blood in vomit- help please

Rhinog has been OTJ for over a year. Two weeks ago after exploratory surgery he was diagnosed with a lymphoma. He has lost a lot of weight but has no other symptoms. 10 days ago the vet started him on 5mg prednisolone twice a day. At his last check with the vet 3 days ago the mass in his abdomen had reduced a little and he had no side effects from the pred.

Today he didn't eat all of his food. Very unsual! In the last half an hour he has thrown up a days worth of food followed by a significant amount of bright red blood.

Is this the beginning of the end or could it be the prednisolone irritating his stomach? Does anyone have any experience? It's nearly 1am here in the UK so can't phone the vet at the moment.

By the way, once he'd finished vomiting he went straight to his food bowl and started eating and purring.

Any advice gratefully received.

Ruth

 

I don't have any advice, but will be sending positive thoughts your way

 

Could be due to the prednisolone since one of the side effects of the prednisolone is:
"Gastrointestinal: Peptic ulcer with possible perforation and hemorrhage. Pancreatitis. Abdominal distention. Ulcerative esophagitis."

However, it could be something else.

 

Bright red blood indicates a GI bleed high in the tract, like from the esophagus, stomach, or upper small intestine. It's not a good thing, that's for sure, because you don't know WHAT is causing the bleeding.

However, steroids CAN cause upper GI problems, especially if used long-term or in conjunction with NSAIDS. And ulcer is the first thing that comes to mind, but there are worse things that can't be ruled out based on just the info you gave. Has your cat been on pred long-term for the lymphoma?

If you don't have access to an emergency vet, I would call literally first thing in the morning. It's a good sign that he still has an appetite, but any vomiting of blood is baaaad, especially since you have no way of knowing if there's an on-going bleed or not. Are you considering treatment for the lymphoma, or is that not possible with Rhinog?

 

Rhinog has only been on the pred for 10 days now but it is the only treatment the vet will consider for the lymphoma. After the exploratory surgery the vet said we don't have long left with him. She thinks pred is our only option and hoped it would give us a bit longer.

I'm going to phone first thing in the morning. There has been no more vomiting since he ate a little.

 

Ruth I'm sorry to hear that your kitty was diagnosed with cancer. Do you know what specific type of lymphoma? There are many subtypes. There are some treatment options, so don't hesitate to seek out an oncologist (or an internal med specialist, if there are no oncologists in your area) for more information. At some point I was able to find a list of oncologists in the UK, although there is no good, central site with this info.

I would not give the next dose of pred until you speak to the vet. Pred should NOT be stopped abruptly, but she may want to lessen the dose/go to every other dose in case it is causing GI bleeding. Rhinog is on no other type of medication? There are certianly many other types of medication which can treat lymphoma.

Please keep us posted, and take care.

 

Thanks for your advice and kind words everyone.

I spoke to the vet first thing and she said reduce the pred dose by half and give 2ml of Antepsin (sucralfate) an hour before meals to line his stomach.

Rhinog's lymphoma is in the mesenteric lymph nodes. He is on no other medication.

I've just seen him drink a whole bowl of water. I haven't seen him drink from his water bowl since he has been OTJ. I'm off to get some new test strips. I'm hoping he is just dehydrated from the vomiting, but I know that the pred could raise his sugar levels.

 

don't know if this is small cell or large cell but wondering why the cat isn't on chemo as well? can't his/her kidneys/liver tolerate it? my cat has small cell low grade lymphoma in the mesentery but possibly multicentric (in spleen & liver too) and is on 2.5mg prednisolone BID and ceenu once every 4-6 weeks. before the ceenu we tried leukeran every other day but she couldn't tolerate it.

pred + chemo has been a very successful protocol for lymphoma kitties. i think without the steroid my cat would eat even less and would not be as strong/solid. she was on sucralfate for a little while because of slight anemia. otherwise we're alternating antinausea medications as she's often been nauseated with the lymphoma.

i think the dose of pred can vary so it certainly makes sense trying a half dose. cleo's done pretty well on 2.5mg pred BID. she's still diabetic, and her lantus dose has almost doubled since she started pred but her BG numbers are pretty good now.

 

Good to know there are other cats out there with lymphoma in the mesentery that are doing well.

Our vet hasn't said if it is small cell or large cell. She just said it very aggressive. Would this mean large cell?
She thinks the mass grew by 20% over two weeks. (Rhinog's is also on the spleen too).

She did talked about chemo but didn't think it was appropriate in this case.

I feel really out of my depth. Just like I did when he was first diagnosed with diabetes. You think you can trust what your vet is telling you but once again I'm not sure.

 

Ruth, check out the following list (see Oncology, towards the bottom) to see if there is a specialist near you: http://www.ecvim-ca.org/dips%20specialty.htm#Oncology

Please, please consider talking to an oncologist. Even if there is no one within a reasonable distance, you can most likely do a phone consult after they've gotten your cat's records and copies of x-rays. I can tell you are feeling unsure here and doubt makes caring for an ill family member all the more difficult.

 

Thanks for the list. I'm on to it.