Possible lymphoma in diabetic cat - experiences?

[kphmitten]

I posted about Manny not too long ago because he was having scary low readings. He's on Lantus, .5u. Mornings he's ~90-110 so we give no insulin and evenings he's ~290-310 so he gets .5u.

This morning he went in for his dental. His teeth weren't looking good and the plan was to pull most of them. That happened. Unfortunately, the tech felt a lump on his abdomen. X-ray showed a tumor in the kidney area (could give liver). The vet feels it's most likely lymphoma. He's also dropped a 1lb in two months and is now 10.4lbs...he's a maine coon and really should be 16.5lbs for his size. I got him from someone when he was 32lbs 5 years ago and he was diagnosed diabetic about 2 years ago. He eats nearly every 1.5-2 hours from 7am-12am. The vet said with this sort of cancer they typically prescribe Prednisone. The bad news is that's practically impossible to give to a diabetic cat. The good (?) news is his bloodwork they did before the dental was perfectly normal.

It's very stressful right now. I work at an ER vet with specialists so I'm considering the IM specialist and an onco specialist. My vet was realistic with me and said there really is no cure and this most likely won't respond to chemotherapy. The best bet is to see if we can get it biopsied without full surgery and hopefully beyond hope it's benign.

I'm just in a very tough spot. Do I want to pursue expensive diagnostics when the outcome probably won't be in our favor or just try to keep him as happy as I can for as long as I can? Anyone have experience with this? Good or bad. I'm okay with the hard truth; I'd rather know what to expect and know when to make the call for my sugar kitty before it gets too ugly for him.

 

[Deanie and Boo (GA) and Scout]

The vet said with this sort of cancer they typically prescribe Prednisone. The bad news is that's practically impossible to give to a diabetic cat.

What does that mean? You can certainly give prednisone to a diabetic cat. My Boo probably spent about 2.5 years on steroids to treat his chronic pancreatitis. Will it affect the glucose levels? Possibly but if the cat is already on insulin, you just adjust the dose accordingly. It's a quality of life issue--if the pred alleviates another condition, you work the diabetes treatment around it.

My vet was realistic with me and said there really is no cure and this most likely won't respond to chemotherapy.

I don't think your vet is all that knowledgeable about lymphoma. In cats, it tends to respond very well to chemotherapy. My Abbey lived 4.5 years (with excellent quality of life) past her lymphoma diagnosis. There isn't a cure per se but many cats can have a long remission period. Boo didn't fare quite as well but he had a more aggressive form and was an older cat with other health issues. Still, he got another 6 months of eating shrimp and hanging out in the back yard.

Get the diagnosis and speak to an oncologist. If he doesn't have an aggressive form and no other major health issues, there's no reason why he couldn't do very well with chemotherapy.

 

[kphmitten]

I don't know you, but I adore you right now!

 

[Deanie and Boo (GA) and Scout]

I don't know you, but I adore you right now!

LOL, that's funny.

I hate the gloom and doom vets. I think they lead people into making decisions without having the right information to base it on. I always want to know exactly what I'm dealing with and what my treatment options are. Luckily, my vet is very helpful with that.

Some cats with small cell lymphoma can coast along happily for years--and the treatment is pretty mild. The oncologist can explain the options and guide you with your decision.

 

[Larry and Kitties]

- You said "My vet was realistic with me and said there really is no cure and this most likely won't respond to chemotherapy." I do not know how he ca make that statement about not responding to chemo without knowing the type of cancer, if it is cancer. Many cancers response to chemo.
- My Mario had small-cell-intestinal lymphoma (no masses). His oncologist refused to use the pried and he was treated with leukeran. He lived over two years.

 

[lynda and scruffy (GA)]

I second Deanie's recommendation to see an oncologist so you know what you're dealing with. It does seem that cats with small cell lymphoma can have a lengthy period of remission and survival. They can determine the type of cancer by doing a biopsy during a diagnostic ultrasound. In Scruffy's case, he had his first chemo treatment less than 4 hours after his first ultrasound.

Scruffy had very aggressive large cell lymphoma with masses of tumors in his spleen and one large tumor in his liver. Although he was technically tumor-free after only three chemotherapy treatments, his kidneys essentially gave up even before treatment was started. He'd been on insulin for four years, and was diet-controlled for a month less than another four years. His initial in-patient treatment included IV dexamethasone that immediately raised his glucose levels to a diabetic state. He was also given prednisone (only 10mg a day) that was initially intended to be a temporary measure, but when it became clear that his kidneys were so damaged that the chemo protocol couldn't be followed, they continued the prednisone for the remainder of his treatment. I started him on insulin again, but it was quickly evident that being a diabetic this time was the most minimal of his problems. He hovered around the low 100's without insulin, so although I continued to test him, he never actually became "insulin dependent" during his last two months.

I will be thinking about you and your kitty.

 

[kphmitten]

Thank you everyone! I've been reading and am a bit more hopeful. I'm waiting to hear from my work about benefits/discounts because I haven't finished my 90 days yet. He'll be seeing our internist first because our oncologist doesn't do the abdomen ultrasound. The internist also handles certain lymphomas and her experience in diabetes will be helpful. Most likely we'll be seeing both before this is over. Bring it on, it's not like I don't have money just sitting around right now. :sarcasm: