Genny's Case Study  

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Other Diseases/Conditions: Reduced appetite, weight loss, diarrhea (all in 6 months prior to diagnosis). Story: Genny, my 12 year old, spayed female DSH had a checkup in Aug 2009 and was declared healthy except for a broken tooth that should be pulled, and a bit over-weight (as always). She's stayed steady at a bit over 12 lbs despite being on diet kibble for years. The tooth extraction meant full geriatric work-up to see if she could handle the anesthesia, then terrifying (to me) full anesthesia... I put it off. I noticed during the winter that she might finally be responding to her diet. I was very stressed with work during the Spring but decided I ought to take her for a check up because it seemed like she was not eating very well and losing a bit more weight than desirable. Then in May 2010 she began to have diarrhea (yellow ochre, pudding like) every other day or so with normal stool in between. Within a week, instead of getting better she was no longer having normal stools. No vomiting. No lethargy. As loving as always, and possibly more playful, which I attributed to the weight loss (she has shown signs of arthritis in her back legs). I was worried that the broken tooth was so painful that she wouldn't eat, and maybe she'd contracted giardia from our backyard pond. Took her to the vet on June 2, 2010. She got an exam (down to 9.6lbs, Dr. felt some palpable thickening of intestine), complete blood count (normal, except for low potassium), T4 scan (normal), in-house fecal check (no visible parasites) and was sent home with metronidazole in case of bacterial overgrowth or undiscovered parasite. June 12, 2010: back for a checkup... no relief of diarrhea, Genny HATED the metronidizole but I kept winning the twice daily battle, still not eating much. She now weighed 9.2 lbs. She got 150ml of subcu fluids, a B12 injection, giardia test (ELISA negative), radiographs of gut (yup... something swollen, but couldn't rule out pancreatitis). Sent home with more metronidazole, clavamox (ampicillin), probiotics/kaolin, Hills R/D canned food to try, and Mirtazapine (appetite stimulant). June 18, 2010: still no relief from diarrhea. Went for another check. Genny was back to 9.6 lbs (appetite stimulant and me chasing her around putting kibbles under her nose which she would eat). Dr. said she was worried about trying endoscopy because they couldn't tell what the thickening/obstruction was from the radiographs. Her recommendation was exploratory surgery, but that at a minimum I should opt for fine needle aspirate. If I pushed she would let me put her on prednisolone without a diagnosis, but she really, really didn't want to do that. We went home to think... I was terrified about putting a 12 year old kitty through the surgery, but concluded that the only way to get the treatment right was to risk the surgery. She also started on Hills D/D (venison and peas) and I mixed half a spoon of babyfood squash in. June 23, 2010: Genny had two normal-ish stools on Monday... I told the vet but they did ultrasound and saw no change in intestine and Genny had her exploratory abdominal surgery. Thickened small intestine, but no masses. No visible issues with any other organs. Biopsies were taken of her intestines and lymph nodes. While she was under (and handling the anethestic well) they pulled two bad teeth. I picked her up that evening. She looked horrible... very groggy, very gaunt, and clearly in pain. She wouldn't eat or drink or purr. Moved very slowly, and eased herself down onto her side and layed there like she was dead. I felt nearly as awful as she did. June 25, 2010 (today): Genny's eating a tiny bit of canned Hills D/D mixed with enough water to turn it into soup. She got buccal mucosal pain meds every 8 hrs post op. She's moving around a bit. I can coax her into eating her soup and drinking a bit of water but not much so today she got another appetite stim pill (1/4 of a 15mg mirtazapine). The doctor called with results of the biopsy... small cell/low grade lymphoma of the small intestine, also found in lymph nodes. She called a reknowned vet. oncologist for a telephone consult. The recommended therapy is to start 10 days post-op with prednisole (daily) and leukeran (twice per week without stopping, instead of the usual 4x week followed by 3 wks off). That means we'll start around July 2nd. Outcome: Starting chemo on July 2. I'll keep you posted... - By Lauren Genny's Mom -

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