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Cat: Amanda Reyes
female, mix of American Shorthair and Burmese

Type of Lymphoma:
GI - gastrointestinal, infiltrative, no mass, high-grade

FeLV Status:

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Amanda's Case Study  

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Other Diseases/Conditions:
IBD and Kidney Renal Failure, both probably related to lymphoma. Since start of chemotherapy kidneys have normalized.

Story: The first symptoms we noticed were a drastic reduction in eating, first, and then drinking, over the span of about 3 days in April. Amanda continued to not eat and then became dehydrated badly so we took her to emergency vet.

Our cats have been lifelong indoor/outdoor cats, so it is more difficult to notice vomiting/diarrhea than in indoor kitties. Still, we did notice Amanda vomiting yellow-bile like vomit, about twice a week at first, then more frequently.

Well, after emergency hydration, she went to vet for x-rays. Nothing showed up. Her weight was down from normal 9 pounds to 8 pounds. Her appetite picked up for only about 2 days, then tapered off drastically again. Back she went to vet for ultrasound. Results were very inconclusive, lymphoma, IBD, pancreatitis, and other possibilities were discussed but nothing definitive at all. She was given Prednisone shot, perked up for a few days, tailed off, went back to vet for prednisone pills. Baytril, then Flagyl, were prescribed...little change occurred in her general lack of appetite and malaise.

Now, not every day was a bad day. She would have perky days sometimes and eat well. But generally her eating would decrease, and by mid-May her weight was down to 7.5 pounds.

Other symptoms noticed then and now too: Strange "hunching" behaviour...sort of like crouching. We learned to associate the "crouching" with stomach pain and/or stomach cramps. Odd chewing motions of her mouth, and licking lips often would precede a vomiting episode. Once she didn't make it to her indoor litterbox and diarrhea was found on the carpet...actually it was more like 'pudding stools'...very soft.

Bloodwork revealed normal readings at first but then her kidneys started going out. We began doing daily sub-q fluids at home. Lymphoma had spread to Amanda's kidneys and was affecting their function.

In early May, an endoscopy was performed. Our former internist did the endoscopy and gave us the false diagnosis of "advanced pancreatitis". Prednisone was increased. But two weeks later, Amanda went downhill again and was down to eating almost nothing.

I realize now that the old internist and her steroid treatment were actually "treating" the cancer...it's just that prednisone will only give a lymphoma kitty about two months of life. The lymphoma is causing her lack of appetite, nausea, IBD, etc., and the prednisone will treat it...but only for a short while. That's why Amanda would perk up, and then go down, and then the old internist would increase the dosage.

At the point where even 10mg of prednisone daily were doing nothing at all, and when our old internist suggested that was "pretty much the end" for Amanda, my wife and I searched and found a new vet/internist. A second ultrasound was performed, pancreatitis was ruled out, prednisone was weaned off, and exploratory surgery was recommended as ultrasound revealed "unusual thickening" of at least two intestinal areas. Exploratory surgery provided full-thickness biopsies, which confirmed high-grade lymphoma throughout the GI tract. After a week and a half to recover from surgery, first chemo session was initiated on July 5th, 2005. The first chemo drug was L-Esparaginase (Elspar), which was followed by Vincristine on July 8th. WBC and RBC counts were too low for scheduled chemo on July 15th, but by July 22nd counts were normal and Cytoxan (Cyclophosphamide) chemo was injected. Amanda was officially pronounced "in remission for GI lymphoma" on July 22nd, 2005, which is where she stands at the current time.

Outcome: Updated 8/29/2005 - Dear friends of Amanda:
It is through our tears and with heavy hearts that we bring you sad news. Our sweet brave kitty has gone from this world.

Her condition had gone from bad to worse from about the middle of August. Over this last weekend she had gotten to the point where she could barely walk or stand up without falling down. Her front right paw was a horrible sight as it became rather suddenly useless over the last couple of days and she would try to push herself up with her knee. Amanda was so brave and fought so hard. This morning we brought her in to confirm with our vet/internist that nothing more could be done for her. We helped her on her way to the place where she will no longer feel pain, sorrow, hunger, sadness, and grief. She is happy now and at peace.

Monday, we let her have her last wish, a beautiful warm sunny day in her beloved backyard. She lay under the flowering bushes and dozed in the warm sun, listening to the birds singing under a bright blue sky. We syringe-fed her outside so she could enjoy every minute. When the sun went down and it came time to go in, she protested and went to hide behind her piece of plywood. We let her alone. A few minutes later we couldn't find her in the yard, but there she was inside on her bed. Somehow, she had made it back in. To the end, she wanted to do things her on her own, something she always took pride in.

She died from cancer that was in her brain and Central Nervous System (CNS). Nobody knew it was there. It was doing terrible things to her mobility, especially her right paw, her back, and her hips and back legs. As you know, Amanda had been diagnosed with GI lymphoma, but she was probably multi-centric. By the time the non-appetance and lethargy showed their symptoms, apparently the cancer was already in her brain and CNS.

Another theory is that, because she had an extreme sensitivity with chemo drugs, her weakened body and immune system may have allowed her GI lymphoma to spread to her brain and CNS.

A cruel irony is that the chemo drugs that she was taking don't work on brain/CNS lymphoma, because of the "brain blood barrier". So the GI lymphoma was "in remission" but her poor sweet body was still being ravaged by cancer.

I put this info out there for your information only. It is a moot point to us to determine exactly why and how she died. Her illness was something that everybody, Darlene, myself, our vet/internist, and especially Amanda herself... everyone tried absolutely the best we could do. We don't want to dwell on why she died, we would rather remember how she lived, and how she fought so bravely.

This morning, barely able to move, she stretched out her bad paw (which we thought was injured somehow but was probably affected by stroke/nerve damage). She stretched out her paw to play with a fishing bobber toy which she loved to play with her Daddy, even though she hasn't been able to play in weeks. And she used the last of her strength to jump from the chair to her Mommy's play desk area, to play with her beloved Mommy one last time.

We placed her in her beloved backyard as we promised her, in a nice sunny spot. It was a spot that she herself had picked out the day before. We said our last goodbyes and filled the grave with our tears. Looking up, we saw that her final resting place was directly under the gaze of our stone cherubic angel statue. It was so fitting a place, for our sweet Amanda is forever with the angels now. God let us borrow her for awhile, 14 years and 10 months, but now our sweet angel has gone home.

We want to thank everyone for all their help, in both the lymphoma group and pancreatitis group. Just sharing our kitty's ups and downs was such a help. Please don't give up the brave fight. Amanda never did, and neither did we.

Someday, we will probably make a trip to the Fremont Animal Shelter and look at the adorable kitties. But it's going to be a long while. We want to remember our sweet baby Amanda for a long time. She gave us everything she had, every day of her life and we want cherish her memories.

Amanda Reyes - 10/31/1990 to 9/6/2005

All the best thoughts and prayers for your brave kitties,

Paul, Darlene, Angel Amanda, and Timmy

Outcome: In remission for GI lymphoma as of 7/22/05.

- By Paul Amanda's Dad -
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 Chemo Protocol Used 

Elspar, Vincristine, Cytoxan, Prednisone were used, you can find more about this combination of chemo drugs in the document below listed in alphabetical order [under Chemo Drugs] Chemo & Protocols [pdf].

 Holistic Remedies Used 

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