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Feline Lymphoma » Group Forum

So many questions

  
Angel Onyx

What\'s to eat?
 
 
Purred: Thu Nov 11, '10 7:33am PST 
Hi, everybody. My 13-year-old calico, Onyx, was just diagnosed with lymphoma. The vet made the diagnosis after aspirating her swollen neck lymph glands.

The day after the diagnosis, the vet went in for rotator cuff surgery, so I haven't had a chance to discuss this with him in much depth. The other oncology vet at his practice won't be in until tomorrow.

But on the phone, he outlined several possible courses of treatment, the "gold standard" being weekly IV chemo for several months, which he said would most likely result in remission for a year, maybe longer. If Onyx comes out of remission, a second course of chemo has a 50% chance of putting the lymphoma back in remission.

Option 2 involves an oral chemo med, the name of which I can't remember, but it has to be given in the vet's office, and prednisone, either by injection or orally.

And there may have been a third option, but I was so distraught I probably wasn't absorbing all the info.

I'd like to hear about the options others were given, and any questions I should ask the vet before deciding on a course of treatment.

Cass, Onyx's pet human.
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Miss Mittens- (Angel DG- #14)

I'm a soft,- gentle summer- breeze
 
 
Purred: Thu Nov 11, '10 10:40am PST 
Hi Cass!

I'm so very sorry about Onyx. How frightening it is when we learn that our cat has cancer! The word strikes fear into our heart and we don't know what to do or think. We feel so alone and don't know who to turn to for help or even what questions we need to ask.

My first piece of advice is to take a deep breath, clear your mind and try to stay calm. You have a lot of questions you need answered and important decisions ahead of you and you need to think clearly.

You need to talk with (or better yet, meet in person) either the vet who did the surgery or the oncologist, or both, and ask your questions and insist on clear and honest answers. If you don't understand something they tell you, question until you do understand.

Here are a few questions I'd ask:

What type of lymphoma does Onyx have? What is the prognosis for that type of lymphoma? Is the lymphoma only in her lymph nodes? Could it have spread to any other organs? Is more testing needed to see if the cancer has spread? How many tumors does she have and how many lymph nodes are involved? How well does that type of lymphoma respond to chemo in either option 1 (IV) or option 2 (medication)? What is the average life expectancy of cats with this type of lymphoma without chemo? What is the average life expectancy of cats with this type of lymphoma who undergo chemo?

What are the likely and possible side effects from the IV chemo treatment, if any? By weekly IV chemo, do they mean once a week or several times each week? How long does each weekly treatment take? When the vet says *several months* what does he mean? Will the prognosis of 1 year mean, e.g., 6 months on chemo and then 6 months in remission? Or is it something like 6 months on chemo and then 1 year in remission? What is the cost of each treatment? What is the estimated cost overall? What tests other than frequent blood tests will Onyx have to get as she undergoes chemo?

For the oral chemo: what is the prognosis of cats who chose this option? How successful is this option on average? What are the side effects from the medications? What medication will be given or are there a few options as far as chemo meds they might try? Will the medications have to be given every week for the rest of Onyx's life? How well do most cats tolerate the medications. What is the cost compared to option 1?

I'm sure even more questions will come to you.

Please check the group's links to get started on your research so you can learn everything you can about feline lymphoma and chemo.

Another thing I suggest you do right away is join the Yahoo Feline Lymphoma group. They have over 2,000 members and some of those members are very well informed and knowledgeable. Members have cats who have or have had just about every type of lymphoma there is and they know about all the different chemo protocols that are available and can probably tell you what protocol has been the most successful with most members.

I hope other members will see this thread and join in the discussion.

Good luck! I'll be purring very hard for Onyx.
hug

Edited by author Thu Nov 11, '10 10:41am PST

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Gracie

I am- Snowflake\\\'s- birth mommy!		 
 
Purred: Thu Nov 11, '10 10:55am PST 
Hi Onyx,
I have nasal lymphoma.. i was diagnosed in April 2010... immediately i was put on weekly chemo which was administered via IV at the hospital ( i go to the matthew j ryan vet hospital in phila which is near my house). I went every week but IV was only given every othr week, so the weeks i went there and did not get IV is beause i would get an exam there and blood count test. Then they would send my mom home with cytoxin, an at home chemo pill. So I would go there one week, get IV chemo ( vincristine) . Then go the next week, get nothing in hospital but instant blood counts and an exam. If all looked ok with blood count, they would send mom home with my chemo pill which would be given the next week at home. then after a few months, they switched me to every other week visits. So i would go to the hospital for vincristine but instead of coming back the next week for a checkup, they would send mom home with the cytoxin pill and she would just give it to me without me having to go back for the exam. Then after 6 months, they moved me to monthly chemo. So i got vincristine on Oct 16 and they sent mom home with cytoxin.. but i got the cytoxin 2 weeks after the vincristine... so they are spreading out my chemo a little more now... I go back on nov 16 and hopefully things will go well so i can continue monthly chemo. then they mentioned if things are ok, eventually would move to 3 month chemo.. etc.. I had to undergo some diagnostic tests including a cat scan but that requires general anesthesia and has some risks because of that. So your oncologist may recommend some diagnostic tests. Discuss with the doctor the risks and ask what is really really needed to avoid risks for onyx...
another option they threw out there was radiation which did not extend life expectancy any more and had bad side effects ( in my case, i could have gone blind since my lymphoma is in my nasal area). So mom opted for chemo and i have been on it 7 months now. Mom is told to make sure i eat and keep my weight on.. its very important. I have not had any nausea really.. just every so often but nothing major. There are pills to help with that.. but overall i have had no side effects from chemo. i have been energetic, happy, playing , purring, eating... I wish you all the best and just ask ur mommy to discuss tests with the doctor and find out what risks they have..and find out what is really truly needed if they discuss diagnostic testing. Just know that chemo is very well tolerated by cats because they administer at very low does.. so they just try to treat the disease and not cure it.. thats what they explained to me. So quality of life is very good with cats on chemo.
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Angel Onyx

What\'s to eat?
 
 
Purred: Sat Nov 13, '10 2:15pm PST 
This is so helpful, thank you so much. Thank you, Gracie, for reassuring me that it's possible for a cat to have a good quality of life while on chemo.

I'm already thinking that Onyx needs to see another vet. We like our main vet and his colleagues very much -- they are close, caring and quite capable of dealing with the usual feline ailments. But I'm not at all confident that they have a handle on this. The head vet outlined the options briefly for me over the phone, but I didn't catch it all. The other vet at his practice who does chemo was extremely vague today when I went in to speak to her.

I'd done a little online homework and had a lot of questions, but I didn't get satisfactory answers. For one thing, the diagnosis was made on the basis of lymph node aspiration. Is that sensitive enough to distinguish between lymphoma and other types of cancer? I gather that nasal lymphoma is pretty rare in cats, but that nasal carcinoma is less so. When I asked the vet if the treatment would be the same in either case, she said "yes," but sort of tentatively.

I'll be doing a lot more research.
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Misha Angel

Misha Mouse- snuggle muffin
 
 
Purred: Mon Nov 15, '10 4:12am PST 
Onyx, I got sick and mum took me to the vet.I had a fever and very high white count. He said I might have fluid in or around my lungs and wanted an x-ray. Well, a big tumor showed up in my x ray. He wanted to schedule surgery to take it out.Mum said she would schedule it when I felt better and I was put on antibiotics.Meanwhile, Mum took me to an oncologist at the specialist hospital. They did an ultrasound and a needle biopsy. They found the tumor in my belly was lymphoma. Cutting it out wasn't an option because at that stage I would have bad cells in other places already. So in our case, going to the specialist-the oncologist was a good idea. My options were IV chemo which he said I had about a 60% chance of remission, at home chemo and predisolone which was less effective or 3rd,to basically just make me comfortable. Mum opted to take care of me at home with the prednisolone and leukeran(chemo pill). This option prolonged my life about 2 months. I probably would have done better with the IV chemo. But mum didn't want to leave me at the vet twice a week to start, spend thousands of dollars and only have 60 % chance of remission. She wanted to take care of me at home. It sounds like yours was caught earlier and your options and prognosis are better. I still suggest seeing a specialist to find out exactly what kind of cancer you have so they know the best drugs to use.
We will be purring for you and checking in with you!
Huggies,
Misha and Mum
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Snooky

Life is a good- kitty treat!		 
 
Purred: Sat Jan 15, '11 6:10pm PST 
Hi, Onyx --
I am in remission from nasal lymphoma. The chemo was long, but it's not too bad and it's been 3 years since my diagnosis. I'm still ok! It's spaced out so -- after a while -- you go every month, then every 2 months. Then they just stop it. You'll just sleep a little more and maybe lose a whisker or two. I hope you feel better. I'll be thinking of you and hoping you're doing well!
Prrrrrr - Snooky
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