Bad week for Board, i guess -- Cleo's lymphoma's back :(

Status
Not open for further replies.
that's been the major freak out issue for me, laur: spending so much on testing/diagnostics only to get NO definitive result. i mean, how do you remove a grossly swollen spleen with lymphocytes but no definitive diagnosis? how do you surgically get in there to take even easier liver aspirates with no definitive diagnosis? how do you aspirate time and time again with no definitive diagnosis? [if it weren't for the positive find in the mesentery we'd probably STILL be stalling on treatment.] i just cringe coz each time we do this we spend enuf for 2.5 months of cancer treatment without doing one thing to treat or getting one firm diagnosis. very frustrating.

"assuming" the bone marrow aspirate would be more definitive, but i'm sure you can tell i've about given up on the idea of aspirating anything more. it's funny but not funny!

so was leukemia brought up in danny's case, too?
 
chriscleo said:
thanks, deanie. this is part of email from onco vet:

"The bloodwork revealed increased lymphocytes in the peripheral
circulation. This could be from increased cancerous cells being produced
in the bone marrow (true leukemia), or it could be secondary to overflow
from the liver. The only way to know for sure would be to do a bone
marrow aspirate."

i'd have to look back at her CBC results but RBC count is low and i think at least 3 other values are not in normal range.
Click to expand...


It could also be due to something as simple as a virus. That would also cause increased lymphocytes. Was her wbc count increased or elevated? Do you have any idea who read the slide? Did they see anything abnormal on the slide and if so, did they refer it to a veterinary pathologist?

The thing is, if there are cancerous cells in the bone marrow, there's a very good chance you're going to see those in the peripheral blood. It's pretty rare to see the abnormal cells only in the bone marrow. So if all they saw was an increase in normal looking lymphocytes, I don't know that I'd be in any hurry to do a bone marrow aspiration.

Here's a few examples of the types of cells you can see:

Normal lymph
normallymph.jpg


Reactive lymph

reactivelymph.jpg


Atypical lymph

atypicallymph.jpg


lymphoblast

lymphoblast.jpg


multiple lymphoblasts

lymphoblastscsf.jpg
 
chriscleo said:
so was leukemia brought up in danny's case, too?
Click to expand...

Yes, it was. The IM vet was very suspcious of leukemia and didn't give Danny much hope if that's what he had. I looked back on the old site to see what I could find, and only came up with http://www.felinediabetes.com/phorum5/r ... ?8,1029945 . Deanie was giving what proved to be very sage advice for me too -- since Danny didn't turn out to have leukemia after all.

(Deanie, you are such a wonderful asset to this group, and I haven't said it recently -- but THANK YOU for all that you do.)

I never did get a good answer for what caused the problems but it just sort of resolved iitself. We did stop the maintenance chemo though, I think partly as a result. I had forgotten that we did the flow cytometry in addition to the bone marrow aspiration. It was a very stressful time since all of it came back negative. That's what had happened for the two weeks prior to Danny's lymphoma diagnosis: test after inconclusive test. I kept bringing him back to the hospital and saying, "something's wrong - find it!" Very suspicious for cancer but all negative biopsies, etc. Then a lymph gland suddenly swelled up, and finally we could start chemo. (That puts me in mind of Jess' dog Elliott, who was fully checked out and negative something like 9 days before getting dx with very bad cancer.)

Aw, Danny just came over and collapsed across my forearms... making it hard to type, so I'll end this here.
 
Antech Diagnostics 6/23

Value.............. Reference Range
WBC 24.4 (hi).............. 3.5-16.0
RBC 6.2.............. 5.92-9.93
HCT 28 (lo).............. 29-48

Neutrophils 12688 (hi)..... 2500-8500
Lymphocytes 9272 (hi)..... 1200-8000
Monocytes 732 (hi)..... 0-600
Eosinophils 1708 (hi)..... 0-1000


mistaken--rbc not low this time. just lo normal.
u/s revealed enlarged nodes in liver not found previously. aspirated with no definite conclusion. IM vet taking aspirate found well-defined lymphocytes and said she got sample smack dab from in there. pathologist reviewed but i don't have copy of report. i'll try to get it tomorrow when she gets blood drawn.

thanks for the info. i'll read further. appreciate the slide photos -- would be nice to show onco vet without hurting her feelings re my candor.
 
reading what both deanie and laur wrote.......

and want to note that the liver nodes seen and the wc elevations do not necessarily have to be connected.
cp will also cause wc to go up. Winnie's was always all over the place from her cp.

wondering if cleo gets regular c & s since she is on pred. ( as you know roid can cover up outword symptoms)

best of luck at the vets. ((( chris )))
 
C & S? don't know that one...

and, yep, cleo ALWAYS seems to have pancreatitis when they do the ultrasound. IM vet confirmed it this time again.
 
lol. thanks linda. wasn't thinking urine. brain locked on blood questions.
yes, multiple C&S run (after cysto), with no evidence of infection. they've said one possibility is liver infection. don't know how you test further for that. well, duh, i guess you could run a C&S on that too.

oh well, off to blood draw...
[edited to add: asked them to add a reticulocyte count as well so they will. they've been talking anemia for a while now.]
 
Just sending some big hugs to (((((you and Cleo))))).

I'm in awe the amount of knowledge being shared/discussed.
 
Status
Not open for further replies.
Back
Top