Bad week for Board, i guess -- Cleo's lymphoma's back :(

just got the call from the vet.

she was diagnosed with small cell low grade multicentric lymphoma last year, and her grossly swollen spleen was removed. the lymphoma was definitive in the mesentery and presumed but not definitively found in the spleen and liver (hence, multicentric).

her monthly blood/urine test results have been okay until yesterday, when she presented with elevated white blood cells and lymphocytes.

she was on prednisolone BID and CCNU every 4-6 weeks after trying leukeran + prednisolone made her really sick for 2 months. so now we don't know whether we'll need another chemo to add to the mix or need to change protocols altogether. trying to see whether her numbers are better 2 weeks after i give her CCNU pill, or whether we should just do abdominal ultrasound and/or chest xray to see if there are masses now and possibly to aspirate to see if the cancer has progressed or mutated into something worse.

she's lost weight over the past few months. still a little over 9 pounds and 5Ps are ok. even attacking her mean little sister sometimes, so quality of life is good but man, such awful news on top of other friends with lymphoma battles to contend with.

anyway, i'd appreciate your thoughts if you have any experience with this and your prayers and good wishes regardless.

cancer sucks so much.


[update at bottom but nothing definitive til pathology report comes back monday afternoon]

 

Re: Bad day for Board, i guess -- Cleo's lymphoma is back

((((Chris))))

it does suck, and I feel for you and Cleo.
Prayers for you both ((((hugs))))

 

Re: Bad day for Board, i guess -- Cleo's lymphoma is back

Wow - it's like a lymphoma outbreak - so many kitties dx'd so close together.

Hope the meds work for your girl.

Emmy & Dude (& Mittsi too)

 

Re: Bad day for Board, i guess -- Cleo's lymphoma is back

Aww, so sorry to hear about Cleo's test results :cry:
I hope you can find a combination of meds that work.

*hugs*
Odiesmom

 

Re: Bad day for Board, i guess -- Cleo's lymphoma is back

F*CK!!!! Oh man... I am so sorry about this ((((((((((((((((((((((((CHRIS)))))))))))))))))))))))))) Sending lots of cyber hugs for you and Cleo.

 

Re: Bad day for Board, i guess -- Cleo's lymphoma is back

I'm so sorry. I hope you can find some meds that will help. Thinking of you and Cleo

 

Re: Bad day for Board, i guess -- Cleo's lymphoma is back

oh chris, i'm so sorry. cancer does suck --- big time!
i have no advice, but i'll certainly hold you both close in thought and prayer...
(((hugs)))

 

Re: Bad day for Board, i guess -- Cleo's lymphoma is back

((((Chris and Cleo)))) Many, many good thoughts for you both.

 

Re: Bad day for Board, i guess -- Cleo's lymphoma is back

(((Chris))) I'm so sorry. Lots of thoughts and prayers for you both.

 

Re: Bad day for Board, i guess -- Cleo's lymphoma is back

Oh Chris, I don't want to hear this. I'm so sorry, hoping they find something that can easily throw her back into remission quickly. It must be going around. Justin has dropped a pound in the last 6 weeks. Haven't been weighing him regularly as I was so focused on Fallon's cancer. He is at 9 lbs now which is the lowest he has been in 2 years. I'm going to try and figure out what is going on.

Sending our prayers to Cleo!

 

Re: Bad day for Board, i guess -- Cleo's lymphoma is back

Of course you have my prayers...

 

Re: Bad day for Board, i guess -- Cleo's lymphoma is back

I am sorry for this and hope that you and your vet can find a way to get her healthy again

Jen

 

Re: Bad day for Board, i guess -- Cleo's lymphoma is back

i'm so sorry to hear this, yes cancer sucks, in both beans and animals .

 

Re: Bad day for Board, i guess -- Cleo's lymphoma is back

 

Re: Bad day for Board, i guess -- Cleo's lymphoma is back

Sending prayers fro both of you.

Lymphoma sucks. i wish we could outlaw it.

 

Re: Bad day for Board, i guess -- Cleo's lymphoma is back

from one lymphoma survivor to another...cleo hang in there!
i've had elevated wbc and lymphocites many times since my own recovery, and occasional unexplained weight loss which sent me into a tizzy but each time the scans produced nothing.
it's all so scary once you've been down the road once...our fingers and paw are all crossed for cleo.

 

Re: Bad day for Board, i guess -- Cleo's lymphoma is back

(((Chris and Cleo)))
I hate this!

 

Re: Bad day for Board, i guess -- Cleo's lymphoma is back

I lost Bunny 8/8/03 to lymphoma. It was in his spleen and one kidney. We never did chemo. We did do pred. I'm SO sorry you and your girl (who looks so much like my beloved Queen my heart hurts!) are going through this AGAIN!!!!!!!!!!

I started collecting Cancer Cat Stories/treatments after Bunny's dx. I have seen remissions...some of them lasted five years, but the cat died from another/different cancer...and some lasted only months. I have seen hospice cats (treated with only pred) go anywhere from a few months to well over a year. I have also seen Many Miracles happen on this board and I am always looking for any cancer success story--PRAYING FOR IT....
Hoping and Praying Cleo is one of them!!!!!!!!!!!!

HUGS

 

Re: Bad day for Board, i guess -- Cleo's lymphoma is back

#$%#%$!!!!! Cancer sucks so bad. :sad: Hoping & praying you find something that puts it in remission again!

 

Re: Bad day for Board, i guess -- Cleo's lymphoma is back

(((cleo))) (((chris))) not the update i had hoped to see you have our good wishes, both of you.

 

Re: Bad day for Board, i guess -- Cleo's lymphoma is back

Sending good thoughts and lots of love your way!!!

 

updated

path report comes monday afternoon but via ultrasound they saw suspicious areas of liver that they aspirated (can't really get nodes there but aspirated--took samples).

SO i don't really know anything. we suspected the lymphoma was in the liver and spleen but couldn't prove it. so this looks like the 1st proof. so whether it's progressed lymphoma of the same kind, or a different kind altogether, we won't know til path report comes back. (hoping it hasn't mutated and pretty hopeful about that.)

regardless, obviously what we've been doing isn't going to be enuf so something has to change.

chest xray looked good and no masses found other than liver.

so right now i have a stoner kitty coming off the anesthetic. she's pretty funny like that. she stood up on me the whole car ride looking out of the car at all the people and everything, so back to normal lickety split.

i knew she was feeling really sick all week. lots of crying and carrying her stuffed toy around asking to be picked up. so i asked the internist whether the u/s showed pancreatitis and it did, so we got bupe for her. really glad we got it. so she'll get pain meds maybe tonight. waiting for anesthetic to wear off totally.

update here, http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=18610, but i'm not confident enuf in my oncologist (i am, but i just want a 2nd oncologist opinion), so the internal med doc who did cleo's ultrasound will confer with the head oncologist tomorrow and call me again then. IM vet and cleo's onco vet already conferred this morning. i don't think i can go the biopsy route. surgeon has already been in there and seen the liver when spleen was removed and it would just break my heart to get nothing definitive again after all we've been thru.

 

I am so sorry that you and the beautiful Cleo are going through this. I hope you will get better news that you expect. Many good thoughts and prayers are headed your way.

 

Oh Chris. Darn it I'm so sorry. Please know that you and Cleo are in my thoughts and prayers. Why does this have to happen to our precious babies? I just don't get it. Our little girls are fighters though. They'll make it.

 

I am soo sorry Chris, you and Cleo are in my thoughts.

 

So sorry, Chris...very upsetting news. Sending strongest possible good thoughts your way.

 

I'm so sorry Chris. Prayers for you two.

 

I'm sorry Chris... I'll send prayers to your Cleo. My Cleo was also diagnosed with a lymphoma last April but it's too late for her...

Really sending lots of prayers your way...

 

((( Chris )))

Ah, sweet that she wants to cuddle when she doesn't feel well. I hope the path report helps in deciding what course of treatment to try next. Sounds like you're on top of things and caught the changes early.

 

Chris, you and Cleo have my thoughts and prayers. Yes, cancer does suck. It's taken my sweet MIL 6 years ago. I pray that the path report shows all good things. I look forward to your next post on little Cleo. *HUGS*

 

It breaks my heart to hear this .......praying hard she will go back into remission quickly. Thinking of you both ((((((Chris & Cleo))))))

 

Sorry to hear this but it may still turn out all right. Danny had multicentric lymphoma and chemo 3 years ago, and we had a scare like yours, about 2 years back now. Loads of tests and biopsies amd fear, but it turned out to be nothing. I hope you are similarly lucky. Give Cleo lots of kisses from her friends around the world. Fingers crossed!

(((Chris)))

 

(((Chris and Cleo))) Lots of prayers for both of you. Fingers and paws crossed for a good path report on Monday.

What a sweetheart with her toys and wanting to be held.

 

Chris ... Just seeing this now . I'm so sorry - wow! This just sucks, not much else to say & I so wish there was. Your dedication and will to fight for making sure gorgeous Cleo gets the best care possible is just inspiring. Cleo couldn't be in better hands than yours. Keeping you both in my thoughts and praying that you & Cleo will triumph over this once again!! Sending positive thoughts, hugs & head scratches for Cleo and all your babies ...

 

So sorry for you and Cleo - but at least her quality of life seems OK, which will make it a LITTLE easier for you right now.

Like the others I pray the right meds can be found to give her more time with you.

 

Damn lymphoma - gah! I'm very sorry to hear this. I pretty much knew when the lymphoma was taking control again with H. Things went fairly quick after that. As you may already know, despite H's large and intermediate cell lymphoma we chose the "chemo lite" with pred and chlorambucil [H fortunately tolerated this well - besides the diabetes]. I just wanted his last days to be good days - and I think we did a pretty good job at that goal. We'd done chemo with his mom and we'd get a few good days then her just being a sick wreck from the chemo [but not all cats are like this].

I'm not a huge believer in needle aspirations - they can miss and H's brother was actually mis-diagnosed WITH cancer when he did not have it from a needle aspiration. Laparotomy to remove any cancer and get real biopsies is IMHO the best option. Of course the health of the cat at the time can factor into that.

Anyway, there are no good answers with the lymphoma thing. Whatever you do, Cleo has a A+++ cat mom.

 

thank everyone. i'm feeling pretty defeated right now but i'm not a quitter. we'll keep going as long as she's purring and eating. ... ok, past then. she stopped both at diabetes diagnosis but i got her back and she's still looking half her age.
thank you, laur. it really does help to hear positive stories from the trenches. (((HUGS)))

cancer sucks so much. if the world put HALF the energy into cancer treatment/cure that it does into fighting, we'd have a cure by now.

 

Oh, nooooooo.... You're right - cancer sucks.

Sending healing vibes your way.... :sad:

 

Also, I wanted to note that despite the hex on dry food here [for very understandable reasons] - I did free feed H Evo dry [along with whatever wet and home cooked he wanted] at the last couple months and it did not effect his BGs nor did it seem to aggravate his triaditis. I did this because calories became more important than BGs and dry is calorie rich. But as I said that particular bag of Evo did not effect his BGs. So YMMV. As you know we make sacrifices for the treatment of lymphoma [e.g. pred vs. diabetes] - the dry food ultimately became one of those sacrifices without the sacrifice. We were also doing LRS so he was plenty hydrated - just in case anyone wants to argue the hydration point.

 

i know dry food and steroids get a bad rap around here but not for really sick kitties battling cancer or hepatic lipidosis. so yes the dry food is back in the equation (mix of wellness core and crappy tasty stuff so she'll at least eat it), as is prednisolone and liver/GI support.

so she gets around twice her normal dose of insulin, her numbers aren't as great (we can't sustain a 70-130 range any more), and her diabetes went from tightly regulated to just regulated, but we're balancing various health issues as well as can be expected. she gets SQ fluids more because of pancreatitis and chemo, anyway.

our normal rules fly out the window somewhat when cancer is involved.

 

Saying prayers for your sweet girl to beat this again... "With God all things are possible"

 

so far update is not good. asked other oncologist at practice to look at cleo's case for me and he thinks it's turning into leukemia (not the leukemia virus but still the lymphoma progressing). gave her chemo last saturday so in another week we'll recheck her bloodwork and will probably change her back to leukeran.

i HATE to do it. it made her so sick and she couldn't handle it in pill or chewable form. turned her off pill pockets for a month coz i tried to hide them in those. that was a crisis for us, as she has to take so many meds and the pill pockets helped so much.

anyway, so that's where we are. i just wish we'd have more months of stability instead of walking on eggshells month after month. she still vomiting even despite antinausea and antivomiting meds, but otherwise quality of life is good.

 

I have been giving Bert his meds smashed up in Beechnut baby food, Beef specifically in table spoon amounts and even Blue Bunny regular vanilla ice cream or half & half. You have probably tried these already, but, just in case.... I had to give the pockets up because Bert can't do those anymore either.

I hope the chemo works wonders and she does not get so sick. We are doing a three hour drip with the chemo because we can't put Bert out anymore for direct injection.

Hope all goes well.

 

thanks, george.
i've tried to give meds in baby food before but she rejects it. afraid to try chemo in it coz we can't afford for her to bite down on it (unsafe) PLUS if she gave up on baby food i'd be screwed. it's my go to food for sick kitties.
just got a pill popper in the mail from drsfostersmith.com so hoping that will help. she fights tooth and nail against oral meds, tho, unless i can convince her via pill pockets.

as i'm responding to you anyway, may as well update further. monday she goes for follow up bloodwork to see if ccnu helped at all this time. but as increased lymphocytes were found in her peripheral circulation the assumption is that her lymphoma is progressing to leukemia. next step may be a bone marrow aspirate. ugh.

 

Chris,

have you considered a feeding tube? It would solve a number of problems for you. First off, you could get plenty of high quality food and those critical calories into her. Second, many pills can be given via the tube, either crushed or cut small. Danny had an esophageal tube for like 8 weeks, which got him through hepatic lipidosis and fattened him up just prior to the cancer hitting, which was critical to his survival. The tube got us through the first couple weeks of his cancer treatment too. He got an infection so it was removed, but had he still needed tube feeding, he could have had one on the other side. The infection cleared right up. In hindsight I would have been cleaning the skin his tube more often and using an antibacterial soap then spraying with an antiseptic spray. The feeding tube does not hurt, from all accounts. Honestly, it was such a relief to be able to get food and meds into Danny so much more easily -- so much less stress. The placement is quick under anesthesia. I would never hesitate to have one done.

Another thing to try is breaking the pill (if possible) into smaller pieces, then putting each one into a partial or whole pill pocket. (I'd probably use whole for a chemo tablet.) Then, roll the pill pocket in freezedried crushed salmon or chicken, so it's dusty. Then press small bits of the dried meat into the pocket to disguise it more. Feed with similarly sized chunks of the freezedried stuff. This has worked wonders for me, even with a cat that's pill pocket aversive. In fact I've taken to feeding these as occasional treats to get all the cats in the mindset of 'yay, gobble gobble' when they see one. After the pill, I make sure to follow with a chunk or two of the salmon or chicken to push it all down.

One more idea - if Cleo likes fish, she might like wild salmon oil. That will add lots of calories plus nutrients. Coco loves loves LOVES lapping up his salmon oil - I give it after his 'dusted' pills since the freeze dried stuff could trigger constipation for him, which I have to watch out for due to his nerve injuries. It's helped him gain back the weight he'd lost.

hugs,
laur

 

Sending prayers and hugs for you and Cleo to beat this.
Kellie

 

I just bought a syringe hoping to mush some food and pills to gether and shoot it in slowly.

I have had some success with a tablespoon of Blue Bunny Vanilla Ice cream mixed with a little half and half and then ground up meds. You can also feed it in with a small syringe.

Tonight I'm going to try a little Bummble Bee crab. The salmon oil sounds like it might be appealing. Clam juice works on occassion.

Hope all is better than expected and hope you have good news to report.

 

Chris, you may want to clarify that with your vet. Lymphocytes are normal cells in peripheral circulation.

 

thanks, deanie. this is part of email from onco vet:

"The bloodwork revealed increased lymphocytes in the peripheral
circulation. This could be from increased cancerous cells being produced
in the bone marrow (true leukemia), or it could be secondary to overflow
from the liver. The only way to know for sure would be to do a bone
marrow aspirate."

i'd have to look back at her CBC results but RBC count is low and i think at least 3 other values are not in normal range.

 

Chris,

Still sounds very much like what happened with Danny. I really agonized over the bone marrow aspiration, because I was very afraid it would be painful for him, but finally had it done. It was clear, thank heavens. I know the awful worry you are feeling, but keep up your hopes. It can still turn out well.

You are in our thoughts.

laur and Danny (Big One)

 

that's been the major freak out issue for me, laur: spending so much on testing/diagnostics only to get NO definitive result. i mean, how do you remove a grossly swollen spleen with lymphocytes but no definitive diagnosis? how do you surgically get in there to take even easier liver aspirates with no definitive diagnosis? how do you aspirate time and time again with no definitive diagnosis? [if it weren't for the positive find in the mesentery we'd probably STILL be stalling on treatment.] i just cringe coz each time we do this we spend enuf for 2.5 months of cancer treatment without doing one thing to treat or getting one firm diagnosis. very frustrating.

"assuming" the bone marrow aspirate would be more definitive, but i'm sure you can tell i've about given up on the idea of aspirating anything more. it's funny but not funny!

so was leukemia brought up in danny's case, too?

 

It could also be due to something as simple as a virus. That would also cause increased lymphocytes. Was her wbc count increased or elevated? Do you have any idea who read the slide? Did they see anything abnormal on the slide and if so, did they refer it to a veterinary pathologist?

The thing is, if there are cancerous cells in the bone marrow, there's a very good chance you're going to see those in the peripheral blood. It's pretty rare to see the abnormal cells only in the bone marrow. So if all they saw was an increase in normal looking lymphocytes, I don't know that I'd be in any hurry to do a bone marrow aspiration.

Here's a few examples of the types of cells you can see:

Normal lymph


Reactive lymph



Atypical lymph



lymphoblast



multiple lymphoblasts

 

Yes, it was. The IM vet was very suspcious of leukemia and didn't give Danny much hope if that's what he had. I looked back on the old site to see what I could find, and only came up with http://www.felinediabetes.com/phorum5/r ... ?8,1029945 . Deanie was giving what proved to be very sage advice for me too -- since Danny didn't turn out to have leukemia after all.

(Deanie, you are such a wonderful asset to this group, and I haven't said it recently -- but THANK YOU for all that you do.)

I never did get a good answer for what caused the problems but it just sort of resolved iitself. We did stop the maintenance chemo though, I think partly as a result. I had forgotten that we did the flow cytometry in addition to the bone marrow aspiration. It was a very stressful time since all of it came back negative. That's what had happened for the two weeks prior to Danny's lymphoma diagnosis: test after inconclusive test. I kept bringing him back to the hospital and saying, "something's wrong - find it!" Very suspicious for cancer but all negative biopsies, etc. Then a lymph gland suddenly swelled up, and finally we could start chemo. (That puts me in mind of Jess' dog Elliott, who was fully checked out and negative something like 9 days before getting dx with very bad cancer.)

Aw, Danny just came over and collapsed across my forearms... making it hard to type, so I'll end this here.

 

Antech Diagnostics 6/23

Value.............. Reference Range
WBC 24.4 (hi).............. 3.5-16.0
RBC 6.2.............. 5.92-9.93
HCT 28 (lo).............. 29-48

Neutrophils 12688 (hi)..... 2500-8500
Lymphocytes 9272 (hi)..... 1200-8000
Monocytes 732 (hi)..... 0-600
Eosinophils 1708 (hi)..... 0-1000


mistaken--rbc not low this time. just lo normal.
u/s revealed enlarged nodes in liver not found previously. aspirated with no definite conclusion. IM vet taking aspirate found well-defined lymphocytes and said she got sample smack dab from in there. pathologist reviewed but i don't have copy of report. i'll try to get it tomorrow when she gets blood drawn.

thanks for the info. i'll read further. appreciate the slide photos -- would be nice to show onco vet without hurting her feelings re my candor.

 

reading what both deanie and laur wrote.......

and want to note that the liver nodes seen and the wc elevations do not necessarily have to be connected.
cp will also cause wc to go up. Winnie's was always all over the place from her cp.

wondering if cleo gets regular c & s since she is on pred. ( as you know roid can cover up outword symptoms)

best of luck at the vets. ((( chris )))

 

C & S? don't know that one...

and, yep, cleo ALWAYS seems to have pancreatitis when they do the ultrasound. IM vet confirmed it this time again.

 

Culture and sensitivity - test for urinary tract infection

 

lol. thanks linda. wasn't thinking urine. brain locked on blood questions.
yes, multiple C&S run (after cysto), with no evidence of infection. they've said one possibility is liver infection. don't know how you test further for that. well, duh, i guess you could run a C&S on that too.

oh well, off to blood draw...
[edited to add: asked them to add a reticulocyte count as well so they will. they've been talking anemia for a while now.]

 

Just sending some big hugs to (((((you and Cleo))))).

I'm in awe the amount of knowledge being shared/discussed.