Pippin - possible nasal tumour

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fjm
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Pippin - possible nasal tumour

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Pippin has had a slight one sided snuffle for some time - he had a full examination and blood tests two months ago which did not find anything significant. This week he started bleeding from nostril and tear duct, and I immediately took him back to the vet. We hoped it was a tooth abscess, which is still a possibility, but it has not responded as hoped to the antibiotic injection he was given. He is now on a second AB (fortunately so palatable he considers it a desirable treat), and we will see if that is more effective. But I have a strong feeling it is a nasal tumour, probably lymphoma. He is 18 with advanced arthritis and early CKD, and I do not think I would consider radiotherapy or chemotherapy for him, but if anyone has experience with managing nasal tumours it would be helpful to know more. He is already on daily loxicom for his arthritis and is still eating reasonably well, but his quality of life is already compromised from the arthritis and I think hard decisions may need to be made sooner rather than later..
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Re: Pippin - possible nasal tumour

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Google throws up a curveball straight away, VCA animal hospitals describing the nasal discharge as "pus-like or streaked with blood" which certainly wouldn't have me fearing the worst just yet based on Pippin's symptoms. Although I'm a bit stumped for any other explanation, especially of the blood, until the blood came up you'd wonder maybe a polyp. Can polyps rupture and bleed?

My old Sarah had skin cancer of the planum - the flat hairless front of the nose - which often spreads into the nasal cavity or even the lungs. In her case it was a scabby lump, the top layer of skin was skimmed off, the scabby bit came back but we did nothing more and she had many more happy healthy years before something else got her. But our vet said chemo for cats is a breeze compared to humans, with no hair loss, no significant nausea or inappetance, no real side effects to speak of. There are different chemos of course but it might be worth a closer look than instant dismiss. With the proviso of course, about his general state of health and quality of life - and how much the decline in his quality of life might be due to this and how much better he might be than he was before his snuffle began.
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Re: Pippin - possible nasal tumour

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It is a bloody discharge rather than pure blood, with swelling under the eye. I think it will take more investigation to be sure, but the months of sniffles are typical of lymphoma. His quality of life was adequate before this started, but edging towards borderline - he is very creaky and his only real pleasures are eating and sleeping, preferably in the sun. One more summer, perhaps?
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Re: Pippin - possible nasal tumour

Post by booktigger »

What antibiotic did they give you? Molly had an abscess, we were given an antibiotic with the proviso that if it didn't help, it might be SCC rather than an abscess, so I was dreading having to take her back 5 days later when it hadn't cleared up, but we had a different vet on that day who just said it hadn't been a strong enough antibiotic and the second one, plus lancing, cleared it up, she was about 18 at that point too. So fingers crossed it just needs something different. If not, Metacam is a COX inhibitor, so does slow certain cancers like SCC (which a nasal one is likely to be, as external nasal ones are)
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Re: Pippin - possible nasal tumour

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I am ashamed to say I haven't checked which it is, but I do hope you are right BT. He is looking a little better this evening after two doses, so just possibly I am worrying too soon. When I saw the bloody discharge my immediate thought was abscess, although it didn't seem to have the foul smell I associate with them - there again I had just got out of the car and was more than a bit in shock at being greeted by Pip with blood all over his face, so I didn't really stop to sniff, just bathed his face with one hand while phoning the vet with the other!

(Just checked. They are Zodon - clindamycin - 3/4 tablet per day.)
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Re: Pippin - possible nasal tumour

Post by Meezy+ »

Hi FJM,

Were X-rays taken? How would the vet know what's going on without Dental and Cranial X-Rays . Seems like he is just guessing and prescribing AB's indiscriminately . By now you should have a definitive diagnosis. Please do not think Pippin has Just one more summer let's find out exactly what is going on before having those thoughts!

Please keep informed if you would. Thank you.
All my best to Pippin!
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Re: Pippin - possible nasal tumour

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Good point BT about metacam, I seem to remember when our vet explained about lymphoma versus IBD for Boo she talked steroids and metacam. Also my friend keeps rats and they are very prone to tumours which are controlled with metacam and another drug.

Also sometimes ABs don't seem to do much for a while and suddenly kick in towards the end of the course. Fingers crossed.
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Re: Pippin - possible nasal tumour

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X-rays will probably be next, Meezy, but as they will require anaesthesia the first step was to control what appeared to be a painful dental abscess. I was monitoring the snuffle over the last weeks - it is only 4 days since the bleeding, so it is quite possible the antibiotics have not yet taken effect, but the vets had obviously hoped for more obvious improvement yesterday. At this stage I am gathering information - if it is cancer, and steroids and metacam can help, that is extremely useful to know.
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Re: Pippin - possible nasal tumour

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Pippin had a fine needle aspiration of a swollen lymph node in his neck on Monday - the vet has just phoned with the results, and as we strongly suspected it looks as if Pippin has a tumour in the nasal cavity, and the lymphoma has already spread into the lymph node. We could do more investigations to confirm it and stage it - x-rays and biopsy, both requiring a general anaesthetic - but as the treatment options would be far too invasive for the vet to recommend or me to contemplate we have agreed palliative care with meloxicam and antibiotics. His vet thinks he may be OK for some time, but I am already aware that he is slowing down even further.

I am sad of course, but he is 18 years old and has had increasingly severe arthritis for the last 10 years, and I have been aware of his life becoming smaller and less rewarding over the last months. While he is eating reasonably well and not in pain, we will take each day as it comes. One more summer, or at least a few more weeks of lazing in the sun…
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Re: Pippin - possible nasal tumour

Post by booktigger »

Sorry to hear the worst case was confirmed, fingers crossed the meds keep him stable enough to have one last summer.
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