6/25 Lucy PMPS=216;+2.5=223 // Lab & Chlorambucil

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mariko

mariko

Member Since 2011
Good morning!
I am going to repeat some of what I wrote in yesterday morning's condo because it disappeared, and I didn't re-write.

Yesterday's condo

Yesterday
AMPS=155 (0.75u); +2=162; +8.5=319; +10.5=304
PMPS=274 (0.5u); +2.5=194; +3.5=198; +5.75=193; +9.5=158

Today
AMPS=167 (0.5u); +2.5=191; +8.75=218
PMPS=216 (0.5u); +2.5=223

Lucy's cobalamin test came back, and she's too high again. :roll:
The lab ss is updated with both Lucy's & Ginger's latest b/w, if you care to take a look please.
The vet is happy that Lucy's getting enough B-12, but wants to reduce the dose from every other week to every 3 weeks.

Her white cell count is pretty high again.
The vet said that the high white cell count combined with the low total protein indicates that her IBD is severe.
She said that is the biggest issue with her right now, and probably will not be treated with food change alone.
We discussed our options, and decided to put Lucy on chlorambucil, which she said she has used for severe IBD and lymphoma patients.
She said one of the side effects of this drug is bone marrow suppression, and she's had one cat patient that went anemic on it, but recovered quickly after stopping it.
The vet thinks it's not a dangerous medication as long as we monitor closely.

So, I am going to start giving chlorambucil from this weekend.
The vet suggested I start on weekend so I can keep an eye, and also she works from Sunday to Wednesday so if anything happens I can call her.
She said if it was going to cause bone marrow suppression, we'd know early, so we are to re-check her CBC within 7 to 10 days.
I am thinking about checking twice, first after a week because I want to catch it early if it's going to cause anemia, and then again after another week in case the first one was too early.
I'l have to discuss with the vet if this is a reasonable idea.
She said usually they start from a higher dose before moving onto a maintenance dose, but she was considering skipping the starting dose part, and just start her on a maintenance dose.
Partly because Lucy is a sensitive cat, partly because I get stressed with new things, partly because I was really worried about it causing inappetence.
Another thing she said is that it usually takes 3 weeks for chlorambucil to take effect.

:?: :?: These are pretty much all I know about chlorambucil so far.
If anyone has any experience or knows about chlorambucil, I'd really appreciate any input.
Did it work? Did it cause nausea? etc. etc. :?: :?:

Lucy had a good appy day yesterday, but her appy is just so-so this morning.
She finished the 1st breakfast, and I am about to offer the 2nd serving.

Sorry about the long post again.
I hope everyone's having a nice day.
 
Re: 6/25 Lucy AMPS=167;+2.5=191 // Lab & Chlorambucil

I'm just wishing you good luck with the Chlorambucil and hang in there vines.
 
Re: 6/25 Lucy AMPS=167;+2.5=191 // Lab & Chlorambucil

More recently (2010), a protocol where the cats get a chlorambucil dose calculated as 20mg/m2, once every 2 weeks (and no chlorambucil in between) was published. It has been seen to be as effective as the protocols with higher dosing frequency, and has the advantages that it's less pilling for the owner and the cat, less chemo overall, and that the cat has time between chemo doses to feel better and not be getting dosed with the chlorambucil frequently. Some cats tend to feel a little down the day after receiving chlorambucil so if they are getting dosed less frequently they have many fewer "down" days.

The 20mg/m2 is a little confusing but the dose can be determined from the cat's weight (in kg) and the cat chart if you scroll down here: http://www.vspn.org/Library/Misc/VSPN_M02045.htm

I can get you more info if you want me to so PM me or I will stop searching. Good luck.
 
Re: 6/25 Lucy AMPS=167;+2.5=191 // Lab & Chlorambucil

Hi Mariko.

I just want to wish you luck with the new drug and send good appy vines to Lucy. I know you are reluctant to add another med, but consider how lucky you are to have options beyond what you've already been doing. Who knows? This just might be the thing to give Lucy some relief! Sending positive vines and hugs, too. :YMHUG:
 
Re: 6/25 Lucy AMPS=167;+2.5=191 // Lab & Chlorambucil

Sending prayers, too, that the new med helps Lucy feel better!
 
Re: 6/25 Lucy AMPS=167;+2.5=191 // Lab & Chlorambucil

Many vines for Lucy and you as you figure out this new drug. Amazing that these are available now.
Liz
 
Re: 6/25 Lucy AMPS=167;+2.5=191 // Lab & Chlorambucil

Hello,
I don't post often on the board, but your header about chlorambucil (Leukeran) caught my eye. I just thought I would tell you briefly about my experience with it. My non-diabetic cat, Teddy, was on Prednisolone and Leukeran for seven years for intestinal lymphoma. It gave him an amazing seven-year remission from his cancer. I can't really comment on what the appropriate dosing would be for your cat, but Teddy started on more of a pulse regimen (high dose for four days every three weeks) for his cancer and later transitioned to a maintenance schedule of every other day dosing. His CBC was monitored initially every couple of weeks, and after he was stable on it, every few months. His PCV did drop to and hover at a low normal level. He experienced some nausea and inappetance, particularly with the pulse schedule. This would manifest as some occasional vomiting and some pickiness in eating. I gave him Ondansetron to help manage nausea, and it seemed to help. I consider Leukeran to have been a miracle drug for Teddy, and it gave me seven years that I would not have had with him otherwise. My diabetic cat, Bear Man, also tried Leukeran for his severe IBD. Bear tried pretty much everything over the years. For him, the Leukeran did not really seem to help him very much, and he did not seem to tolerate it as well as Teddy did. I think it is definitely worth trying for Lucy, and it sounds like you and your vet are going about it in a very cautious way. I hope that it helps her.
 
Re: 6/25 Lucy AMPS=167;+2.5=191 // Lab & Chlorambucil

Good luck with the new med. I hope it helps Lucy. Hopefully Lucy's appy is better this evening. :YMHUG: :YMHUG:
 
Elise - Thank you so much for your help with gathering information. Greatly appreciated.

Linda - Thank you so much for sharing your experience.
Hearing your first hand experience is very helpful.
It is very encouraging to know that this drug helped Teddy so much. I hope the same will happen to Lucy.

Dyana, Tricia, Amy, Liz and Carla - Thank you very much for your encouraging words.
They help me me to stay positive.

I googled some information on chlorambucil use for lymphoma/IBD between work, and printed out some articles to read tonight.
As I scanned through them, I was getting pretty depressed and overwhelmed.
"Lymphoma" and "Cancer" are such scary words.
But I'm going to stay positive about this. I think positive attitude is very important!

Lucy is eating better this evening, and she had a very good poo before dinner. :-D
It seems 0.5u isn't enough after all, but I'm going to give it a couple more cycles.
 
Wow, you have been so busy lately, Mariko. You're such a good bean, and to two kitties who have special needs! It's so overwhelming with all the things to consider and try, and I'm so glad that some people can help you out with advice and comments/info. Many healing/feel awesome vines to both Lucy and Ginger from me :-D . And hugs to you! :YMHUG:
 
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