by Sandra Fatio
In February 2013, I noticed that Socquette showed lower energy, appetite, stayed hidden. I then noticed that she had less stool and tried to eat her litter and then vomited a lot. I decided to consult my vet. He detected immediately that she had an intestinal mass and thought it could be a lymphoma. We organized an echography and a fine needle biopsy. Two days after the biopsy, she suddenly had signs of ileus (vomitting, lethargy, fever) and I decided to go to the vet university hospital near to my place. They confirmed the ileus and informed us they could try to operate to relieve the obstruction, but gave also the indication that if it was a lymphoma, it could have a bad issue. We decided to try the operation. The operation discovered a 5x5x10 cm jejunal mass without any other lesion. The biopsy of lymph nodes, liver and spleen were without tumor. She recovered very quickly and returned at home at day 3. We had then the information of the definitive histological diagnose and were informed that without chemo, she couldn't live more than one month.
We take 2 days to think about the therapy and finally decided to begin with the treatment, and to stop it if she couldn't tolerate it. We were proposed a Madison-Wisconsin Protocol, that meaned intravenous chemo every week for 4 weeks, then one week free, then again 4 weeks chemo, one week free, then every two weeks with chemo, during 25 weeks. It was really challenging and we decided to do it and cancelled our vacations. We immediately saw a benefit of the chemo, but with the time, we had to manage a lot a effects who were interfering with her health. Vincristine is known for its vomiting and obstiping effect. The vets first gave us tablets against nausea and vomiting but it wasn't strong enough. Because I'm myself a physician, I suggested I could do some injections against nausea and vomiting and it really helped her. I also had to fight against obstipation with some laxatives and some paste against hairball formation because of the bad intestinal motility. She succeed the 6 months therapy, but I have to transmit that to choose such a therapy is really a deep engagement from the "cat parent" and that a cat cannot survive such a therapy if the parent is not really invested. We had to fight to give her appetite and from other blogs, I found that mirtazapine could be a help and I also suggested this therapy to the vets. Mirtazapine had really changed the prognostic during the therapy. I have the impression, that if the result of chemo studies by cats are not so good, it is because of the general effects of chemo, where the vets are not really aware and not really counseling. During 6 months, it was a daily investment, with a lot of emotional difficulties.
But now, she is 6 months after the end of the chemo, she is receiving a maintenance treatment with prednisolone every 2 days, and lomustine (CCNU) every 5 weeks, that she tolerate extremely well. She gained 600 g since the end of the chemo. She is very active, happy, very close to us, has almost a second youth. She was 8 years old when she was diagnosed.
we don't regret to have this treatment, but would like to explain to others to do that only if you are ready to invest a lot of time to help the cat to go through. If not, it is just suffering for the cat and his owner.
Update on April 2014: Socquette is now 13 months after diagnosis and is doing well.
update on June 2014:
Since Eastern, Socquette developped diarrhea. we first found a giardiasis, and she had two rounds of metronidazole and one round of panacur, without success. She lost a lot of weight. I was thinking of exocrine pancreatic insufficiency and we looked after that. She was diagnosed with pancreatitis. We tried pancreatine, it reduced a little the diarrhea and we began a vitamine B12 therapy. An abdominal US confirmed that she was still in remission.
Unfortunately, she couldn't gain any weight despite a ravenous hunger and became very weak. She died at home very suddenly, probably from multi-organ failure due to cachexia. It was very sudden, she spent her last hours on our bed, and we could pet her till the end.
She will be very missed and we will always remember her.
[ click photos to enlarge ]