8/17/2018 PHOEBES AMPS 166 +4 61 +7 84 Pmps 92 vet updates and lab values entered on my ss

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Phoebes (GA)

Phoebes (GA)

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http://www.felinediabetes.com/FDMB/...-included-partial-update.201230/#post-2237777

MissP is feeling pretty good today. Vet called her white blood cells are thru the roof at 33000. I will just put the results here. She's waiting for lab to look at the cells to see if they are immature cells or mature cells. Looks like it's pointing to lymphoma or some other diesease. It was all a blurt pretty much heard high white cells and mind went blank. :'(
 

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:bighug::bighug::bighug:
Good thoughts that it's something simple and not those worst case scenarios.

Phoebs feeling good is key. I love the picture of her from yesterday - such a pretty girl
 
They sent the lab as a rtf file i have no idea what that is or how to download it. so asking them to resend as pdf.
 
Please don't think the worst re: high white cell count. Rose has had high WBC for several months. My initial thoughts were of the worst, but she has been responding to ABs, so it is at least partially due to infection. WBC can be caused by both infection and inflammation.

I hope it is something simple. Until you know different, please don't think the worst. :bighug:
 
Carol in Chicago said:
Please don't think the worst re: high white cell count. Rose has had high WBC for several months. My initial thoughts were of the worst, but she has been responding to ABs, so it is at least partially due to infection. WBC can be caused by both infection and inflammation.

I hope it is something simple. Until you know different, please don't think the worst. :bighug:
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Thank you, but the vet is sending those worse thoughts my way. She's always been upfront and no holds bar kinda gal. But I get what your saying. I have wondered tho just from her weight loss and muscle wasting, it's something.
 
My Tiffany had a very high white count and it was intermediate cell lymphoma. She was projectile vomiting once or twice a week and had pudding stool. Did your vet suggest you get an ultrasound by a boarded radiologist? That would be the next step. I’m not suggesting your kitty has cancer but early diagnosis if lymphoma is key to remission. Even large and intermediate cell are treatable. :bighug:
 
You can't diagnose lymphoma via bloodwork. Having said that, there are certain things that can indicate it's a possibility. The one I worry more about for Miss P is that she is losing weight. I presume she is eating the same? The small cell group I belong to says weight loss can be one of three things, diabetes (can't be better controlled than Phoebe, hyperthyroidism - looks fine there, and small cell lymphoma. Seems it's something a number of our acro kitties get, Neko, @JeffJ s Leo, and likely Wes's Jack. The good news, if you call it that, is that cats can go into remission, possibly for years, and the drugs to control it are fairly well tolerated. But this is jumping ahead of things, what did your vet suggest next? Typically an ultrasound resound is step two.

BTW, I think you got the potassium and sodium entries mixed up in the Labs entries. It also helps if you put in bold or colour the values that are out of range,

Glad to hear MissP is top of form today. That's also very important. :bighug:
 
Yes she said next step is an US or xray to see if we see anything she couldn't obviously feel. She is waiting for the slide read to come back on immature lymphocytes or mature.
 
tiffmaxee said:
My Tiffany had a very high white count and it was intermediate cell lymphoma. She was projectile vomiting once or twice a week and had pudding stool. Did your vet suggest you get an ultrasound by a boarded radiologist? That would be the next step. I’m not suggesting your kitty has cancer but early diagnosis if lymphoma is key to remission. Even large and intermediate cell are treatable. :bighug:
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Yes she did say US was next. We are doing the B12 shots for 6 weeks to see if she puts on any weight. That gives us time to save up for next set of tests.
 
Wendy&Neko said:
The one I worry more about for Miss P is that she is losing weight.
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When she first got sick she went down to 11.8 pounds. Then we got her back up to 15. The food she ears is the same if not more. She gets about 4 cans of ff a day. I can't watch her wilt away to nothing. I am gonna add the powdered egg whites, and possibly fish oil but is that suggested for IBD? Or panc?
 
Summary of Leo's small cell lymphoma:
- Spring 2017 stopped eating, couldn't hold food down
- external diagnostics including ultrasound, no issues found
- open gut (surgery) biopsies
> during this open gut, the vet said there was no obvious cancer or issues
> 2 or 3 sites came back positive for SCL
- Prednisolone and Leukeran (chlorambucil) started - and continues for the rest of his life

The pred helped a lot, stimulating hunger possibly as a side effect.
And here was are 13-15 months later with a fairly healthy, happy Leoberry back to normal weight. If I did it again, I would see if they could do small incision surgery to pull the biopsies.
Dad - we need fud - LD and Leo 08-17-2018.JPG
 
JeffJ said:
Summary of Leo's small cell lymphoma:
- Spring 2017 stopped eating, couldn't hold food down
- external diagnostics including ultrasound, no issues found
- open gut (surgery) biopsies
> during this open gut, the vet said there was no obvious cancer or issues
> 2 or 3 sites came back positive for SCL
- Prednisolone and Leukeran (chlorambucil) started - and continues for the rest of his life

The pred helped a lot, stimulating hunger possibly as a side effect.
And here was are 13-15 months later with a fairly healthy, happy Leoberry back to normal weight. If I did it again, I would see if they could do small incision surgery to pull the biopsies.
View attachment 38242
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So really the US was useless? And the biopsies were not much more help. We talked about maybe starting her on pred and just work around the bg. She has plenty of room to go up a little. Leukeran any wild side effects?
 
Firstly: :bighug::bighug::bighug: for you Angela and some scritches for Phoebe.

Secondly: This sending out labwork is driving me crazy! Why don't vets do that in-house? Mine currently does and I couldn't fathom waiting days for results. How long until that manual differential comes back (the blood cell slide)?? Makes me want to come over there and read it myself so you can have those answers sooner rather than later (I'm a lab tech, I read blood slides daily).
 
I think they tend to send labs out because the outside labs calibrate their machines more often and the vets feel the results are more reliable.

My lymphoma cat had severe thickening of the intestines and the radiologist said severe IBD or lymphoma. She was diagnosed via endoscopy. Her symptoms indicated it more likely to be lymphoma. She didn’t have any masses.

Your cat’s symptoms aren’t as dramatic as Tiffany had but in retrospect I think she had IBD from Hills KD which morphed into lymphoma. I doubt your cat has large cell or intermediate cell. So no rush tp proceed unless symptoms get worse (anti-jinx). :bighug:
 
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Phoebes said:
So really the US was useless? And the biopsies were not much more help. We talked about maybe starting her on pred and just work around the bg. She has plenty of room to go up a little. Leukeran any wild side effects?
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Ultrasound tells you if there is gut thickening, which means either IBD or small cell lymphoma. It can also detect any masses. It also tells you if the thickening is in a place that can be reached by endoscopy, which is less invasive that a full thickness biopsy. Both require anesthesia though. Before starting pred, I would check her heart. Neko had budesonide instead of pred, cause her heart could not stand pred. Bonus, it didn't impact her blood sugars like pred does. The main Leukeran side effect is nausea around the dosing. A pulsed dosing protocol where it is given every two weeks instead if every other day, really helps. You use Cerenia and ondansetron to counter the nausea. Neko was originally on an every other day Leukeran to start, and never got a break from nausea until I moved her to pulsed. And you probably want generic chlorambucil compounded, Leukeran is the more expenive brand name in the US.
 
For Leo, Wendy is correct. The ultrasound was done in case there was some large mass. Other kittehs tumors have been found that way. The ultrasound for Leo did find intestinal wall thickening - indicative of acro growth, IBD, or SCL.

It is interesting in Leo's case. The vet said there were zero visible signs in the open surgery of any issues. So we sat on pins and needles until the biopsy results came back in.

Leo is getting compounded chlorambucil. It doesn't seem to cause him much nausea as he eats like a pig. Leo originally got "every other day". We have moved him to every third day after consultation with an internal specialist.

SCL is indeed a scary proposition. Some kittehs like Leo are lucky. Either we caught it early, or he is just responsive to the drugs. Some kittehs are not lucky. In the case of our vet tech, her kitteh died three or four months after detection, despite the same treatment. The treatment is relatively inexpensive:
- $23 of prednisolone is a 2 month supply (~$12/month)
- $30 or $40 chlorambucil is now a 3 month supply (~$12/month)

When I first got the chemo (last year) they told me the price over the phone
"thirty two fifty three" or simliar
I said wow, that is expensive. I don't know if I can afford $3,000 for a 2 month supply.
She laughed and said "thirty two dollars, not thirty two hundred".
WHEW!:eek::smuggrin:
 
JeffJ said:
Leo is getting compounded chlorambucil.
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What does this mean? Like into liquid for rubbing on ears or put into food? Thank you for the information. That's definitely a better price than we were afraid of. That's doable. Was there any bad diarrhea with the chlorambucil? My best friends cat is on a chemo drug of some kind and he has explosive messes. I'm glad Leo is doing so well :)
 
Oh sorry. Yes, the chlorambucil is compounded into a chicken flavored liquid. It comes in a plastic bottle with a top that allows a food syringe to attach to. Kinda like ampicillin. And they provide the 1ml food syringe.

Leo never got diarhhea from it. Not even once in a year. In fact, his current bottle is almost out and I am picking up a new one on Monday with a 4 month supply. Some have argued that it does not hold up that long in suspension. That has not been my experience. I ensure it is refrigerated the whole time.

If you go the chemo route...and that part is unknown yet for you...be very careful. You are supposed to use gloves. What a pain. I did that for a month. Now I am just very careful to not get any on me. And I wash my hands 3 times after each dose.
 
It's more common to get chlorambucil compounded into a capsule. In Canada, name brand Leukeran is cheaper and I just give it in a pill pocket - using gloves to handle it. I looked at liquid, but the version here expired after a week, so I would have always been running to the compounding pharmacy. Plus there is the issues of handling with liquid.
 
The prednisolone can be ordered online without prescription (I think).
The chemo has to have a prescription. I get it compounded at a local pharmacy, after the vet calls in the order.
 
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