Cushing's or Cancer?

Discussion in 'Acromegaly / IAA / Cushings Cats' started by Alex1313, Jan 5, 2019.

  1. Alex1313

    Alex1313 New Member

    Joined:
    Jul 2, 2018
    I have posted recently about Henrietta's horrible skin lesions and the possibility of Cushing's. The vet wanted to try her on an antihistamine first to see if the lesions resolved. Well, in the mean time, her abdomen has become distended and she gained about a pound of weight in abdominal fluid. She saw her IM specialist today who did an abdominal radiograph and there was so much fluid in her abdomen that she couldn't really see her organs. The fluid is not in her lungs and the heart looks normal so the suspicion is either a tumor with Cushings or stage IV pancreatic cancer possibly. Some fluid was taken out of her abdomen and sent for cytology today. As the tech was handing her back, a length of tissue tore off of Henrietta's back with all the fur attached, much like Elmer's glue would peel off the back of your hand. The vet finally saw this process for herself for the first time and this, with the abdominal distension is what led her to the two suspected issues. If she has cancer, that's it, there is no choice but to do hospice. If it's Cushing's there's a possibility for treatment. My question is, with Cushing's is the abdominal fluid a usual symptom because it doesn't appear to be from anything I've read although I do see many describe a round belly. I'm trying to make the best decision about what diagnostics to subject her to at this point. She is in pain because of the abdominal fluid buildup. Her body temp is also lower than it should be at about 98.

    She was recently switched to Lantus from PZI because of lesions forming at the PZI injection sites. These lesions have not been an issue with Lantus and her BG has been under better control at about 3.5 units twice daily.
     
  2. Alex1313

    Alex1313 New Member

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    Jul 2, 2018
    I think you meant to post a "new thread" instead of replying to an existing one about something unrelated. Try deleting this comment and going to the top of the cushings/acromegaly group and choose the "new thread" option.
     
  3. Pamela & Amethyst

    Pamela & Amethyst Well-Known Member

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    Dec 11, 2016
     
  4. Pamela & Amethyst

    Pamela & Amethyst Well-Known Member

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    Dec 11, 2016
    Thanks! Good LUCK!
     
  5. Ana & Frosty (GA)

    Ana & Frosty (GA) Well-Known Member

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    Jan 19, 2018
    So from my experience with my Cushing’s kitty there isn’t usually fluid in the belly simply from Cushing’s.

    If the vet thinks the fluid could be due to cancer, the skin tears could be a part of paraneoplastic syndrome. We considered it as one of the possibility when we were working up Frosty for his skin tears. OR the kitty could have Cushing’s in addition to something else going on. :(

    Either way, i am sorry you guys are dealing with this. The large skin tear at the scruff that you’re describing is what my IM vet and I were both very afraid of, and she said she has seen it happen to other Cushing’s cats. We had to be creative about restraining him for vet visits and when I had to chance his onesies because he really didn’t like it and was a biter.But despite being careful, towards the end of our journey, Frosty’s skin would slough off just from me gently handling him.

    Another thing about skin tears that my vet told me when we first went to see her, is that regardless of cause, skin tears are associated with a poor prognosis. Frosty lived 5 months after his first skin tear. 4 of those months his quality of life was good. Maybe the vet can give you more info based on her experience.

    Again, so sorry you’re going through this. Let me know if there’s any other questions I can help answer. ❤️
     
  6. Alex1313

    Alex1313 New Member

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    Jul 2, 2018
    The IM we're seeing is big on diagnostics and doing things "by the book" is always her strong recommendation....so when she started telling me that diagnostics past cytology were probably not going to be useful, I broke down crying. I've known something was not right with Henrietta for the last year and haven't been able to substantiate my concerns with any solid lab results. The vet told me the same thing you did, that the skin tears were likely from one of two things and that her strong suspicion is stage III pancreatic cancer, which she suspects caused the diabetes in the first place. I get the cytology report tomorrow. I've already made contact with the at-home euthanasia vet so that we can have a plan in place. I'm hoping she has many more months but at this point the only reason she's eating is the buprenorphine dose she's on every 8 hours.

    I've rescued, nursed, cared for dozens and dozens of cats in the last ten years and it just seems so rare that death comes gently for any of them. Thank you for answering my questions on this and other threads. I am keeping her as comfortable as possible.
     
  7. Ana & Frosty (GA)

    Ana & Frosty (GA) Well-Known Member

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    Jan 19, 2018
    I'm so sorry you're going through this. Have you gotten an answer from the vet? Also, how accurate is paracentesis in cats? In humans, even if you get fluid out of the belly or whatever cavity it's building up in, there's a chance that even if there's cancer cells, they may not be caught.

    I understand the devastation you're feeling with your baby being sick. I too hope this is something she can recover from, and it's definitely hard to go through the multiple vet visits and workup and the waiting. I definitely understand.

    Being in the medical field, I kind of think death doesn't come gently for most beings, to be honest. :( I know it's a super depressing thing to say, but it's something I've noticed after working in multiple roles in the hospital for the last 10 years. After the way I lost Frosty, I do believe we are fortunate to have the option of euthanasia. I hope you won't have to go that route, but if you do, we are here for any support. Please keep us posted.

    Hugs. :bighug:
     
  8. Alex1313

    Alex1313 New Member

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    Jul 2, 2018
    The results from the cytology only showed high amounts of protein so cardiac causes were ruled out, which is what the vet suspected initially anyway. The vet suggested that unless I wanted to subject Henrietta to exploratory surgery, that an echo probably wouldn't be all that useful. I wasn't going to do that to her as she was already in much discomfort. Her breathing became very difficult over the weekend and she was euthanized at home. I'm heartbroken, I miss her terribly.
     
  9. Ana & Frosty (GA)

    Ana & Frosty (GA) Well-Known Member

    Joined:
    Jan 19, 2018
    Oh man, really sounds a lot like Frosty. :( I am so sorry for the loss of your beautiful girl. But you did the difficult, kind thing. ❤️

    Frosty had his home euthanasia appointment on a Monday afternoon, but his breathing started to suddenly deteriorate the night before. We gave him his lasix and heart medicine but by the morning it was much worse. I stayed home that day to be with him, but the home vet couldn’t come out until noon. I gave him a full dose of his pain medicine hoping he would calm down, but he kept worsening. So i rushed him to the ED. Sadly, he passed away in my arms before they were able to give him any medicine. I was crushed. I blamed myself for waiting too long, and still do. I still don’t know exactly what took him, but Cushing’s is an ugly disease, and so is pancreatic disease (Frosty had pancreatitis). I know how difficult it is to go through this. We are here for you. Feel free to visit the Grief forum too for more support. :bighug:
     
  10. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Hi Alex - I'm sorry for your loss of Henrietta. From this thread, it really sounds like you did all you reasonably could to provide Henrietta a great life. It's always hard to lose them. May your sweet kitteh fly freely and wait for you at the Bridge.

    Ana - you did everything you could, and you gave Frosty almost an extra year of life. Instead of dying on the street, you welcomed him into your home and gave him the best. He was a lucky kitteh to find you as a kitteh-Mom.
     

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