Chloe's Story
by Lisa Ayers
Chloe was diagnosed November 30, 2010 with small to intermediate cell lymphoma of the larynx. She was roughly 13 years old. Chloe had come to us about 11 years prior as a stray cat. Her age at the time was guestimated to be about 2. In December, the tumor had begun to obstruct Chloe's airway and interfere with her ability to eat, breathe, drink or meow. She had been seemingly healthy a month before other than an occasion raspy meow. A tumor in her throat was found during a teeth cleaning and was biopsied. The first biopsy was negative for cancer but positive for bacterial infection so Chloe was treated with antibiotics but she started to slip downhill quickly. The day after Thanksgiving, she was re-biopsied. On 11/30 biopsy results had not yet come in and Chloe's breathing was now very labored. Our regular vet gave her a shot of steroid to aid her breathing and we travelled to the emergency vet to see what options were available. At the time we were quite certain Chloe would not make it another day. She spent most of the day on oxygen while we waited for the biopsy results. Our regular vet located the biopsy and got the results rushed through. This biopsy showed no sign of infection but showed low to intermediate grade lymphoma. Chloe was immediately started on the University of Wisconsin Madison protocol and received l-asparaginase and Vincristine. Her response was immediate and within 36 hours she was breathing normally and no longer made noises when trying to eat. A week after when she was being packed up for chemo, she meowed for the first time in over a month. Her appetite seemed good but for the first month of treatment, she lost weight. We started to make an extra effort to present her with food and she regained her pre-cancer weight in about a month. Chloe responded without major side effects to each of the drugs in the protocol. Her White Bloodcell Count was low after each of the first 3 rounds of Vincristine and the chemo was postponed each time until her WBC recovered. The vet adjusted the dosage of Vincristine and the issue with low WBC was resolved. Chloe was sedated at 9 weeks post diagnosis and declared to be in remission. The tumor was no longer present in her throat. At week 22, the vet thought Chloe recurred due to her having lost weight but upon exam was still considered in remission. Chloe's weight had regained her pre-canceer weight a month after diagnosis and previously seemed stable so we no longer were specifically supplementing her meals but she dropped weight suddenly around week 22 losing a pound in a month. She is currently at 5.5 months post diagnosis and cancer free. We did make some changes in diet partly to help her maintain weight and partly because no one knows the cause of lymphoma. We switched initially to holistic dry foods with a goal of over 40% protein and reasonably high fat to reduce carbohydrates and continued to use canned Fancy Feast classics. We supplemented the food with a type of probiotic called Digestive Tract Conditioner which has probiotics and cranberry juice in it which I believe helped Chloe some in dealing with the drugs passing through her kidneys. We had had to put one of our other cats on a diet so we think weight loss was due to that, with the diet food being not appropriate for Chloe. Chloe seemed to have periodic issues with smelling food and we needed to be more diligent about presenting her with opportunities to eat to keep her weight up. Dry food is always available but apparently for her it is not sufficient for weight maintenance. At week 22 of treatment, she was also diagnosed with a slight heart murmur due to slight thickening of the walls of the heart, that needs to be monitored annually. After the first three months of treatment, doxorubicin was substituted for methotrexate in the protocol due to a combination of methotrexate not being readily available and concerns of digestive issues with the methotrexate. The doxorubicin had been tolerated well so that was continued. After 6 months of the Wisconsin Madison protocol, she was 'graduated' from the program. Since we were not comfortable with totally stopping treatment we started chlorambucil. Initial treatment was pulsing with 4 mg/day for 4 days followed by a 3 week gap, then repeating the dosing. This was discontinued on day 3 due to side effects from the chlorambucil. On day 2 Chloe had started twitching periodically. On day 3, a Sunday, she started having frequent massive involuntary muscle spasms. We found it as a rare side effect of the drug on the internet and waited impatiently for the drug to clear her system. Three weeks later, Chloe started on chlorambucil at 2mg three days a week. She tolerated this well in general and had no spasms. the dose was dropped to 1.5mg after a month and then to 1.25 mg after 3 months. In September 2011,she is currently at 9.5 months post diagnosis and cancer free. She is a happy playful cat and enjoys her walks and the company of her kitty siblings.
It is now January 2012 and Chloe is still in remission. We had to take Chloe off the leukeran after November 2011 due to it causing her neutrophile count to be continually depressed. She has done very well since we stopped and has put on some weight and remains very active and happy, She is especially happy about no longer having such frequent checkups and is much more relaxed around the house.
Update February 2013: Chloe is still cancer free and currently on no chemo meds. She is 15+ and happy and seems as healthy as before the cancer.
Update Feb 2015 - Chloe is still alive and thought to be in remission. She is still quite active and for 17+ doing well.
Update August 2016 - Chloe died July 19th. She most likely was still cancer free but we will never know for sure. She had developed some neurological issues and had been on Keppra for something called feline auditory Reflex syndrome for a year before her death. She was diagnosed as hyper thyroid immediately before her death but had lost the ability to swallow and the vet could not find a successful treatment for that and we let her go. She was about 19 yrs old and had led a good life. 
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North Carolina, USA
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Chloe
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