1/11/24 Max ultrasound report

[Max & Lori]

I’m posting Max’s abdominal ultrasound report from 1/9/24 done at NCSU. This was done by a board certified radiologist there. I’d like to just get some thoughts on this. This is something I’m completely unfamiliar with so any information I would greatly appreciate. We are scheduled to return in 3 months for a repeat ultrasound (or sooner if needed). They said he could have a biopsy done at that time. I don’t know if I should or not. They left it up to me. Please share any knowledge you might have @Marje and Gracie @tiffmaxee @Tiger(GA) and Ruth @Suzanne & Darcy
Thank you all again for your encouragement and helpful information.

 

[Max & Lori]

Previous post https://felinediabetes.com/FDMB/threads/1-9-max-amps-268-2-257-167-4-89-5-76.285480/#post-3141924

 

[tiffmaxee]

I’m glad the ultrasound was done by a board certified radiologist. I’m no expert at reading these but it sounds like the changes could all be benign or not. I think I would see how he does and is he isn’t feeling well do a repeat at a month and if doing well wait 3 months just liked you decided to do much as I hate not knowing. I did a biopsy for my 7 year old and didn’t get a diagnosis due to vet and or lab screw ups so I knew what watching feels like. Maybe someone else will be along later with more knowledge.

 

[Max & Lori]

I’m glad the ultrasound was done by a board certified radiologist. I’m no expert at reading these but it sounds like the changes could all be benign or not. I think I would see how he does and is he isn’t feeling well do a repeat at a month and if doing well wait 3 months just liked you decided to do much as I hate not knowing. I did a biopsy for my 7 year old and didn’t get a diagnosis due to vet and or lab screw ups so I knew what watching feels like. Maybe someone else will be along later with more knowledge.

Okay thanks Elise. It is hard not knowing, but honestly more than anything I’m going by how Max feels and right now he’s really been doing well considering all that’s happened in the last couple of months. He still has his 5 Ps and eating well. I know things with cats can change quickly but I’m just going by what I see. I’ve known for a while now that ultrasound isn’t diagnostic for IBD, but we’ve treated him for that because diet changes helped in addition to Budesonide. I’ve always known there was a possibility of something worse. Max doesn’t have very good luck with his health, but to see him you’d never know it.

Hopefully there may be others to help us. I just tagged a few people who offered support the other day. Thank you.

 

[carfurby (GA)]

 

[Tiger(GA) and Ruth]

Like Elise @tiffmaxee said, I too am very glad to hear the US was done by a board certified radiologist and that the clinic sent you the report! I don't have medical knowledge, except that I went through something similar with my Tiger. I guess if it was me, I would want more info about the spleen changes, was there some symptoms you could look for? It is great that he has the 5 P's going for him(my poor girl was struggled to eat and vomiting ). Overall, that US sounds like a good game plan to monitor and do another US. I guess I just wondered if there was something you could watch for yourself, besides his appetite and such? I totally get how hard it is to sit on one's hands and do nothing and I send my strongest vibes for anxiety relief and healing for Max! This forum is all about moral support and kindness, not a pity party or judgement or whatever. You say that Max doesn't have good luck with his health but just know, you are doing an awesome job with Max, he is one very blessed kitty to have you in his corner!

 

[Max & Lori]

Like Elise @tiffmaxee said, I too am very glad to hear the US was done by a board certified radiologist and that the clinic sent you the report! I don't have medical knowledge, except that I went through something similar with my Tiger. I guess if it was me, I would want more info about the spleen changes, was there some symptoms you could look for? It is great that he has the 5 P's going for him(my poor girl was struggled to eat and vomiting ). Overall, that US sounds like a good game plan to monitor and do another US. I guess I just wondered if there was something you could watch for yourself, besides his appetite and such? I totally get how hard it is to sit on one's hands and do nothing and I send my strongest vibes for anxiety relief and healing for Max! This forum is all about moral support and kindness, not a pity party or judgement or whatever. You say that Max doesn't have good luck with his health but just know, you are doing an awesome job with Max, he is one very blessed kitty to have you in his corner!

Thank you Ruth! Trying my best. He’s a good boy but he has caused me to be more anxious for sure. I’m getting better about it though, once I process what’s going on. I appreciate all of the kindness for sure. I’m thankful Max is still feeling good most days and I’m doing what I can to keep him that way as long as possible. He is a strong, happy boy and I think that his perseverance is what keeps him going. That plus a lot of love.

I was just curious if anyone else had seen anything like this on ultrasound before and what they thought. It’s fine if not. Just thought I’d post the reports and see. Thanks so much.

 

[tiffmaxee]

I looked up some of the terms. It seems the spleen could be either benign or not. I think a biopsy would be needed to confirm. It’s hard when this happens when deciding upon what I assume would be surgery to get a biopsy if they are benign changes. Fortunately no masses were seen. That’s good news.
Hi Ruth. @Tiger(GA) and Ruth

 

[Wendy&Neko]

I really like the phrase "now normal gastrointestinal tract" and "thinner muscularis layer". The lymph nodes change don't say too much. That can happen with IBD too. Who knows, might even be a reaction to something in the kidney food. Spleen would be the only question, but I don't know anything about it.

He still has his 5 Ps and eating well.

That - that is what is important!

 

[Max & Lori]

I really like the phrase "now normal gastrointestinal tract" and "thinner muscularis layer". The lymph nodes change don't say too much. That can happen with IBD too. Who knows, might even be a reaction to something in the kidney food. Spleen would be the only question, but I don't know anything about it.

That - that is what is important!

I don’t know either. She did say he was now mildly anemic and that could cause the spleen to look that way.

 

[Suzanne & Darcy]

I don’t know either. She did say he was now mildly anemic and that could cause the spleen to look that way.

I’m still contemplating, reading and rereading this report. My first reaction is that the radiologist is just being very thorough and is mentioning every possibility. They must do this. It would not be right if they didn’t at least mention the various possibilities consistent with what they see. There are a lot of changes that occur with normal aging as well. Personally, I doubt it’s any of the alarming possibilities mentioned, particularly because Max is eating well and checking all the 5 P boxes. Because of that, if Max were my cat, I would adopt a “wait and see” approach. I also still want to know if the biopsy would be done by FNA. I would not allow a full surgical biopsy. Maybe you answered this before and I missed it, or maybe everything was happening so quickly that you didn’t discuss it with the vets. Big hugs, Lori! Be happy that Max is happy! I was really pleased to read about his GI tract!!

Oh, if he is mildly anemic (which can happen with kidney disease and also just the anemia of chronic disease) are you doing the B-Complex supplementation as recommended on Tanya’s site? I’m sure you are already aware of how to do this. I’ve had success in using the Jarrow B-Right in both CKD kitties and other cats who do not even have kidney disease, but simply have a low-ish hematocrit.

 

[Max & Lori]

I’m still contemplating, reading and rereading this report. My first reaction is that the radiologist is just being very thorough and is mentioning every possibility. They must do this. It would not be right if they didn’t at least mention the various possibilities consistent with what they see. There are a lot of changes that occur with normal aging as well. Personally, I doubt it’s any of the alarming possibilities mentioned, particularly because Max is eating well and checking all the 5 P boxes. Because of that, if Max were my cat, I would adopt a “wait and see” approach. I also still want to know if the biopsy would be done by FNA. I would not allow a full surgical biopsy. Maybe you answered this before and I missed it, or maybe everything was happening so quickly that you didn’t discuss it with the vets. Big hugs, Lori! Be happy that Max is happy! I was really pleased to read about his GI tract!!

Oh, if he is mildly anemic (which can happen with kidney disease and also just the anemia of chronic disease) are you doing the B-Complex supplementation as recommended on Tanya’s site? I’m sure you are already aware of how to do this. I’ve had success in using the Jarrow B-Right in both CKD kitties and other cats who do not even have kidney disease, but simply have a low-ish hematocrit.

I was alarmed at first, but after calming down and thinking about it I know they have to mention every possibility. It was the same way when I was working in healthcare. I am thinking the same as you and I tend to think this may be something else that’s been going on with him. They said it would be a FNA. I definitely wouldn’t agree with surgery. The vet also agreed with me deciding to wait on the biopsy, but again she had to mention it. I am doing the B complex the same as what you suggested using the same brand and filling the gel caps. Thanks for taking the time to look at this for me Suzanne.

Thanks to all the others for their time also.

 

[Marje and Gracie]

I was alarmed at first, but after calming down and thinking about it I know they have to mention every possibility. It was the same way when I was working in healthcare. I am thinking the same as you and I tend to think this may be something else that’s been going on with him. They said it would be a FNA. I definitely wouldn’t agree with surgery. The vet also agreed with me deciding to wait on the biopsy, but again she had to mention it. I am doing the B complex the same as what you suggested using the same brand and filling the gel caps. Thanks for taking the time to look at this for me Suzanne.

Thanks to all the others for their time also.

Hi Lori

well….i sat down and read this last night, looked up reactive vs metastatic to be sure that the first was benign and the second not…..and I feel sound asleep. Some dry reading there! I know with words like “infiltrative” we question more rather that can be metastatic but, honestly, his report leads me to believe he doesn’t know so, like the others, I lean to he’s covering all his bases. That is very typical in human reports, too, and I think they don’t want to commit themselves without a biopsy. And I feel you’ve made the right decision for Max right now. That’s just my opinion, FWIW.

Sending both you and Max tons of hugs.

 

[Staci & Ivy]

I’ve had success in using the Jarrow B-Right in both CKD kitties and other cats who do not even have kidney disease, but simply have a low-ish hematocrit.

Hi Suzanne, what is the dosing for this supplement? I’m looking at it for Ivy as well.

 

[Staci & Ivy]

I was alarmed at first, but after calming down and thinking about it I know they have to mention every possibility. It was the same way when I was working in healthcare. I am thinking the same as you and I tend to think this may be something else that’s been going on with him. They said it would be a FNA. I definitely wouldn’t agree with surgery. The vet also agreed with me deciding to wait on the biopsy, but again she had to mention it. I am doing the B complex the same as what you suggested using the same brand and filling the gel caps. Thanks for taking the time to look at this for me Suzanne.

Thanks to all the others for their time also.

Hi Lori, it sounds like everyone here agreed that they are covering their bases. You’re doing all your due diligence for Max and you’re so wonderful with him.
I’m glad to hear he’s happy and 5Ps are all going well. Wishing you and Max a peaceful Friday

 

[cecile & bella]

I was going to say like the others, the radiologist is listing all possibilities, but if you compare the 2, there is not much progression, which does not go with a very agressive cancer (either the lymph nodes or the nodules), and as Suzanne said, Max is doing well, which is a very good sign that there is not something really bad evolving.
I hope you have a very ood Friday

 

[Suzanne & Darcy]

Hi Suzanne, what is the dosing for this supplement? I’m looking at it for Ivy as well.

Hi, Stacy! You take one Jarrow B-Right B-Complex capsule and divide it into 10 small capsules size 4 or 5 and give it once per day. Size 5 capsules are smaller than the size 4. I use the size 4 because it leaves me a little room to put a few small pills in there so I can give Ginger her blood thinner and her Lasix all in the same capsule with the B-Complex. If I were just doing the B-Complex alone I might try using a “drop” measuring spoon and fitting it into a size 5 tiny capsule.

 

[Suzanne & Darcy]

I was alarmed at first, but after calming down and thinking about it I know they have to mention every possibility. It was the same way when I was working in healthcare. I am thinking the same as you and I tend to think this may be something else that’s been going on with him. They said it would be a FNA. I definitely wouldn’t agree with surgery. The vet also agreed with me deciding to wait on the biopsy, but again she had to mention it. I am doing the B complex the same as what you suggested using the same brand and filling the gel caps. Thanks for taking the time to look at this for me Suzanne.

Thanks to all the others for their time also.

I thought we had talked long ago about the B-Complex, but I didn’t see it on your signature so I asked to make sure. He probably has a long list of supplements I am glad you’re feeling a bit better now that you’ve had more time to process everything and read the report. We all do that. You kind of get hit with new information at the vet and they start talking about biopsies and whether you want to proceed, etc. and most of us kind of freeze up mentally and do not even usually think of the questions we want to ask (I start thinking of them on the way home and afterwards!)

 

[Max & Lori]

I thought we had talked long ago about the B-Complex, but I didn’t see it on your signature so I asked to make sure. He probably has a long list of supplements I am glad you’re feeling a bit better now that you’ve had more time to process everything and read the report. We all do that. You kind of get hit with new information at the vet and they start talking about biopsies and whether you want to proceed, etc. and most of us kind of freeze up mentally and do not even usually think of the questions we want to ask (I start thinking of them on the way home and afterwards!)

Same here on freezing up when getting hit with potentially bad news, especially when not expecting that. Then the fact we’d been there all day long, and trying to get home in dark and stormy weather. It was all way too much at the time, but we are taking it one day at a time now and we are okay. Max is on a lot of meds. I didn’t list his supplements but he’s on the B complex, Omega 3, probiotics, and psyllium. Not sure if something else is recommended. I’m not as experienced as you with supplements and apparently my vet isn’t either. She’s never mentioned anything about it. I get most of my info from here on the message board.

 

[Max & Lori]

I was going to say like the others, the radiologist is listing all possibilities, but if you compare the 2, there is not much progression, which does not go with a very agressive cancer (either the lymph nodes or the nodules), and as Suzanne said, Max is doing well, which is a very good sign that there is not something really bad evolving.
I hope you have a very ood Friday

Thanks so much. I think the same. Hope you have a great weekend.

 

[Max & Lori]

Hi Lori

well….i sat down and read this last night, looked up reactive vs metastatic to be sure that the first was benign and the second not…..and I feel sound asleep. Some dry reading there! I know with words like “infiltrative” we question more rather that can be metastatic but, honestly, his report leads me to believe he doesn’t know so, like the others, I lean to he’s covering all his bases. That is very typical in human reports, too, and I think they don’t want to commit themselves without a biopsy. And I feel you’ve made the right decision for Max right now. That’s just my opinion, FWIW.

Sending both you and Max tons of hugs.

No worries Marje, thank you for taking the time to review and research this information. I’ve been doing the same. I think I’m the opposite though, the more I read, I get more and more into it and can’t go to sleep! I’ve had to just let that worry go as best I can for now. Thanks.

 

[Lori C & Tango]

Max sure has been through a lot. He's an amazing kitty and you are doing all that you can for him. I'm glad Max is doing better most days. I hope your both able to have a peaceful weekend.