Jett's Story
by Kirk S.
August 2011 our nine-year old cat, Jett, (weight 15 pounds) went through a bout of diarrhea, out of the litter box, and vomiting. A trip to the vet and a blood test revealed an elevated level of calcium, an indicator of possible cancer. At that time my wife and I could not afford any more intensive tests.
Our vet recommended observation while changing her diet, She suggested another blood test in three or six months. We changed her food bowls and her diet. Jett's diarrhea and vomiting stopped.
March 2012 her symptoms came back. Took Jett (11 pounds) back and the blood work was more conclusive that it was cancer. An ultrasound revealed a mass in the liver area.
At this time my wife and I were in a better financial situation. We knew we weren't going to give up on her, so we told the vet to do everything possible.
For me the cancer diagnosis was difficult to hear. For my mother's last year of life, I was her stay-at-home caregiver. She also had cancer. I had no idea of what to expect in being a caregiver for a cat with cancer.
The surgery found the mass was only fat, not a tumor. Tissue samples from the major organs, plus a bone marrow sample, were take for biopsies.
We were told the tests indicated lymphoma. The senior vet at the hospital told us it was very treatable. He added if it was his pet, he would go ahead with chemotherapy. He presented a six month Feline CHOP protocol, complete with a cost estimate of $2,200. Again, my wife and I were financially able to take this chance.
When we decided to obtain our cat's records three months later (more on this) we found out how serious her condition was. When we read the pathology report is when we found out it was extramedullary plasmacytoma. It is a rare type of cancer for felines.
My wife and I both work for a major medical corporation. We work with multimedia and educational materials for doctors and patients. That either makes us the best kind of owners for vets to deal with or the worst. We did have a lot of questions, which probably put us in the latter group.
When Jett's chemotherapy started on April 1, 2012, we had a lot of questions. Our regular vet did say Jett's condition was rare but treatable. She added two feline oncologists were being consulted and would be kept updated on her condition. She said there are limited studies or information on feline cancer, with most research performed on dogs with cancer.
When I heard that, I decided to keep a journal of Jett's therapy. I hoped (and still hope) it could be of some future use to feline medicine.
Feline CHOP protocol has four main steps. Week one - injection of Vincristine. Week two - Cytoxan pill. Week three - Vincristine. Week four - injection of Doxorubricin. Jett's first session also included an injection of L-Asparaginase. For the first month at home we would give her Prednisolone orally, once a day. This protocol is similar to what human leukemia patients undergo.
The first side effect is a lack of appetite. Food aversion is to be expected, since cats associate the nausea and other side effects to their food. A leukemia patient told me his favorite foods tasted like metal when his chemo started. He had to find something he liked, which was a little demoralizing. We could only imagine what our cat was feeling.
Another side effect lasted for 24 hours after an injection of Vincristine. She would vigorously dig in her litter box, then splash all the water out of her water bowl. Our vet could not offer an reason for it.
The closest explanation I can find is peripheral neuropathy in humans, a tingling and numbness sensation in the fingers, hands and feet. The leukemia patient I wrote about earlier went to physical therapy to insure muscle strength in his limbs.
Another side effect dealt with hairballs. We were told there would be some fur loss from chemo. It was evident most of her fur was ingested when Jett was cleaning herself. Her hairballs were very large (1/2" by 4"/5"). Obviously fur in her stomach meant no food or nutrition. We stuck to a strict every other day hairball medicine routine.
Another side effect from the Vincristine took place about 64-66 hours after her injection. She would go through the dry heaves; no vomit or fluid expelled. Since she would normally receive her injection around noon on Tuesdays, it would mean she'd wake me with these heaves between 4ma and 6am on Friday mornings.
As we progressed through therapy, her reaction to Vincristine lessened but getting her to eat was difficult. We tried all different varieties of wet and dry food. A quick microwave of wet food to increase the aroma, which was more like a stink. We would grind up freeze dried beef cubes to sprinkle on her wet food. It got to the point we would spoon feed or finger feed her Gerber baby food.
By mid June 2012 Jett was down to 7 1/2 pounds, half her normal body weight. To say we were discouraged is an understatement. I had contacted a veterinarian medical school in our area to obtain a Willed Animal release form to donate Jett's body to medical science, since it looked like she would soon die.
After her June 26, 2012, we noticed a large swath of fur missing from the back of her neck behind her right ear, as if she had pulled away from someone holding her. We knew from experience she could pack a punch when she wanted to fight.
This marked a turning point. One, we were convinced Jett had been mishandled. The staff at the hospital denied any mistreatment but did say Jett has a reputation of being "difficult to handle." We know our cat is difficult but we were still mad.
We made several crucial decisions that week. One, as long as Jett has strength to take on a vet tech, she had enough strength to live. She was telling us not to give up.
We asked the clinic for all of her medical records. It was in reading the test and pathology reports we found how serious Jett's condition was. My wife and I wondered aloud that if we knew how serious her lymphoma was, would we have gone ahead with chemo? Doubtful.
Asking for medical records also had an effect on the staff at the hospital. We weren't just owners dropping off our cat for treatment. We were really watching what was happening, which should have happened in the first place.
We also decided chemo day would be handled differently. Before the incident we would drop her off at 7am on our way to work. We would pick her up at 6:30pm on the way home.
To lessen her interaction with staff, I would take the day off. Drop her off as late as I could, around 11am, and pick her up as soon as possible, around 1pm.
It was as if everything came together. Her appetite began to increase. Finding a brand of wet food she would gobble up also helped. She was no longer lethargic. By the middle of July 2012, we celebrated her 10th birthday.
The vet staff had also noticed. Jett was now only handled by the chemo tech and our vet. Each therapy visit was marked by improvements, especially her weight.
September 18, 2012, was her last injection of Doxorubricin. She had lasted through the six month protocol. Our vet and chemo tech beamed with pride after that last injection.
Jett is now on a treatment plan of 1mg of Leukeran, three times a week. She will most likely be on this course for the rest of her life. We've also gone from once a month blood tests to once every two months.
She's been 8 1/2 pounds since August 2012. Doubtful she'll return to her normal weight, but she is at a healthy, active level.
The fur from her surgery and bone marrow test sites took a long time to grow back. When it did, it initially grew back very curly, which is not uncommon in human chemo patients.
We also noticed something interesting about her gray fur when it began growing. The roots were true gray with red tinged tips. In all the months of therapy we didn't notice the Doxorubricin had tinged her gray with red. The medicine has the nickname of "The Red Death" because of its deep ruby red color.
After reading this, you're probably wondering why we stuck with our vet. One, there aren't too many vet hospitals with in-house chemotherapy. Second, my wife and I think we're pretty good judges of people. Although she's young (only two years our of vet medical school) we know she genuinely cares for Jett and her other patients. As we learned how to be caregivers of a cat with cancer, I think she learned how to work with us.
Here it is, December 2012. A holiday season we didn't expect to have with our cat. There aren't any guarantees but we hope we have a few more with her.
Update. Jett passed very quickly on July 3, 2013. She had changed her daily habits, which we took as a sign that she was getting ready to pass. Her final struggle only took a few hours.
On her 10th birthday, we asked for one more year and we got that. So grateful for having all the extra time we had together.
Jett's remains have been donated to a local veterinary school for education and research.
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California, USA
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Jett
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