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My treatment options

  
Misha

Misha Mouse- snuggle muffin
 
 
Purred: Fri Oct 23, '09 12:27pm PST
Hello kittys,
Please, anyone who can help respond. Mum just talked to the oncologist. My options seem to be this: Take several weeks of I.V. chemo twice a week then start on a lower dose. This is what the vet recommends. I have a 60% chance of getting "better"and may live 6-10 months longer then without treatment. Option 2 is to take a shot of Elspar to kick things off then start on the leukeran. I could also take predisone but I am not a good candidate for that being diabetic. Just one shot of this Elspar is 230$
Mum is leaning towards the shot then home care with the Leukeran. I HATE going to the vet and mum doesn't want me spending the last months of my life going to the vet a lot and feeling sick from strong chemo.
What do all you kitties have to report? 12 weeks of IV chemo just sounds awful to me and mum!
Worried about options,
Misha

Edited by author Fri Oct 23, '09 12:35pm PST


Miss Mittens

Fat is in! Don't- be thin!
 
 
Purred: Sun Oct 25, '09 5:02pm PST
Hi Misha,

Sorry not to respond until this evening (it's been a BAD weekend for us!)

Your mommy is faced with a very difficult decision. Option 1 would depend on your temperament and how calm you are and how long your mommy thinks you can tolerate going to the vet twice a week for 12 weeks. Some kitties handle it very well and others don't. That's 3 months of chemo twice a week for a 60% chance for 3-7 chemo-free, cancer-free months.

Is the outcome for Option 2 the same as for Option 1? Personally, that's what my mommy would do for me, even if the odds were lower. She knows that taking me for twice a week treatments lasting 12 weeks would stress me out so much that the few extra months it would give me wouldn't be worth it. She wants me to have as much quality of life during my final days as possible.

As for cost, the initial $230 for Option 2 seems reasonable and when you compare it to what the chemo IVs could cost overall, it has to be much cheaper.

I don't take Leukeran but believe the cost of a month's supply is reasonably priced. As for prednisone, ask your oncologist if you could try not taking it. Sally Maria has heart disease and can't take prednisone. She's been taking only Leukeran and is doing very well and is in remission.

Hope others can chime in here. Purring for you and your mommy. There is no wrong decision here and no matter what decision your mommy makes, it will be the right one for both of you.



hug

Edited by author Sun Oct 25, '09 5:09pm PST


Sally Maria

Mama's baby!
 
 
Purred: Sun Oct 25, '09 5:54pm PST
Misha, what type of lymphoma do you have? Do you have high grade or large cell? This is how they usually refer to it when a kitty has a mass. Or do you have small cell or low grade? This is the type Miss Mittens and I have. In my case, I had cancer cells throughout the walls of my intestines, not one localized mass, that caused swelling and thickening that interfered with my body's ability to absorb the nutrients and vitamins from the food I was eating.

Miss Mittens is right about one thing. Option #1 will be difficult if you're the type of kitty who doesn't like going to the vet. The IV chemo treatments are costly and can really be uncomfortable for kitties who have vet fears and anxieties.

As I mentioned to you before, I don't take Prednisone. I tried when I was first diagnosed but the two types I tried, Prednisolone and Methylprednisolone, caused my lungs to fill with fluid and mama had to rush me to the ER with heart failure. I'm not sure if the same thing happens when you have diabetes, but there is another steroid that is specially made to only be broken down and absorbed in the intestines called Budesonide. After a break for my heart and lungs to get stronger, I was going to try taking it but I was in remission by then so mama figured why bother if I was doing so well on Leukeran alone.

You'll hear over and over again that Leukeran takes a while to work, usually anywhere from 8-10 weeks. This is true to a point. Even though I was still very weak and lethargic, my white blood cell count showed improvement by my 2nd CBC (about 5 weeks after starting chemo). Depending on how serious your vet considers your lymphoma, it might be worth your meowmy asking if you could try Leukeran first and then, if there's no improvement, moving on to something stronger.

I have been officially in remission for 14 months. My mama has let both my regular vet and my IM vet know that when I come out of remission (if my heart and kidneys don't have other plans), that she does not want me to have any type of IV chemo. She feels that with my age and my personality, it will be too much of a strain on me. I'm not telling you this to dissuade your meowmy from trying the IV chemo. If your meowmy chooses that route, it may work out just fine for you. There have been kitties who have done extremely well on it (see angel Shep's diary for an inspiring story). But from what I've read and been told, it's not always an easy course of treatment. Then again, NO chemo treatment is a picnic.

I have done very well with option #2 and have heard of lots of other kitties who have been successful with it as well. It wasn't easy at the beginning and mama wondered many times if she was doing the right thing. I still have to go regularly to be weighed and to have my CBC checked (now every 3 months) and I still take my 1mg Leukeran every other night. The last couple of months I've started vomiting again because of it but this has been greatly helped with 1/2 Pepcid twice a day. I would give this treatment a try to see how you do. If it doesn't work, then your meowmy knows that you need something stronger. Every kitty responds to chemo differently but I hope that you can have the good results that I am having.

Hope this helps!!

Hugs & Purrs,
Sally Maria


Fela Kiti- ®- 5/1/06-7/16/- 09

Can I play with- that too?
 
 
Purred: Sun Oct 25, '09 5:56pm PST
I did chemo & prednisone & responded really well
it's not easy for our pawrents to have to make these decisions & chemo itself isn't too bad cost-wise...my prednisone was filled at my pawrents pharmacy for $10 instead of $55 at the oncologists

Misha

Misha Mouse- snuggle muffin
 
 
Purred: Sun Oct 25, '09 6:46pm PST
What kind of chemo did you have Feli kiti? Thanks everyone for their responses. The reason I am not supposed to have Prednizone is because it can increase insulin in the blood and I am diabetic. I will ask about the other one you mentioned Sally Maria. I don't know what stage I am. I will ask the vet Tuesday. My cancer surrounds my intestines and is in the lymph nodes around there. Not in my intestines as far as we know . It is a big mass and in the x-ray one can see it is already pushing my intestines back towards my butt. That is why we are going to start with a shot.
I will write back Tuesday after my shot and vet visit.
Thanks everyone! I am reading the links with my mum!

Rufus - In Loving- Memory 12/17

Momma's little- angel
 
 
Purred: Sun Oct 25, '09 9:21pm PST
From what I remember, Elspar is a really powerful chemo drug and is usually used as a "rescue drug" when other types of chemo stop working. $230 may seem like a lot, but it's probably not when compared to what you would spend on IV chemo twice a week. My visits were usually between $100-$150. The Leukeran was around $55 for just over a month's supply.

I was a great patient, so I tolerated the IVs and all the vet visits, but my Momma knows that she wouldn't be able to do the same thing with my sister who is a fraidy cat and drama queen.

Best of luck to you.

Fela Kiti- ®- 5/1/06-7/16/- 09

Can I play with- that too?
 
 
Purred: Mon Oct 26, '09 5:15pm PST
they tried different "protocols" & rotated the drugs... I had elspar, cytoxan, vincristine, adriamycin, leukeran & i think some other one...don't remember the name but it was initials...
Dr Philibert said that cuz the tumor i had was very aggressive, we had to be aggressive in fighting it...
because i had hypercalcaemia as a result of the tumor, my pawrents also mixed 1/4 tsp metamucil into my food 2x a day to help bring the calcium levels down & fight the tumor that way too (it produced excess calcium & my body couldn't dispose of it fast enough)