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-   -   Cat diagnosed with rare cancer--not sure what to do (http://www.pets.ca/forum/showthread.php?t=80487)

Mom2Kitty March 13th, 2012 10:05 PM

Cat diagnosed with rare cancer--not sure what to do
 
I took my approx. 12 year old tortie, Kitty, to the vet last Wednesday because she had vomited several times in the past 2 weeks. She has always been a vomiter but mostly due to eating way too fast. This was different. I expected the vet to tell me that she was diabetic or hyperthyroid because she is always ravenous. She was at the vet in Sept. due to weight loss and blood tests show that she had some pancreatic issues. Vet said to switch her to canned food. I actually thought that she had gained a little of her weight back since then. I was wrong. She had lost nearly a pound. (She is down 4 lbs since 2010) The vet squeezed her abdomen and thought he felt something. It was all downhill from there--x-ray then ultrasound, then biopsy. By Friday afternoon, I knew that Kitty had a mast cell tumor in her small intestine that had spread to an adjacent lymph node.

The vet said that there is no consensus on how to treat this type of cancer when it is in the intestines because there just aren't that many cases seen (mast cell tumors are more commonly on the skin or in the spleen). The options presented to me over the phone were surgery and chemo (have to also do chemo because it already started to spread), just chemo, or steroids only (this would just be a comfort measure). My initial thought was to go at this with both barrels blazing. The vet asked me to think about it over the weekend.

Kitty had a surgical consult today and it wasn't good. Apparently, the prognosis is 2-5 months with or without surgery. With surgery and chemo, Kitty may get as much as 12 months. He said that she may be able to get that with chemo alone, they just don't know. He said if it were his cat, he would have a really hard time making this decision (and he's a surgeon). What makes the decision really difficult is that Kitty is asymptomatic right now. She hasn't even vomited any since last week when I changed her food to Nature's Variety Instinct canned and cut her back to 1/2 can at each meal time (my husband had bumped her up to 2/3 a can because she was always wanting more, I think this is what made her vomit). She is acting like her normal self. The surgeon is concerned that surgery could go poorly and I will have missed out on the remaining good days I have with Kitty. I tend to agree. Also, I would really want a better prognosis than that before subjecting Kitty to such a serious procedure.

Tomorrow we have a consult with the oncologist. I will consider chemo if she thinks it will be of benefit to Kitty. I have already been told that there are no published reports of treating this type of cancer with chemo alone so they don't know what it may accomplish, if anything. If Kitty were to do chemo, I would almost certainly go the pill route other than taking her in to the vet for weekly chemo. I think the weekly version is more effective but the vet said that Kitty would have to be sedated for it because she is so squirmy. The vet didn't think weekly sedation was a good idea. I am wondering if anyone can share with me their experience with kitty chemo and if you thought the results were worth it for your pet? I want to have Kitty for as long as possible but I don't want to create a lot of stress on her trying to keep her with me a few months longer.

I would also greatly appreciate any other suggestions--dietary, supplements, etc that may help support Kitty's health right now.

sugarcatmom March 14th, 2012 07:38 AM

Oh my gosh, I'm SO sorry you and Kitty are going through this! My heart goes out to you :grouphug:. I haven't had to deal with a cancer diagnosis in a cat, but I do know of other pet owners that have gone the chemo route for lymphoma. Cats usually tolerate chemo quite well (much better than people do). The other thing with at least trying it is that if the side effects do become too much to bear, you can always stop. As long as Kitty is okay with the process, it might give you a little extra time together without too much stress.

You're on the right track with her diet. Definitely low-carb (cancer cells feed off of carbs), and good quality ingredients. Maybe add some raw food in there as well if she'll go for it. I like to rotate brands and flavours of canned to keep the cats interested and to prevent any possible nutritional excesses or deficiencies.

As for supplements, you might want to look into something called Transfer Factor. It's derived from colostrum and can boost immune system health. The vet might also be able to suggest some things, like perhaps a multivitamin (I like NuCat).

And of course, the most important factor in all of this: your unconditional love. It's easy to get obsessed with a sick kitty's health and to focus too much on every little sniffle and sneeze. Try to take a step back now and then and just love on her, cuddle her silly, and appreciate her for the life lessons she's teaching you during this difficult time. Think of it as an amazing journey the two of you can share together.

All the best. :goodvibes:

althe March 14th, 2012 09:50 AM

my experience with oral cancer
 
Hi Mom2Kitty,

I can only share my experience with you, knowing full well that each pet owner and each pet is different.

Our experience started with a loose front right fang in August, and we didn't think much of it as we've had other cats who've lost teeth around 10 years old (and we had never had an experience with cancer or any other very serious illness). But our cat Pisica was given a "fairly certain" diagnosis of oral squamous cell carcinoma in mid-November. We were told this was a very aggressive type of cancer (we never let her go back outside after this point). The vet told us the only treatment option was quite invasive facial surgery + chemo, and that this would only extend her life by a few months (2-5 months is what they told us), and that her quality of life would probably be poor because she'd be recuperating from these procedures. She weighed 10 pounds in August; she was down to 6 pounds by mid-November. We decided not to go the route of the medical treatment. The vet prepared us for the worst and within a couple weeks, by early December, she began having trouble breathing and eating; the cancer was destroying the right side of her face. By Dec 20th, the cancer had destroyed the whole right side nasal passage and she had paralysis on the right side of her face. We used small gauze pads + warm water to wipe nasal secretions and wash around her mouth. Because cats regulate their body temperature through breathing, she began spending more and more time sitting next to the baseboard heater, so I immediately purchased 2 small heating pads for her favorite sleeping spots and she loved always having a warm spot to go to. Throughout this entire time, she "acted normal"; she still expected her food on schedule, she still thought she could go outside (which she obviously couldn't), and she still tried to clean herself like she normally would (although this was difficult for her because of breathing problems), and she still wanted to cuddle with everybody and anybody she could. Around xmas time we had started giving her very mushed up poached salmon, but by new year's she was barely able to swallow any food. In the final 10 days, the vet gave us pain killer medication to be administered orally with a syringe (something akin to morphine), but our little trooper would have nothing of it. We said goodbye to her on January 9th.

Pisica was the most affectionate cat I've ever known; she wanted to be held and cuddled constantly, and we were lucky that circumstances allowed us to be with her nearly every minute in the last two months of her life. These were important considerations for us, and we don't regret the choice we made to not opt for the surgery and chemotherapy.

This is probably the most difficult part of our relationships with our pets. There isn't anyone who's in a better position or more qualified than you are to make the decision. Like another contributor told me, it's important not to second-guess yourself and simply be at peace with whatever decision you make.

Tee

Mom2Kitty March 14th, 2012 09:50 PM

Thank you both so much for your replies! Althe, your Pisica sounds like a brave little kitty. I loved the photos you posted on your other post about her brother mourning her.

Kitty and I had some good news (well, what passes for good news nowadays) today at our meeting with the oncologist. I was so much more hopeful after this visit. She said that she absolutely would get the surgery done if Kitty were her cat. She said the risks of the surgery are outweighed by the benefits. She said she would also recommend taking out the spleen while they are in there because this cancer is commonly starts in the spleen and moves to the intestine and Kitty doesn't need her spleen, so may as well take it out and not risk it. They will also take small biopsies of other organs and lymph nodes to make sure it has not spread (although she does not expect to see that it has spread).

What sold me on the surgery is that the oncologist said that if the tumor was not removed, the chemicals and histamines that it releases would cause ulcers to form in Kitty's intestine and the ulcers would eat through her intestine and cause a bowel leak. She said the poor prognosis of 2-5 months associated with this cancer is due to the fact that a lot of cats get diagnosed when these ulcers start causing them problems and there is not much to be done then.

If the surgery is a success, she recommended the once per week chemo for 4-6 weeks and then Kitty could take the chemo pill once every 4-6 weeks. She was hopeful that Kitty would not have to be sedated for the chemo because it is a fairly quick injection.

She said if things go well, Kitty could live another 12-18 months and have a good quality of life.

Kitty is scheduled for surgery tomorrow. It will not be the first surgeon I spoke to doing the surgery. I opted to have someone in the office with the oncologist do it. This surgeon lists "tumor removal" as one of her areas of special interest (the other surgeon had orthopedics listed). I will post an update after the surgery.

I felt so hopeless yesterday after the meeting with the surgeon, that I started to cancel today's appointment. It is still not sunshine and rainbows, but I feel a sense of hope now.

I'm so thankful that we found this in time to give Kitty a chance. I am so, so thankful that I took Kitty to the vet for that vomiting issue and so thankful that he squeezed around on her good and found that lump. I go to a very low-tech, old school vet near retirement age. Sometimes I get concerned that he doesn't have all the fancy equipment that the newer vets have but he always give my cats good care and doesn't try to oversell us on stuff. I will never doubt him again.

Now I just have to see if I can get Kitty in the carrier for the third day in a row tomorrow morning!

hazelrunpack March 14th, 2012 10:00 PM

Wishing you and Kitty all the best tomorrow, Mom2Kitty! :goodvibes: :grouphug: Keep us posted!

althe March 15th, 2012 08:06 AM

Hi Mom2K,
That's great news for you to have what seems like a relatively positive prognosis. Like you, my primary vet is older and approaches most situations holistically and I absolutely adore him; I have a secondary vet "clinic" who has all the modern equipment, but who unfortunately falls short in the personal care dept.

My thoughts are with you and Kitty. It sounds like you're on the right track. I'll look forward to hearing how she's doing over the coming months.

tee

Rgeurts March 15th, 2012 09:47 AM

Hi Mom2Kitty :)

I'm sorry you are going through this, but I'm very happy to see some postivie news for you and kitty :grouphug:

I just went through the same with one of my boys, a 12 yr old Malamute/GSDx. He was diagnosed in Feb. of last year with Malignant Histiocytic Sarcoma, an extremely rare disease, had surgery on March 16 (a year ago tomorrow) to remove the bottom lobe of his left lung, then through a round of Chemo. His diagnosis was very poor. 30-120 days with or without chemo if the cancer was disseminated, up to 18 months with chemo if it was not disseminated. He did very well until Sept. of 2011 when we found 3 lumps. He had them removed and not even a week later had a couple more. We opted not to put him through anymore surgery. We started another round of Chemo, which didn't help or slow the growth at all. His cancer had become immune to it and was now disseminated. As fast as they were growing and spreading, he was only in the couple of months life expectancy, but made it for 6. We just lost him on March 4. One reason I believe we were blessed to have had him in our lives as long as we did after diagnosis is the Chemo and holistic treatment. He saw our regular vet for the chemo and a holisitic vet for immune support and a Chinese cancer fighting herb. Boosting the immune system is so important along with a low carb diet and filtered water. Cancer feeds on carbs/sugar. If you have a good holistic vet in your area, I'd highly recoemmend it for quality of life. The year we had may not seem like much to most people, but considering the form of cancer he had, it was a huge blessing to us. Good luck to you and your kitty :grouphug:

Mom2Kitty March 15th, 2012 08:35 PM

Thank you so much everyone for taking time out of your day to offer me some comfort! Rgeurts, I will definitely check to see if we have a holistic vet. Thank you for that suggestion.

Kitty came through her surgery great today!:thumbs up The surgeon said the mass was kind of in the junction between the small and the large intestine. So she had to remove that junction and then a little bit of the small intestine and a little bit of the colon. She said that Kitty will have diarrhea for a couple weeks as her body adjusts to that change. Because the surgery wound up having to involve the colon, the risk of there being an infection went up. There were 3-4 enlarged lymph nodes in the area of the mass and she was able to remove them all. They took the spleen out but she said it did not appear to be cancerous. She said there was "granulation" in the liver but she did not seem to be concerned about it. I'm just going to wait for the biopsies they took of other organs to come back before I start worrying about what that means for her liver. I'm enjoying the first stress free night in over a week.

She hopes that Kitty will be back eating her regular food by the time she leaves there on Saturday.

Rgeurts March 15th, 2012 09:38 PM

Wonderful news, Mom2Kitty!! Stress free nights are valuable :lovestruck: :cloud9: :grouphug:

Here's hoping and :pray:'ing for good biopsy results!

hazelrunpack March 15th, 2012 10:04 PM

So glad to hear she did well, Mom2Kitty! :grouphug: Now for a good path report and speedy healing!! :goodvibes:

sugarcatmom March 15th, 2012 11:08 PM

[QUOTE=Mom2Kitty;1036458]
Kitty came through her surgery great today!:thumbs up [/QUOTE]

Woohoo! So glad that it went well. Sending you and Kitty big healing vibes and a stress-free recovery. :goodvibes:

growler~GateKeeper March 16th, 2012 11:36 PM

Speedy Healing :goodvibes: :goodvibes:

Mom2Kitty March 17th, 2012 01:02 PM

We were able to bring Kitty home today:) She does NOT like her cone but she seems to be adjusting to it. I bought a Comfy Cone for her but unless/until she gets this plastic cone off, we are not going to attempt to use it. We're afraid if we take off the cone she's wearing we won't be able to get the new one on. I went to the pet store to look at thunder shirts to see if I could use one of those instead of the cone. But, I need it to cover her whole tummy and it didn't look like it would.

We took all the regular height tables out of the living room so she wouldn't be trying to jump on them. My husband built her some nice wide steps with boxes so that she can get on a low end table that we put in front of the window for her. He also brought her favorite desk chair in the living room and positioned it so she can go directly from her window perch to the chair seat without jumping. Of course, she doesn't want to do it the easy way! She has a get appetite. She ate her amoxicillin pill that we put in her food with no issue. We just have to keep an eye on her in the coming days because in the first 2-7 after surgery is when there could be problems with the interior sutures :fingerscr:pray:

hazelrunpack March 17th, 2012 04:48 PM

You sound like us--always moving the furniture around for the dogs' convenience!! :laughing: I'm glad Kitty is doing so well!! And I think you made a wise choice about not changing the collar unless absolutely necessary. :D

Sending more :goodvibes: for an effortless and swift recovery!

chico2 March 17th, 2012 05:00 PM

Mom2Kitty,I just read all the post and I am so glad all went well:pray:for a speedy recovery for little Kitty..:grouphug:

Mom2Kitty March 19th, 2012 09:58 PM

Kitty's biopsy results came back today. We got more good news :thumbs up They were able to get the whole tumor out of her intestine. Samples taken from both of her intestines were fine which means the cancer had not spread beyond the tumor. The spleen did have some cancer but that's okay because it was removed also. The liver and other organs were clear. I was really worried about her liver, so this was a big relief. We made an appointment to get her sutures out on the 28th and she will have her first chemo treatment that day if the surgeon says she is healed sufficiently. You would never know she just had this major surgery from the way she is acting. If it were not for the cone getting in her way, I think she would be back 100%.

Thank God I went to see that oncologist!!

hazelrunpack March 19th, 2012 11:46 PM

That's such great news, Mom2Kitty!!! :grouphug:

marko March 20th, 2012 08:18 AM

This is fabulous news Mom2Kitty :goodvibes: :cat: :goodvibes:

Mom2Kitty June 23rd, 2012 10:04 AM

Hello everyone, I just wanted to post an update on Kitty's treatment. Since having surgery, she has been getting chemo every 2 weeks. She switches back and forth between intravenous chemo (vinblastine) and pill form (CCNU) the next week. She has had 7 of 8 treatments. She is doing great!

The chemo has had very little effect on her as far as negative side effects go. She got nauseous and threw up one time. That has been about the extent of it.

She had an ultrasound when she was halfway through the chemo treatments and it did not show any new growths. She will have another ultrasound next time at her last treatment. The doctor said she could not be more pleased with how Kitty is doing.

Kitty has gained nearly 2 pounds since her surgery. She's starting to look like her old self again. :thumbs up I wish I could figure out how to post a picture.

hazelrunpack June 23rd, 2012 11:51 PM

Glad to hear things are going so well, Mom2Kitty! :highfive:

If you have pics on your hard drive, you can upload them to the site by clicking the paperclick icon in the Post Reply dialogue box menu. Another dialogue box will come up allowing you to navigate to the image you want to upload. Click on it, then click on "upload". Likely you'll have to resize your images to get them to the proper size for uploading.

Good luck! :D I hope we get to see Kitty's pic soon.

sr7628 July 4th, 2012 08:13 AM

hi mom2kitty,

my cat, klaus, has recently been diagnosed with the same type of cancer. they found a mass in his intestines and said his spleen was enlarged from the ultrasound. they conducted surgery and removed the tumor from his intestines and also saw that a lymph node was affected and very large, but were unable to remove the lymph node since it was such a vascular area and there was potential for him to lose too much blood. i don't think they removed the spleen. they did a tissue biopsy of the lymph node and it came back as a mast cell tumor.

my vet has told me that chemo doesn't prove to be very effective against this type of cancer but that steroid treatment can stave off advancement very well, maybe even a couple of years. similar to your kitty, klaus has displayed minimal symptoms. he was throwing up frequently for a couple months (which is what brought me to the vet in the first place), and he would have periods of the day when he was lethargic and hiding under my bed. but he always seemed to snap out of it after a couple hours and was back to his energetic, playful self.

i've been scouring the internet for information on intestinal mast cell tumors and there's not a lot of information out there to help me figure out what the next step should be and what the prognosis may be. it seems not very hopeful for cats, but klaus is only 5 and i hope he can fight it off for a few more years at least.

i am also in NC (raleigh). i was wondering where you are and where you took kitty? and also if she is still doing well? thanks!

Mom2Kitty July 12th, 2012 09:55 PM

Sorry I'm just seeing this after being on vacation in a terrible place with no internet! Ugh, how do people live like that!

sr7628, I went to Carolina Veterinary Specialists in Greensboro. Kitty's oncologist is Dr. Suzanne Rau and she is absolutely wonderful! I highly recommend her. Kitty just went for her final chemo yesterday and had an ultrasound as well. She has no disease in her organs and 2 lymph nodes that were enlarged at the last ultrasound (done halfway through the chemo) are now shrunk to normal size :thumbs up Dr. Rau was ecstatic. She never suggested to me that chemo was not necessary or would not help. If it is not too far for you to drive, I would definitely recommend that you see her or at least get a second opinion from someone in Raleigh.

I REALLY could not be more pleased with Kitty's outcome. If you read all my posts, then you saw what a hopeless situation this seemed when it all started.

Has your vet prescribed Pepcid for Klaus? Mast cell disease causes the kitty to produce a lot of chemicals like stomach acid. Kitty takes a 10mg Pepcid everyday to combat that (she takes 1/2 of the tablet in morning and half at night). It is just regular human Pepcid.

Mom2Kitty July 12th, 2012 10:05 PM

I will also add that Kitty really had very little side effects from the chemo. The Vinblastine (which is the stronger I.V. form of chemo) twice made her a little nauseous a few days later. She threw up once or twice and for a day or so, didn't have much appetite. The first time she got sick, they adjusted her next treatment and gave her antibiotics to keep her blood count up. The second time she got sick it was much milder (we just kind of noticed that she wasn't running around as much and acting like herself). The pill form of chemo which the vet called CCNU had no side effects whatsoever. Kitty had 8 rounds of chemo. She went every 2 weeks and we alternated between the 2 kinds.

Kitty is doing absolutely great! She plays like a kitten still. I'm going to go try to post a picture now that I have instructions.

Mom2Kitty July 13th, 2012 12:49 AM

sr7628, I just wanted to add that there is not a lot out there about the efficacy of treating mast cell intestinal tumors in kitties because it is usually caught too late to do anything--I got this straight from the vet. The mast cell tumor spins out histamines and other chemicals that will cause ulcers to form in the intestines. Those ulcers will eat through the intestines and cause the bowels to leak--this is when most cats get diagnosed. It is really too late to do anything at that point. That is why this disease is reported to have such a poor prognosis. Please do not be discouraged by the poor survival/prognosis rate. It sounds like Klaus's disease, like Kitty's, was caught very soon.

Also keep in mind that the lack of information about how to treat mast cell could also be the reason that there is little out there to suggest that chemo is an effective treatment. The first surgeon I spoke to told me there was little point in operating to remove the tumor because the prognosis would still be 2-5 months. Out of desperation I went to see Dr. Rau about treating it with chemo. Dr. Rau told me about an unpublished paper that one of her colleagues from vet school had written which found that surgery is beneficial treatment for mast cell tumors. Dr. Rau said if it were her cat she would do surgery and chemo. I listened to Dr. Rau and here I am 4 months later with a healthy Kitty.

I hope you will get a second opinion on the chemo especially since Klaus still has that lymphnode with mast cell that couldn't be removed.

I can't remember if I mentioned it in an earlier post or not, but Kitty also takes a steroid everyday. I think it is called prednisolone.

SuperMax April 13th, 2014 06:26 PM

How did Kitty do after chemo was done?
 
My cat Max is doing great 4 months post surgery from his intestinal mast cell and I am just wondering how your cat did and any advice from your experience. Thank you! :ca:


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