9/22 Ruby AMPS 262/+5 157/+8 77/+10 74/PMPS 76/+2 155

https://www.felinediabetes.com/FDMB...192-3-182-8-146-10-202-pmps-182-2-191.253275/

We had an appointment with Ruby’s oncologist this morning and now she’s doing her post-onco dipsy doodle. DBF is home with her and fed her a smidge of HC at +8 and I told him to hold off until I got home for shot time.

I relayed all of the drama of the past two weeks to the doctor. She said despite all that was going on Ruby is doing well. She’s gained more weight and so she did not see the need to do an ultrasound.

@Wendy&Neko I asked about chlorambucil again and why she is choosing not to use it with Ruby yet. She said because Ruby’s clinical signs are fine, because she doesn’t want to give more meds than necessary, because she doesn’t want to create the need for more vet visits as chemo might entail. She also said that prednisolone, while not a traditional chemo drug, has been proven to cause apoptosis or programmed cell death with lymphocytes. Not only does it have anti-inflammation properties but it can also stop the lymphoma from progressing. Pred does not work on all cancers, like breast cancer tumors, for example, but it has been shown to work with lymphoma. I found this bit of information useful and heartening.

 

I haven't been responding lately, but just want to give all my cheers to you for doing a nice job with Ruby, dear Katherine My little civvie is doing great on pred, (and another drug for her liver and gallblader) eating well, and we are living well one day at a time. Not going the route of confirming cancer at this time.
Much love to you and Rubes and the rest! BE gone, you ^(&%$ fleas!

 

Evening Katherine, I'm so happy Ruby had a good report today.
Great that she put more weight on!
Nice to see those greens today!
I see a poop today
Have a good night Katherine, and kisses to Ruby

 

Would love to see the papers on that research. Claims without published data are irrelevant. Most specifically I'd like to see papers on the part about stopping lymphoma from progressing.

You mean the constipation and or diarrhea is fine?!? Almost three months on pred, those symptoms should be gone by now. To me those are clinical signs that the lymphoma is not being treated. And killing the lymphocytes is indeed the role of pred, think of it as mop up duty. However, what you really want to do is treat the disease (lymphoma) that is producing the excess lymphocytes. That's what chlorambucil does. At some point when the lymphoma progresses enough, the prednisolone will no longer be able to keep up with the amount of lymphocytes produced. As far as blood work goes, you wouldn't have to go into AMC each time for a checkup, you could have it done at your regular vet or even acupuncture vet and send the results to AMC.

 

Thank you, Jan! I had no idea you had a civvie on pred. I'm so glad she is doing well.

 

Constipation has been a problem for Ruby for a long time, and according to the doctor, chlorambucil does not stop it. Ruby very rarely gets diarrhea, like once every 3 months and it's short-lived, and usually induced by too much Miralax or most recently with Clavamox. We are at a good dose of Lactulose now. I'm happy to keep an eye on her, and as soon as she stops eating and loses weight, there will be no stronger indication that she needs the chlorambucil. Perhaps Ruby's case is mild. She has had three ultrasounds done since a year ago, and all of them have said pretty much exactly the same thing--that she had slight thickening in her jejunum. The measurements never got larger, have always remained stable.

I don't like the unregulated diabetes, I don't like the constipation, but we are managing and she seems better than ever: eating well, very little vomiting except when I forget to feed her overnight, jumping onto tables and windowsills like a bunny, and being super lovey. We have an ultrasound scheduled for a little more than 2 months from now and we shall see.

 

Neko's U/S measurements went down by 30% a couple months after starting chlorambucil and budesonide. She had a bit of constipation before diagnosis and treatment cleared up it within a month. Since she had acro and CKD, I wasn't sure if they were contributing, but the only thing that was changed was the addition of those two meds, and meds for her heart that don't impact the gut. Both civvies on pred and chlorambucil returned to beautiful/normal poos fairly quickly too.

I'm glad she's otherwise doing well, just worried about the "elephant in the room".

 

Mind you, all of the ultrasounds were done before the SCL diagnosis and the introduction of the pred. If at the next ultrasound the thickening is improved, I think we will have a good answer to the question of the "elephant." And then 6 months later we'll check again. Almost nothing goes unnoticed around here (well, except for the fleas for a while), and my cat mom alarm bells are on high alert. I just have to take this one step at a time and trust this doctor.

 

I'm glad Ruby had a good vet visit and got a good report. I hope she surfs safely tonight.

 

She had a poop! DBF messaged me this afternoon to tell me the good news!

Now we have a bounce going on. But tell me, does this look like a sick kitty to you?

 

What an encouraging report on Ruby … and very interesting! Have a great night!

 

Hilarious! Poop texts! She looks beautiful! Not sick at all.

 

I think I may have mentioned before that I had a cat with SCL (well, I have had two so far). Maverick was on pred for a long time and it stopped all his visible symptoms (diarrhea and inappetance and weight loss were the main ones.). It worked great until it didn’t cut it anymore and we had to add in the chlorambucil (which he did amazingly well on.). I’m not saying this is the best approach… it just happened to be the way things worked our

 

She is such a pretty girl. You have all been on my mind and pleased to hear the oncologist’s review of how Ruby is doing. Big hugs to all of you.

 

For sure chlorambucil will be in Ruby’s future. I have a suspicion that Ruby’s relatively young age is also what is making the doctor hesitate and she wants to buy us some time before chemo to prevent secondary cancers from developing. Do you remember how long Maverick was on pred alone before going to chlorambucil?

 

No way does she look like a sick kitty to me!
If you keep posting these adorable pics of Ruby I'm going to hop on a train and head to Hoboken and snatch her up
She's just too darn precious
@PerfumedCatMom

 

AWWW!!! Beautiful little one

 

It was a good long time... like 18 months or even more before he had to go on the Leukeran.