Recurred Lymphoma - Ongoing
Posted: Wed Dec 24, 2014 4:06 pm
Hi all, I want to use this to externalize the current situation with my cat.
She is a 14 year old tabby called Tippex. We have had her ever since she was a kitten. 5 years ago she had a successful cancer surgery and has been happy until now.
About 8/9 days ago, she stopped eating and lay in hiding places. She was unresponsive physically, to touch (only to move away and ensure she could hide), and to food she would do much the same, turn away. After 2 days of this, we took her to the vet and they found a growth, and immediately placed her on a liquid drip while offering her wet food, which she refused as she did at home.
After 3 days we agreed for her to undergo a laparotomy in order to accurately diagnose the growth, and best determine our options from that point on. The results confirmed aggressive small cell lymphoma which is touching 3 organs, ruling out surgery or radiation therapy.
A feeding tube was placed in her during the laparotomy as it was clear the cancer was inhibiting her ability and willingness to eat. She has since come home on the vet's advice, with our role currently being to feed her and monitor her general condition. She has passed one stool that i am aware of during these 8/9 days. She is urinating about 3 times daily, and not showing discomfort while doing so.
She currently weighs 2.9 kg, which is down from 3.4 the last time she was at the vet (2 days ago) and she is lethargic. Today, after 2 days of her being fed and monitored at home, we took her to the vet and aside from the weight loss, she showed no signs of dehydration, which is something, and we discussed the 2 viable palliative options in her case: chemo and steroids. The convo went along these lines: her prognosis is not good due to the nature and stage of the cancer, and the possible benefits of chemo compared to steroids, with their comparative stress levels, was marginal. We decided on steroids immediately, and she had her first half tablet about 2.5 hours ago.
Now, I decided to follow up with the vet, to ask her opinion about whether it's ethically justified in giving her palliative care, as opposed to euthanasia, given her condition / prognosis / weight. She said for the time being, steroid treatment is the ethical decision, and mentioned that after consulting with the oncologist, chemo might be more beneficial to Tippex than first thought. So the plan is to keep feeding her and giving her the steroid, as well as an antibiotic she's already on and we will take her back to the vet on monday.
If she responds well over the next week, the chemo would be a combination of prednisolone and chlorambucile. Other thing to mention is that the oncologist noticed something about her billary tract was atypical for her condition (i think the swelling).
If everything is clear, over the next week I'm hoping she puts on some weight, but I am going to continually have in mind that there is a threshold beyond which euthanasia is the only choice. Given her weight, i'm not exactly sure where this line exists. She does not appear to be in sustained pain, although I know cats are stoic and will hide this fact if they are, she is reasonably responsive and still shows signs of happiness and warmth. Today is, really, with the steroids, the first day of any kind of treatment which addresses the cancer so I suppose it is something that has to be assessed on a careful, day by day basis.
She is a 14 year old tabby called Tippex. We have had her ever since she was a kitten. 5 years ago she had a successful cancer surgery and has been happy until now.
About 8/9 days ago, she stopped eating and lay in hiding places. She was unresponsive physically, to touch (only to move away and ensure she could hide), and to food she would do much the same, turn away. After 2 days of this, we took her to the vet and they found a growth, and immediately placed her on a liquid drip while offering her wet food, which she refused as she did at home.
After 3 days we agreed for her to undergo a laparotomy in order to accurately diagnose the growth, and best determine our options from that point on. The results confirmed aggressive small cell lymphoma which is touching 3 organs, ruling out surgery or radiation therapy.
A feeding tube was placed in her during the laparotomy as it was clear the cancer was inhibiting her ability and willingness to eat. She has since come home on the vet's advice, with our role currently being to feed her and monitor her general condition. She has passed one stool that i am aware of during these 8/9 days. She is urinating about 3 times daily, and not showing discomfort while doing so.
She currently weighs 2.9 kg, which is down from 3.4 the last time she was at the vet (2 days ago) and she is lethargic. Today, after 2 days of her being fed and monitored at home, we took her to the vet and aside from the weight loss, she showed no signs of dehydration, which is something, and we discussed the 2 viable palliative options in her case: chemo and steroids. The convo went along these lines: her prognosis is not good due to the nature and stage of the cancer, and the possible benefits of chemo compared to steroids, with their comparative stress levels, was marginal. We decided on steroids immediately, and she had her first half tablet about 2.5 hours ago.
Now, I decided to follow up with the vet, to ask her opinion about whether it's ethically justified in giving her palliative care, as opposed to euthanasia, given her condition / prognosis / weight. She said for the time being, steroid treatment is the ethical decision, and mentioned that after consulting with the oncologist, chemo might be more beneficial to Tippex than first thought. So the plan is to keep feeding her and giving her the steroid, as well as an antibiotic she's already on and we will take her back to the vet on monday.
If she responds well over the next week, the chemo would be a combination of prednisolone and chlorambucile. Other thing to mention is that the oncologist noticed something about her billary tract was atypical for her condition (i think the swelling).
If everything is clear, over the next week I'm hoping she puts on some weight, but I am going to continually have in mind that there is a threshold beyond which euthanasia is the only choice. Given her weight, i'm not exactly sure where this line exists. She does not appear to be in sustained pain, although I know cats are stoic and will hide this fact if they are, she is reasonably responsive and still shows signs of happiness and warmth. Today is, really, with the steroids, the first day of any kind of treatment which addresses the cancer so I suppose it is something that has to be assessed on a careful, day by day basis.