? Chlorambucil for lymphoma

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It's Smokys 12th birthday today so I gave him a little bit of FF gravy lovers turkey feast. The poor little guy was so happy to get a few bites of it.
 
Smoky is not wanting to eat much since this morning. I'm very worried about him. He is eating less and doesn't show much of an interest in anything. I don't know what to do. The meds don't seem to be helping much so far.
 
I'm sorry to hear this. Did his vet have any opinion as to how long it may take for him to possibly show an improvement? Do you think the chlorambucil may be causing him to not want to eat? I cut back on the chloramb. a bit with my previous kitty because it was not making her feel very well at first. She had been in the hospital for a few days though and it took a good while when she got home for her to start eating again. I had bowls of recovery food sitting every in the house and put her in the bathroom at night with food and water so she would be as close to the food as possible.
 
I do think that the chlorambucil is making him too sick to eat. He is vomiting for two days following each dose. His vet said to give it twice a week so that's at least 4 days each week that he is sick. His vet gives him 3 to 12 months to live and that's with treatment. The lymphoma is diffused and making it difficult for him to digest any of his food. What did you mean by recovery food?
 
Hills and Royal Canin make a recovery food that is very high in calories for cats who are recovering from illness and need extra calories. One of the them is an AD, I think it is Hills AD. I think it's something like a pate chicken liver. I believe my kitty was given anywhere up to a possible 12 months. When she started vomiting the chorambucil I stopped it and just left her on the pred. for a while. I knew it would be a shorter time span without the chloramb. but she was not tolerating it at all after 11 months.
 
I asked my vet about Hills AD and she told me it was low calorie so it was easier to digest it for cats recovering from serious illnesses. I though she might be wrong about that. I thought about giving Smoky the chlorambucil once a week to see how he does on that. He doesn't seem to be tolerating the chemo drug from the beginning.
 
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My mistake- it's high in fat not calories so I imagine it's not good for pancreatitis. It has a similar calorie count than other canned food. There is another one for recovery I used too. I had to get my cat eating and the recovery food was a good option for her at the time.
 
It was the Royal Canin RS recovery food that was the one with chicken liver. Not sure about calorie count though but my cat loved this food when she was sick and was the only one she would eat much of. My memory is getting foggy!
 
Tiffany hid as well. It's the disease making him feel sick. When the meds kick in he will feel better. Bupe lasts about 8-12 hours so I wouldn't wait 5 days to give it again. Ask your vet. I don't know about where you live but in my state and many others vet's have to give prescriptions so we can get meds elsewhere. :bighug:
 
I checked into some non profit groups for help with paying for cancer treatments for cats. Half of them are no longer in existence and 1/4 of them are no longer accepting new patients. The rest of them offer a one time grant of $500 if your vet gives a prognosis of 50% survival rate or higher but they have very long waiting lists.
 
Lillie said:
It was the Royal Canin RS recovery food that was the one with chicken liver. Not sure about calorie count though but my cat loved this food when she was sick and was the only one she would eat much of. My memory is getting foggy!
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It wouldn't hurt to try the food
 
tiffmaxee said:
Tiffany hid as well. It's the disease making him feel sick. When the meds kick in he will feel better. Bupe lasts about 8-12 hours so I wouldn't wait 5 days to give it again. Ask your vet. I don't know about where you live but in my state and many others vet's have to give prescriptions so we can get meds elsewhere. :bighug:
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I waited five days to give the bupe because I thought I was supposed to give him the whole syringe. Each syringe has enough bupe for five days. My vet didn't explain the dosing to me very well. I could have hurt or even killed him with that much of an overdose.
 
Lisa and Smoky said:
I waited five days to give the bupe because I thought I was supposed to give him the whole syringe. Each syringe has enough bupe for five days. My vet didn't explain the dosing to me very well. I could have hurt or even killed him with that much of an overdose.
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Maybe worth trying some bupe, Lisa?
 
Smoky vomited quite a bit today. I called his vet who wanted me to bring him in again. I don't trust this vet too much. She is always wanting me to bring him in all the time. She never talks to him or me except to ask what his symptoms are.
I told the clinic I didn't want to stress him out unduly and vet told me to skip his dose of chlorambucil tonight. She called in a prescription for ondansetron since the cerenia doesn't help that much. I think it's the chemo drug making him so sick. He is a cat who rarely vomits so for him doing so for three days is odd. It started the day after his first dose of chlorambucil May 9 before bed.
 
It can go very fast in some cases. You just don't know a head of time when you start treatment so it's good you tried everything possible up to this point and gave him the best chance you could. I hate going through these things with my fur kids- just hate it! It's just too sad and it always takes me a good while to come to terms with all of it.
 
I went down to talk to Smokys old vet.
He didn't want to stress my boy out so he came to my house to see him. How many vets will do that these days? He said that his prognosis was not good and with aggressive treatment he might live another 6-9 months. He is sleeping a lot and seems very unhappy. My vet recommended having him put to sleep soon. He said that's it's my decision to make though. I have the ondansetron for nausea and bupe to keep him comfortable until then.
 
Lisa and Smoky said:
I went down to talk to Smokys old vet.
He didn't want to stress my boy out so he came to my house to see him. How many vets will do that these days? He said that his prognosis was not good and with aggressive treatment he might live another 6-9 months. He is sleeping a lot and seems very unhappy. My vet recommended having him put to sleep soon. He said that's it's my decision to make though. I have the ondansetron for nausea and bupe to keep him comfortable until then.
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Bless your old vet, Lisa. You'll do what's best for your boy. :bighug::bighug:
 
I can't help feeling that the specialist who diagnosed him in Oct with IBD was wrong about that. I think he had the lymphoma developing all this time. My old vet said the IBD could have morphed into cancer and it might just be a very aggressive type. Or it cld have been a slow moving lymphoma and the outcome might still have been the same. It's hard to get a few days off from my job on a weekend in the summer. I was able to get off work for June 9 and 10th and I have regular days off on June 11 and 12. I spoke with his original vet for an appt to come in on June 9 to have him put to sleep. It's the best thing I can do for him.
 
Symptoms can be pretty much the same for both especially if the IBD is severe. Treatments are the same too. You old vet is probably right about the outcome whether he was treated for IBD or lymphoma. I'm sorry Smoky was one of the ones who had this progress to this extreme. Making him comfortable now is important and is a good thing to do until your next visit in June.
 
Lisa and Smoky said:
I can't help feeling that the specialist who diagnosed him in Oct with IBD was wrong about that. I think he had the lymphoma developing all this time. My old vet said the IBD could have morphed into cancer and it might just be a very aggressive type. Or it cld have been a slow moving lymphoma and the outcome might still have been the same. It's hard to get a few days off from my job on a weekend in the summer. I was able to get off work for June 9 and 10th and I have regular days off on June 11 and 12. I spoke with his original vet for an appt to come in on June 9 to have him put to sleep. It's the best thing I can do for him.
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This is heartbreaking, Lisa. It's impossible to answer the "what if" questions and it will stress you more trying to. For now, taking it one day at a time and keeping him comfortable is best. We're all here for you. :bighug:
 
Smoky quit vomiting right after I stopped giving him the chlorambucil.
I'll see how he does on the ondansetron.
Thank you for thinking of us and all the kind thoughts sent our way.
 
Hi Lisa, I thought I would share with you my very recent experience with possible IBD and lymphoma. Earlier this month (May 6th) I started my 19-20 year old Lily (Himalayan) on chlorambucil. She had been slowly losing weight over the past year and then in late March she started having terrible diarrhea and her already low weight plummeted. She also started collecting fluid in her chest and abdomen (something was exacerbating her heart disease). A trip to the cardiologist and heart meds took care of the fluid, but she continued to decline, with ongoing diarrhea and continuing weight loss, despite eating voraciously. Her blood work indicated she had some kind of severe systemic inflammatory process as well as kidney disease, and an abdominal ultrasound showed that she had thickened bowel loops. Thinking it was IBD, she was immediately switched to a limited ingredient diet, given some B-12, and put on dexamethasone injections (pred was contraindicated because of her heart disease).

After a couple of weeks, there was no improvement at all, so intestinal lymphoma was suspected. By this time, Lily was weak, uncomfortable, and the diarrhea was just getting worse. Things got so bad, I truly thought that Lily would not make it through another week. Like Smoky, Lily was also too frail for a biopsy, but we decided to assume she was dealing with lymphoma and try the chemo. Lily seemed to be very uncomfortable for about a day and a half after her first treatment (although she did not vomit), but she has now had 4 treatments (2 mg every 3rd day along with daily steroid injections), and her nausea after each treatment seems to be easing. I do make sure she has eaten a good amount of food before I pill her. I only started seeing improvements in her symptoms a couple of days ago (after treatment #4), so progress has been slow. However, her terrible diarrhea is starting to show signs of resolving (she even had one perfect stool yesterday), which is a *huge* breakthough. She is also feeling better and is following me around the house again. I don't know if she will actually go into remission or put on any weight (she is still skeletal-thin), but her quality of life seems to have improved, and that is the most important result.

You may want to give the chemo a little longer to see if it helps Smoky. Also, make sure you give food before giving the chemo pill, and please *do* try the Odansetron. I went through chemo myself a couple of years ago (for intestinal lymphoma, oddly enough) and took Odansetron for the nausea--it is quite the miracle drug! If none of this ends up helping Smoky, then you can you take some comfort in knowing that you have done all that you can do.
 
Thank you so much for sharing your story. My old vet thinks that Smoky may be one of the few cats who can't take chlorambucil. The other major hurdle for me is that I just don't have the means to pay for treating the lymphoma. The chemo pills, the frequent bloodwork, meds for nausea and vomiting,etc. I can barely scrape by with getting his insulin and diabetic supplies. He has a laundry list of medical issues and now seems to have fluid buildup in his abdomen. I can't say that for sure but his belly seems pretty swollen.
 
Thank you for your prayers and thoughts.
I really hate it that I don't have the money to help Smoky and have to let him go in part because of that. I just don't want him to suffer and be in pain.
 
Better times from before:
 

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Having more money doesn't always make a difference. I had enough money at the time to treat my previous kitty for lymphoma and I still had to let her go. She still succumbed to this disease. You've helped Smoky and tried the meds used for his conditions. I don't see where you could have done any more.
 
My old vet would agree with you. You actually said almost the same things that he did to me. It's just me feeling guilty I didn't start him on the chlorambucil sooner, back at end of Oct. It may have been a better now
 
Lisa and Smoky said:
Smoky was at the vet to get another ultrasound done. He has had drastic weight loss and is not gaining back the weight. The vet thinks he has intestinal lymphoma which started out as IBD. He also has an enlarged kidney. He wants to treat him with chlorambucil and prednisolone. Anyone else have any experience in giving this to their cat?
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Lisa and Smoky. Sorry to hear Smoky isn't feeling well. My previous car Bud was diagnosed with lymphoma after some ongoing weigh loss. After more diagnostic they found a mass in his upper intestine. Diaged as lymphoma..Options were surgery and chemo. He was already 17 yrs old so I didn't want him to suffer through surgery and chemo. My vet opted for oral prednisone after an initial injection to see how things would go. Bud surprised all of us and responded well to the prednisone. Three weeks later the mass had shrunk to the size of a pea and he was eating well , gaining weight with more energy than I has seen in a couple years. We dropped the prednisone to once every other day. Bud lived another four years and it was kidney failure that got him not the lymphoma. I guess the moral of the story for me was picking the less invasive method turned out to be the right choice....but like people every cat is different. Hoping the best for you and Smoky!
 
Jeff Davis said:
Lisa and Smoky. Sorry to hear Smoky isn't feeling well. My previous car Bud was diagnosed with lymphoma after some ongoing weigh loss. After more diagnostic they found a mass in his upper intestine. Diagnosed as lymphoma..Options were surgery and chemo. He was already 17 yrs old so I didn't want him to suffer through surgery and chemo. My vet opted for oral prednisone after an initial injection to see how things would go. Bud surprised all of us and responded well to the prednisone. Three weeks later the mass had shrunk to the size of a pea and he was eating well , gaining weight with more energy than I has seen in a couple years. We dropped the prednisone to once every other day. Bud lived another four years and it was kidney failure that got him not the lymphoma. I guess the moral of the story for me was picking the less invasive method turned out to be the right choice....but like people every cat is different. Hoping the best for you and Smoky!
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What kind of diagnostic tests did you have done? Smoky had two ultrasounds done but vet determined that he was too weak to get a biopsy done. The first ultrasound showed a slight thickening of the intestinal wall. The second one several polyps along the intestinal wall plus enlarged kidneys.
 
I gave Smoky ondansetron, 1 mg about 30 minutes before giving him chlorambucil. I gave him a half can of food with the ondansetron, he gets sick taking meds on an empty stomach. He vomited about 2 hours after taking the chemo drug. Should I have waited longer to give him food? He feels really hot and was laying on the bathroom tile which is cooler. Should I give cerenia as well? Is one med better for nausea and one for vomiting?
 
I know in people ondansetron can be taken with or without food so it may not have made any difference when you gave him his food. My cat would throw up the chlorambucil no matter what about 1-2 hrs. afterward. From what I've heard the cerenia is good for vomiting and the ondansetron is good for nausea but hopefully others will come in here who have experience with both.
 
I'm a bit worried about him getting dehydrated. He vomited three times in an hour. This was two hours after the chlorambucil was given. He sneaked into some dry kibble and threw that up a few minutes later. He is bugging me for food but I don't think I shld give him anymore right now. I'm giving him some bupe so maybe that will relax him a little
 
Three times in one hour is a lot. I would be worried about dehydration. Can you give him fluids, or can you have your vet give him fluids tomorrow?
 
I don't have fluids to give him at home. I have to work tomorrow and my vet is only in the office from 8 am to 1 pm. He is drinking water now though.
 
There are a couple others that could be used according to Leo's specialist but I can't remember the names. One may have been cyclophosphamide. I do remember though that she said he would need an echo cardiogram before administering it. Not sure if this recommendation was just because Leo had a previous blood clot or if it is regularly done.
 
I came home from work today and my roomie said that Smoky vomited twice. She said it was a lot both times. I gave him 1/4 tab of ondansetron this morning after his breakfast. I can't give him the chlorambucil, it is making him really sick. The ondansetron doesn't seem to be helping much with the vomiting. I might just give him the cerenia again for now.
I am very worried about him getting dehydrated. He seems really hungry most of the time and was fine for the six days prior to giving the chlorambucil. He wasn't nauseous and didn't vomit once.
I don't think I can take care of him properly as far as paying for treatment for the lymphoma goes. I feel like I don't have a choice and am being forced to have him put to sleep by my circumstances.:(
 
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