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Cat: Emma
Domestic Shorthair (Spayed female)

Type of Lymphoma:
Multicentric Large Cell - Stage V

FeLV Status:
negative




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Emma's Case Study  

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Other Diseases/Conditions:
None

AT DIAGNOSIS: Seizures, started 2004, cause not determined.

Story: Emma adopted me at the local Animal Shelter in May of 2001. She and 4 siblings had been found motherless in an alley when they were only a few weeks old and were raised by a wonderful foster family. Emma still acts like a kitten; she is extremely affectionate and is always getting into things. Other than a few mysterious seizures, Emma had never been sick a day in her life, but on October 5, 2005, I knew something was terribly wrong. She was huddled in the corner, struggling to breathe. Rushing her to the Vet, they found her chest cavity full of fluid and all of her lymph nodes very enlarged. The Vet told me immediately that she suspected Lymphoma but would aspirate one of the lymph nodes to check for cancer cells. In the meantime, the fluid was drained so she could breathe easier and an x-ray was taken which showed a tumor in her chest, a mass in her abdomen and "something strange with her liver". The lab test came back positive along with a dire prognosis. Try chemotheraphy, which would not cure her, but could possibly bring about remission for some period of time; put her on pallative drugs that might keep her alive for a few months; or do nothing and watch her drown in fluid. I was stunned that my kitty could be perfectly healthy one day and terminally ill the next, and I took her home to think all of this through. If she had been elderly, or had a lot of other health problems, my decision may have been different. But after reading the case histories here and everything else I could find, I knew I had to give her a chance.

Emma went back to begin her Chemotherapy two days later. In the interim, her chest had filled up and had to be "tapped" again, and the lymph nodes in her neck had grown from the size of a grape to the size of a walnut. It was incredible how quickly this disease struck and how swiftly it seemed to be moving.

October 7, 2005:
Emma received Vinchristine and Cytoxan today, the start of the COP protocol, and went on 10 mg. Prednisolone daily.

Things were pretty rough at first. She was no longer having trouble breathing, but she was lethargic and by Day 5, had completely stopped eating. She was started on Ciproheptadine and was syringe fed Hills a/d for several days. When she went back a week after her treatment, she had lost almost 1 1/2 pounds, but there was no fluid at all and no enlargement in her lymph nodes. She seemed to go into remission with the very first dose.

November 2005:
Emma has finished the weekly treatments and will be going to every three weeks. Still no sign of cancer. She has become incredibly fussy about food, but she has gained back nearly a pound. The Pred dosage has been reduced to 10 mg every other day and she has been on 4 mg Cipro daily.

December 2005:
Emma seems to feel bad for a week after her treatment and then bounces back and feels fine for two weeks. Getting her to eat enough is a constant battle, but her weight is staying pretty stable. She has been a lot less active and seems not to feel well. She is sitting and sleeping in a strange, hunched up position that makes me think her tummy hurts. We have started her on 1/4 Pepcid ac twice a day to see if this helps. Also, her WBC has started dropping after her treatment, but has rebounded enough to continue.

January 2006:
Emma seems depressed and is not interested in food, despite the Cipro. The Pepcid seems to help, so we are continuing that, but I have decided to stop the Cipro for a while. One of the side effects can be depression, and it seems to have stopped working anyway, so I want to give her a break from it and see what happens. I monitor how much she eats, as best I can with another cat in the house, and have been supplementing with a/d on days she has not eaten at least 6 ounces of food. The lymph nodes in her neck were slightly enlarged when we went for treatment on 1/16, but had shrunk again a week later when we went in for her CBC, so she seems to be only in partial remission at this point. WBC dropped to 1330, and the Vet does not want to continue giving her Cytoxan if it doesn't come back up to at least 2000.

After being off the Cipro for about 10 days, Emma seems much happier and active again. She is also eating well, we have been able to put the syringes away. Aside from all of the shaved spots for blood samples and IV catheters (plus the spot on her side where her chest was tapped in October and the fur still hasn't grown back!), you wouldn't know she was sick. Her WBC is still low, 1900, so she got a dose of Vinchristine only this time.

February 2006:
After much anguish, I have persuaded the Vet to try a new protocol encorporating Elspar. Since her lymph nodes are enlarging again, I think we need this to "zap" the cancer fast and try to get her back into remission.

We are starting a 25 week program using the Madison-Wisconsin protocol on 2/8.

Outcome: Updated April 2006 - Emma lost her battle with Lymphoma on April 6,2006, exactly six months after diagnosis and just a week after her 5th birthday. She was such a gentle, sweet little soul. She is sorely missed and will be loved always.

Outcome: Updated 3/17/2006 - Emma has completed the first cycle of the W-M protocol. We were very hopeful that the Adriamycin would work, but she still isn't back in remission. We started the second chemo round this week and also starting giving the following which were prescribed by a holistic vet.

Homeopathic Remedies (Liquids that are mixed with water)
Carcinosin LM5

This remedy was originally derived from breast cancer tumors, but Im not sure what it is made of today. Seems to be a very highly regarded remedy for cancers.

Silica LM1
Made from rock crystal; a strengthening influence in every way. It can provide the most benefit to weakened individuals.

Phosphorous LM1
Made from the natural element/mineral; its good for alleviating inflammation.

Supplements
Marrow Plus tab twice a day
Milletia (Ji Xue Teng) herbal supplement to nourish and build both red and white blood cells
Power Mushrooms tab twice a day
Reishi Mushroom supplement to boost immune system efficiency
Antiox-10 1 capsule per day
Grape Seed Extract Antioxidants to help control cellular damage and slow down mutation and growth of cancer cells
Thorne Feline Basic Nutrients 1 capsule a day
Complete vitamin, mineral and amino acids supplement

It's too early to tell what, if any, effect these will have and I can't say I'm a convert to holistic medicine yet. Just open-minded. We're still hoping for the best.

Outcome: Updated 2/22/2006 - It seems the Elspar only put Emma back into remission for two weeks. She had been feeling great up until yesterday. I thought she was suddenly quiet and mopey because of the Cytoxan she had last week; but today all of her lymph nodes were enlarged, not just the ones in her neck, and the Vet said it felt like the abdominal mass was coming back. She gets Vinchristine again tomorrow and we are hoping that keeps the cancer at bay until we can try the Adriamycin next week. The Vet did say that if Emma starts having trouble breathing, she would give her the Adriamycin ahead of schedule.

It is so hard not to get discouraged. We were all so "up" for the past couple of weeks; after getting a clear X-Ray and having a happy, active kitty around. With all of the ups and downs, it's easy to start feeling like you're winning the occasional battle, but losing the war.

I'm still hopeful, though. Adriamycin is the only drug in the MW protocol that we haven't tried yet, so maybe it will be the ONE.

- By Melody Emma's Mom -
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