Advice for Clide, Diabetes AND Cancer - Help!

[RenaRF]

Hey everyone - sorry to put the 911 next to this, but I need some ideas/education/advice prior to my visit to the veterinary oncologist tomorrow.

Backstory: Clide is 16. He is a diet-controlled diabetic. He has always had chronic stomatitis (mouth), and has had full mouth extractions. In September, the vet dentist biopsied a mass on the inside of his right cheek - it came back as oral squamous cell carcinoma (OSCC). We decided that since it was all soft tissue, we would try to remove it. Clide had surgery late September/early October. Pathology showed it to be a low grade OSCC, removed with pretty clean margins. So yay for us.

Fast forward to late November. I notice Clide pawing at his mouth (right side). This is not totally uncommon given his stomatitis, but because of the earlier cancer, I wasn't taking any risks. He went to the vet dentist for a biopsy, laser treatment to address inflammation, and MRI (all under one anesthesia). The inflammation is at the back inside "hinge" of his mouth. Biopsy came back last Wednesay (12/19) as a recurrence of OSCC. The vet dentist said the location makes it not a candidate for surgical removal, and I trust him.

We went to the oncologist the next day, 12/20, and started him on carboplatin chemotherapy. His first round was that same day, and thus far he hasn't experience side effects (thank God).

Everything I read about stomatitis (or any chronic oral inflammation) shows that addressing the inflammation CAN help with treating the cancer. I'm not thrilled with the idea of using an NSAID (meloxicam, metacam, piroxicam etc.) at this point because the carboplatin is a bit hard on the kidneys and NSAIDs, to me, are really end of life types of drugs due to the risk of renal toxicity.

SO. I want to get him started on prednisolone. The oncologist didn't want to risk it - but I've explained that I will home test to get a baseline and then test as he's on the steroid. I purchased a Freestyle Lite meter, because while I CAN get blood, I can never get enough for the other meters to actually read it. Clide's post-breakfast reading on the Freestyle Lite was 87. I will test again tonight.

So my questions: what should I expect with prednisolone? Any chance it won't elevate his BG at all? He's never been on insulin - should I ask for that from the oncologist as well before starting him on the prednisolone? Are the Freestyle Lite meters fairly accurate? What questions should I be asking?

Thanks in advance. While Clide worries that right side of his mouth when he eats, he's otherwise doing REALLY well and I want to give him a shot with these treatments. He's my sweet boy.

Rena (and Clide - and the rest of the crew, Rufus, Feats, Meatball & Bella)

 

[BJM]

While the prednisolone might raise his glucose, cancer tends to take the carbs, so it may wind up averaging out.

You might want to read about neoplasene which might be useful. There's a Yahoo group for it. Not FDA approved, but you may be in a situation it could be worth investigating, maybe trying.

 

[RenaRF]

Thank you - I hadn't heard of Neoplasine. My oncologist has an email and I occasionally email him things I've read, so I'll send that over. He's on a more traditional chemo, carboplatin and seems to really be tolerating it well. BUT - with this type of mouth cancer, and especially in a cat with Clide's history of chronic oral inflammation, I feel really almost frantic about getting him started on some kind of anti-inflammation drug to try to address that. This cancer has pretty bad statistics - low, relatively short survival rate. But Clide is a fighter, he's happy to be alive, and so we're going to try for and with him.

 

[BJM]

A positive review of neoplasene: HolVet page on it.

And a very contrasting viewpoint: here

And finally, a testimonial -personal story, not a research study.


Fish oil may be beneficial as an anti-inflammatory (it certainly makes a difference in my arthritis!)

 

[Sandy and Brie]

Hi Rena
I'm sorry that Clide has had recurrence of his cancer. My diabetic kitty Brie also has cancer. In brief he had pyelonephritis at the end of June. I did a follow up US in the beginning of Oct and the US showed a mass on his liver and enlarged gastric lymph nodes. At the time the radiologist thought mast cell or lymphoma. I repeated the US in the beginning of Nov and the mass on the liver unchanged, gastric lymph nodes were increased in size and it also showed stomach wall thickening. The radiologist at that point thought Brie most likely has large cell lymphoma. I opted from the beginning not to do the biopsies. Brie is atleast 15 years old. He was diagnosed as a diabetic at 11. I adopted him when he was 10. He was rock solid stable on Lantus 1 unit twice a day for 4 years. His sugars prior to pred were running 120 to 140. My vet was very reluctant to put him on pred. She decided to start the pred after his Nov US. Since starting the pred his sugars have gone up. I was seeing numbers in the high 200's at first. There have been a few times that his sugar has been as high as 350. Very upsetting. I do home testing at least once a day prior to his pm shot. Currently he is getting 3 to 3.5 units twice a day. There have been a few times that his sugar was a little lower and I adjusted his dose. It has been somewhat challenging. I'm always afraid of him going hypo. I can usually tell when his sugar is running higher because he will sit by the water bowl. He luckily has a great appetite. So far I don't have any issues such as nausea and vomiting to deal with. I use the IPET glucometer and I've been very happy with it. I've never seen anyone here posting that they use this meter. I feed him ff classics mostly salmon because it is lowest in carbs. I understand your reluctance with metacam and piroxicam. I had a kitty with bladder cancer in June and had him on piroxicam. With a grave diagnosis of bladder cancer there really wasn't much choice. Unfortunately I had to let Boo go.

Best of Luck
Sandy