Just about making sure I get all of the medicine into him. Like if he fights me when I try getting the syringe in his mouth, which he did when I administered buprenorphine in the past.