Willy might have cancer / high-grade lymphoma Treatment thread

[Margot Lane]

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



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.

Is a bit of a pill pocket not an option? (Sorry in advance if I missed a mention of this earlier).

 

[cmshap]

Is a bit of a pill pocket not an option? (Sorry in advance if I missed a mention of this earlier).

I did mention it earlier, but no worries if you missed it... this thread is very long.

Willy has occasionally needed antibiotics throughout his life due to chronic respiratory symptoms that came from when he was sick before being rescued. So I've been giving him pills for at least part of each year over the last decade.

He has always outsmarted pill pockets. Ever since he was 1-2 years old... I could never get pills into him that way. He would pick up the whole pill pocket, chew on it for a while, then spit out the pill.

I've even witnessed him chew and swallow the pill pocket, and then finally spit out the pill.

I did make an attempt with pill pockets again before his chemo started (with the prednisolone pills). Didn't work when he was young, still doesn't work today.

So I learned how to pill him years ago, and I could reliably do it every time, until he got these tumors.

 

[cmshap]

Update: 1 day post-chemo (4th dose)...

There was definitely a little tumor shrinkage overnight. So I think the new drugs are working.

This is a good thing, but I'm wary about feeling too optimistic. The same thing happened after his first dose of lomustine; his tumors started shrinking right away. But then they started growing back after 3 weeks.

At least I know he will be more comfortable in the coming weeks. After his facial tumor got so big before this last appointment, he was shaking his head and scratching at it constantly. He is already doing that less frequently today.

A funny thing I observed recently: he sometimes sleeps with his eyes partially open. I never noticed it before this week. He was just doing it today (pictured).

 

[tarasgirl06]

Update: 1 day post-chemo (4th dose)...

There was definitely a little tumor shrinkage overnight. So I think the new drugs are working.

This is a good thing, but I'm wary about feeling too optimistic. The same thing happened after his first dose of lomustine; his tumors started shrinking right away. But then they started growing back after 3 weeks.

At least I know he will be more comfortable in the coming weeks. After his facial tumor got so big before this last appointment, he was shaking his head and scratching at it constantly. He is already doing that less frequently today.

A funny thing I observed recently: he sometimes sleeps with his eyes partially open. I never noticed it before this week. He was just doing it today (pictured).

Elvis does this a lot. Sneaking up on him is not gonna happen!
Good news in your UPdate. Day by day.

 

[fionasmom]

COP chemotherapy has had some good results in cats, so let's hope that it might help Willy.

 

[cmshap]

COP chemotherapy has had some good results in cats, so let's hope that it might help Willy.

Do you mean CHOP? I am not doing that protocol.

Some of the drugs currently being used in Willy's treatment are included in CHOP, I believe (cyclophosphamide and vincristine)... but the difference is that CHOP involves weekly treatments.

It could very well be that CHOP is what Willy needs. But I can't come close to affording it. These monthly treatments are hard enough. My oncologist told me that a CHOP protocol treatment followed to completion would cost up to $10,000.

So I have to do only monthly treatments, which may not be enough, but it's the best I can do.

Another factor with weekly treatments is just putting your cat through that trauma so regularly. It is highly stressful for Willy, and he's a really easygoing and cooperative cat. But he gets really scared, every time.

My oncologist said that some people opt not to do CHOP for this reason alone. Like some cats will go into hiding for days after a vet visit, and then their humans never see their cats anymore during what could be the final phases of their lives.

 

[fionasmom]

I meant COP which is vincristine, cyclophosphamide, and pred. CHOP is slightly different and has also been used as you have said. Don't spend any time telling yourself that CHOP might be what Willy needs but you were not able to do it. Studies show different success rates, many very close, and you are definitely doing mainstream, current therapy for Willy. You already did lomustine which is also a very accepted treatment. You do have to consider cost and Willy's response to what is going on. Causing huge stress to him would be extremely detrimental in its own right. Veterinary care on this level is hugely expensive, so much so that even a moderate pet insurance policy would not cover it entirely. My GSD had immunotherapy for his melanoma, but one plus is that he had no reactions and only ever believed that he had a nice car ride to see his friends at the clinic.

I have known a couple of people who did the CHOP protocol and the cat literally did hide forever. One very sad case was a cat who became so upset at the prospect of going to the vet that it escaped the house and was never found again.

 

[tarasgirl06]

Do you mean CHOP? I am not doing that protocol.

Some of the drugs currently being used in Willy's treatment are included in CHOP, I believe (cyclophosphamide and vincristine)... but the difference is that CHOP involves weekly treatments.

It could very well be that CHOP is what Willy needs. But I can't come close to affording it. These monthly treatments are hard enough. My oncologist told me that a CHOP protocol treatment followed to completion would cost up to $10,000.

So I have to do only monthly treatments, which may not be enough, but it's the best I can do.

Another factor with weekly treatments is just putting your cat through that trauma so regularly. It is highly stressful for Willy, and he's a really easygoing and cooperative cat. But he gets really scared, every time.

My oncologist said that some people opt not to do CHOP for this reason alone. Like some cats will go into hiding for days after a vet visit, and then their humans never see their cats anymore during what could be the final phases of their lives.

Good on you for your careful consideration of various aspects of various treatments. It's not just about physical, as you obviously know. It's about true quality of life. You're doing the right and best things for Willy. Your loving care is such an important part of his treatment. IMHO, it's the MOST important part. And it can't be bought.

 

[cmshap]

Second update: 1 day post-chemo (4th dose)...

All afternoon, Willy has been hiding and sleeping in spots where he's never slept before, all of which are isolated and away from me.

He's never done this before, so it's a little worrisome. He's also barely eaten anything today.

I'm just going to assume he's not feeling well from the new chemo drugs just administered yesterday. I hope that's all it is.

After his initial dose of lomustine, he never hid from me or looked like he felt sick... but it did take 2-3 days before I started noticing positive effects. Hopefully this is just a temporary thing.

In the meantime, I called my general vet today to discuss end-of-life... like what she recommends that I look out for, when I will know it is time, and how the euthanasia process works. I want to be prepared for this moment whenever it comes, so I don't feel so overwhelmed. And actually, talking about it today helped me feel better about it.

She specifically recommended a resource from Ohio State University called "Honoring the Bond." It contains a list of questions/statements that you answer and score numerically, and then it will give you an indicator of your pet's current quality of life.

She said that it would be a good idea to go through this questionnaire on a regular basis, even if Willy is feeling and acting well. Because you will have numerical data points which you can look at over time and see if there is a decline.

This is the website. The questionnaire is a PDF file that is a little further down on the page... scroll down a little and look for the "How will I know?" link.

Honoring the Bond: Support & Resources for Pet Owners | OSU Veterinary Medical Center

I am also attempting to attach the PDF to this post.

Edit: The section in the PDF titled "Anticipatory Grief" is exactly what I have been feeling lately. I didn't know it was common enough to have a name.

 

[tarasgirl06]

Second update: 1 day post-chemo (4th dose)...

All afternoon, Willy has been hiding and sleeping in spots where he's never slept before, all of which are isolated and away from me.

He's never done this before, so it's a little worrisome. He's also barely eaten anything today.

I'm just going to assume he's not feeling well from the new chemo drugs just administered yesterday. I hope that's all it is.

After his initial dose of lomustine, he never hid from me or looked like he felt sick... but it did take 2-3 days before I started noticing positive effects. Hopefully this is just a temporary thing.

In the meantime, I called my general vet today to discuss end-of-life... like what she recommends that I look out for, when I will know it is time, and how the euthanasia process works. I want to be prepared for this moment whenever it comes, so I don't feel so overwhelmed. And actually, talking about it today helped me feel better about it.

She specifically recommended a resource from Ohio State University called "Honoring the Bond." It contains a list of questions/statements that you answer and score numerically, and then it will give you an indicator of your pet's current quality of life.

She said that it would be a good idea to go through this questionnaire on a regular basis, even if Willy is feeling and acting well. Because you will have numerical data points which you can look at over time and see if there is a decline.

This is the website. The questionnaire is a PDF file that is a little further down on the page... scroll down a little and look for the "How will I know?" link.

Honoring the Bond: Support & Resources for Pet Owners | OSU Veterinary Medical Center

I am also attempting to attach the PDF to this post.

Edit: The section in the PDF titled "Anticipatory Grief" is exactly what I have been feeling lately. I didn't know it was common enough to have a name.

*PRAYERS* and also best thoughts and hope that Willy is just feeling like having a rest and adjusting to the effects of his treatment, and will soon be close to you once again.
Thanking you for sharing the important information which may very well be helpful for others. Having had many, many losses in many circumstances, I know it can be very helpful, especially for those who have never gone through it, to have supportive and educational information.

 

[iPappy]

Second update: 1 day post-chemo (4th dose)...

All afternoon, Willy has been hiding and sleeping in spots where he's never slept before, all of which are isolated and away from me.

He's never done this before, so it's a little worrisome. He's also barely eaten anything today.

I'm just going to assume he's not feeling well from the new chemo drugs just administered yesterday. I hope that's all it is.

After his initial dose of lomustine, he never hid from me or looked like he felt sick... but it did take 2-3 days before I started noticing positive effects. Hopefully this is just a temporary thing.

In the meantime, I called my general vet today to discuss end-of-life... like what she recommends that I look out for, when I will know it is time, and how the euthanasia process works. I want to be prepared for this moment whenever it comes, so I don't feel so overwhelmed. And actually, talking about it today helped me feel better about it.

She specifically recommended a resource from Ohio State University called "Honoring the Bond." It contains a list of questions/statements that you answer and score numerically, and then it will give you an indicator of your pet's current quality of life.

She said that it would be a good idea to go through this questionnaire on a regular basis, even if Willy is feeling and acting well. Because you will have numerical data points which you can look at over time and see if there is a decline.

This is the website. The questionnaire is a PDF file that is a little further down on the page... scroll down a little and look for the "How will I know?" link.

Honoring the Bond: Support & Resources for Pet Owners | OSU Veterinary Medical Center

I am also attempting to attach the PDF to this post.

Edit: The section in the PDF titled "Anticipatory Grief" is exactly what I have been feeling lately. I didn't know it was common enough to have a name.

I went through a similar questionnaire with Tag. I found it very helpful, and it made it easier for me to put that anticipatory grief aside and stick with the facts. Many times I assumed his quality of life would be poor, when it wasn't, I was allowing myself to see him sleeping in the chair as "laying around in pain" when he wasn't. The questionnaire's really did help.
Anticipatory grief is 100% normal, and I think everyone feels it in situations like this. My mistake was letting it consume me. Please do your best not to let it consume you, as hard as it is.
As tarasgirl06 said, every animal is an individual and different medications will affect them differently. If Willy is sleeping quietly and is resting, I'd leave him do so and if he acts groggy or lethargic in the morning, I'm sure the oncologist won't mind if you call them to give them an update and ask if there's anything you should be doing. Tag was going to the vet 2-3 times a week, and while he did not stress over it he would come home and sleep a lot. It just plain wore him out.
Edit: As far as liquid medication goes, would burrito wrapping Willy in a big, fluffy blanket and keeping his sore ear away from your shoulder and putting the meds in his mouth potentially work? If he pulls away his ear won't be near you and the only thing it will press on is a blanket that has plenty of fluff and give to it. Just an idea.

 

[cmshap]

*PRAYERS* and also best thoughts and hope that Willy is just feeling like having a rest and adjusting to the effects of his treatment, and will soon be close to you once again.
Thanking you for sharing the important information which may very well be helpful for others. Having had many, many losses in many circumstances, I know it can be very helpful, especially for those who have never gone through it, to have supportive and educational information.

Thanks.

I've had a few losses myself. But not quite the same as this. Willy is going to be a unique experience.

I mentioned this in another thread before, but my younger brother passed away suddenly about 14 years ago. Obviously, that was devastatingly hard, and I won't ever be "over" it, but the fact that it was sudden, and I didn't know about it until after the fact, made it different.

It wasn't "easier" but it was just different from an emotional standpoint, vs. watching someone decline over time and anticipating it.

The closest analogue would maybe be my grandparents, two of whom I lost in the last couple of years. They gradually declined and I visited them often as it was happening. But they were 98 and 99 years old, and it was their time, so it just made more logical sense, even if it was hard to observe.

I had pets as a kid who I had to say goodbye to, but all of the vet stuff was handled by my parents, so I was never totally aware of what was going on, and I wasn't the one having to make any decisions about their end-of-life. I only observed it as a kid and didn't have to figure any of it out myself.

So this is a first for me, where I am in control, and I have to make the call when it is time. And I have to be the one to bring my pet in for euthanasia. I've never experienced that before, and it honestly scares me. So I'm trying to prepare as best I can ahead of time by gathering information and asking questions.

 

[Mighty Orange]

The Blog – Get Busy Living Read this please. I used it against lung cancer my pet scan was clean.

 

[tarasgirl06]

Thanks.

I've had a few losses myself. But not quite the same as this. Willy is going to be a unique experience.

I mentioned this in another thread before, but my younger brother passed away suddenly about 14 years ago. Obviously, that was devastatingly hard, and I won't ever be "over" it, but the fact that it was sudden, and I didn't know about it until after the fact, made it different.

It wasn't "easier" but it was just different from an emotional standpoint, vs. watching someone decline over time and anticipating it.

The closest analogue would maybe be my grandparents, two of whom I lost in the last couple of years. They gradually declined and I visited them often as it was happening. But they were 98 and 99 years old, and it was their time, so it just made more logical sense, even if it was hard to observe.

I had pets as a kid who I had to say goodbye to, but all of the vet stuff was handled by my parents, so I was never totally aware of what was going on, and I wasn't the one having to make any decisions about their end-of-life. I only observed it as a kid and didn't have to figure any of it out myself.

So this is a first for me, where I am in control, and I have to make the call when it is time. And I have to be the one to bring my pet in for euthanasia. I've never experienced that before, and it honestly scares me. So I'm trying to prepare as best I can ahead of time by gathering information and asking questions.

I'm sure I'm not alone in being glad TCS is here for your support. Support helps. Bigtime. And you don't have to take it. Or you can take however much you want or need, at any time.
Among my many losses were several people I cared a lot about who took their own lives. One of them requested her two beloved cats be adopted by either their vets, who were unable to accept, or by me, who accepted very, very willingly. They were beloved of me in their own right, and also as living connections to my dear friend who could not stay here.
Another loss was a beautiful cat I adopted as a mature adult with an unknown background, who suddenly became paralyzed in her hind quarters a very short time after I lost my father. I had to get the information from the emergency vet as to her condition and make "the call" in the same visit. I did not know how, or if, I could endure this loss so soon after my father's passing, only a couple of months after adopting her. But I had no choice.
They say what doesn't kill you makes you stronger. If that is true, I must be extremely strong. And with every loss of a loved one, we endure and become more understanding, hopefully more compassionate, and yes, definitely stronger. I hope you share my knowledge and belief that this earthly life is not "the end" and that we will be reunited with our loved ones in due time in a MUCH better place. I hope that this will also be of comfort to you.
But for now, cherish every moment with Willy! and one day at a time.

*From top: Tomo & Kinoko in their original home; Tomo, Kinoko and Samuda in my home shortly after joining us; and Corrie angel during her too short time with us.*

 

[cmshap]

Third update: 1 day post-chemo (4th dose)...

As I said, Willy has barely eaten anything today. And I need him to eat his treats, as they are my current vehicle for prednisolone delivery (until I get the compounded liquid form next week). So, I dosed him with an extra-large amount of Mirataz a couple of hours ago.

It is technically "expired" which is why I am using more than the recommended dose.

He just ate all the medicine-coated treats, and then a decent amount of kibble. So the Mirataz does still work even if > one month old. Actually, my tube is about two months old now, and it still works.

Willy did jump up in my lap for about 10 minutes, but then went off to sleep by himself somewhere else again.

 

[iPappy]

The Blog – Get Busy Living Read this please. I used it against lung cancer my pet scan was clean.

This is amazing. Thank you so much for sharing this!

 

[iPappy]

Third update: 1 day post-chemo (4th dose)...

As I said, Willy has barely eaten anything today. And I need him to eat his treats, as they are my current vehicle for prednisolone delivery (until I get the compounded liquid form next week). So, I dosed him with an extra-large amount of Mirataz a couple of hours ago.

It is technically "expired" which is why I am using more than the recommended dose.

He just ate all the medicine-coated treats, and then a decent amount of kibble. So the Mirataz does still work even if > one month old. Actually, my tube is about two months old now, and it still works.

Willy did jump up in my lap for about 10 minutes, but then went off to sleep by himself somewhere else again.

If he ate a big meal and took the prednisolone, he'll probably sleep things off a bit more.
I might have missed it, but did the oncologist give you any information about possible side effects of the new chemo? If he has a day or two of needing Mirataz and sleeping things off and it's not uncommon with that type of chemo, it would ease my mind a little personally.

 

[cmshap]

I might have missed it, but did the oncologist give you any information about possible side effects of the new chemo?

Nausea, vomiting, diarrhea were the common side effects I was instructed to watch out for during chemotherapy. But this was all explained in the beginning with his first treatment of lomustine. There were no special instructions after yesterday's vincristine/cyclophosphamide treatment.

I posted this in the beginning, but I'm attaching another copy of the sheet I was given after his first chemotherapy appointment.

 

[iPappy]

Nausea, vomiting, diarrhea were the common side effects I was instructed to watch out for during chemotherapy. But this was all explained in the beginning with his first treatment of lomustine. There were no special instructions after yesterday's vincristine/cyclophosphamide treatment.

I posted this in the beginning, but I'm attaching another copy of the sheet I was given after his first chemotherapy appointment.

Ah, I must have missed that. Thanks for the repost!
I have no experience with vincristine, but I did look around a bit and it looks as though lethargy is not an uncommon side effect for a few days. Here's hoping Willy will be back to his old self once he sleeps this off.

 

[cmshap]

He had a little more energy tonight, but the latest challenge is that he is scratching at his tumor area constantly. I am almost at the point of putting an e-collar on him, but he is sleeping right now.

I've been physically stopping him from scratching, so he has been trying to outsmart me by going around the corner into the hallway, where I can't see him, to scratch.

His ear is a little inflamed, and the last thing I want is an open wound while he is immunocompromised. I'm going to be watching him tonight... if he wakes up and starts scratching again, the collar goes on.

I don't yet know if it will work. I bought it for after his biopsy surgery but never needed to use it at that point. It's a soft one that isn't very big, but I measured his neck and picked the correct size, and it had tons of positive reviews on Amazon.

Edit: Does anybody have any ideas for how to possibly relieve his itching? I can put a collar on him, but I'd prefer to take away the itching sensation, if possible.

This has come up before, when he was scratching at his tumor area as it was shrinking after the first treatment. Kwik commented on it at the time with some insight as to how it feels. I'm hoping that the reason for itching is shrinkage... but still, he could hurt himself.

Of course, whenever I have an issue arise, it is the beginning of a weekend, and I have to wait 3 days to talk to my vet. It never fails.