? 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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    It's Smokys 12th birthday today so I gave him a little bit of FF gravy lovers turkey feast. The poor little guy was so happy to get a few bites of it.
     
  2. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

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    Happy Birthday Smoky!!!
     
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  3. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Smoky is not wanting to eat much since this morning. I'm very worried about him. He is eating less and doesn't show much of an interest in anything. I don't know what to do. The meds don't seem to be helping much so far.
     
  4. Lillie

    Lillie Member

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    I'm sorry to hear this. Did his vet have any opinion as to how long it may take for him to possibly show an improvement? Do you think the chlorambucil may be causing him to not want to eat? I cut back on the chloramb. a bit with my previous kitty because it was not making her feel very well at first. She had been in the hospital for a few days though and it took a good while when she got home for her to start eating again. I had bowls of recovery food sitting every in the house and put her in the bathroom at night with food and water so she would be as close to the food as possible.
     
  5. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I do think that the chlorambucil is making him too sick to eat. He is vomiting for two days following each dose. His vet said to give it twice a week so that's at least 4 days each week that he is sick. His vet gives him 3 to 12 months to live and that's with treatment. The lymphoma is diffused and making it difficult for him to digest any of his food. What did you mean by recovery food?
     
  6. Lillie

    Lillie Member

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    Hills and Royal Canin make a recovery food that is very high in calories for cats who are recovering from illness and need extra calories. One of the them is an AD, I think it is Hills AD. I think it's something like a pate chicken liver. I believe my kitty was given anywhere up to a possible 12 months. When she started vomiting the chorambucil I stopped it and just left her on the pred. for a while. I knew it would be a shorter time span without the chloramb. but she was not tolerating it at all after 11 months.
     
  7. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I asked my vet about Hills AD and she told me it was low calorie so it was easier to digest it for cats recovering from serious illnesses. I though she might be wrong about that. I thought about giving Smoky the chlorambucil once a week to see how he does on that. He doesn't seem to be tolerating the chemo drug from the beginning.
     
    Last edited: May 16, 2017
    Reason for edit: New info
  8. Lillie

    Lillie Member

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    My mistake- it's high in fat not calories so I imagine it's not good for pancreatitis. It has a similar calorie count than other canned food. There is another one for recovery I used too. I had to get my cat eating and the recovery food was a good option for her at the time.
     
  9. Lillie

    Lillie Member

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    It was the Royal Canin RS recovery food that was the one with chicken liver. Not sure about calorie count though but my cat loved this food when she was sick and was the only one she would eat much of. My memory is getting foggy!
     
  10. tiffmaxee

    tiffmaxee Well-Known Member

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    Tiffany hid as well. It's the disease making him feel sick. When the meds kick in he will feel better. Bupe lasts about 8-12 hours so I wouldn't wait 5 days to give it again. Ask your vet. I don't know about where you live but in my state and many others vet's have to give prescriptions so we can get meds elsewhere. :bighug:
     
  11. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I checked into some non profit groups for help with paying for cancer treatments for cats. Half of them are no longer in existence and 1/4 of them are no longer accepting new patients. The rest of them offer a one time grant of $500 if your vet gives a prognosis of 50% survival rate or higher but they have very long waiting lists.
     
  12. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    It wouldn't hurt to try the food
     
  13. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I waited five days to give the bupe because I thought I was supposed to give him the whole syringe. Each syringe has enough bupe for five days. My vet didn't explain the dosing to me very well. I could have hurt or even killed him with that much of an overdose.
     
  14. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Maybe worth trying some bupe, Lisa?
     
  15. Yong

    Yong Well-Known Member

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  16. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I have been giving him the bupe since Friday night, every 12 hours if he needs it.
    I usually give it to him once a day at night.
     
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  17. Kris & Teasel

    Kris & Teasel Well-Known Member

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    The link that Yong sent is interesting.
     
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  18. Susan and Timmy

    Susan and Timmy Member

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    Just thinking of you and your sweet boy. Hoping and praying for improvement.
     
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  19. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Smoky vomited quite a bit today. I called his vet who wanted me to bring him in again. I don't trust this vet too much. She is always wanting me to bring him in all the time. She never talks to him or me except to ask what his symptoms are.
    I told the clinic I didn't want to stress him out unduly and vet told me to skip his dose of chlorambucil tonight. She called in a prescription for ondansetron since the cerenia doesn't help that much. I think it's the chemo drug making him so sick. He is a cat who rarely vomits so for him doing so for three days is odd. It started the day after his first dose of chlorambucil May 9 before bed.
     
  20. Lillie

    Lillie Member

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    aww-Sorry to hear this.
     
  21. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Me too Lilly. I wish I had a better update for him. I feel that I am losing him far too fast.:(
     
  22. Lillie

    Lillie Member

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    It can go very fast in some cases. You just don't know a head of time when you start treatment so it's good you tried everything possible up to this point and gave him the best chance you could. I hate going through these things with my fur kids- just hate it! It's just too sad and it always takes me a good while to come to terms with all of it.
     
  23. Kris & Teasel

    Kris & Teasel Well-Known Member

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    :bighug::bighug: for you and Smoky.
     
  24. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I went down to talk to Smokys old vet.
    He didn't want to stress my boy out so he came to my house to see him. How many vets will do that these days? He said that his prognosis was not good and with aggressive treatment he might live another 6-9 months. He is sleeping a lot and seems very unhappy. My vet recommended having him put to sleep soon. He said that's it's my decision to make though. I have the ondansetron for nausea and bupe to keep him comfortable until then.
     
  25. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Bless your old vet, Lisa. You'll do what's best for your boy. :bighug::bighug:
     
  26. Lillie

    Lillie Member

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    :bighug::bighug::bighug: Hugs for you and Smoky.
     
  27. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I can't help feeling that the specialist who diagnosed him in Oct with IBD was wrong about that. I think he had the lymphoma developing all this time. My old vet said the IBD could have morphed into cancer and it might just be a very aggressive type. Or it cld have been a slow moving lymphoma and the outcome might still have been the same. It's hard to get a few days off from my job on a weekend in the summer. I was able to get off work for June 9 and 10th and I have regular days off on June 11 and 12. I spoke with his original vet for an appt to come in on June 9 to have him put to sleep. It's the best thing I can do for him.
     
  28. Lillie

    Lillie Member

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    Symptoms can be pretty much the same for both especially if the IBD is severe. Treatments are the same too. You old vet is probably right about the outcome whether he was treated for IBD or lymphoma. I'm sorry Smoky was one of the ones who had this progress to this extreme. Making him comfortable now is important and is a good thing to do until your next visit in June.
     
  29. Yong

    Yong Well-Known Member

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    I'm so sorry you had to make this decision, Lisa :bighug:. Enjoy your time with him and make him comfortable. He knows you love him. We are here with you :bighug:
     
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  30. Kris & Teasel

    Kris & Teasel Well-Known Member

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    This is heartbreaking, Lisa. It's impossible to answer the "what if" questions and it will stress you more trying to. For now, taking it one day at a time and keeping him comfortable is best. We're all here for you. :bighug:
     
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  31. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Smoky quit vomiting right after I stopped giving him the chlorambucil.
    I'll see how he does on the ondansetron.
    Thank you for thinking of us and all the kind thoughts sent our way.
     
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  32. Donna and kitties

    Donna and kitties New Member

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    Hi Lisa, I thought I would share with you my very recent experience with possible IBD and lymphoma. Earlier this month (May 6th) I started my 19-20 year old Lily (Himalayan) on chlorambucil. She had been slowly losing weight over the past year and then in late March she started having terrible diarrhea and her already low weight plummeted. She also started collecting fluid in her chest and abdomen (something was exacerbating her heart disease). A trip to the cardiologist and heart meds took care of the fluid, but she continued to decline, with ongoing diarrhea and continuing weight loss, despite eating voraciously. Her blood work indicated she had some kind of severe systemic inflammatory process as well as kidney disease, and an abdominal ultrasound showed that she had thickened bowel loops. Thinking it was IBD, she was immediately switched to a limited ingredient diet, given some B-12, and put on dexamethasone injections (pred was contraindicated because of her heart disease).

    After a couple of weeks, there was no improvement at all, so intestinal lymphoma was suspected. By this time, Lily was weak, uncomfortable, and the diarrhea was just getting worse. Things got so bad, I truly thought that Lily would not make it through another week. Like Smoky, Lily was also too frail for a biopsy, but we decided to assume she was dealing with lymphoma and try the chemo. Lily seemed to be very uncomfortable for about a day and a half after her first treatment (although she did not vomit), but she has now had 4 treatments (2 mg every 3rd day along with daily steroid injections), and her nausea after each treatment seems to be easing. I do make sure she has eaten a good amount of food before I pill her. I only started seeing improvements in her symptoms a couple of days ago (after treatment #4), so progress has been slow. However, her terrible diarrhea is starting to show signs of resolving (she even had one perfect stool yesterday), which is a *huge* breakthough. She is also feeling better and is following me around the house again. I don't know if she will actually go into remission or put on any weight (she is still skeletal-thin), but her quality of life seems to have improved, and that is the most important result.

    You may want to give the chemo a little longer to see if it helps Smoky. Also, make sure you give food before giving the chemo pill, and please *do* try the Odansetron. I went through chemo myself a couple of years ago (for intestinal lymphoma, oddly enough) and took Odansetron for the nausea--it is quite the miracle drug! If none of this ends up helping Smoky, then you can you take some comfort in knowing that you have done all that you can do.
     
  33. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Thank you so much for sharing your story. My old vet thinks that Smoky may be one of the few cats who can't take chlorambucil. The other major hurdle for me is that I just don't have the means to pay for treating the lymphoma. The chemo pills, the frequent bloodwork, meds for nausea and vomiting,etc. I can barely scrape by with getting his insulin and diabetic supplies. He has a laundry list of medical issues and now seems to have fluid buildup in his abdomen. I can't say that for sure but his belly seems pretty swollen.
     
  34. Donna and kitties

    Donna and kitties New Member

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    I am so sorry to hear that your boy is having even more problems. And sadly, the cost of care can limit options. Poor Smoky and poor you. My prayers are with you both.
     
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  35. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Thank you for your prayers and thoughts.
    I really hate it that I don't have the money to help Smoky and have to let him go in part because of that. I just don't want him to suffer and be in pain.
     
  36. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Better times from before:
     

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  37. Lillie

    Lillie Member

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    Having more money doesn't always make a difference. I had enough money at the time to treat my previous kitty for lymphoma and I still had to let her go. She still succumbed to this disease. You've helped Smoky and tried the meds used for his conditions. I don't see where you could have done any more.
     
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  38. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    My old vet would agree with you. You actually said almost the same things that he did to me. It's just me feeling guilty I didn't start him on the chlorambucil sooner, back at end of Oct. It may have been a better now
     
  39. Lillie

    Lillie Member

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    And he also may not have been able to tolerate the chlorambucil any better back then than he's doing now so if you would have put him on the chloramb. back then it may not have made any difference.
     
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  40. Jeff D / Sketch

    Jeff D / Sketch Member

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    Lisa and Smoky. Sorry to hear Smoky isn't feeling well. My previous car Bud was diagnosed with lymphoma after some ongoing weigh loss. After more diagnostic they found a mass in his upper intestine. Diaged as lymphoma..Options were surgery and chemo. He was already 17 yrs old so I didn't want him to suffer through surgery and chemo. My vet opted for oral prednisone after an initial injection to see how things would go. Bud surprised all of us and responded well to the prednisone. Three weeks later the mass had shrunk to the size of a pea and he was eating well , gaining weight with more energy than I has seen in a couple years. We dropped the prednisone to once every other day. Bud lived another four years and it was kidney failure that got him not the lymphoma. I guess the moral of the story for me was picking the less invasive method turned out to be the right choice....but like people every cat is different. Hoping the best for you and Smoky!
     
  41. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    What kind of diagnostic tests did you have done? Smoky had two ultrasounds done but vet determined that he was too weak to get a biopsy done. The first ultrasound showed a slight thickening of the intestinal wall. The second one several polyps along the intestinal wall plus enlarged kidneys.
     
  42. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I gave Smoky ondansetron, 1 mg about 30 minutes before giving him chlorambucil. I gave him a half can of food with the ondansetron, he gets sick taking meds on an empty stomach. He vomited about 2 hours after taking the chemo drug. Should I have waited longer to give him food? He feels really hot and was laying on the bathroom tile which is cooler. Should I give cerenia as well? Is one med better for nausea and one for vomiting?
     
  43. Lillie

    Lillie Member

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    I know in people ondansetron can be taken with or without food so it may not have made any difference when you gave him his food. My cat would throw up the chlorambucil no matter what about 1-2 hrs. afterward. From what I've heard the cerenia is good for vomiting and the ondansetron is good for nausea but hopefully others will come in here who have experience with both.
     
  44. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I'm a bit worried about him getting dehydrated. He vomited three times in an hour. This was two hours after the chlorambucil was given. He sneaked into some dry kibble and threw that up a few minutes later. He is bugging me for food but I don't think I shld give him anymore right now. I'm giving him some bupe so maybe that will relax him a little
     
  45. Lillie

    Lillie Member

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    Three times in one hour is a lot. I would be worried about dehydration. Can you give him fluids, or can you have your vet give him fluids tomorrow?
     
  46. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I don't have fluids to give him at home. I have to work tomorrow and my vet is only in the office from 8 am to 1 pm. He is drinking water now though.
     
  47. Lillie

    Lillie Member

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    I'm glad to hear he's drinking.
     
  48. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I heard from a friend about giving an alternative med instead of chlorambucil. I'm not sure what the name of it is though.
     
  49. Lillie

    Lillie Member

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    There are a couple others that could be used according to Leo's specialist but I can't remember the names. One may have been cyclophosphamide. I do remember though that she said he would need an echo cardiogram before administering it. Not sure if this recommendation was just because Leo had a previous blood clot or if it is regularly done.
     
  50. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I came home from work today and my roomie said that Smoky vomited twice. She said it was a lot both times. I gave him 1/4 tab of ondansetron this morning after his breakfast. I can't give him the chlorambucil, it is making him really sick. The ondansetron doesn't seem to be helping much with the vomiting. I might just give him the cerenia again for now.
    I am very worried about him getting dehydrated. He seems really hungry most of the time and was fine for the six days prior to giving the chlorambucil. He wasn't nauseous and didn't vomit once.
    I don't think I can take care of him properly as far as paying for treatment for the lymphoma goes. I feel like I don't have a choice and am being forced to have him put to sleep by my circumstances.:(
     
  51. Lillie

    Lillie Member

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    Maybe he just cannot tolerate the chlorambucil. Maybe you could just leave him on the pred along with the cerenia and ondansetron and see how he does. It's really not good for him to be vomiting this much and if he was better before the chloramb. maybe it would be good to just discontinue it.
     
  52. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I don't think I will give him the chlorambucil again Lillie. I'm wondering if I should still have a CBC done when he only had 3 doses so far. The vet said after 4 doses have one done. Realistically, what are his chances w/o taking a chemo drug? I'm just thinking out loud here.
     
  53. Lillie

    Lillie Member

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    I don't know what his chances would be without the chemo. For my kitty once I stopped the chloramb. she started losing weight very quickly and that's when I decided to let her go. She was 17 1/2 yrs old though and her kidneys were starting to decline also. It doesn't mean all other cats will react the same as she did. I would go with what the vet recommended only after 4 doses for the CBC. Leo right now is limping on his leg that he had the saddle thrombus in over a year ago. I'm just praying it's not another clot because they do not usually survive a second one. I guess I will be awake all night keeping an eye on him in case there is a sudden drive to the ER. Darn!
     
  54. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Oh no Lillie! :eek:I'll be praying with you that it's not another clot again. I didn't know cats could get those. We will be with you if you need to pull an all-nighter. Hopefully, that won't be the case though.
     
  55. Lillie

    Lillie Member

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    Saddle Thrombus is more prevalent in male cats who have cardiomyopathy but the odd thing is that Leo does not have heart disease so they have no idea why he got it to begin with. I gave him his Plavix early tonight just in case and have an urgent email in to his specialist. I think I will be getting a fish next time I want a pet. (just kidding)
     
  56. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Smoky seems to be getting worse fairly quickly. The chlorambucil is making him sick, he has vomited at least twice a day after taking it. This happens for a few days following the dose as well. The ondansetron doesn't help with the vomiting at all, just the nausea. The cerenia worked far better for vomiting.
    It's scary to see him going downhill even though he is being treated for the cancer.
     
  57. Yong

    Yong Well-Known Member

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    So sorry Smoky is not doing well, Lisa. Remember we are here for both of you :bighug:[​IMG]
     
  58. Lillie

    Lillie Member

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    Are you still giving him the Cerenia? Maybe that would be better than the ondansetron at this point. I would think that stopping the chloramb. might not be a bad idea if it's making him that ill. Poor guy- it's hard on them to be vomiting so much.
     
  59. Sarah27

    Sarah27 New Member

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    Hi, ,I am not sure if you read this book yet, it would really help you, and I highly recommend it, it's called "What to expect when your cat has cancer A survival handbook for feline cancer and treatment". It's one of the best cat books I have ever read. The author's cat had IBD and was diagnosed in 2015 with pancreatic cancer and was given 3 months or less to live, but he's alive today and in remission and doing great. His miraculous true story is intertwined throughout the book and it has the cats medical records to prove it inside the book. It's a must-read for everyone who has a cat because 1 in 3 cats will be diagnosed with cancer and the book talks about what you can do now for cancer prevention and about the warning signs of cancer, and if your cat has cancer, what you can do now to help him to fight cancer. It's well written, lots of resources and 330 pages. I read it this weekend and will keep re-reading it, there's a lot of information in there. i am sure Lisa there is helpful information in this book for you. It's on sale now at www.catcancers.com Hope this helps you and Smoky.
     
  60. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Thank you so much for replying. I will read the book and review it for future reference since I have family and friends who own cats.
    I've had an oncologist tell me already that it's highly likely that Smoky has intestinal lymphoma and now probable renal cancer. He is too frail for any type of radiation therapy or surgery. His low body weight won't allow him to be put under for a biopsy and he can't tolerate chemotherapy drugs.
    Unfortunately, I don't have the financial means to care for his medical conditions. Smoky is fading fast and is not able to digest his food very well with the mass in his abdominal wall. Outside of surgery and radiation treatments which I won't put him through I will have to let him go soon.
     
    Last edited: May 22, 2017
    Reason for edit: Add on to post
  61. Lillie

    Lillie Member

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    We do our best- that's all we can do, with love and comfort. Kisses for Smoky.
     
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  62. Larry and Kitties

    Larry and Kitties Well-Known Member

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  63. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I did join this group and they are helping me to work thru everything.
     
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  64. Lillie

    Lillie Member

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    That's great you found this group and they're helping. Let us know how it goes.
     
  65. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Smoky is eating less the last week or two. He is continuing to lose weight. I checked him after work today and he is down to 7 lbs. I may have to try and get him in sooner if he keeps losing weight so fast.
     
  66. Lillie

    Lillie Member

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    I'm so sorry to hear this. This part is so hard to deal with. My previous kitty was down to 4 lbs from her usual 7. She was a petite cat to begin with so at 4 lbs she was so very tiny at the end.
     
  67. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Smoky was the opposite since he is half Maine coon and half Russian blue. He was 14 lbs down to 7 now so half his weight was lost. His old vet said to just watch him each day and go from there.
     
  68. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I'm taking Smoky to his old vet tomorrow. It's his time to cross the rainbow bridge. I'm praying that he will make it until tomorrow morning at 11:45 am Eastern time zone. I will be devastated if he passes away at home sick and in pain. I give him bupe but he is in such bad shape. Please say a prayer everyone for him to make it until it's time.
     
  69. Lillie

    Lillie Member

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    Sending prayers. You gave him a good chance and did everything you could for him. I have several cats that have crossed the bridge now. It's never easy, no matter how many times you go through it. So sorry it's Smokys time to leave.
     
  70. Susan and Timmy

    Susan and Timmy Member

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    Thinking and praying for you both. My GA Smudge will be waiting at the bridge for your sweet boy.
     
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  71. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Thank you Lillie. Please say a prayer he will make it through the night.
     
  72. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Your Smudge and Smokys much older brother Felix, GA in Feb 2006 will meet him at the bridge.
     
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