? Chlorambucil for lymphoma

Discussion in 'Feline Health - (The Main Forum)' started by Lisa and Smoky, May 4, 2017.

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  1. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Smoky was at the vet to get another ultrasound done. He has had drastic weight loss and is not gaining back the weight. The vet thinks he has intestinal lymphoma which started out as IBD. He also has an enlarged kidney. He wants to treat him with chlorambucil and prednisolone. Anyone else have any experience in giving this to their cat?
     
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  2. Phoebes

    Phoebes Well-Known Member

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    I am following this too. My vet suggested it as well. My best friends cat has been on it for 3 months. He gained 1 pound and is doing much better. But has gawd aweful dierear and it stinks. Joey is his name. She has Monica, Chandler. And Joey. I have Phoebe :)
     
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  3. Lillie

    Lillie Member

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    My previous cat was on both chlorambucil and pred for intestinal lymphoma. She was on it for about 11 months and did pretty well until she developed an intolerance to the chlorambucil and threw it up every time I gave it to her. At that point she declined quickly and the pred alone was not enough. While she did well on it she gained all her weight back, ate really well, and had no diarrhea. She did throw up now and then but not very often. She was also on b-12 injections that helped a lot. Had I caught her condition earlier she may have done better but she was pretty sick by the time they diagnosed it. Very frequent blood tests need to be done to check for other problems the chlorambucil can cause. Some cats do very well on it for several years but my kitty was not so fortunate. It's worth a try to see how well he does and you would most probably know pretty quick if it's helping. Poor Smokey- sending kisses from Leo.
     
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  4. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Thanks Lillie for your story. I may give it a try although I don't have results back yet from blood work. The vet wants me to start right away but can't get the chlorambucil until Monday. How often do I need to get blood work done? I think my vet said once a month.
     
  5. Lillie

    Lillie Member

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    I think (but not sure) it was once a month in the beginning but later on it was every three months. The pred got her eating right away and she started gaining weight pretty quickly too. I hope Smokey does well on it.
     
  6. Wendy&Neko

    Wendy&Neko Well-Known Member

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    An endoscopy or surgical biopsy is the gold standard for diagnosing small cell lymphoma. But you have to do those before starting pred. My civie is on both prednisolone and Leukeran (chlorambucil) and has been over a year. The pred immediately stopped his vomiting. My girl Neko was on budesonide and Leukeran. She had heart issues which precluded pred, and it doesn't impact the blood sugar as much.

    There are a couple of protocols for the chlorambucil. The pulsed dosing or dosing every two weeks is usually easier on them than the every other day method.

    There is a online groups.io list for Feline smallcell lymphoma that you might want to join.
     
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  7. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Smoky hasn't had any vomiting so far which is odd for his diagnosis. Does the chlorambucil make them feel sick? I've heard it was a chemotherapy drug. I will definitely look into the groups for support.
     
  8. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I'm glad you're getting some really good info here, Lisa.
     
  9. Lillie

    Lillie Member

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    I was told that most cats tolerate it pretty well but my cat was not so fortunate. She was ok with it at first but after about 11 months of being on it she started to get sick from it.
     
  10. Wendy&Neko

    Wendy&Neko Well-Known Member

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    My two cats had different reactions to chlorambucil. Neko got quite a bit of nausea from it, but that is why the every two week dose helped. She would feel off for about four days, then she would be Ok for 10'days. My other kitty is mostly a bit quiet for just one day after . You definitely want to have some anti nausea meds around, such as ondansetron and/or cerenia.
     
  11. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Does the chlorambucil have to be taken for a long time?
     
    Last edited: May 5, 2017
    Reason for edit: Add on to post
  12. Lillie

    Lillie Member

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    For my kitty it was to be permanent but there may be other cases that are different as to the reason they are on it to begin with. My kitty did go to remission on this, but it was a temporary remission.
     
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  13. Tracey&Jones

    Tracey&Jones Well-Known Member

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    I tried the every other day method on Jones and it was too hard on him - he slept every second day and felt like crap - no way to live. Vet suggested once a week but as Wendy pointed out to me that wasn't a recognized protocol. With Jones, lymphoma was never confirmed and will most likely not be with a endoscopy which is the only real way to confirm. That said with the pred - his IBD seems better to the vet upon palpitation of the belly though it is still "spongy" as she calls it. I still have the Leukeran on hand and have considered doing the pulse dose method and I will be discussing with the replacement vet. To see what she thinks. It will require regular blood work though to ensure his bone marrow does not become too compromised.

    The other issue I had is that the Leukeran is eliminated through the urine, at the clinic was insistent that he be kept by himself and have his own litterbox. That is not a good thing to do to a social cat - it stressed him right out.
     
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  14. Larry and Kitties

    Larry and Kitties Well-Known Member

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  15. Lillie

    Lillie Member

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    I had forgotten about that. I do remember now that the specialist asked me if I had any other cats using the same litter box. Fortunately I didn't so it was ok but I was very careful about cleaning it out and used gloves. It's also one of the reasons I had the chloram. compounded to a liquid so I did not have to handle the tablet. If I remember right my kitty was on it every other week for two days. I did not administer it every other day-.
     
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  16. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    We have three cats in the house now. I could not lock Smoky in a room by himself, he wld be miserable. I have an appt with his old vet that he's been going to for years on Monday to go over treatment options and possible euthanasia shld it come to that.

    The staff at cat clinic were giving me a hard time about sending results for ultrasound to his old vet. I don't really like it there as the staff are not friendly at all. They are too business like and almost indifferent.
     
    Last edited: May 5, 2017
    Reason for edit: New info
  17. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Mario used the pills (that was years ago when they were reasonably priced). I used a pill gun to administer the pill to avoid touching it. I consider using a liquid more dangerous since with my experience is that some liquid meds seem to get out of a cat's mouth
     
  18. Lillie

    Lillie Member

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    We all know our cats better than anyone else and we all have a sense of what would make them miserable etc. It's a hard decision to make but I know when I looked at my previous cat near the end I just knew she had had enough. It was heart breaking but I knew I was making the right decision for her. I know you will make the right decision for your Smokey whether it be medication or the 'other'. Sending you my most sincere wishes for healing - both for you and Smokey.
     
  19. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Thanks Lillie:bighug::)
     
  20. Tracey&Jones

    Tracey&Jones Well-Known Member

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    Lillie is right. We each know our own kitties. Best of luck in finding the path you need Lisa that works the best for you and Smokey.
     
  21. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Chlorambucil as liquid is not recommended. The shelf life isn't as long and much easier for you to be exposed to it. i used gloves to stuff it in a pill pocket. My Theo will be on it for life, unless it stops working. Some vet's may lower the dose a bit once remission is reached. Remission can last several years.
     
  22. Lillie

    Lillie Member

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    I had the chlorambucil delivered every month from the compounding pharmacy. The liquid was the only way I could get it in my kitty, as she was impossible to pill orally.
     
  23. Wendy&Neko

    Wendy&Neko Well-Known Member

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    My Neko was impossible to pill, until I got the Buster pill gun.
     
  24. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Update on Smoky: I'm a bit hesitant to try medications first. I can't know for sure if it's lymphoma without a biopsy being done. I don't want him to suffer though.
    I have an appt with my old vet on Mon to talk about the option of euthanasia. They require pre counseling before performing one. His current vet prescribed B12 injections for me to give once a week. She said his potassium is low so gave me Renakare tablets. A course of antibiotics: Enrofloxacin for that; Prednisolone in place of the Budesonide, and bupe for pain. She had to call in a prescription for the Lukeran so can't get that until Monday.
     
    Last edited: May 5, 2017
    Reason for edit: New info
  25. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Hi Lisa,
    Are these new meds because of the blood work results?
     
  26. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Most of them are prescribed due to the blood work. I don't have the results back yet for the EPI. The Chlorambucil is for the suspected lymphoma. I pray I'm not giving him these meds needlessly Kris.
    I'm trying not to rush into the "other" option w/o having all the facts and talking to the vet first. I gave him his first dose of antibiotics and prednisolone. The B12 injection I plan to give him on Sunday's.
     
    Last edited: May 5, 2017
    Reason for edit: New info
  27. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Yes, most of them are due to results from blood work. The Lukeran is for suspected lymphoma but can't get that until Monday. I need to talk to vet first before making any final decisions. I pray I'm not giving myself false hopes about these meds being able to help him
     
  28. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Oops I just double posted on my own thread.o_O I really need to get some sleep.
     
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  29. Lillie

    Lillie Member

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    It's very stressful trying to make these decisions. Maybe you'll feel better when you discuss it all with your old vet.
     
  30. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    He has been Smokys vet since he was a kitten. He was unable to treat him with the advanced health issues that he has.
    It's the reason I went to the new vet in the first place. I'm getting ready to go to bed and I'll try to get some sleep.:facepalm:
     
  31. Kris & Teasel

    Kris & Teasel Well-Known Member

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    As I said before, give it time. Talk to your old vet to see what he says. Maybe these new meds will perk him up a bit so you can think more calmly about a plan going forward.
     
  32. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Thanks Kris, that sounds good to me. :)It's hard to think clearly right now and the lack of sleep is wearing me down.
    My friends and my mom are pushing me to have him put to sleep but he's my cat after all.:oops:
     
  33. Yong

    Yong Well-Known Member

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    Try to catch up on your rest, Lisa. Don't let your friends and mum pressure you. Smoky is your friend and your family :bighug:
     
  34. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Your decision and yours alone, Lisa. :bighug:
     
  35. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Prednisolone was a game changer for my civie Theo. I hope it has the same results for your Smoky. Leukeran is not a fast acting drug. It can take a few months to achieve remission. However, once in remission, small cell cats can have a good life for several years. For me I give one pred in a pill pocket per day, then the Leukeran in pill pockets once every two weeks. It's not much work for me. In the US, you can get pred compounded into chew treats at the major on line compounding pharmacies.
     
  36. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    My vet prescribed him 2 mg of Lukeran twice a week. I mentioned the pulse dosing to her but she didn't know what I was talking about. I can't actually pick it up for him until Monday though.
     
  37. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Larry posted the link to the paper describing every two weeks, or pulse dosing. Maybe send that to the vet. It's easier on the cats, and involves less Leukeran so easier on your wallet too.
     
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  38. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I will show her the link but I doubt she is one of those vets who is willing to listen. Maybe if I print it out she will read it but who knows. Thank you to @Larry and Kitties for posting the link.
     
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  39. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Smokys old vet called me back today to go over the results of his ultrasound. How many vets will do that on a Sunday? It's not looking good for my boy. There are multiple growths showing up on the ultrasound. It's not just in the intestinal wall and both his kidneys are enlarged.
    His old vet said renal cancer may be there as well. There is just no way to tell w/o a biopsy being done but I'm not going to do that to him. I have to question why his current vet would suggest all these new meds having read this same report.

    I don't know if it's right or not to try and give him the chlorambucil and have him go through possible side effects from that.
    I did tell my old vet that I would need a few weeks to make a final decision.
     
  40. Lillie

    Lillie Member

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    Im so sorry to hear this. I'm sure you'll make the right decision for your boy.
     
  41. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Thanks Lillie
     
  42. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    His old vet said I could try the meds but that I was delaying the outcome. He said I shld ask his current vet why she prescribed all those meds for him. It comes down to his quality of life for me.
     
  43. Lillie

    Lillie Member

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    You old vet is most probably right. The meds could possibly make him feel better for a while, but would probably just delay the outcome. It makes me sad even though it's not my kitty because I know how you feel right now.
     
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  44. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I was just thinking this morning about Smoky being diagnosed with IBD back in Oct 2016. The new vet I was taking him to suggested using the chlorambucil to treat his IBD. The ultrasound at the time showed some slight thickening of his intestinal wall. I was afraid to try the chlorambucil because it was a cancer drug. The vet also wanted to put him on prednisolone but he was on vetsulin at the time and his BG was in 400-600 range. I was worried the pred would keep it in the high ranges and he was put on budesonide instead. He did so much better after being switched to prozinc.

    I was thinking that I should have started him on the chlorambucil and prednisolone back in October and it might have made a huge difference in the long run. I can't go back and start over and now Smoky is in a worse condition. His 12th birthday is coming up on Friday.
    Thanks for letting me rant.
     
  45. Kris & Teasel

    Kris & Teasel Well-Known Member

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    You're allowed to rant. Lisa. You did what you thought was best for Smoky back in October and you couldn't have predicted then that he'd do so much better on ProZinc. None of us has a crystal ball. :bighug:
     
  46. Lillie

    Lillie Member

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    I went through the same kind of thinking with my previous cat who had lymphoma. I kept thinking that if only I had put her on the meds sooner she may have survived. We make the best choices we can at the time with the information we have. My current specialist for Leo told me that even with pred and chlorambucil she has seen the disease progress anyway. It may slow it down some, but eventually she sees it return. I would have done the same thing in giving the budesonide in lieu of pred. due to the diabetes. You did good for Smoky, you took care of him, you regulated his BG, you are a good cat mom and Smoky knows this.
     
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  47. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Sometimes he gives me this look. Its kind of like " Mom, I'm just really tired"
    I talked to his current vet who says she has seen cats do really well on chlorambucil. I don't really like it there though. They act like you're bringing in a car for repairs. They never even talk to Smoky when I've taken him there.
     
  48. Kris & Teasel

    Kris & Teasel Well-Known Member

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    You're at another of those points like October 2016 where you have something to try but you're worried about the effect on Smoky. It's not an easy decision, given how he's feeling, etc. I'm sorry that the cat vet clinic is so cold and, well, clinical. You could use some advice given in a warm and compassionate manner to compare with what your old vet has said.
     
  49. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Smokys original vet doesn't think that the chlorambucil may help him in the long term. He is concerned that all it may do is slow down the disease and cause Smoky to feel even worse from possible side effects from the drug.
     
  50. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I certainly understand this, Lisa. Such a hard thing to figure out.
     
  51. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    It's weird trying to figure out whether to try out the chlorambucil for a month or make arrangements for him after putting him to sleep. I found an online support group for anticipatory grief for those about to lose a pet. Also, one for people that have pets with cancer.
     
  52. Kris & Teasel

    Kris & Teasel Well-Known Member

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    This is one of the really good things about the Internet - finding others who're going through what you are.
     
  53. Lillie

    Lillie Member

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    These on line support groups can be a good thing to join. I joined the Rainbow Bridge Pet Loss support group after Ms.Kitty passed and it was very helpful at the time. It really helped me to be able to process a lot of what I was feeling.
     
  54. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I saw that support group as well. I wish I could find a way for Smoky to feel better now. I hate the idea of taking him to the vet to be put to sleep since he will get stressed by the car ride and being away from home. It's extremely expensive to have that done at home.
     
  55. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I couldn't do the "pulse dosing" or once every two weeks in my area even if I wanted to. They won't do that where I live. It's only prescribed by 2 mg capsules given twice a week. Plus we have three cats and I wld have to lock Smoky in my bedroom for 2 days after giving a dose.
    He would be locked up all the time with that type of dosing schedule. That's just not fair to him
     
  56. Susan and Timmy

    Susan and Timmy Member

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    (((Lisa)))
    I'm so sorry you are having to make these decisions. I know how excruciating it is and wish I could help make it easier for you. Whatever you decide for your sweet boy will be the right decision at the right time. I don't have any knowledge of the meds you're talking about, so I can't offer anything there. Just thinking of you and Smoky.
     
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  57. Lillie

    Lillie Member

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    You could always do your own type of dosing once you got the chlorambucil and try the every other week. They do make this in a pill form and also in chew treats from compounding pet pharmacies but it doesn't sound like your vet is willing to offer an alternative form of the med. Of course then you would still have the problem of separating him from the other cats, just not so frequently. I was in a really confused place dealing with this at one time but eventually it became pretty clear what I needed to do. It takes time to process all of it.
     
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  58. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    To do that I wld have to give him 2 capsules in one day of 2 mg each and then repeat that two weeks later. I don't know if that wld be safe or not since it is a powder inside a capsule. I think the every other week dosing is usually 4 mg every two weeks, isn't it? I don't know much about that.
     
    Last edited: May 8, 2017
    Reason for edit: New info
  59. Lillie

    Lillie Member

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    I can't remember what dose my kitty was on but I do remember that it was every other week and initially was a tablet. I later had it compounded into a chicken flavored liquid. It seems kind of odd that the clinic didn't offer any other form and dose. They must have their own protocol that is pretty much set and that they don't vary from.
     
  60. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    My current vet still says 2 mg twice a week. I was thinking of giving him 4 mg once a week. She also said even with the chlorambucil he might only have three months to a year. I'm not sure I want to put him thru all of that just to keep him going for me.
     
    Last edited: May 8, 2017
    Reason for edit: Add on to post
  61. Lillie

    Lillie Member

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    I certainly see your point. We don't want to keep them going just for us.
     
  62. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    The vet gave me vitamin B12 to give to Smoky once a week. Here is a pic of a 1 mL syringe. It's a pretty big syringe and instructions are to give 0.25 ml. Does anyone know where that is on the syringe? Is it halfway mark between 0.2 and 0.3 mL on syringe?
     

    Attached Files:

  63. Larry and Kitties

    Larry and Kitties Well-Known Member

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  64. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Yes, 0.25 ml is halfway between 0.2 and 0.3
     
  65. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    My current vet insists there are guidelines she has to follow and the pulse dosing is not a part of that. She said that she can't prescribe every other week dosing schedule. I live in northeastern PA where they only allow for every other day dosing or twice a week dosing.
     
    Last edited: May 8, 2017
    Reason for edit: New info
  66. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Thank you @Larry and Kitties
    My vet called in a script to a compounding pharmacy for twice a week dosing, capsules are 2 mg each. Is it safe to give 4 mg once a week or better to keep to the 2 mg twice a week? My vet also tried to tell me it's not necessary to separate the cats if one is on Chlorambucil. I have had everyone on here tell me differently. I don't know what to think now.
     
  67. Wendy&Neko

    Wendy&Neko Well-Known Member

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    I wonder if it's time for a consult with an internal medicine vet or an oncologist that will be more up to date on treatments and dosing. You absolutely do NOT have to lock Smoky up in your bedroom after giving a dose. Just make sure you scoop the litter box frequently, especially the pee. And change out the litter often too. You should wear gloves when handling the medication. The formula for larger doses given less frequently (or pulse dosing), is based on the cat size. My two cats were larger and getting 6 mg a dose. But you do have to be careful that kitty is not getting too large a dose. There should be follow up blood tests to make sure his blood counts are still stable when on the chemo.
    Some cats live up to an extra four years after starting chlorambucil. That's a pretty good slow down in my books.
     
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  68. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes, it would be.
     
  69. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I'm still trying to decide on whether I can go the route of chlorambucil and frequent blood testing and the higher financial costs for that. Smoky is only about 7.5 lbs right now. He has two enlarged kidneys and multiple nodules on his intestinal wall is what I think the vet called them. Unfortunately, I don't have the means to consult with a specialist. I have been considering having him put to sleep.
     
  70. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

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    More BIG HUGE HUGS Lisa...whichever path you choose will be done out of an enormous love for him. This decision really stinks, went thru this with one of my dogs 4 years ago. We didn't go the chemo route but he wasn't nearly as sick as Smoky - we did just more or less hospice care for many months.

    HUGS AND HUGS and hugs and hugs,
     
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  71. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Yes it is "safe". However, an oncologist should give the dosing.
    I never separated Mario form my other cats
     
  72. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    His current vet called in the dosing to the pharmacy. The prescription is for 2 mg every 3-4 days which I'm guessing is twice a week. I don't know if I'm comfortable giving him this drug twice a week. They don't allow pulse dosing where I live, at least for a regular vet. I don't have the financial means to see an oncologist.
     
  73. Lillie

    Lillie Member

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    Has Smoky been responding to the pred. at all yet? I know you started him on this a few days ago. Was wondering if it has helped his appetite at all. My kitty started eating like crazy on it.
     
  74. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    He was already eating pretty good although he does seem to be eating more now. I am wondering about giving him the chlorambucil twice a week instead of once a week
     
  75. Lillie

    Lillie Member

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    Mar 10, 2017
    It's hard to know how he will respond. You can always stop it if you feel he's not doing well on twice a week. The b-12 should help him feel a little better. I know it perked my kitty up and she had been really sick.
     
  76. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Sep 6, 2016
    Smoky is getting B12 injections once a week. Plus he has potassium pills and antibiotics to take.
     
  77. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    Is it possible to get an endoscopy? If it isn't small cell, the drugs won't help for long if at all. Starting pred will make a diagnosis difficult. It's a hard decision. Good luck.
     
  78. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Sep 6, 2016
    I won't put him thru getting a biopsy. He has lost too much weight and I don't have the means to pay for expensive treatment. The vet believes it is small cell going by the ultrasound. Of course, he can't be sure w/o a biopsy being done. I am just trying the meds to see if it helps him to feel better. I'm giving it a month and if he is still sick or gets worse I'll have to do what's best for him and let him go.
     
    Kris & Teasel likes this.
  79. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    I totally get it. You might need more than a month if small cell. They respond slowly but once they do they feel much better.

    My Tiffany had intermediate cell. I bought her close to a year and it's much more aggressive.
     
  80. Lisa and Smoky

    Lisa and Smoky Well-Known Member

    Joined:
    Sep 6, 2016
    My mom is throwing a guilt trip at me now about Smoky. I just found out on Sunday the results of the ultrasound and the treatment options for him. She keeps telling me he is suffering every day and is in constant pain. I guess she wants me to not even try to treat the lymphoma at all and just put him to sleep right away.
    She is not even taking into consideration that the meds may actually end up helping him to feel better. She says all the meds will do is make him sicker or not help at all. I'm not stupid and I know I will have to let him go at some point, it's cancer after all. Sorry, I'm ranting again, it's just so frustrating.:oops:
     
  81. Lillie

    Lillie Member

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    Mar 10, 2017
    You may get a lot of different opinions but you have to go with how you feel about the situation. I wanted to at least give my kitty a chance to feel better and see if the meds would help. She did feel better for quite a while and they did help her for about 11 months. I knew it wouldn't be long term but for some reason I wanted her to feel better for at least a while even if I was contemplating having her put to sleep. I didn't want her to think I was giving up on her. Sounds kind of crazy and illogical but for some reason it made a lot of sense to me. I didn't want to not try. She was too frail at the time for a biopsy but her specialist was 99.9% sure of the diagnosis. With Leo I had the endoscopy done because he was not ill and is a pretty hardy cat.
     
  82. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Sep 6, 2016
    It's not crazy at all Lillie. I feel exactly the same way that you did. I have to at least try the meds first and would like to see him feel better first. Even knowing I would have to let him go later on down the road.:bighug:Smoky is also too weak to have a biopsy done and I don't have the means to get one done anyway.
     
    Last edited: May 10, 2017
    Reason for edit: New info
  83. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Sep 6, 2016
    I did a really dumb thing with his pain meds. :banghead:His vet told me they were pre-filled syringes so I asked about dosage. The vet never bothered to show me how to measure on the syringe. She just said the syringes were individual doses. I gave him the entire syringe full of bupe three nights in a row, each one of them is enough for 4 to 5 doses. I could have killed my kitty was my first thought.:nailbiting::confused:
    The pharmacist was kind enough to put water in a 1 mL syringe and showed me how to dose for each day from the same syringe. I am so mad at myself and the vet for not making sure I knew what I was doing first. :mad: the pharmacist told me to wait 5 days from Monday to give bupe again. I'm such a terrible cat mommy, could have really hurt him or worse.:(
     
  84. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    You've had a lot of stressful things on your mind, Lisa. Mistakes happen, especially when we're dealing with a lot but he survived this. Was he extra slow and dopey when he was given that much bupe? I hope you can get more bupe to replace what you've used and I'd fault your vet for not explaining clearly. When I had bupe for Teasel's cystitis pain the syringe was clearly marked with a black line to show one dose. They weren't prefilled, though - I had a small amount of bupe in a separate bottle.
     
  85. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Sep 6, 2016
    He was very slow and lethargic. I had my vet call in a prescription for bupe. It's how I found out about giving him too much. I'm picking it up today but pharmacist recommended waiting until at least Friday night to give him any.
    I only gave him one dose of the chlorambucil in Tuesday night. He vomited up some food on Wed morning and twice this morning. I gave him a quarter tab of cerenia. I feel so bad for him that he is getting sick from the chemo drug. The pred is making him eat a lot more than he was.
     
  86. Lillie

    Lillie Member

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    Mar 10, 2017
    I would keep an eye on the vomiting after giving chloram. If he continues this he may not be tolerating the med. Are you dosing him on a full stomach?
     
  87. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Sep 6, 2016
    He doesn't tolerate meds on an empty stomach well. I feed him a can first and wait a little bit before giving him the pill.
     
  88. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    Some kitties do, some don't get nauseous from the chlorambucil. Next time I would give the Cerenia before giving the chlorambucil, so it can block the nausea receptors. Some cats do better with ondansetron (Zofran) as their antinausea drug, some need both. Ondansetron is a human med that you get the vet to write a prescription for but you get filled at a regular pharmacy. I give ondansetron a couple hours before, with and the day after the chemo. Kitty Neko needed it for 3 days after the chemo.
     
  89. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Sep 6, 2016
    I can't really give him the cerenia that long before giving him the chlorambucil. I get home from work and give him the chlorambucil about 2 to 3 hours after that. What if his dosing schedule is twice a week dosing? It's prescribed to give to him 2 mg capsules every 4 days. I would have to give him cerenia nearly every day wouldn't I?
     
  90. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Feb 28, 2012
    ECID - each cat is different. You have to see how Smoky responds to the chlorambucil and dose any anti nausea medications as needed by him. Typically having anti-nausea meds on board first is best. And you'd give it daily as long as he needs it afterwards.
     
    Lisa and Smoky likes this.
  91. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Sep 6, 2016
    His second dose is for Saturday so it may help him to give cerenia before that? Also, a day or two after chlorambucil is given?
    Smoky hasn't had any good days lately. I'm worried about him feeling so poorly
     
  92. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

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    Jul 19, 2011
    Wendy, what dose were you giving?
     
  93. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Dec 28, 2009
    With Mario, I gave 1/4 of 10 mg Pepcid AC with the 2 mg chlorambucil pill. It seemed to help with nausea the next day.
     
    Lisa and Smoky likes this.
  94. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Feb 28, 2012
    Depended on the cat. Theo needed less than Neko. Theo needed 1 mg, Neko 2 mg. But I would run dosing and medicines by my vet first.
     
  95. Lisa and Smoky

    Lisa and Smoky Well-Known Member

    Joined:
    Sep 6, 2016
    That sounds like a good idea to me. My vet will be against me buying anything OTC for him. She just wants me to get everything through her clinic. Also, the cerenia is $25 for two tablets. The dose is 1/4 tab given as needed. The Pepcid AC sounds more cost effective to use.
     
  96. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Sep 6, 2016
    Smoky had vomited for two days after the dose of chlorambucil. I gave him cerenia which seemed to help a little bit.
     
  97. Lillie

    Lillie Member

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    Mar 10, 2017
    How is Smoky doing now?
     
  98. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Sep 6, 2016
    He is coming out of hiding more than he was. He still doesn't feel well. He vomited again this morning. That's the third time since Tuesday night. I'm worried the chlorambucil is having a bad effect on him. He has only had one dose so far though. He is getting the second dose tonight. I'm giving cerenia 2 hours before that to see if it helps him.
     
  99. Lillie

    Lillie Member

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    Mar 10, 2017
    Good luck. I hope things get better and the Cerenia helps.
     
  100. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Sep 6, 2016
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