Update on my boy Jax

[Nick&Jax]

https://www.felinediabetes.com/FDMB...ll-dealing-with-diarrhea.292216/#post-3194265

Good evening everyone. It has been a few months since I have posted. A lot has happened since then and I wanted to update you all and possibly get some insight on what I’m dealing with now.

Back in July Jax had terrible diarrhea due to the low carb kibble. Thank god I was able to make the transition to wet food. I was able to use freshpet’s version of “kibble”. Which then led him to fancy feast classic pate. Which he is 100% on now. And all of that helped clear up his diarrhea. I was so happy to have that fixed and him eating FF pate.

Now about a mouth ago Jax started vomiting and almost stopped eating completely. I took him to the vet. We ended up doing all kinds of blood work, X-rays, and an ultrasound. I was told he either has IBD or small cell lymphoma. So I then contacted an internal medicine specialist. Poor guy, then we did a GI track biopsy. My poor baby had been through so much and now he’s been diagnosed with small cell lymphoma in his stomach and lower intestine. I’ve been numb with the news and have been ignoring work for awhile to spend so much time with him.

I am hoping someone here has had some experience with this. And I wanted to list his medications and see if you guys agree with it and or if it is safe for him to take with his diabetes.

The two medications they put him on are:
BUDESONIDE 0.5 tablets once daily.
CHLORAMBUCIL 1.5 tablets on Mondays, Wednesdays and Fridays.

The specialist knows about Jax’s diabetes and told me these medications shouldn’t affect his diabetes but to keep an eye on it. So far so good with the Budesonide, I checked his BGs and they are still green in the 70s.

The Chlorambucil medication we started today. I’m really unsure about this medication. I feel so bad giving my boy chemo drugs. The specialist explained how it has very little side effects for cats. But I just don’t know much about this medication. Hopefully someone here does?

I just want to make sure both those medications are safe for him to take with his diabetes and if anyone here has experienced either of these medications and have any tips or info on it? I was told life expectancy is 2 years from diagnosis. Like I said I’m numb from this information. I just want him to be as comfortable as he can be for these next two years or so. Are these medications going to hinder or affect him negatively for those two years? I just want to make the right decision and make him as comfortable and happy as I can.

Thank you all for your time and help!!
-Nick

 

[Bron and Sheba (GA)]

I’m sorry about the diagnosis. I will tag @Wendy&Neko she is experienced with what you are dealing with.

 

[Wendy&Neko]

I am sorry about Jax's diagnosis, but way too familiar with it! On my third kitty in a row with SCL, the latter one has IBD and SCL, though she's been in remission from SCL for over 5 years. Yes, with the proper protocols, there is a high chance of remission for Jax. All three of mine were vomiters too.

One of the resources that really helped me is a groups.io group that specializes in feline small cell lymphoma. You might want to join it. It doesn't run like FDMB does, but does have lot of resources on it, and an IM vet who drops by occasionally.

There are a couple things you are going to need that aren't on your list of meds. If he's still vomiting, he should be getting Cerenia daily. Also, nausea is a real concern with chlorambucil, especially with the odd dosing protocol he's on (more about that in a bit). You should be getting ondansetron for him and predose it before the chlorambucil by about 1/2 hour. With the every other day chlorambucil, you likely will need to give ondansetron every day. Not all cats get nausea from chlorambucil, but it's better to stay ahead of nausea.

There are two main published protocols for chlorambucil. One is the every other day (though 2 mg, not 1.5) and the second protocol is a larger dose but once every 2 weeks. The size of dose is based on body size. The second one is much easier on the cat, nausea doesn't last as long. And kitty gets lets chlorambucil overall, so better on them as it is a carcinogen. Best part for you is a lot less pilling, and less worry about cleaning out the litter box after.

My first two cats, including Neko, went on every other day first. I really wanted to do every two weeks with Neko but the IM strongly recommended every other day. As expected, she was horribly nauseous so I managed to convince him to switch her. So she was only nauseous a few days out of the two weeks. At the time I was underdosing the ondansetron, what the vet told me to do, but I found out later it was too little. Third cat went straight onto every other day, no way I was going to let her go through the older dosing method after my experience.

Budesonide did not impact Neko's diabetes, though there are few for whom it does. The alternative, and preferable if not diabetic, is prednisolone, but that isn't good for diabetes. Or heart conditions, which is why Neko was on budesonide. Chlorambucil has no impact on diabetes. If it's compounded, it's typically in a capsule so no worries about sugar. I gave the brand Leukeran pill, as I'm in Canada and it's much cheaper here.