Kitty Gus - July 1996 - April 1, 2011

[k9diabetes]

Re: Kitty Gus is sick

Just got off the phone with the vet now that all of Gus' test results are back. He also discussed them with the pathologist who reviewed the biopsies as it's kind of a muddy picture.

The hypercalcemia (high calcium level in the blood) has been diagnosed as idiopathic, which means they don't know why the calcium is high. The only thing to be done for that would be to give subq fluids to help flush the kidneys.

The test for parathyroid hormone came back in the normal range so that suggests there is no growth on the parathyroid gland.

The PTH-related hormone test came back negative, which says there's no raging lymphoma.

The vet says there is a gradient in cats from IBD to lymphoma. They believe that lymphoma often gets started with IBD and it may even be that most cats with IBD eventually will develop lymphoma.

So Gus' diagnosis is severe IBD and/or emerging lymphoma - that he's likely somewhere in the middle of that gradient.

He's being prescribed prednisolone (steroid) for the IBD and leukeran (low-grade chemo drug that's good at targeting lymphocytes).

And he's to stay on a novel-protein diet in case his diet is part of the IBD.

This is a cat who basically can't be pilled. Still working on a solution for that. The vet says it could be compounded into a single medicine but I'm going to try the pills first.

And will try to get him to eat the Lamb IVD.

Natalie

[We Hope]

Re: Kitty Gus is sick

You go, GUS!!!!!!!!

[Denise]

Re: Kitty Gus is sick

This is what I went through with Reba, lots of tests bt nothing that made it a clear dx showing we HAD to use Lysodren. Argh!

Steroids can be compunded into a creanm to rub on the ear, I believe, but I wouldn't think a chemo drug could. You have a pill popper? Saves your fingers but their claws still get your arms.

I've even ahd help with some cats and it can still be a chore! some of mine are famous for holding and spitting them out later.

IBD to lymphoma?

You might consider all meat food since some think that carbs feed cancer cells. I'm getting all mine switched over because of Bubba but it's going to take awhile, I have several kibble lovers and a couple that don't give a hoot about canned so....

How's he feeling now? Any signs of ANYTHING?

[k9diabetes]

Re: Kitty Gus is sick

The IBD to lymphoma continuum was really interesting to me. I noticed that an article by Dr. Tam, who is an IBD expert, covered IBD and lymphoma in cats in one article. He didn't directly relate them but I can see where a chronic case of IBD could lead to lymphoma in the intestinal tract. I'm hoping to get a chance to research this a little.

The thing I "like" about that explanation is it makes sense of Gus' test results. He's not lymphomic enough to come up positive on the tests but there are also lymphoma signs in the ileum and lymph node.

Gus is about the same but doesn't want to eat the IVD.

I managed to get at least part of the prednisolone in him last night. It's syrup and he's wearing part of it on his cheek. The leukeran had to be ordered so will pick that up today. If it's a pill, I"ll try pill pockets but he may not eat them.

He and Katie both fight like kamikaze warriors when they need pills and they're very strong and muscular in the front legs... plus Gus is doublejointed, which makes him very very good at reaching around and snagging skin. I was thrilled that his last antibiotic was a tasteless liquid that could be put in canned food gray.... we shall see how it goes!

Natalie

[k9diabetes]

Re: Kitty Gus is sick

For those interested in the IBD/Lymphoma link in cats, it didn't take much digging to find references to it...

http://www.vin.com/proceedings/Proce...2980&O=Generic

Feline Alimentary Lymphoma

One well-recognized, but poorly defined, example of inflammation-associated neoplasia is the proposed progression from inflammatory bowel disease (IBD) to alimentary lymphoma. This progression is documented in human patients with coeliac disease, and although reported in both the dog and cat, this appears to be far more of an issue in the feline species.

In fact, the distinction between IBD and alimentary lymphoma on histopathological examination of gut biopsies still provides one of the most challenging interpretations for the diagnostic pathologist. Determining whether a mononuclear cell infiltration of the intestinal lamina propria is reactive or neoplastic has now been aided by the techniques of immunohistochemistry and clonality testing. Immunohistochemical labeling for the expression of molecules restricted to T (e.g., CD3) or B (e.g., CD21, CD79a) lymphocytes can determine whether an infiltrate is mixed in nature or monomorphic--the latter being more likely associated with neoplasia.3

In a recent investigation, we reviewed 32 cases diagnosed as alimentary lymphoma by routine examination of HE-stained intestinal biopsies taken from cats with chronic diarrhoea.4 Immunohistochemistry defined these as predominantly T cell tumours, with fewer B cell or null cell lymphomas. Of greater interest, was the group of 5 cases in which immunohistochemistry was able to demonstrate a mixed infiltrate of morphologically-normal cells more consistent with chronic inflammation than neoplasia. The recent introduction of 'clonality testing' (at least in the United States) has provided a second means of making this distinction.5 This methodology determines whether the population of lymphocytes infiltrating the mucosa is monoclonal (i.e., carries a single type of T or B cell receptor) or polyclonal (i.e., a mixed population with numerous different T and B cell receptors)--the former associated with neoplastic transformation. Clonality testing has to date been most widely applied to blood samples or fresh lymphocyte suspensions, but can also be performed with fixed tissue biopsies.

[k9diabetes]

Re: Kitty Gus is sick

Gus had his fourth chemo pill today and has been on the prednisolone daily, none of which seems to bother him. And by mushing up the Lamb canned IVD with water, I've convinced him to eat it fairly consistently, along with some kibble at times if he's really hungry.

This morning he tried to break into the Pill Pockets bag and help himself so those are working wonders for getting his meds into him. Which is cool, since the prednisolone is a lot cheaper as a pill than as a syrup.

Natalie

[We Hope]

Re: Kitty Gus is sick

Keep it up, Gus!

[Denise]

Re: Kitty Gus is sick

I've wondered about the pill pockets for cats as I have several cats that don't eat ANY treats. A friend with a thyroid kitty was having trouble pilling and I told her to try pill pockets and she was amazed at how simple that was! I hope he continues liking them! I've found things that work for awhile and then.....

I've always heard that cats take chemo really well compare to other species. I hope he stays well, keeps taking his meds and eating well!

[eyelostit]

Re: Kitty Gus is sick

Nat, I hope Gus is doing better and taking his pills............

[k9diabetes]

Re: Kitty Gus is sick

So far, the pill pockets are working great.

Some days Gus looks pretty good, some days a little scruffy. Today is a scruffy day. He has put a little weight back on, which is good.

Not much news, which I guess is good news.

Natalie

[Jody]

Re: Kitty Gus is sick

Thanks for the update on the Gus Boy! Nice to hear that he is taking this all in a stride - or at least that's what he wants you to think! I'll have to remember to check on those pill pockets if I ever have to pill Lacey - gosh - I just know that would be a nightmare! Taffy was bad enough - but a cat? Yikes! Jody

[k9diabetes]

Re: Kitty Gus is sick

I had happened to start giving him treats a few months ago in an effort to get him to socialize a bit more, which turned out to be very valuable now that he needs pills twice a day.

I'd sit on the bed and rattle the treat bag and he'd come running. I'd require him to pretty much climb into my lap to get the treat. He'd stay at least long enough for 3 or 4 treats, which was a big accomplishment for him.

Something about those treats they REALLY like and now they lap up the pill pockets too. Katie gets one every time Gus does.

Gus has a blood draw scheduled on Monday, I think mostly to check for anemia from the chemotherapy.

Natalie

[k9diabetes]

Re: Kitty Gus is sick

Gus' blood panel came back with some good news and no bad news. It doesn't really tell us much about the IBD/Lymphoma but does suggest he's not having any serious problems with the treatment.

No anemia.

Calcium dropped into the normal range,
from 13.2 down to 10.5, normal is 8.2-11.8

ALKP improved, from 80 to 40, normal is 0-62.
ALT went up though, from 76 to 135, normal is 28-100

One weird thing - cholesterol went up, from 187 to 235, normal is 82-218.

He also gained some weight, from 12.4 to 13.0 pounds and it seems to be somewhat better distributed.

The vet wants to continue his treatment for another week or two before doing any major evaluations since there's no obvious problems or obvious improvement. Gus remains in the not-great/not-bad gray area, maybe a little better than pretreatment though he might have felt bad as much from the fatty liver issue as the IBD.

It's hard to really test the progress of the IBD/Lymphoma since it doesn't show up in the bloodwork other than the calcium level and that didn't seem to come from the intestinal issues in his case.

Some days he's looks pretty good. Some days he seems sluggish. And the vet said his own wife's cat, which has IBD, does the same thing.

Natalie

[k9diabetes]

Re: Kitty Gus is sick

Tuesday they are gonna ultrasound Gus to see how his lymph nodes and intestine look. He's been on chemo and prednisolone for just short of two months. The chemo, the vet tells me, is a permanent thing since it's a low-grade approach.

The vet's also going to look at his jaw and see if there's a reason for Gus' weird chewing/eating habits.

The loss of hair on the back of his back legs and stomach are commonly either allergies, which seems unlikely given that he's been on a daily dose of prednisolone, or stress. So this weekend I begrudgingly put his cat box back into his kennel in my office. Lordy, I loved not having it in here but he was going to the box barely once a day, saving it all up for one trip out to the box in the garage, so I got the feeling that he really wasn't liking not having his own cat box. If only he wasn't so messy!!!

Natalie

[k9diabetes]

Re: Kitty Gus is sick

Gus was a very expensive child on Tuesday. I'm still waiting for the lab results.

He has some changes in the fat in his liver, which the vet feels is benign.

They took some samples of the lymph nodes with needle biopsies and ran a blood panel.

Previous Results:

Calcium dropped into the normal range,
from 13.2 down to 10.5, normal is 8.2-11.8

ALKP improved, from 80 to 40, normal is 0-62.
ALT went up though, from 76 to 135, normal is 28-100

One weird thing - cholesterol went up, from 187 to 235, normal is 82-218.

July 8 Results
Calcium: 9.9 so dropped still further
ALKP: 54, higher but still within normal range
ALT: 464, quite a bit higher
AST: 204, up quite a bit from 84, reference range is 5-55

I can't remember what AST is... will have to look it up.

The vet wasn't concerned about these.

Then they sent a blood sample to Texas A&M for a special panel (code on invoice is Tli/Pli/Cobalamine/Folate... intended to give us some information on Gus' IBD. Will have to look that up too!

Have been so busy with Chris that I haven't had much chance to explore this new test.

The leukeran, chemo drug, is likely a permanent part of Gus' life.