Re: 1/17 Zener AMPS 104;+2 120;+4 80 U/S lymphoma?
I have not been following Zener's condo regularly lately, but I did stop in today when I saw the lymphoma subject.
As Marje mentioned, my civvie Teddy had small cell intestinal lymphoma. He was diagnosed via biopsies taken by endoscopy. Full thickness biopsy is more informative, but I was not willing to go through such an invasive surgery at the time. Endoscopy (colonoscopy) was uncomfortable due to the prep and sedation, but recovery was quick. I don't believe that we had seen lymph node enlargement on U/S, so aspiration was not discussed at the time. Actually, Teddy had a FNA done on his pancreas shortly before he passed away last year, and recovery from that particular procedure was quick, though the news was not good. Teddy was not a sick kitty at the time of his lymphoma diagnosis. Back then, Bear Man was very seriously ill, and Teddy was healthy in appearance but having some vomiting and blood in his stool. Both cats went in for endoscopy on the same day. I was shocked when the diagnoses came back as IBD for Bear Man and lymphoma for Teddy. The vet reminded me at the time that IBD is no easy disease either, and Bear Man's experiences confirmed that.
In any event, I did not know anything at the time, but the IM vet said that Teddy needed IV chemo and we went for three rounds of that. That was very difficult (sedation needed each time). After no improvement in his symptoms, the vet wanted to cease treatment, saying he had only months to live. I went to researching the options and discovered that a protocol of an oral chemotherapeutic agent, Leukeran (a.k.a. Chlorambucil) with Prednisolone was, at that time, the gold standard. It was still recommended as such when I spoke to an oncologist a couple of years ago, but I cannot state if it is still the case or not. Teddy, who was not a diabetic, started on the protocol, and survived another seven years before he died of a different (pancreatic) cancer. I have to say that I am the world's biggest fan of Leukeran, as it saved Teddy's life. You would have to discuss with a vet whether the protocol would be suitable for Zener, but it is worth discussing. I would try to get in touch with an oncologist if possible. I know that you have a concern about steroids (such as Prednisolone) and diabetes. I don't know if the protocol would work with Leukeran alone, or with Leukeran in combo with Budesonide. I know that Budesonide is used for IBD (didn't work for Bear Man) and that is has a more local reaction in the gut as compared to the more systemic effect of Prednisolone. I don't know if it is a valid replacement for Prednisolone in the Prednisolone/Leukeran protocol. You don't have a full diagnosis at this time, so it is a hard call. That is why I would try to get more info from an oncologist if possible. If there is any possibility that you will want to do any sort of biopsy in the near future, you can't start treatment with any steroid, as it will invalidate the result of the biopsy.
Teddy also took Ondansetron, Pepcid, and other meds as he had fairly chronic nausea, vomiting, mild inappetance, and diarrhea on and off over the years, but was on the whole a very happy and active cat during his "remission". Bear Man was always a very sick cat with his IBD. I understand that IBD can transform into lymphoma over time, as they are somewhat of two things along a continuum. This is another good reason to try and control the inflammation of IBD if possible. The two boys also took Metronidazole as it was reputed to soothe the GI tract, but I believe that this med may now be controversial in this regard (sorry I have lost touch a bit with these topics as Bear and Teddy are gone now).
I believe that Leukeran is also given as a treatment for IBD, so it may not be unreasonable to try it, if an oncologist recommends it. It is a somewhat heavy duty chemo drug, however, and has some side effects, notably inappetance and mild nausea, so it is obviously not something to undertake lightly. It is just something to ask the doctor about. The upside is that it is given orally at home, and that is should not affect BG's. Bear tried it for his IBD, but he could not tolerate it. The only thing that helped him was steroids, and he became a diabetic as a result of taking them.
I know what a nightmare this is for you. I will never forget the day the vet called me with Teddy's diagnosis, especially as I was not expecting to hear that he (the healthier looking kitty) was the one who had cancer. Those were hard times. The only thing that you can do is arm yourself with as much information as you can find, and then go with your gut as to what is right for Zener. There is no right or wrong answer. I just thought that I would share my experience with you. If Zener is happy and healthy(ish) right now, doing nothing for the time being may be the way to go. I'm sorry that you are going through this.
