? 10/10 Hyde AMPS 439 +2 349 +4 286 +6 305 +8 362 +10 435 PMPS 466 Civie Lymphoma?

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Anne & Hyde (GA)

Anne & Hyde (GA)

Member Since 2015
http://www.felinediabetes.com/FDMB/threads/10-9-hyde-amps-418-4-235-pmps-535-4-353.145664/
New vet would like a 12 hour curve so that is our plan for the day! Got the impression that she thought 10u was high but she does have other Acro cats in her practice. I gave her copies of all her numbers and I think the data will support the dose.

As for Jekyll, this is a quote from the interpretation of the ultrasound.

Diffuse intestinal thickening (including a segment in the colon) with mucosal changes and the lymph node changes are most suggestive of a multicentric round cell neoplasia. Biopsy of the intestines would be needed to further evaluate. The large liver cyst is likely benign. The smaller liver nodules may be small benign cystadenomas, although neoplastic nodules are not completely ruled out. Pancreatic changes are likely benign hyperplasia.

The vet thinks it is small cell lymphoma but would need an endoscopy/colonoscopy to rule out large cell lymphoma. For the small cell lymphoma she is recommending prednisolone/chlorambucil.

Has anybody dealt with this before? What have you done for treatment?
 
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Good luck with the curve today. I hope it helps the vet to see what a great job you're doing concerning Hyde's dose increases.

Sometimes I wish medical interpretations were written more like a five your old could understand :rolleyes:

I've never dealt with anything like what your vet described, but I am sending Jekyll so many vines and purrs his way!!! Hugs to you as well :bighug:
 
You may want to put lymphoma ? in your subject line to get more eyes. I'm sorry about the diagnosis. I hope you can find a treatment that helps Jekyll. Sending prayers. :bighug:

Good luck with Hyde's curve today.
 
Sending healing vines and Prayers for Jekyll and good number vines for Hyde's curve. Hugs for you for dealing with all this.:bighug::bighug::bighug:
 
It is my understanding that without a biopsy, it is near impossible to distinguish lymphoma from IBD? I'm so sorry you received that report, what I would recommend is joining the Yahoo Small Cell Lymphoma Mailing List ASAP-- Dr. Jory posts on there. If you make a post asking this question with an ATTN: Dr Jory it may help expedite a reply, plus there are other experienced knowledgable people on that list. My GA Tiger got an ultrasound like your Jekyll's(meaning, it could have been IBD but it could just be lymphoma!!!) so, if I could go back in time, I should have pushed for a biopsy, but that is water under the bridge now. Sending loads of vines, prayers and hugs for all of you! :bighug::bighug::bighug::bighug:
 
There have been kitties here with lymphoma, but I don't personally have any experience with it. Hopefully those who know about it will see your subject line and pop in. If you don't get answers today I'd keep it up there tomorrow. Sometimes on the weekends it's busy here, sometimes it's quiet.
 
By the way, especially with iaa, it really helps to not hold onto a dose that's not getting Hyde into normal numbers. It seems to keep the dose from climbing as quickly if the cat is spending time in normal numbers. Personally, I wouldn't hold onto a dose longer than 6 cycles unless she got to green.

I went back and read through the last few days' posts and saw your concern about using R, both for timing and for causing a fast drop. When you start using R, you use a tiny amount. Most people start at 0.1u, assess what it does, then try 0.25u, then 0.5u. At each dose you can see how much of a drop it causes. You wouldn't give a dose that would cause her to drop several hundred points. We'd help you time it so either you're giving the R when the blood sugar is rising, post-nadir, or at the same time as the shot but with a small enough dose that you're not going to cause a plummet.

I think there would be times you could use it safely without having to get up at 4am. It might only be on the weekend, but even that might be worthwhile.

Not trying to twist your arm, but if those are your concerns - which are valid ones - we would definitely work around them.
 
Down Hyde, we want blues on you please.

My civie recently got the diagnosis of IBD or possibly lymphoma, as did @Marje and Gracie . We are doing a couple months of metronizadole then doing a follow up ultrasound. A biopsy is the best way to determine what you are dealing with. Theo's vet likes to try least invasive first. For a proper biopsy it requires anesthesia. An endoscopy is also an option but often you don't get enough tissue for a definitive answer. I have a couple of references for you that I will add when back home. Check out ibdkitties.net in the mean time. IBD can become lymphoma. Depending on the type of lymphoma, it can be well controlled with meds.:bighug:
 
Gracie's U/S just indicated some thickening the muscularis of her small intestine but absolutely everything else was normal....mucosal layer, liver, pancreas, colon, gall bladder, kidneys, the whole shebang including lymph nodes. The IM specialist is not sure what to think because her ultrasounds have been exactly the same for the last three years but she's just started having symptoms of weight loss and softer poos. She's been dealing with what he thinks is cholangiohepatitis on and off for the last three years; she gets much better and then, for some reason in the summer, her liver values go up and she has vomiting. Because until just a couple months ago, she had no other symptoms, we were reticent to do anything. However, now we have decided to have an endoscopy done on Oct 21 so we will, hopefully, know whether it is just the cholangiohepatitis, IBD, or lymphoma.

From everything I've read, the treatment your vet is suggesting for small cell lymphoma is the standard treatment. Chlorambucil is also known as leukeran and that protocol is also often used to treat IBD. If it's small cell lymphoma, chances are usually pretty good for successful treatment and remission and sometimes the remission can last a lengthy time. Our GA Teddi Bear had large cell lymphoma and it does not have a good prognosis.

I hope that helps, Anne. Sending many vines for you all and esp Jekyll.
 
Gracie's U/S just indicated some thickening in the muscularis of her small intestine but absolutely everything else was normal....mucosal layer, liver, pancreas, colon, gall bladder, kidneys, the whole shebang including lymph nodes. The IM specialist is not sure what to think because her ultrasounds have been exactly the same for the last three years but she's just started having symptoms of weight loss and softer poos. She's been dealing with what he thinks is cholangiohepatitis on and off for the last three years; she gets much better and then, for some reason in the summer, her liver values go up and she has vomiting. Because until just a couple months ago, she had no other symptoms, we were reticent to do anything. However, now we have decided to have an endoscopy done on Oct 21 so we will, hopefully, know whether it is just the cholangiohepatitis, IBD, or lymphoma. We also took the conservative route of just watching through u/s for the last three years but it's time to try and figure it out. We will not do open surgical biopsies so I'm hoping he can get the samples he needs to tell what's going on. Evidently, there is about a 75% chance of identifying the issue through endoscopy. It does require anesthesia but, like Wendy, we are very lucky to have a board certified anesthesiologist here who knows the best protocol for Gracie so she will be doing that.

From everything I've read, the treatment your vet is suggesting for small cell lymphoma is the standard treatment. Chlorambucil is also known as leukeran and that protocol is also often used to treat IBD. If it's small cell lymphoma, chances are usually pretty good for successful treatment and remission and sometimes the remission can last a lengthy time. Our GA Teddi Bear had large cell lymphoma and it does not have a good prognosis.

I hope that helps, Anne. Sending many vines for you all and esp Jekyll.
 
I have no experience with lymphomas myself but from what I've read around here the small cell lymphoma is not as scary as it sounds and does respond well to treatment. So, horrible as it feels to say it, I'm wishing that one on Jekyll :bighug::bighug::bighug:
 
Hi Anne,

My Civvie, Harvey, has intestinal lymphoma. They had to do a biopsy to confirm that it wasn't IBD because his was in the central part of the intestine. If it had been in the top, they could have diagnosed with an endoscopy, and if it had been at the end, a colonoscopy would have done it. Just our luck to need surgery!

Harvey is on Prednisolone and Chlorambucil (Leukeran). He was diagnosed in February and is doing very well on this treatment. He's maintaining his weight and his appy is great. So it isn't necessarily as scary as it sounds. I was concerned about the possibility of his developing diabetes with all that Pred, and was told we could reduce it if he would eat either a unique protein diet or an intestine-friendly prescription diet. We had no success with either (picky cat), but he's doing fine on the same low carb, low phos, foods everyone else gets. Sending vines for Jekyll.
 
Sorry for the dx for Jekyll. The thickening of the intestine is pretty typical of the IBD. When we were at CSU, Grayson had a scope to check out what was going on. Even with subsequent ultrasounds every 6 month, there didn't appear to be much change, other than intestine returning to normal size post-SRT. In March of last year all was normal. By August, his WBC and eosinophils were extremely elevated. At one point 85X. That was when we got the eosinophilic leukemia/Hyper-eosinophilic Syndrome dx. He was on Prednisolone and a chemo drug used for Sickle Cell Anemia (hydroxyurea). By the time he was dx, the mass was the size of a 12 ounce coke can, and the eosinophils were in the blood, liver and spleen was mottled. I know it's hard to be positive when you get a difficult diagnosis, but we just have to do what we can until they tell us otherwise. It may be that you have a couple years, and that the intestine is just IBD. Hang in there.
 
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