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OT: Cat people with medical knowledge

(deactivated member)
on 6/7/11 8:31 am - San Jose, CA
Recap: Three months ago, I took my two cats to the vet.  The main reason was to check out what was up with Onyx, our ~6 year old giant Maine Coon mix, who had been gaining weight despite not seeming to eat that much - he was up to 19 lbs, and he had a "thing" on his butt that wouldn't come off and I was afraid it was an infected anal gland, plus I was worried about hypothyroidism and/or diabetes.  The result of his exam and blood work was that he had poop stuck to his butt because he is very furry and - oh, the humiliation! - too fat to clean himself properly.  So he got a "sanitary shave" and advice to restrict his feeding.

I brought Isis, our ~8 year old Maine Coon mix, in at the same time, mostly to get them on the same yearly check up schedule.  She had been a 12 lb cat, but had lost weight recently, despite eating a lot - she was down to 9 lbs.  However, her exam turned out to be devastating - her liver enzymes were up in the thousands, instead of under 100.  We took her back for an Xray, and her liver was clearly enlarged.  The vet said we could do an ultraound and liver biopsy for a more definitive diagnosis, but it was likely liver cancer.  I asked if doing that expensive testing would likely yield information that could lead to being able to DO something, and he said no.  He also told me that the Xray showed arthritis in her spine that indicated she was significantly older than we thought - perhaps that she was about 12 rather than 8.  I decided not to put her through the biopsy, and took her home to die.

I decided in the meantime to not treat Onyx's obesity, because the cats free-feed together - they have dry food available all the time (Taste of the Wild kibble), and they split a can of wet food most days.  I didn't want to disrupt their habits - I figured I could put Onyx on a diet after Isis died.  We started adding some Milk Thistle oil and Fish Oil to their wet food, hoping to give some relief to Isis' liver.

So for the last 3 months, every time I see Isis asleep, I have to check for whether she is breathing.  I examine her all the time, looking for signs she is in distress, etc.  But she has been fine - no change whatsoever (except she seems to have become a nicer cat now that she is getting more attention!).  So I decided to take her back to the vet on Friday for more blood work.

The result?  Her liver enzymes, while still VERY high, are about 1/3 of what they were before (instead of 1200 for one, down to 450; instead of over 2000, about 800 - but they are still both supposed to be under 100).  Her thyroid (T4) was high, as was her calcium.  So now the vet says that she probably has lymphoma (because of the high calcium) as well as hyperthyroid.  So we have begun treatment with Tapazole, and will retest in a month.

Again, the vet wants to do an ultrasound and liver biopsy, saying that if it lymphoma, we could do chemo.  I'm not thrilled with the idea of putting a 12 year old cat through chemo, so I deferred for now, figuring we could see what happens after a month on the Tapazole.

Anyone have any experience with anything like this?  What would you do?
Pupcake !.
on 6/7/11 8:43 am - Stranded in, IA
I'm sorry you and Isis have to go through this.

I am a medical professional and have delt with a lot of end stage (metastitized) cancer.  In humans as well as cats I would reccomend treating symptoms but not the cancer itself.  Let her feel as well as she can- don't kill her whith chemo.

IMHO she isn't going to die suddenly in her sleep.  She will move slower and slower, get weaker etc.  So try not to worry so much, enjoy the time she has with you.

Hugs,

Pup
Elizabeth N.
on 6/7/11 8:49 am - Burlington County, NJ
My late beloved Graustock had hyperthyroidism. Before he was diagnosed, he got into a liver issue. Apparently the dramatic weight loss caused some kind of upset of stuff. He got so nauseated from his high liver enzymes that he couldn't eat and wound up with a peg tube for three months. He recovered nicely from that and lived well for several more years, to eventually expire of old ago. Poor lil guy probably had a stroke in his last couple days. It was so heart wrenching :-(.

One of my SILs had a kitty with cancer, I forget what kind. He got chemo, in a pill or two x number of times per week or month, and lived nicely for several more years. I don't think it was the cancer that killed him.

If I were in your shoes and could afford it, I'd certainly do the ultrasound now, and possibly also the biopsy if kitty is well enough to handle anesthesia.

NormaBee
on 6/7/11 8:58 am
RNY on 10/13/09 with
Hi Diana,

I had a similar situation with my Pumpkin who was about 13 years old when she started having similar issues to your Isis. She just didn't seem like herself and was hiding a lot under the bed. I took her to the vet and he also found weight loss despite eating a lot, elevated liver enzymes, enlarged liver. The vet told me it was very likely some sort of cancer, and I took her in to the animal hospital where they confirmed the diagnosis of lymphoma.

This hospital had a very aggressive chemo treatment option, and since she was already pretty advanced in the lymphoma, this is what they recommended. They said Tapazole would not be very effective for her in where she was. It was weekly and lasted 3 months, alternating two different drugs, and there would've been a lot of additional medications she had to take, including appetite stimulators, anti-nausea, etc., all of which would have to be administered by me. I was terrified and apprehensive but decided to do it to give her a chance. She was already having some trouble breathing due to the fluid build up in her chest cavity, so she was kept in the oxygen cage for several days. Long story short, she seemed to recover slightly after the first treatment, and I brought her home after 5 days. Unfortunately that night, she went into respiratory distress again and we went back to the hospital. I decided not to go through with the chemo, because she was suffering and she really hated the car, the carrier, taking pills, and dealing with all that. Hardest decision I ever had to make, but I tried objectively to assess her quality of life having to get in the car weekly, getting drugs, taking a lot of pills, having trouble breathing. I was fortunate in that money was not a consideration for me, but she was further along than it sounds like Isis is. I think it makes sense to do a month on the Tapazole and see how she responds.

Finally, I found a wonderful Feline Lymphoma Yahoo Group that has many knowledgeable people who are extremely well-versed in the disease, treatment, and drug protocols that exist, as well as being a great support group. They were really helpful to me as this was my first pet and I felt overwhelmed, I believe there is also a vet that specializes in lymphoma who frequently answers questions as well. Here is the link, I hope this is helpful:

pets.groups.yahoo.com/group/feline_lymphoma/

(Note: although it says they focus on young cats, I found the group to have equal representation from owners with older cats.)

You and Isis are in my thoughts.
        
H.a.l.a. B.
on 6/7/11 9:09 am
RNY on 05/14/08 with
I have a cat and I can understand where you are coming from. I would not put a 12 year old cat though a trauma of scan, biopsies, and chemo.
I would try to make her comfortable, as much as a can/ This is what i would do:
1. switch to organic cat food (slowly)
2. use the supplements that you are using now - apparently -0 it is helping
3. introduce (slowly) more supplements - add probiotcs (human grade) - I open a capsule and add to my cat's wet food - both cat can benefit
4. to make her more comfortable and at ease - start adding Bach rescue remedy to her water - a few drops to a cup of water - again - both cats will be more happy and relax.
5. you can also look for a homeopathic liver support drops - again - add (slowly) to the water or just give her one drop on a nose (adding homeopathic drops to water further dilutes the homeopathic making it STRONGER... so be careful with that).

Lots of love and attention.

H.a.l.a RNY 5/14/2008    

Need to bitch?  or Rave?  To find new R&R - 3.0 group..- send a PM -  to get included...

"Failure is not falling down, It is not getting up once you fell..."

 "So pick yourself up, dust yourself off, and start all over again...." 

ModestoK
on 6/7/11 3:57 pm
Diana  (& Hala)

Just wanted to note that if you do choose to follow the advice of using Rescue Remedy, be SURE that you get the PET version.  The normal version for humans has alcohol, and with Isis' stressed liver you don't want to add even the slight amount of alcohol to her system.

My vet actually told me this when I had a kitty that had sudden liver failure.  We kept her going for a few weeks with medications, force feeding, and fluids- but she hated every second of it.  She went downhill so fast we decided to forego additional treatments.  We had her put to sleep so she wouldn't be in any pain and because continuing to force feed her was torture to her

It did appear, though, that it was a sudden illness rather than cancer- so there weren't many options.

I certainly hope she continues to improve.   As someone else noted - there is some awesome support and information available online.  Currently, I have a kitty with chronic kidney failure, but have kept him going for 4 months with fluids despite his diagnosis. 
They let us know when it is time to stop fighting for them.

Kim 
                                      ~  Kim  ~

                             HW - 283        SW - 257.5     Goal - 156
Thanks to all the DS vets who have paid it forward - I <3 you guys!  
Looking for DS support & information?   Check out :     http://weightlosssurgery.proboards.com/index.cgi
         
H.a.l.a. B.
on 6/8/11 7:41 am
RNY on 05/14/08 with
Thanks. I never thought of that.  Appreciate the comment.

H.a.l.a RNY 5/14/2008    

Need to bitch?  or Rave?  To find new R&R - 3.0 group..- send a PM -  to get included...

"Failure is not falling down, It is not getting up once you fell..."

 "So pick yourself up, dust yourself off, and start all over again...." 

CarolineM
on 6/7/11 9:22 am
 I'm sorry you're going through this. My cat Tamsin had a similar situation a few years ago, enlarged liver, elevated enzymes and  losing weight while eating huge amounts of food, and the doctor thought liver cancer was the likely cause. 

I decided not to do much medical intervention, mostly due to her being 18 years old. She lived almost a year after that vet visit, and I think her quality of life was good until the last week or so of her life, when she started having seizures and I had her euthanized. I don't regret not treating the (probable) cancer more aggressively, but in a younger cat I would have.

It sounds reasonable to me to see how Isis does on a month of Tapazole and go from there.

Good luck.

Caroline
  HW 400   SW 355    CW 178   GW 180           5'10"
        
Judi J.
on 6/7/11 9:28 am - MN
I'm glad her liver levels went down. I'd do what you are doing.
(deactivated member)
on 6/7/11 9:45 am - San Jose, CA
Hmmm ... I'm not receiving any OH notifications the last few days ... I just saw that I had responses.

Thanks to everyone - I am taking all suggestions to heart and thinking about what to do.  Fortunately, the Tapazole is in a fish-flavored form, so I don't have to shove a pill down her throat.  I'm opting for least stress at this point.

BUT - if Isis isn't going to drop dead at any moment, I guess I have to start addressing Fat Boy Onyx's weight problem now!
beemerbeeper
on 6/7/11 10:44 am - AL
DS on 09/30/09 with
I would keep a cat or dog comfortable by any means and if not possible I would euthanize.  I would not do tests, chemo, or other forms of treatment for a pet unless it had a very high CURE rate and I really felt the pain and suffering that the treatment/tests caused would be FAR surpassed by the outcome.

But that is just me.  My animals are my family but this is how I feel.

I'm sorry you are going through this and I hope that whatever happens that you feel that you have made the right decision.  I think any decision you make is the right decision for you.

~Becky





h_squared
on 6/7/11 10:56 am - IN
Certainly a tough decision for you.

Our experience with feline lymphoma (and canine for that matter) is to let it take its course.  Especially when the animal(s) in question are seniors.  Chemo is only going to delay the inevitable and the quality of life will be diminished. Our beautiful Ori was diagnosed at age 11 with lymphoma and we decided that until she started to show signs of pain and discomfort, that we would do nothing up to that point.  Once she started downhill, everybody got their chance to say goodbye, got a last pat and we took her to the vet.  Our vet was so compassionate, we stayed and held her and told her how much we loved her until she closed her eyes for the last time.  That's been 6 yrs ago and I still choke up thinking about it.  

My heart goes out to you and your family on making such tough call.
~Heather

www.facebook.com/hphsquared

The difference between 'involvement' and 'commitment' is like an eggs-and-ham breakfast: the chicken was 'involved' - the pig was 'committed'.  -Anonymous

    
    
RedAppleCandie
on 6/7/11 2:09 pm, edited 6/7/11 2:09 pm
How terrible for you!

My childhood kitty Trouble had to be euthanized last year.  He was 16, and in the advance stages of kidney failure.  One of his kidneys had already shut down, and we could not afford the pricier options to keep him alive any longer.

I was a wreck for days and days.  The only thing that brought me through it was the other 2 kittys that I have.  They knew something was wrong, and were a big source of comfort to me in those weeks.  Even now, I catch one of them doing something that Trouble used to do, and I know they miss him too.  
Photobucket

  
Miss_Kitty
on 6/7/11 3:19 pm - New Bedford, MA
I have a cat that is approximately 14. She has a growth on her side (about the size of a mole) Her vet said not to worry about it. A few weeks ago, I found another growth on her spine, bigger than the other one. So now she has 2 growths. My fear is that it may be tumors. But she acts fine. Doesn't seem to be in pain. She's the same lovable best friend she always has been all these years.

So, why fix something that doesn't seem to be broken?

Just keep an eye on her. And I agree with an earlier post,....... don't kill her with chemo. It's bad enough for us humans, but at least we know why it is happening. Your cat won't. Take it easy.

Do you see the glass as half empty or half full? I say, what difference does it make--I paid for a full glass,so either way I am getting jipped!!!

White_ Dove
on 6/7/11 3:26 pm
 One of my cats lived for five years after being diagnosed with feline lymphoma.  It started on her neck after a rabies vaccine.  We had the tumors removed three times.  It kept coming back and I finally just let it take its course.  She lived two years after the last  surgery.  She was very happy and very spoiled.  The cancer finally went into her digestive system and we made the decision to have her euthanized. She was 18 and I had raised her from four weeks old. We did no chemo.
(deactivated member)
on 6/7/11 4:11 pm, edited 6/7/11 4:13 am
Well all I can say is a death sentence diagnosed by a vet isnt necessarily true according to the Cat lol ....


My sweet lil 6 lb Kitty Mini me was diagnosed with chronic renal failure /kidney insufficiency 6 years ago and he's THRIVING thanks to daily attention to his drinking filtered cool refrigerated water ( with lots of praise when he drinks ) .. the occasional antibiotic course when his tiny urinary system gets blocked up ...special vet- prescribed high quality food ( and a fresh meat diet )

and daily attention and petting and love .

I think the latter is the MOST important for both human and cat .
(deactivated member)
on 6/7/11 4:58 pm - San Jose, CA
I SO appreciate the thoughts and ideas you all have shared .. I'm sitting her more than a little verklempt at your stories.

It sure seems that the vets are guessing, more often than not, and I should not treat his guesses at a death sentence.  I will continue to to monitor how she is doing, treat the easy thing (the hyperthyroid) with medication, and see how she's doing next month.

I don't want to put her through chemo.  Perhaps surgery to remove her thyroid at most - but not if her liver enzymes are too high, or her calcium numbers indicate she is a poor surgical risk.

Perhaps less is more in this case.  But good food and loving attention can also be good medicine.

THANK YOU AGAIN!!
spedcon
on 6/7/11 7:29 pm

Diana, You are a good kitty Mom. I have kept up with your story and I'm sorry you have to make these decisions. I am happy to hear there has been some improvement.

It's really hard to deny a kitty a yummy treat when they can look at you with those big kitty eyes the way they do. I swear, my Sheldon actually rolls on his back, puts his paws in the air and smiles at me when he wants "kitty crack".

We just think  food is rough on us....damn kitty treats!  My cat loves those crunchy little squares of joy! He relates any bag opening to treats. I have to be a good Mom and just say no! He is a bit on the heavy side as well.

Please keep us posted on their progress. Hugs!          Connie
 

Elizabeth N.
on 6/8/11 9:28 am - Burlington County, NJ
Often getting the hyperthyroidism under better control makes them MUCH more comfortable. If she's eating and doing okay, wait and see is a perfectly reasonable thing to do. You can decide later if you want to do something differently.

(deactivated member)
on 6/8/11 1:19 pm
I'm so sorry! We love our pets so much it hurts to see them hurting.

We have an older beagle and he has gotten fatter as I've gotten thinner. Maybe you could Onyx hooked up with a DS  : )

So, this November our beagle (Barney) went in for a check up and he tested very high in liver enzymes. The vet was really surprised that he was eating well and looked so good -- so he had us bring him back a couple of weeks later to test again. Tested a lot higher than the first time, still eating and looking good though. Tested a 3rd time, same thing.

The vet said it was either cancer or some other vague issue -- could be several things -- some treatable, some not so treatable. He wanted to do a biopsy and more tests to figure out what the problem was. We had decided ahead of time if it was cancer we were not going to do anything for him, except comfort measures. We did not do the biopsy or further testing. It is now June and Barney is still looking good, no vomiting and eating well. ( I guess in dogs not wanting to eat is very serious)We don't know how long he will be with us but we are so very happy he still is.