Aside from her heart trouble, Sally has had a relatively healthy life. She was never officially diagnosed with IBD, but I kept her on chicken free food just to be on the safe side. She was always a "puker", sometimes once a week, sometimes once a day. It never seemed to cause her any harm or discomfort so it didn't raise any red flags in my mind.
At the beginning of February last year, I took Sally in for her yearly "senior" check up. I was pretty upset when her lab results came back with an elevated white blood cell count and blood in her urine. Dr. Hansche figured it was a UTI so she was prescribed an antibiotic and I was told to bring her back in a couple of weeks to have the tests repeated. I took her back three weeks later and while her urine was clear, her white blood cell count was exactly the same. Since she seemed to be doing well overall, we decided to give it a couple more weeks and then re-test her. So in mid April we went back again and yet again her WBC was unchanged from the previous two tests. Also troubling was the fact that she was down to 7 lbs 1 oz from 8 lbs in February. When you only weigh 8 lbs and lose a whole pound in 8 weeks, something is wrong. Dr. Hansche recommended further tests to see if it was just a stubborn infection or something more serious. I made the appointment for Wednesday of that week. Sunday and Monday she was fine. Tuesday we got home from work to find she had vomited. Nothing odd about that, except it had an unusually strong smell. She vomited again later that night and after following her to the litter box, I realized she was constipated. She vomited again over night and twice in the morning so I began to worry that her bowel was blocked. I took her to ABC for her tests. X-rays and an ultrasound were inconclusive so Dr. Hansche said she needed a endoscopic biopsy. They would check her blood work to make sure everything was okay and then do the procedure the following day.
Dr. Hansche called me Thursday morning to say that Sally's clotting time was very slow and that he was nervous about her developing a bleed after the procedure. ABC doesn't have 24 hour care so she'd be alone and unwatched if she stayed there overnight or, worse yet, she could develop one at home with me. He strongly suggested a specialist for the biopsy and gave me two choices: an internal medicine vet in San Diego that he'd worked with a lot or one in Carlsbad that he wasn't as familiar with. I chose the San Diego vet and managed to get an appointment the next day. Dr. Hansche was worried that she may have lymphosarcoma and wanted her to be seen as soon as possible.
We spent an hour with Dr. Richter at VSH on Friday and he agreed with Dr. Hansche's hunch. He repeated the ultrasound and was 95% sure but wanted to be 100% sure so he would do the biopsy to confirm. A specialized blood test showed that Sally was deficient in vitamin K so they gave her an injection before the procedure. The biopsy went well and we brought home a pretty weak kitty the next day. Dr. Richter said that they'd have the results in a couple of days.
I realized after a couple of days that Sally also managed to catch a URI during one of her overnight stays so I called Dr. Hansche for some antibiotics while I waited for the biopsy results. Then came the call I'd been dreading. On April 23rd, my worst fears were confirmed. Sally had small cell (or low grade) intestinal lymphoma. Instead of having one solid mass, she had cancer cells throughout the walls of her intestines which had caused significant thickening and swelling which interfered with her body's ability to get the vitamins and nutrients she needed from the food she was eating. It caused her to lose weight and to be vitamin B-12 deficient. It also caused the vomiting, diarrhea and constipation because the walls of her intestines were no longer smooth and food wasn't passing through as easily. After two months of wondering, it was good to finally know what was wrong, but why oh why did it have to be cancer??
Dr. Richter wanted her to start her chemo right away. She'd take Prednisone every day and a chemo drug (Leukeran) every other day. She'd also get vitamin B-12 shots weekly for 4 weeks and then once every 4 weeks. Because of the URI, Dr. Hansche told me to delay her chemo for a couple of days to give the antibiotics a chance to work. I figured the Prednisone wouldn't be as risky so I started giving it to her and figured I'd wait until she got her first B-12 shot to start the Leukeran and everything would be okay.
Not so.
After just four doses of Prednisone, Sally's lungs filled with fluid. We came home from work one night around 11:30 to find her breathing rapidly. I knew in my heart was wrong (although I didn't know why) so I rushed her to the nearest emergency vet. They immediately put her in an oxygen cage and started her on a diuretic. The ER vet warned me that she was very sick: pulmonary edema, congestive heart failure on top of lymphoma was a lot for a little kitty to handle. She was not very optimistic about her chances but said they'd do their best.
By 8 am the next morning, they started weaning her off oxygen. She improved to the point I was able to bring her home that night. She still had a raspy sound to her breathing and was pretty weak but had the sparkle back in her eye. I was told to discontinue the Prednisone, go ahead and start her on the Leukeran and to keep her on the diuretic.
I was scared silly of the Leukeran. I didn't think twice about it until I read the label and saw that I had to wear gloves when handling it so I looked on the internet and was horrified to read that it was a carcinogen and could cause me to get cancer if I didn't handle it correctly. I was going to poison my cat! I was sure of it! I kept putting off starting her on it until Dorian put his foot down and made me give it to her. I sat on the floor with her and just sobbed because I was so afraid of what it would do to her but yet I wanted her to have a shot at remission. So I gave it to her and waited. She slept a little more than usual the next day but didn't seem the worse for wear. Maybe this would be okay.
The first couple of time she took it, Sally slept a bit more than usual the next day but didn't seem to have any other negative side effects. Dr. Hansche conferred with Dr. Richter and they decided to try her on Methylprednisone, which is the metabolized version of Prednisone and would have less of the fluid retention side effect which had caused her pulmonary edema. I got her prescription filled and started her on it and hoped for the best.
If I thought the first three weeks of Sally's life post-diagnosis were rough, I was in for a rude awakening.
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