6/6 Ruby AMPS 79/+4 66/+8 68/PMPS 68/+3 77 pathology report

[Katherine&Ruby]

Yesterday was not such a happy day for me and Ruby.

But we march onward and upward. I screwed up with posting the pathologist's report yesterday, so here it is again. Would love any feedback from all of you who are more familiar with SCL than I am. Wish we didn't have to wait for an oncologist to weigh in so we could start treatment immediately as I see her appetite waning again, but I also feel better knowing it will be in the hands of specialists who can help me juggle Ruby's many health conditions and make her as comfortable as possible as we move forward.

Healing thoughts for all of the sick kitties and hugs to everyone. Have a beautiful Sunday.

 

[Marina & Chico]

Ohhh Katherine, i am very sorry for the diagnosis hope you will manage to get it under control as soon as possible

 

[Katherine&Ruby]

Ohhh Katherine, i am very sorry for the diagnosis hope you will manage to get it under control as soon as possible

Thank you, Marina. Me too. It's good that I know now and that the diagnosis was so clear as I know it's not often the case that one is able to distinguish IBD easily from SCL.

 

[Pamela & Amethyst]

Healing hugs and prayers

 

[Purrberry]

I'm so sorry to hear of the diagnosis. It does seem that lymphoma is all too common in our beloved cats. I hope she can get on the path to treatment very soon, and that you BOTH feel better!

 

[Our Dolly Girl (GA)]

Yesterday was not such a happy day for me and Ruby.

But we march onward and upward. I screwed up with posting the pathologist's report yesterday, so here it is again. Would love any feedback from all of you who are more familiar with SCL than I am. Wish we didn't have to wait for an oncologist to weigh in so we could start treatment immediately as I see her appetite waning again, but I also feel better knowing it will be in the hands of specialists who can help me juggle Ruby's many health conditions and make her as comfortable as possible as we more forward.

Healing thoughts for all of the sick kitties and hugs to everyone. Have a beautiful Sunday.

Hi Katherine, I just read the pathology report and I am so sorry. I hope you get a treatment plan soon.
My previous kitty Funny Face was believed to have the same thing. Funnyface had high blood pressure, hyperthyroidism, diabetes not controlled, IBD. She was on Dexamethasone, a steroid for the IBD and probable small cell lymphoma. We didn’t know and obviously her vet didn’t know that the steroid was making her diabetes uncontrollable. We gave her 1 unit of Lantus twice a day and I took her to the vet a couple days a week for her BG. Scary, right? We did not have a biopsy so the scl was not definitive. We treated her with shots and 5 pills a day for 18 months before we knew it was time to say goodbye. She was 15. We were not as educated nor did we have the people on FD to help steer us in the right direction. Looking back, I have daily notes on her, we needed far more help and didn’t even know that.
I believe Ruby has a good chance for treatment and recovery. I pray she does. Sending healing, loving prayers to you both. Ruby is so fortunate she has you.

 

[Katherine&Ruby]

Hi Katherine, I just read the pathology report and I am so sorry. I hope you get a treatment plan soon.
My previous kitty Funny Face was believed to have the same thing. Funnyface had high blood pressure, hyperthyroidism, diabetes not controlled, IBD. She was on Dexamethasone, a steroid for the IBD and probable small cell lymphoma. We didn’t know and obviously her vet didn’t know that the steroid was making her diabetes uncontrollable. We gave her 1 unit of Lantus twice a day and I took her to the vet a couple days a week for her BG. Scary, right? We did not have a biopsy so the scl was not definitive. We treated her with shots and 5 pills a day for 18 months before we knew it was time to say goodbye. She was 15. We were not as educated nor did we have the people on FD to help steer us in the right direction. Looking back, I have daily notes on her, we needed far more help and didn’t even know that.
I believe Ruby has a good chance for treatment and recovery. I pray she does. Sending healing, loving prayers to you both. Ruby is so fortunate she has you.

First of all, I think Funny Face is the best name for any cat. It makes me smile every time you talk about her. I thank the heavens for having pointed me to the FDMB or else I would be utterly overwhelmed and lost. I probably would have listened to Ruby's primary vet and started steroids, but I'm so glad I went ahead and got the endoscopy before doing so because now I know to treat the lymphoma as well. I do hope she and I can have more years together as a result. Thank you so much for all of your kindness, Adrienne.

 

[carfurby (GA)]

Sending prayers.

 

[thebigfuzz]

Healing thoughts and prayers to you.

 

[JaxBenji]

Nice cycles for Ruby Sending positive thoughts for a treatment plan to come together soon Ruby sure is lucky you have you watching over her.

 

[Wendy&Neko]

I would try joining the SCL groups.io group again. People there are much better than reading biopsy reports than me, though it does look pretty clear what is going on inside Ruby. A definitive diagnosis does make it so much easier to jump into treatments, though I am so sorry you have to wait. You'd think they'd be OK going ahead with at least the steroid part of the treatment which should help her in the short term, and no need to wait for anything before starting that now.

 

[Katherine&Ruby]

I would try joining the SCL groups.io group again. People there are much better than reading biopsy reports than me, though it does look pretty clear what is going on inside Ruby. A definitive diagnosis does make it so much easier to jump into treatments, though I am so sorry you have to wait. You'd think they'd be OK going ahead with at least the steroid part of the treatment which should help her in the short term, and no need to wait for anything before starting that now.

I am trying to rejoin the SCL group, wrote to the owner to request access as it seems I've been blocked for reasons unknown. Yeah, I'm not sure why they're passing the buck to oncology. Maybe to stage it to see if intravenous chemo or radiation would be a better option? That seems rather drastic to me right now but I dunno. Someone was just saying in the IBD FB group that a steroid might not be necessary and to treat with chlorambucil alone, so if that's what the oncologist wants me to do I'd be happy with that, but I've been reading about SCL since yesterday and I never heard of treating SCL without steroids.

 

[Katherine&Ruby]

Nice cycles for Ruby Sending positive thoughts for a treatment plan to come together soon Ruby sure is lucky you have you watching over her.

Thanks, Susanne. I'm glad I restarted the insulin and can keep Ruby's numbers low. Hopefully she stays nice and steady and continues to nosh. Hugs to you and give Benji some scritches from me.

 

[Wendy&Neko]

Maybe to stage it to see if intravenous chemo or radiation would be a better option?

That's not how you treat small cell lymphoma. If they mention that, have them look at the latest veterinary oncology text books. And find another oncologist or IM vet. There are rescue chemo drugs, that can help if kitty falls out of remission after being on chlorambucil, but you don't want to start there.

Someone was just saying in the IBD FB group that a steroid might not be necessary and to treat with chlorambucil alone, so if that's what the oncologist wants me to do I'd be happy with that, but I've been reading about SCL since yesterday and I never heard of treating SCL without steroids.

It can take time for chlorambucil to really start turning things around. You need that steroid in the interim. I wouldn't listen to someone in a IBD group.

 

[Katherine&Ruby]

That's not how you treat small cell lymphoma. If they mention that, have them look at the latest veterinary oncology text books. And find another oncologist or IM vet. There are rescue chemo drugs, that can help if kitty falls out of remission after being on chlorambucil, but you don't want to start there.

OK. I worry that Ruby is really far along and that's why they have referred me to oncology. But perhaps I need to shut down that voice in my head.

It can take time for chlorambucil to really start turning things around. You need that steroid in the interim. I wouldn't listen to someone in a IBD group.

The person who said that is a moderator and she is currently treating her SCL kitty without steroids. Don't worry, I'm not basing any final decisions on anything I'm hearing on Facebook. I trust your point of view and the doctors more. I researched the oncologists at AMC and found one who would be amazing to work with who co-authored a study on feline LCL and SCL. Hope I get her.

 

[Diane Tyler's Mom GA]

Hi Katherine, just wanted you to know I have been thinking about you and Ruby ♥
I hope you can get in with the oncologist soon and get the one you just mentioned above. Is there anyway you can request her ?
Big kisses for Ruby, I'm happy to see her numbers are still looking great ♥

 

[Suzanne & Darcy]

I am trying to rejoin the SCL group, wrote to the owner to request access as it seems I've been blocked for reasons unknown. Yeah, I'm not sure why they're passing the buck to oncology. Maybe to stage it to see if intravenous chemo or radiation would be a better option? That seems rather drastic to me right now but I dunno. Someone was just saying in the IBD FB group that a steroid might not be necessary and to treat with chlorambucil alone, so if that's what the oncologist wants me to do I'd be happy with that, but I've been reading about SCL since yesterday and I never heard of treating SCL without steroids.

You are right, Katherine (about the steroids.) First of all, let me say that I am very sorry about this. I read the pathology report. There are some things in there to be relieved about actually (such as no evidence of neoplasia in the stomach). Definitely small cell is better than large cell. I have had cats with SCL. I used to be a member of the SCL groupsio group. I got kicked off. Not for any post or anything that I ever did. The owner just doesn't like me. I hope that, one day if I have another cat with SCL she will re-accept me into the group. Maybe I shouldn't write that here, but that's what happened at the beginning of this year (me getting kicked off the group.)

Anyway, of course she will need steroids. Hopefully you can use the Budesonide instead of prednisolone. My cat, Maverick, did extremely well on Leukeran for years. I am sure, with all of the reading that you do, you are aware of the pulsed dosing protocol being the most up-to-date way of doing Leukeran (chlorambucil). Having Dr. Jory Olsen on that group is very helpful, too, when he is able to chime in (very nice of him to do this.)

Give Ruby big hugs. She is such a trooper. How is she doing today with appetite and her demeanor? Big hug to you cat Mama! Hang in there. Ruby will have the very best of care, if I know anything about you at all!

 

[Suzanne & Darcy]

Oh, I don't see anything in that report to indicate that Ruby is "very far along." Don't go there! When my Maverick (mentioned in my earlier post) had SCL and had been on Leukeran for a few years, he got "very far along." It was a large tumor in his intestines, not a diffuse spread of the disease. We tried the rescue drug Lomustine, but he couldn't handle it. My main advice would be to get regular ultrasounds done on Ruby so you can get an idea of how things are looking inside. Don't assume that everything is okay just because she seems okay and is eating well. Cats are so good at coping until things are out of control. One day they just stop eating. That's what happened with Maverick. It's my fault for not taking him in for more regular ultrasounds because he was just "doing so well" (and honestly he was for a number of years). The thing about chlorambucil is that it "works really well until it just stops working." Ruby is a survivor. She's going to do GREAT and be with you and Frank for many years to come. If any cat can beat the odds, it's Ruby. I bet you get her into remission!

 

[Katherine&Ruby]

Hi Katherine, just wanted you to know I have been thinking about you and Ruby ♥
I hope you can get in with the oncologist soon and get the one you just mentioned above. Is there anyway you can request her ?
Big kisses for Ruby, I'm happy to see her numbers are still looking great ♥

I'm going to try to request this oncologist but she seems like a bit of a rock star, so I dunno what the chances are of me getting in this week to see her. It's more important, of course, that we get to see any doctor as soon as possible before Ruby starts going downhill again. And from what I understand, the doctors work as teams at AMC so I hope that this doctor will at least have some input. Love to you, dear Diane, for always being there for us.

 

[Suzanne & Darcy]

@Wendy&Neko is right about saying... why wait to start a steroid? I don't understand that. The only reason steroids are usually withheld is when you are going to do a biopsy, because it will interfere with getting accurate biopsy results. Since you've already done the biopsy, I wish they would have prescribed some Budesonide for her. It is amazing how fast that steroid reducing inflammation in the gut starts to make them feel better and start acting and eating better! I've seen it in my own kitties (IBD and SCL). But hopefully you will have an appointment soon?

 

[Katherine&Ruby]

@Suzanne & Darcy, thank you so much for looking at the report! There's so much for me to absorb right now that I'm grateful to have your input. Ruby's been fine. I just fed her a snack after she waved her tail at me for a few minutes while pacing at my feet. It's a banner day when she signals me for food and her BGs stay low. I've got her on a regular schedule with her anti-emetic and antacid meds and she seems to be reacting well.

Yes, I am glad that the lymphoma is not in her stomach and I have to restart her pre- and probiotic regime to get at some of that inflammation that is present there. I took off all her supplements in case they were aggravating things. I did indeed read about pulse dosing as the most up to date protocol. Thankfully Ruby has gotten really good at swallowing her pills wrapped in salmon flavored pockets. Did you have to take Maverick in for blood work regularly while he was on chlorambucil? Hopefully I can get future ultrasounds done with the local vet so that all of these preventative diagnostics aren't so expensive. Feel like I am drowning in all of these bills but I can't not help her. She is my heart.

I am going to call tomorrow morning first thing for an oncology appointment. If they say I can't see anyone for many more days, I will ask her IM for a budesonide script. If she says no, I will find out why.

Thank you again. I know how much you have on your own plate with Darcy, and appreciate you spending the time to put my mind at ease.

 

[Wendy&Neko]

The groups.io group does not recommend ultrasounds after treatment is started, unless there is a reason to. My SCL kitty number two had an ultrasound in February that looked perfect. A couple months later I lost him to pancreatic cancer. The ultrasound did not help prevent or detect it. Which reminds me of something I seen from the SCL group (and experience). A lot of SCL kitties pass from other things with SCL still in remission. Kitty number three has not had an ultrasound in over 3 years. (anti-jinx) More frequent bloodwork at the beginning to make sure they are handling the chlorambucil well, then the time between blood draws is extended.

 

[Katherine&Ruby]

Sorry about your kitty, @Wendy&Neko. I did read somewhere today (I need to start compiling notes!) that there is a high remission rate for SCL and that most of the kitties died from other things in the end unless they come out of remission. Then their survival rates are low. Thanks for letting me know about the ultrasounds. I'm definitely going to get pet insurance for my next round of kitties!

 

[Emily R]

Katherine, sending you so many hugs. I hope the chlorambucil is the silver bullet.

 

[Suzanne & Darcy]

We did bloodwork more regularly in the beginning and then not as frequently. I just mentioned the ultrasounds because I did not recheck Maverick for a couple of years, and by the time I did, his intestinal tumor was over 4 cm (1.5 inches) long. I wish I had caught it earlier and we had been able to start the rescue drug sooner.

 

[Katherine&Ruby]

We did bloodwork more regularly in the beginning and then not as frequently. I just mentioned the ultrasounds because I did not recheck Maverick for a couple of years, and by the time I did, his intestinal tumor was over 4 cm (1.5 inches) long. I wish I had caught it earlier and we had been able to start the rescue drug sooner.

 

[Diane Tyler's Mom GA]

I'm going to try to request this oncologist but she seems like a bit of a rock star, so I dunno what the chances are of me getting in this week to see her. It's more important, of course, that we get to see any doctor as soon as possible before Ruby starts going downhill again. And from what I understand, the doctors work as teams at AMC so I hope that this doctor will at least have some input. Love to you, dear Diane, for always being there for us.

Absolutely to get Ruby in there ASAP with anyone of the doctors.
They most likely work as a team so that's good. Stay strong my friend.♥