Fred might have cancer UPDATE--looks like heart disease

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Martica and Fred, Jan 18, 2010.

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  1. Martica and Fred

    Martica and Fred Member

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    Jan 15, 2010
    So following up to my earlier post on Friday night about Fred's breathing problems after I gave him fluids, I took him to the vet today. He took an Xray and showed it to me and his entire right lung was 85% white opaque--meaning no clear black space, indicating some sort of mass. The left lung was 80% black, some opaqueness. The bottom edges were sharp rather than fuzzy, apparently indicating this is probably not fluid, more like a mass, probably cancer. He could not see the heart and he said that the white part was so opaque it was probably too white to be just fluid. He said it could either be:

    1. lung cancer
    2. fluid
    3. twisted lung or something like that

    He also detected an gallop rhythm in his heart rate (which the December vet in Pennsylvania had also noted). My vet said that their could be a heart issue, and that could be affecting the lungs, or it was the lungs that could be affecting the heart in this way.

    So I guess this explains some of the things I"ve noticed, the recent breathing problems (3 times now, 1 bad on Friday night with the mouth open), and also I have noticed that in the past few months he would cough if I picked him up and (I thought) accidentally squeezed him too tight while doing so. It was a little bit of a cough, but I guess if he has some mass I would have compressed it and limited his lung capacity in some way even more.

    Even though I seem to think that these breathing problems--and LIMPNESS--have always followed the fluids, my vet does not seem to thing it's the fluids. He can't really explain the limpness but theorized that it could be that Fred is getting deprived of oxygen from the vastly diminished lung capacity and that could somehow be making him limp. He wasn't really sure.

    His kidney values have gotten worse in the past month, and most likely because I have been given a lot less fluids (because of the limpness). Here are his recent values:

    BUN
    Apr, Sept and NOv 2006: 36, 34, 35
    Aug 2007- 45
    Nov 2007- 52
    Jan 2008--44
    Dec 2008--56
    June 2009-75 (this is when we went on fluids--at first 150ml/day)
    Aug 2009-58 (After this I dropped the fluids to 50-100/day and started noticing limpness in Oct/Nov/Dec/Jan
    Dec 09-78
    Jan 2010-68 (he dropped but vet said it was probably because he was eating less over the last few days)

    CREATININE
    Apr, Sept and NOv 2006: 2.5/ 2.6/2.8
    Aug 2007- 2.7
    Nov 2007- 3.3
    Jan 2008--3.4
    Dec 2008--3.4
    June 2009-4.2 (this is when we went on fluids--at first 150ml/day)
    Aug 2009-3.4 (After this I dropped the fluids to 50-100/day and started noticing limpness in Oct/Nov/Dec/Jan
    Dec 09- 4.2 (back to what he was in June after I started giving less fluids
    Jan 2010-5.2 (so he's significantly increased)

    BODY WEIGHT
    Dec 08--13.2 lbs
    Jun 09--11.7 lbs
    Aug 09--11.3 lbs
    Dec 09--10.6 lbs
    Jan 10-- 10.7 lbs (I think, thereabouts--about the same as last month, but he is skinny--spine and hip bones showing)

    PHOSPHORUS
    Dec 08-5.0
    Jun 09--6.0
    Aug 09--5.0
    Dec 09--7.5
    Jan 10--8.2 (vet said we could start giving a Phos binder like epichitin or amphigel--any one better than the other?)

    POTASSIUM
    Jan 08--5.1
    Dec 08--4.7
    Jun 09--4.5
    Aug 09--4.7
    Dec 09--4.1
    Jan 10---didn't see the figure for today, but vet said he doubted that low K would cause the limpness because Fred is always in the normal range, I have also been giving him a Renal Essential vitamin crushed up in his food for a month or two now so he's getting some extra as well.

    Vet said something about giving him...mertasipine?....not sure, wrote it down but now forgot what he said to give it for...

    Tomorrow we are doing an echocardiogram to check his heart and an ultrasound to check the lungs. Based on what he sees he will do a lung aspiration to draw out fluid and/or tissue to analyze in the lab. He said there is a very small risk of lung puncture/air in lung from this--should I worry?

    He basically told me that he thinks that Fred is dying. I said, well he was purring this morning a lot and is alert and walking--and blood sugar has been great for past 10 days. He said that the blood sugar is not really the main problem, it's the worsening kidneys--and he said when Creatinine is at 5.0 cats start to feel really bad and eat less, and also the breathing issue, especially the 'attacks' can be very stressful and traumatizing, and he said at some point if these continue I need to think of his quality of life, especially with the breathing.

    As far as what we find out tomorrow, he said that if it's a heart issue, which he thinks is not likely, there could be a drug to use. He said if it was cancer, given Fred's age, other diseases, overall state, he would not want to put him on chemotherapy, He said the median extended lifespan from chemo is just 6 months for cats of all ages--and considering his age--19 and 5 months--it would not be worth putting him through this. He said if it was lymphoma, perhaps giving him a shot of l-arginanase or something could possibly shrink a tumor and give hiim a little better quality of life for a while. If it's this twisted lung thing, not sure what he said about that, but that sounds less likely.

    So he was basically telling me that either I not do the echo and ultrasound and just take care of him at homoe and try to keep him comfortable...or we could try to determine exactly what is in the lungs and possibly do something.

    So I'm pretty sad about this. I've had Fred since he was 4 months old. I can't imagine being without him.

    I asked the vet what to do if he has another breathing attack--he basically said nothing, just reassure him and keep him calm.

    I'm afraid to give him fluids, although he def. is dehydrated (I am watering his Wellness and also giving him water--bringing these all up to him), So far in the last 14 hours he's eaten about 3/4 of can of Wellness, which is more than past few days I guess. His bs is low, right now at +14--didn't give shot yet--he's 185. Last night at +12 he was 50 and so I didn't give him shot till +20 when he was 454, vet thinks he may have hypoed, although I don't think so, jsut got low, he wasn't eating much--his numbers have been 100s/200s/300s in past 10 days. Vet thinks I should give him lower dose while he's eating less.

    I would appreciate anyone's thoughts about any of this.

    Also, what should I do if he has another breathing attack?

    Also, vet thinks I should give him fluids--even 50ml--but I gave him 30 ml last night and he had the slight breathing and limpness. I'm afraid to, but I know he needs some. (And he doesn't resist them, he likes them, purrs and I have a heating pad on him and we use a 26 gauge needle so fluid goes in slowly). Not sure what to do...give him 10-15ml?

    Fred is now sleeping.
     
  2. Jess & Earl

    Jess & Earl Member

    Joined:
    Dec 28, 2009
    Re: Db/CRF Fred might have lung cancer...would like opinions

    Sent you a PM answer to this as it pertains to NYC. Short answer is, experience and training can make a big difference.

    I just read through your post very quickly as my dog is dancing around in front of the door to go out for his exercise walk, but for the other questions I remember: For the breathing, there is nothing to do tonight--just go to the ER if he has prolonged respiratory rate and effort (RR should be ~35 max while resting), or if he appears faint or his gums look very pale, bluish, or "muddy" (hard to describe, you'll know it if you see it).

    I'm sorry things are looking grim -- at least on paper, if not clinically. Please let me know if there is anything else I can do. Write back with any more specific questions, I'll check back later.
     
  3. Emmy & Dude

    Emmy & Dude Well-Known Member

    Joined:
    Dec 28, 2009
    Re: Db/CRF Fred might have lung cancer...would like opinions

    I'm so sorry to see these results of Fred's tests. Poor little guy - I wish I had some advice, but I don't - the only thing I can do is send you many, many healing vibes - hope that it is indeed something that can be treated - and keep you in my thoughts and prayers. Will be watching for updates from you.

    Scritches to your sweet boy.

    Emmy & Dude (& Mittsi too)
     
  4. Martica and Fred

    Martica and Fred Member

    Joined:
    Jan 15, 2010
    Re: Db/CRF Fred might have lung cancer...would like opinions

    I"m afraid to give him fluids again, although the vet thinks I should. I know he needs them (looking dehydrated) but not sure what to do.
     
  5. Dana & Thomas

    Dana & Thomas Member

    Joined:
    Dec 28, 2009
    Re: Db/CRF Fred might have lung cancer...would like opinions

    I am sorry to hear about Fred. Our civvie, passed away just over 18 months ago of lung cancer. He had given up eating, drinking or pooping by the time we let him go. But he remained affection and did purr up until the bitter end.
    I send prayers out to you and to Fred.
    Dana
     
  6. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Re: Db/CRF Fred might have lung cancer...would like opinions

    I'm sorry I have no advice but am praying for your Fred.

    Jeanne
     
  7. Martica and Fred

    Martica and Fred Member

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    Jan 15, 2010
    Maybe not lung cancer, but heart disease

    So Fred and I went back to the vet today for an ultrasound and echocardiogram.

    Looks like his bad lung that was all opaque in the Xray is actually collapsed, so the lack of space means it looked like a mass on the Xray. The vet said he would not know why it's collapsed, could be cancer--although he said it was too risky to aspirate so they didn't, so not possible to do a biopsy. He said it could also be fluid around it putting pressue on it, or maybe something to do with the heart.

    His heart, as it turns out (was not visible in the xray) is abnormal. Enlarged left side I think, and tricuspid something or other and leaky valves. We will get the cardiologist report on Thursday. The vet said all he could say about it was that it was abnormal. he said we would know more about what kind of medicine could be taken when we get the report.

    His good lung--the vet aspirated it and drew out 100ml of fluid. He said the fluid was beige, whereas cancer fluid tended to be pink/red or white, although it could be beige. But his white blood cell count was also good so perhaps not cancer. But they saw some 'nodules' or somesuch and those could be cancer.

    But it seems that the good lung had fluid in it and it seems that after it being removed, Fred feels better. I can totally tell. AND his breathing is much quietter and his purring is smoother, more normal, not raspy and irregular. So I'm feeling somewhat better about this.

    The bad news I guess is that the drugs for heart disease are bad for kidney disease and vice versa. He told me NOT to give any more fluids (which I knew aLL along) and so that's could. But of course that's not good for the kidneys so I'm supposed to encourage more water drinking if i can. He also gave me phosphorus binder, the powder epichitosan or something. (Phosphorus went up to 8.2 I think). He did NOT rec. the renal food because the thinks Fred's appetite is more important.

    So I guess I now have to read up on the heart disease, and managing the 3 diseases. His blood sugar is good these days at least. I guess there is a group for this?

    My big question is that Fred is bonier now--can see his hip bones and some spine. I want to fatten him up--is it ok to perhaps be a little more lenient on food--like give some seafood flavors--esp. if I'm taking the phosphorus binder?

    Anyone ever hear of this collapsed lung thing? Anyway, for it to reinflate?

    Also the cardiologist said the fluid would return to the good lung--is this true? Anyway to avoid it? Obviously not giving fluids will help.

    Any tips appreciated. The vet said that Fred is still dying (yesterday he told me if cancer, it was a matter of weeks, or maybe months.) But my impression is that it's not as bad as cancer could be....? He's felt pretty good today, good appetite, etc. So I"m feeling like he's not as sick as I thought. Although he has been sleeping nonstop. Maybe I'm deluding myself. Anyway, it seems like things are better for Fred. I'm hoping...
     
  8. Martica and Fred

    Martica and Fred Member

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    Jan 15, 2010
    Oh, by the way, his potassium was 4.0, in normal range, so he didn't think that the limpness was from that, or that there was a need to supplement. AND in retrospect, the limpness after fluids is DEF. a sign of heart disease, right?

    And I'm just shocked that if that vet I visited in Pennsylvania noticed the 'gallup' rhythm, why didn't he bring it to my attention (it was just in the report). As I understand, this is a sign of heart disease. Perhaps my knowing this 6 weeks ago would have saved Fred 6 extra week's of fluids that were hurting him further....:( :sad:
     
  9. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Dec 28, 2009
    Based on my experience collapsed lungs (pneumothorax) do not resolve (re-inflate) on their own. For humans they re-inflate them by placing a tube through the chest wall into the space between the lung and chest wan and draw a vacuum in that space. After awhile the lung reattaches to the chest wall. About 20 years ago I had a spontaneous (cause unknown) pneumothorax.
     
  10. Dana & Thomas

    Dana & Thomas Member

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    Dec 28, 2009
    I am still praying for both of you during these difficult times. If you want to talk, I am available.
    Dana
     
  11. Martica and Fred

    Martica and Fred Member

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    Jan 15, 2010
    Fred is SO MUCH better since our vet visit. I'd like to believe he's not sick (or very, or dying) anymore. He purred all last night and all this morning. And got up in the middle of the night to eat, and ate some this morning and seems happy. I wonder how long it takes for the lung to refill with fluid? I guess this is why he feels better. And his breathing is VERY quiet. I guess they can live ok with one lung?
     
  12. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    I am praying for you both. Heart meds has made a world of difference in my Waldo. I hope they work for Fred too.

    Jeanne
     
  13. HollyandSpader(GA)

    HollyandSpader(GA) Well-Known Member

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    Dec 28, 2009
    Sending good thoughts to both of you!
     
  14. Emmy & Dude

    Emmy & Dude Well-Known Member

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    Dec 28, 2009
    Am so happy to see that Fred is feeling better - quality of life - that's the important thing and it sounds as if he's just happier and feeling better.

    Good news - hang in there. Sending lots and lots of good vibes.

    Emmy & Dude (& Mittsi too)
     
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