Friday, October 19, 2012

Cats, Cancer and Chemotherapy – a technician’s personal experience



Curie receiving Adriamycin administration

Cancer. Whenever people, myself included, hear the “C” word, we enter into a state of despair. In its many forms, cancer is one of the most common problems affecting humans and animals today, but still very poorly understood. We either hear stories about or watch loved ones who go through terrible side effects of chemotherapy – nausea, pain, infections, long hospital stays, hair loss, and this is what we picture when the veterinarian mentions chemotherapy as a treatment option for your cat’s cancer. However, human chemotherapy is much more aggressive – we know what we are going through and why. People choose to subject themselves to the treatment in the hopes that they can soldier on. Should we make that choice for our cats?

In veterinary medicine, the goal of chemotherapy is to control the cancer without causing excessive pain and suffering in your pet. While some animals will experience side effects, most tolerate the drugs we use much better than humans do. Cats do not usually experience hair loss, though hair may be slow to regrow if shaved. While some cats do experience nausea, most of the time, it is easily controlled with anti-nausea drugs. Many cats will eat shortly after receiving a dose of chemotherapy! Some cats will feel tired for about 24 hours after treatment, but most will continue to keep their normal routines, and feel quite good.

Many small lymphocytes and two dividing cells or "mitotic figures"
Many know that chemotherapy is a method of cancer treatment that uses drugs to try to kill the cancer cells, but really, chemotherapy refers to any kind of treatment that involves medication. By definition, taking an aspirin for a headache is a form of chemotherapy, and it should not be a “bad” word. Not all cancers are treatable with chemotherapy. One of the most common cancers in cats is a cancer called lymphoma, which is also a very treatable cancer.

My cat, Curie, has been with me since college. She was an adult stray that showed up on a friend’s doorstep. I took her in, took her to the vet, got her spayed, vaccinated and treated her for parasites. She’s had bouts of dental disease issues, but otherwise has always been a healthy, hearty girl. In 2010, she started to lose weight - gradually, at first, but I kept bringing her in for bloodwork and it all looked fantastic, especially considering she was over 10 years of age. So, I put down more food. I joked that since all her bloodwork was so good, her weight loss must mean she had cancer.


Many lymphocytes of varying sizes, suggestive of lymphoma
The spring of 2012, I brought her in, and she was being cranky (always a feisty girl, she’s gotten more cantankerous with age!) and so we anesthetized her to draw her blood. Once she was asleep, we noticed two lumps on the left side of her neck, right near her jugular vein. After we drew her blood, one of the doctors collected a fine needle aspirate sample of the lumps and looked at it under the microscope. It was determined that the lumps were probably enlarged lymph nodes, based on the cells the doctor saw under the microscope. Enlarged lymph nodes could occur due to some sort of infection in the body, or could be due to lymphoma. We collected a slightly larger sample, called a TruCut biopsy, and sent it into the lab for a pathologist to examine.

Meanwhile, her bloodwork was still great, she still seemed to feel good other than her weight loss, and her x-rays came back with no sign of metastasis (cancerous spread) to the chest or abdominal lymph nodes.

My little chatterbox the day before surgery. See the swelling on the left under her jaw?




The pathologist determined that she had lymphoma. Often, when only cervical (neck) lymph nodes are affected, surgery will cure the disease. This is known as Feline Hodgkins-like lymphoma. We took Curie to surgery and she did very well. The lymph nodes were much larger than they appeared from the outside, and were very close to some important nerves. Dr. Bailey was concerned that Curie might have some lasting laryngeal paralysis and lose her voice, or might have some other nerve damage, but she recovered 100% of her function and has been just as talkative as ever!

I started monitoring her neck at home, just as a precaution, making sure to pet her under her jaw every evening when she sat on my lap while watching television. Unfortunately, there are a lot of lymph nodes in the neck, and while they looked normal at the time of surgery, about 2 months later, two more lymph nodes in the same chain (on the same side) became enlarged. At this point, rather than play “chase the cancer” through the rest of her cervical lymph nodes two by two, and put her through more surgery, we decided to try chemotherapy.
Curie's incision post-surgery.

Curie started with a dose of Vincristine, and then we checked her white blood cell count the next week. She seemed to feel no adverse effects from her first dose, and her lymph nodes were back to normal size. Every week after that, she returned for a CBC to check her white blood cell and red blood cell counts, and then got a dose of chemotherapy. We usually use a rotating cycle of drugs to treat lymphoma called the Modified Wisconsin Protocol (Vincristine, Cyclophosphamide, and Adriamycin in the hospital and Prednisolone given at home). We did have to delay one dose a week because she caught a cold, and developed some anemia (low red blood cell numbers). After some antibiotics and antivirals, and some injectable medication to stimulate her red blood cell production (Iron, B12 and Epogen), she was ready to continue the process.

Seven months post-surgery.
There were only a couple times that Curie had any kind of reactions. Both times she got cyclophosphamide, she vomited right after getting the drug. If she has to repeat chemotherapy, we will pre-treat her with an anti-vomiting medication before giving the cyclophosphamide. Five days after her first dose of Adriamycin, Curie had a seizure. She had a seizure of unknown origin in 2010, so we don’t know if this seizure was spontaneous or related to the chemotherapy. The second time she got Adriamycin, she did not have a seizure, but she did have some vomiting and diarrhea 6 days after treatment. She also vomited two large hairballs – did she vomit because of the chemotherapy or because of the hairballs or both? Who knows? Other than that, in 9 weeks, she felt very good for the majority of the time. She gained a little weight and then maintained it, when she had been losing weight for a long time prior to starting chemotherapy. Her appetite improved – she actually started knocking the butter dish off the kitchen counter, trying to get to the butter – something that she has never done before in the last 13 years. In fact, before this, she rarely got on the kitchen counters at all!

Leukeran is a tiny pill
Now that she has completed her injectable chemotherapy, and her lymph nodes have reduced in size, Curie can take oral chemotherapy at home (Leukeran and Prednisolone), as long as she continues to get a CBC checked every three weeks to make sure her cell counts don’t drop too low. Her hair is a little thinner on her belly, she has fewer whiskers than she used to, and her hair still has not fully regrown from where she had surgery, but she still seems to feel good. In fact, when I head to the kitchen in the evenings to get her pills, she runs ahead of me because she knows that she will get her favorite treats afterwards!

As a technician, I have always felt that cats seem to do well with chemotherapy, and so far my experience with my own cat has reinforced that belief. While she is not as robust a cat as she was before she developed cancer, her attitude is the same, her habits are the same, and I know that it is unlikely that I would still have her at this time if we had not started chemotherapy. I am so happy with how well she has done the last 5 months while being treated with chemotherapeutic drugs, and I hope that she continues to do well, and eventually goes into remission.


****

Still begging for treats!
One of the best ways to tell if your cat is handling chemotherapy well is to see how they respond to their first dose or two. Usually, you will see your cat improving in 1-2 weeks. My other cat Marley also has lymphoma (in his nose, and therefore, inoperable), and I always notice that he stops wheezing and sneezing about 5 days after a dose of chemotherapy. With chemotherapy, it is fairly easy to evaluate, and help the doctor evaluate, whether the chemotherapy is working after only a few doses. Committing to start chemotherapy does not mean committing to the entire process – if at any time your cat is not tolerating the treatment, or not responding well, the chemotherapy can be stopped. In most cases, if chemotherapy is offered, it is definitely worthwhile trying.

Possible side effects include:
  1. Suppression of the bone marrow
    The type of white blood cell that normally prevents development of serious bacterial infections (neutrophil) can be decreased. If this happens the cat can be at risk of developing severe life-threatening infections. This is the most serious potential side effect, and it is one of the reasons that we monitor the CBC while cats are being treated with chemotherapy – weekly in the initial phase and every 3 weeks after that. If the neutrophils are too low then further treatment is delayed until they have returned to normal. The CBC also allows us to monitor for anemia (decrease in red blood cells) and look for chemotherapy-related changes in the blood smear. Monitoring the cat with these blood tests helps us identify and treat problems before they become serious.
  2. Gastrointestinal side effects (nausea, vomiting and diarrhea, inappetence)
    With the most common drugs used at the recommended doses, digestive effects are uncommon. A few cats will, however, develop various gastrointestinal side effects. Most of the time appetite stimulants and anti-vomiting medications easily manage these effects and keep the patient comfortable. If more severe or long-term side effects occur, then the drug causing them can be stopped and an alternative drug can be tried that may be better tolerated.
  3. Extravasation of drug
    Chemotherapy drugs that are administered into a vein can be extremely irritating and painful if inadvertently given outside of the blood vessel. If your cat is grumpy or wiggly at the veterinary office, he or she may need sedation for the placement of IV catheters or even while giving the chemotherapy drug in order to make sure that things go smoothly and safely for all involved.
Additional resources:

13 comments:

  1. Patients with cancer endure challenging symptoms resulting from the cancer itself or the side effects of conventional treatments. Through research our journey has led to an informed selection of complementary therapies that embody the intelligent pursuit of wellness. Click to purchase, read more about our complementary therapies, or review clinical support materials.[+]
    Treatment

    ReplyDelete
  2. I felt like this article was a very light-hearted and, somewhat, inaccurate look at cat chemotherapy. You might want to have addressed the lack of appetite that is worrisome, or the difficulty many cats have with pill-taking (which adds to their stress), etc. I came to your blog to see how long it took for the lack of appetite to go away, and really didn't get a definitive answer. Since my cat is impossible to give pills to, that makes the lack of eating last even longer. Chemo is still a serious choice, even though it's not as severe as human chemo. Cats are delicate creatures, and currently, I'm regretting the choice I made FOR her.

    ReplyDelete
    Replies
    1. Nadine -

      We appreciate your feedback regarding this article. This article was not meant to be a comprehensive look at chemotherapy, but a personal perspective on two chemotherapy patients. This technician who wrote it did not experience any lack of appetite following chemotherapy, so that aspect was not discussed in detail. Most cats that we treat at our hospital eat quite well following chemotherapy, or if their appetite is suppressed, it is often for only 24-48 hours. This, however, does depend on the type of chemotherapy medication being received, the individual cat's resiliency, the severity of the cat's disease, the type of cancer being treated, whether or not appetite stimulants are/were being used before or after treatment, and the cat's overall health status and appetite prior to receiving chemotherapy.

      We always discuss the pros and cons of choosing chemotherapy thoroughly with our clients so that they can make an informed decision about whether or not to proceed. Definitely, if a cat is difficult to medicate, oral chemotherapy at home is a less viable option, and many people who cannot medicate their cats will choose to continue the injectable medications, or in some cases, the oral chemotherapeutic drugs can be made into chewable treats, or can be administered orally in the hospital instead of at home.

      For questions about whether or not your cat should be eating following her treatment, the answer is probably best given by your regular veterinarian, as he or she is more familiar with your cat's individual health, and can better work with you to tailor her personal health plan.

      We are very sorry to hear that you are regretting your choice to pursue chemotherapy with your cat. Sometimes, when our choices for our pets do not yield the results we hoped for, we can feel that we made a poor choice. However, if you had not made the choice to pursue chemotherapy for your little girl, she may also have done poorly, and you might have always wondered whether treating her would have given you more quality time. Unfortunately, it is the sad burden of human caregivers to make these challenging decisions for our furry loved ones - and as long as your decision was made with love, you can rest assured that you did your best for her, no matter what your choice.

      Best wishes.

      Delete
    2. TESTIMONY OF HOW I GOT CURED FROM HERPES SIMPLEX VIRUS
      This is real take it serious, who will believe that a herb can cure herpes, i never believe that this will work, i have spend a lot getting drugs from the hospital to keep me healthy, it got to a time that i was waiting for is death to come because i was broke, one day i hard about this great man called DR.EHBOS who is well know for Herpes, HIV, and Cancer cure, i decided to email him I didn't believe him that much, I just wanted to give him a try, he replied my mail and Needed some Information about me, then I sent them to him, he prepared a herbal medicine (CURE) and sent it through Online Courier Service for delivery, he gave my details to the Courier Office. they told me that 3-5 days I will receive the package and after receiving it, i took the medicine as prescribed by him at the end of the two week, he told me to go to the hospital for a check up, and i went, surprisingly after the test the doctor confirm me Herpes simplex virus negative, i thought it was a joke, i went to other hospital and was also negative, thank you for saving my life, I promise I will always testify of your good works. if you are herpes simplex virus patient, contact him and I am sure you will get cured, contact him now: drehbos@gmail.com or whatsapp him +2348133505254 so you can also receive your healing and share your testimony

      Delete
  3. My brother suggested I might like this blog. He was entirely
    right. This post actually made my day. You can not imagine
    simply how much time I had spent for this info! Thanks!


    Feel free to surf to my web site :: fruit diet weight loss

    ReplyDelete
  4. Now-a-days Cancer is spreading very fast in human as well as animals. If, we talk about chemotherapy human therapy is much hardest than animal. Dogs and cats usually tolerate chemotherapy much better than human cancer patients. Good Experience with your cat. Human can share their pain and but animal can’t. So we listen and give treatment as we give a human.

    ReplyDelete
  5. Though my cat's lymphoma is gastrointestinal, I subjectively agree with this post and find it encouraging and realistic. My cat has been on chemotherapy almost 2 years now and my experience is just like this sentence: "While she is not as robust a cat as she was before she developed cancer, her attitude is the same, her habits are the same, and I know that it is unlikely that I would still have her at this time if we had not started chemotherapy." My cat plays and cuddles and eats and bosses me around, and I am so thankful to have her company every day. I also can relate to the occasional difficulty determining the cause of a vomit or other event that this article describes. We're now in a phase of low blood count and need to move to a different medication and this article made me feel encouraged to go forward. I am grateful for the caring and very smart vets who have guided me and my cat through this.

    ReplyDelete

  6. Colorectal cancer, cancer of the large intestine, is the fourth most common cancer in North America. Many cases of colorectal cancer are associated with low levels of physical activity and with diets that are low in fruits and vegetables. Individuals with a family history of the disease have a higher risk. I crumble with this disease for 5 years also with a lot of scaring thought in my head because i was just waiting for death every day of my life until My Son came to me in the hospital explaining to me that he has find a herbal healer from Nigeria to cure my Colo-Rectal Cancer,I was so shocked with the ideal also i was excited inside of me.My son asked me to let us give him a try because we have really heard a lot of scammer pretending to cure all sort of diseases with herbal medicine and some of them never get a positive result at the end of it all but we was very confident on this herbal doctor,like i said we give him a try and he sent me a herbal medicine to drink for three weeks, Sincerely I'm telling you today I' alive and healthy no more laying on sick bed,No more Colo-Rectal Cancer.I'm sharing this testimony on here for people who are sick to contact this Wonderful man,His name is Dr Itua.And His contact Whatsapp_+2348149277967____Email...info@drituaherbalcenter.com / drituaherbalcenter@gmail.com.
    He can cure those diseases like:
    Bladder cancer
    Breast cancer
    Colorectal cancer
    Kidney cancer
    Leukemia
    Lung cancer
    Non-Hodgkin lymphoma
    Prostate cancer
    Skin cancer
    Uterine cancer
    Hiv/Aids
    Herpes
    Hepatits
    Love Spell
    Diabetes

    ReplyDelete
  7. Hello everyone, i'm Linda Harry from United State i was diagnosed with Parkinson Disease  for over 6 years which made me loose my job and my relationship with my Fiance after he discovered that i was having Parkinson, he departed from me, and i tried all my best to make him stays, but he neglected me until a friend of mine  from UK told me Great healer, who will restore my life back with his powerful healing herbal medicine. then he  sent me his email address to contact him- drimolaherbalmademedicine@gmail.com. and i quickly contacted him, and he said my condition can be solved, that he will treat the disease immediately only if i can accept trust on him and accept his terms and condition, i Agreed because i was so much in need of help by all means, so i did all he instructed me to do. And surprisingly after two weeks, He sent me a text, that i should hurry up to the hospital for a checkup, which i truly did, i confirm from my doctor that i am now ( PARKINSON NEGATIVE) my eyes filled with tears and joy, crying heavily because truly the disease deprived me of many things from my life, This is a Miracle, dr imoloa also uses his powerful herbal medicine to cure the following diseases:  lupus disease,  mouth ulcer,  mouth cancer, body pain, fever, hepatitis A.B.C.,   syphilis,  diarrhea,  HIV/AIDS,  Huntington's Disease,   back acne,  Chronic renal failure,   addison disease,  Chronic Pain,   Crohn's Disease,   Cystic Fibrosis,  Fibromyalgia,   Inflammatory Bowel Disease,  fungal nail disease, Lyme Disease, Celia disease, Lymphoma, Major Depression,  Malignant Melanoma,   Mania,  Melorheostosis,   Meniere's Disease,  Mucopolysaccharidosis , Multiple Sclerosis,  Muscular Dystrophy,  Rheumatoid Arthritis, Alzheimer's Disease, parkison disease, vaginal cancer, epilepsy,  Anxiety Disorders, Autoimmune Disease,   Back Pain,  Back Sprain,   Bipolar Disorder,  Brain Tumour,  Malignant,   Bruxism, Bulimia,  Cervical Disk Disease, cardiovascular disease, Neoplasms, chronic respiratory disease,  mental and behavioural disorder,     Cystic Fibrosis,   Hypertension, Diabetes, asthma,  Inflammatory autoimmune-mediated arthritis.  chronic kidney disease, inflammatory joint disease,  impotence,  feta alcohol spectrum,  Dysthymic Disorder,   Eczema, tuberculosis,  Chronic Fatigue Syndrome, constipation, inflammatory bowel disease, bone cancer, lung cancer. contact him on email- drimolaherbalmademedicine@gmail.com. and also on whatssap- +2347081986098

    ReplyDelete
  8. Health wise, I feel like a child dancing in the rain ever since I got cured of hepatitis. I was diagnosed of HEPATITIS B and I was told it has no cure at the hospital, but I was given several antiviral medications to slow the virus’s ability to damage liver. But after sometime the medicine wasn't working and I became very sick with different symptoms like: vomiting, fatigue, dark urine, swollen stomach and so on. I went back to the hospital and I was told it has become chronic with liver problem, and out of frustration I went online to search for something new to try, and I came across Dr. IYABIYE's recommendation, I gave it a try hence it's a herbal medicine. And behold, I was cured after the treatment. I have to wait for months then went back to the hospital and still I was tested negative. You too will be cured. Contact: (Whatsapp: +2348072229413 or +2348158577300) iyabiyehealinghome@gmail.com

    ReplyDelete
  9. Am Richard, I am here to testify about a great herbalist  man who cured my wife of breast cancer. His name is Dr Imoloa. My wife went through this pain for 3 years, i almost spent all i had, until i saw some testimonies online on how Dr. Imoloa cure them from their diseases, immediately i contacted him through. then he told me the necessary things to do before he will send  the herbal medicine. Wish he did through DHL courier service, And he instructed us on how to apply or drink the medicine for good two weeks. and to greatest surprise before the upper third week my wife was relief from all the pains, Believe me, that was how my wife was cured from breast cancer by this great man. He also have powerful herbal medicine to cure diseases like: Alzheimer's disease, parkinson's disease, vaginal cancer, epilepsy Anxiety Disorders, Autoimmune Disease, Back Pain, Back Sprain, Bipolar Disorder, Brain Tumor, Malignant, Bruxism, Bulimia, Cervical Disc Disease, Cardiovascular Disease, Neoplasms , chronic respiratory disease, mental and behavioral disorder, Cystic Fibrosis, Hypertension, Diabetes, Asthma, Autoimmune inflammatory media arthritis ed. chronic kidney disease, inflammatory joint disease, impotence, alcohol spectrum feta, dysthymic disorder, eczema, tuberculosis, chronic fatigue syndrome, constipation, inflammatory bowel disease, lupus disease, mouth ulcer, mouth cancer, body pain, fever, hepatitis ABC, syphilis, diarrhea, HIV / AIDS, Huntington's disease, back acne, chronic kidney failure, addison's disease, chronic pain, Crohn's pain, cystic fibrosis, fibromyalgia, inflammatory Bowel disease, fungal nail disease, Lyme disease, Celia disease, Lymphoma, Major depression, Malignant melanoma, Mania, Melorheostosis, Meniere's disease, Mucopolysaccharidosis, Multiple sclerosis, Muscular dystrophy, Rheumatoid arthritis. You can reach him Email Via drimolaherbalmademedicine@gmail.com / whatsapp +2347081986098

    ReplyDelete
  10. CURED FROM GENITAL HERPES VIRUS AFTER USING DOCTOR HAZIM HERBAL MEDICINE 
    Herbal supplements have existed for thousands of years and can be traced over several different cultures. For now. Herbs are now used to cure diabetics, herpes, chronic pain, asthma,hepatitis b, cancer , ALS , Ovarian Cyst and even  GENITAL HERPES. I like herbs so much. Most of the time, the injection and the drug are only a loss of duration. I was cured of GENITAL HERPES  last year with the use of herbs, I suffered from GENITAL HERPES  for 13 years, but with the help of DR. Hazim Usman  Herbal Medicine, I was cured in a few weeks of using the herbs he sent me by UPS Service Delivery. I don't know the kind of health problem you are facing right now, but I assured you that you will be cured if you contact Dr. Hazim Usman and explain your problem to him, that the issues will resolve in a few weeks , contact Dr. Hazim Usman via his e-mail address:-----( usmandrhazim@gmail.com )-----or reach him via
     WHATSAP number---( +2349058026857)

    ReplyDelete

  11. Very Informative content on chemotherapy Thank you for the article!

    ReplyDelete