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Cat Forum / Health and Behavior / July 2005Sick Cat - Second Opinion or Specialist? Lymphoma?
Hello all - this is my first post and I'm hoping you all have some advice for me. My cat Snowball is about 10 years old. We adopted her when she was around 2 from Humane Society. She's been having normal checkups since then (around 1998) with the last normal one June 2004. In December 2004 we noticed she had lost what we thought was a lot of weight. This was coupled with my husband feeding her people food and her turning her nose up at regular cat food. So we made an appointment with the vet. Tests done: General Health Profile BP2; CBC and Electrolyte Panel; FELV/FIV Test. Vet said all were normal. 1/2005 - Back for recheck - Tests done: Glucose Blood Test;Cystocentesis; Thyroid Level Profile T4. Vet said all were normal. We stopped the people food, started giving wet cat food and her appetite started improving. So much so that she started always begging for food! We were advised to keep this up and bring her in for periodic weighing. We did and she always seemed to be gaining a little bit each time. 5/2005 - Decided to bring back for a formal appointment because even though she was hungry all the time I did not feel she was gaining enough weight. Also she was more lethargic and it seemed like she was vomiting more often than usual. THIS time the vet was alarmed by the cat's distended abdomen/thickened intestines and said based on everything so far, she felt that Snowball was not absorbing nutrients no matter how much she eats and thinks it's lymphoma. SHe advised us to see a specialist for a colonoscopy. A couple of questions: 1. Wouldn't lymphoma have shown up on any of those tests? 2. Why colonoscopy? Why not biopsy? Or ultrasound? 3. Should I get a 2nd opinion from another regular vet or just go to the specialist and see what they say? Thanks in advance for any advice you can give based on your experiences. Pat > Hello all - this is my first post and I'm hoping you all have some > advice for me. [quoted text clipped - 41 lines] > > Pat My cat had advanced stomach lymphona (lining thickeded to 3 times or more of normal, almost no normal tissue left) and his blood tests were fine and until he began throwing up two weeks before we put him to sleep he ate normally (even piggishly) and and showed no distress. I guess if I were you, I'd see the specialist right away for as firm a diagnosis as you can get. Sometimes, they just can't tell with out directly looking at the affected areas. > Hello all - this is my first post and I'm hoping you all have some > advice for me. <snip> > A couple of questions: > 1. Wouldn't lymphoma have shown up on any of those tests? [quoted text clipped - 6 lines] > > Pat From what I understand, and I may be wrong, you will want to ask this of the vet, if they do a colonoscopy, they will do a biopsy at that time. If I were you, I would ask the vet to repeat the bloodwork, since the previous results were a while ago. If she has an elevated white blood cell count, she may have lymphoma. If you do not want to go invasive with the colonoscopy right away, you could opt for the ultrasound. However, the ultrasound cannot make a distinction between lymphoma and IBD, but it can give you an idea as to how widespread this is. My cat Dash died of probable instestinal lymphoma. She had a bad heart murmur, and could not undergo the anesthesia, so we only had the ultrasound. In a way, I wish I could have known for my own piece of mind whether or not it was cancer, although it would not have affected her treatment plan much. She had some other health issues and was not a good candidate for chemo. IF your cat is otherwise in good health, this may be an option for you. Good luck, I'm sorry your kitty is suffering with this. -Kelly > Hello all - this is my first post and I'm hoping you all have some > advice for me. [quoted text clipped - 34 lines] > 1. Wouldn't lymphoma have shown up on any of those tests? > 2. Why colonoscopy? Why not biopsy? Your vet probably wants to try a colonoscopy first and spare your cat the trauma of surgery. > Or ultrasound? Ultrasounds aren't really good for IBD/lymphoma because clinically both appear the same. Biopsy is really the only reliable method of distinguishing IBD from lymphoma. IBD might actually be precursor to lymphoma. > 3. Should I get a 2nd opinion from another regular vet or just go > to the specialist and see what they say? I'd see what the specialist has to say. If you're not satisfied, you can always get a second opinion. > Thanks in advance for any advice you can give based on your > experiences. > > Pat Best of luck, Phil Thank you all. I think I will call the specialist for an appointment for a consulation. I guess I was thinking ultrasound, Phil, because I was assuming it might show a tumor and would be easier on the cat. But it sounds like the vet recommended colonoscopy for the reason you state. Update on Snowball - took her to the specialist who has diagnosed her with Exocrine Pancreatic Insufficiency. Great news because we just get an enzyme to sprinkle on her food, special diet (at least for a while), and an antibiotic for 10 days. So happy we don't have to think about an endoscopy! > Update on Snowball - took her to the specialist who has diagnosed her > with Exocrine Pancreatic Insufficiency. Great news because we just get > an enzyme to sprinkle on her food, special diet (at least for a while), > and an antibiotic for 10 days. So happy we don't have to think about > an endoscopy! Yay, Snowball! Tell us more about this disease if you have time. I have never heard of it. It sounds scary, will it be cured in just 10 days? It's apparently very rare in cats - my vet said Snowball is a minor celebrity around the office ;-). It won't be 'cured' in 10 days - we actually have to give her enzymes for the rest of her life whenever she eats food or the symptoms will return. However, I'm grateful it's not lymphoma as we originally suspected. Thanks! > It's apparently very rare in cats - my vet said Snowball is a minor > celebrity around the office ;-). [quoted text clipped - 3 lines] > return. However, I'm grateful it's not lymphoma as we originally > suspected. Sending best wishes and good purrs for a long, happy life for Snowball. She is very lucky to have someone who takes such good care of her. Now, we cannot possibly help you further without seeing some photos. :) Got a photo web site? LOL - been meaning to. I just uploaded a 'shell' which I plan to improve when time permits. For now, go here: http://home.earthlink.net/~cordes_3. Click on the 'My Pets' link and you'll see Snowball (and Maggie too!). It's been 6 weeks now and although Snowball does not seem 'famished' anymore, she hasn't gained weight yet. The prozyme info says it could take 8 weeks. The problem now is excessive urination. She seems to be drinking more and urinating excessively - like 1/2 the litter box is wet! Even though she was just tested for diabetes 6 weeks ago, I'm guessing I'll have to take her back in. The specialist vet said that they can develop diabetes at any time. Any ideas what else it could be? > Update on Snowball - took her to the specialist who has diagnosed her > with Exocrine Pancreatic Insufficiency. Great news because we just get > an enzyme to sprinkle on her food, special diet (at least for a while), > and an antibiotic for 10 days. So happy we don't have to think about > an endoscopy! Pat, speak to your vet about a cobalamin (vitamin B12) supplement (not much- about 100-250 mcg/wk IM), an oral folate supplement (~400 mcg orally) and an antacid (cimetidine). Cats with EPI almost always have severe depletion of total body cobalamin stores. This causes villous atrophy and intestinal inflammation and also malasbortion, so the pancreatic enzymes may not work by themselves. EPI cats are also often hyperacidic- which can inactivate the pancreatic enzyme supplement. An antacid will help reduce gastric acid secretion and help the enzyme supplement work more efficiently. I'm glad you're using powder- the pills don't work as well (if at all). Best of luck. Phil Hmm - I didn't know that. I will have to give the vet a call and do some research on my own. Thanks! |
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