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Large cell lymphoma in my cat

LisaArk

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@Dr. Christina @Dr. Jean Hofve @Dr. Jeff
My male cat came with the name "Punkin," but we often call him Punk. Lately, he's Punkin because he doesn't have the energy to be a punk...We rescued him from a colleague that died at home. This was a huge trauma because when one dies at home, police come. Punkin hid when the police came and was alone for 2-3 weeks and nobody knows how he survived. He was likley about 6ish or so when we adopted him, and when we took him to the vet discovered he'd never been neutered and he had terrible teeth. So, he was neutered and had some teeth removed. I can't remember, actually, if we were "forced" to vaccinate him or not, I think I refused, but I'm not sure at this point, I'm not home where my records are. Which brings me to possible toxins - I left my apt. 3 years ago because hidden mold was making me sick - I'm still recovering and I did a mycotoxin test on Punk and it was pretty clear.
He has recently been diagnosed with high grade lymphoma, which I know is quite a grave prognosis. This all happened so fast and during a time that was over the top stressful and busy - in court with landlord over the mold, among many other things, so I just took him my a regular vet that I knew before I'd moved - over an hour away though, because he was the only vet that could contain him. He went two rounds of the CHOP protocol and after that I insisted on another ultra sound to see if there was any improvement. In fact, it had spread from the liver to the spleen. He was also on prednisilone, and jjust read that I shouldn't have had him on that during chemo.

Just prior to this diagnosis, he had 2 bladder infections (I have to think all this could be related to stress in my life and sadly, in my marriage in response to all that was going on) Being treated by a regular ol' vet, he was put on antibiotics. In the last year, he also got constipated and for a while would go out of the box. At first I thought it could be some acting out, but after a long relaxed, loving day at home he'd go to the bathroom in another room. He'd often start in the box, but I think he was uncomfortable and he associated the litter box with discomfort. The vet recommended Miralax. I stopped that because lately, as I've been giving him probiotics, it's better and he goes in the box.

Finally, historically, in 2018 he got sick (very shortly after we got him) this was the summary from a vet I took him to -
What the ultrasonographer found was inflammation of the liver (hepatitis) and gallbladder/bile ducts (cholecystitis/choledochitis). There is mineralization accumulation in the bile ducts (cholecystolilthiasis), fortunately no large stones were seen and there was no gallbladder obstruction. They also noted some inflammation in the small intestine, suspicious of inflammatory bowel disease.

The final diagnosis is: cholangiohepatitis and inflammatory bowel disease. Fortunately everything else within the abdomen was normal.
To treat these two diseases in cats, we typically reach for two antibiotics for potential infectious causes of liver and gallbladder inflammation(Amoxicillin/Clavulanic acid and Metronidazole), a steroid to decrease inflammation in the gastrointestinal tract (prednisolone), as well as liver supplements (Ursodeoxycholic acid, aka Ursodiol, which helps to increase bile flow, reduce inflammation, and decrease scar tissue formation AND SAMe, aka Denamarin, which is an antioxidant to support liver healing).

Additionally, IBD can be associated with a food sensitivity to the meat protein (i.e. commonly chicken, beef, pork, and fish), so a diet change is recommended. The gold standard for food sensitivities is to use a hydrolyzed diet, which means that the proteins in the diet are broken down into such small pieces that they do not cause allergic reactions in the gastrointestinal tract to cause inflammation. These diets are made by Hill's (z/d), Royal Canin (HP), and Purina (HA). If Punkin is a picky eater, we can try a novel protein instead, which can be a good alternative in some cases. Novel proteins are protein sources that Punkin has not been exposed to before. This can include rabbit, duck, lamb, even kangaroo. There are prescription diets (also by Hill's and Royal Canin), but there are also over-the-counter diets too. Over-the-counter diets are not as highly recommended because they might contain trace amounts of proteins that cause allergic reactions in some cats. However, they can be as beneficial as prescription diets in some cases. The companies that make limited ingredient diets include: Natural Balance, Merrick, Instinct, Blue, Zignature, Canidae, etc.

I wound up feeding him Royal Canin Rabbit and Danamarin and he did well for years until just recently. Since his diagnosis, I've tried raw beef, lightly steamed beef which he loves for a couple of bites and then he stops.

I'm giving him NHV ES Clear, Animal Essentials Mushroom Defense, BioV Clarity Cancer AM and PM and finally BioV Clarity, Food for liver and kidney. I'd had a consult with a homeopathic vet and he prescribed these things after I told him (much to his dismay, I think) that I was going to go ahead with chemo. He had no idea how much I should give, and he told me to call the company and I didn't get a call back from that company...I've also been chopping up and liquifiying some Vetri Science Senior Mulitvitamins and well as a little vit. B complex (bluebonnet stress B complex) - 1/32 of teaspoon and Jarrow Formula jarrow-dophilus EPS - spread out over his meals during the day.

I really have no idea what I'm doing, and tonight he's not eating and slightly wobbly, but he went through a day like that a couple of weeks ago and I took him to an emergency vet at 6am thinking it could be the end, but he perked up and rallied and has been eating well since and been fairly perky for a cat with lymphoma - I'd also been feeding him Weruva Lamb, but he's lost his taste for that and doesn't eat much of the beef. He seems to like a particular chicken dish, and I always said at the end, he could eat whatever he wanted, food allergies be damned. Tonight he really doesn't feel well, but is still seeking my comfort and not hiding. He stopped being playful about 2 months ago, but still loves his organic catnip and being pet and loved. He loves his caves and going under blankets, so I hung a blanket over the coffee table for a cave like atmosphere...

So, I've sort of been flying blind and could use some guidance regarding any possible treatments, what I should feed him or anything else! I don't have a holistic vet and don't really know how to best help him. I read about Nate the Cat - have you read this? Incurable to Cancer-Free in One Year: How Nate-the-Cat Survived High Grade Lymphoma - Love of a Cat

Also wondering about in home euthanasia as opposed to bringing him in when the time is right.

Sorry for this very long post and thanks for taking the time to read this.
 
Hi Lisa, and welcome!

Wow, Punkin has been through quite a lot, bless you for giving him such a loving home for these years since his original owner died!

It sounds like we may be in the last couple of innings and looking more for comfort than cure (though cure is never impossible!). But more than giving him "things" (herbs, supplements, foods), energy work (homeopathy, Reiki, and if it's within your world, prayer, angel magic, color healing, crystals, etc.) feels like the best area of addition. Of course, keep on with playing, pet-pets, smooches, and anything else that makes him happy!

I totally agree with you about letting him eat whatever he wants! I tell my clients: "If the cat wants Ben and Jerry's, you go to the store!" My any-port-in-a-storm choice is Fancy Feast. Not terrific quality but cats love it, and at this point we want him to keep eating. Sounds like he's tolerating most proteins now, so allergies aren't a big concern (if they ever truly were... IBD is often related to allergies, but could be from the mold, kitten vaccines, prior meds, chronic inflammation from the previous dental disease, etc.).

Sometimes it's best to stop supplements, in case they are affecting the taste of the food or putting him off in any way. Up to you which ones to keep, if any... my inclination would be to keep the ES Clear, and if he'll take one or two more, Mushroom Defense and the B vits. On a complete diet they don't need extra vitamins and minerals (and indeed mineral overdose can become a problem), but Bs tend to be low-ish in canned foods, especially the pate ones. (No dry food, if you haven't heard that before--source of allergens, and causes dehydration, UTIs and constipation.) Oh, and keep the probiotics since they are helping him.

BTW don't worry about prednisolone and CHOP - that's what the P is, it's part of the protocol. If he's not on it now, it may be something to consider, because (1) this late in the game, long-term side effects aren't a concern, (b) it makes them hungry, (c) it's an effective inflammation/pain reliever. I am NOT a fan of steroids, but there are exceptions and Punkin may be one of them.

If you can give fluids at home, I would definitely recommend that. Dehydration causes nausea and headache, not to mention constipation and UTIs. Fluids solve so many issues with cats, and prevents many more!

When the time comes, at-home euthanasia is such a blessing. If that's an option, definitely do that!

You can always talk to an animal communicator about all this, too... sometimes when things are all confused and uncertain, that can really help. We have had quite a few give talks here, I'm not the web genius but @aruna or one of the other vets can point you to those resources.

Hope I caught everything... but in any case, please keep asking questions!
 
Hi Dr. Hofve,

Thank you so much for your reply on a Sunday night! I'm sorry, I hit "reply" few times, not seeing where to post my reply, and so your post has been repeated multiple times. Whoops.

Punkin is on Prednisolone, .5 mls., and has been for a few months now.
The only thing you didn't specifically respond to is the link about Nate the Cat, and his successful protocol for large cell lymphoma. I guess I'm wondering if I should do a last flood of things that helped Nate, or let my boy go into the good night without all of that. I want to feel like I've done all I can for him, yet I don't want to make him miserable. He's been tolerating all that I've been syringing into him well, he's such a resilient trooper. The reason I thought to give vitamins was because I assumed he was depleted from chemo.

Regarding in home euthanasia, do you have recommendations? I've discovered, "Lap of Love" while googling...I'll look up animal communicators, but I do fear we're in the end game. Tonight after posting, he went to the closet and faced the wall, and he hasn't eaten since the morning. He wants to, he purrs when I put food in front of him, but he can't get himself to eat. But after a rough night somewhat like this, a couple of weeks ago, he perked up, and the vet and we agreed that there was still some life in the old boy yet.

Tonight he also urinated about 6-7 times - in the span of a few hours - what could this mean? That has all slowed down now, he got up to drink some water and is next to me and not in the closet now and seems somewhat less miserable. I think this is the prednisolone talking.

So, Nate the Cat's protolcol or leave him alone? Or ask the animal communicator - maybe that's what you were suggesting.

I'm currently looking for a holistic vet in the Fairfield County area - I've recently moved here. I'm comfortable giving fluids, and coincidentally, he started drinking more water tonight...so he seems to need it.

Thanks again.
 
Hi Lisa!

Wow, Punkin has sure been through a lot! Thank you so much for giving him a loving home.

IMHO, everything he has been through (emotionally, spiritually and physically) have resulted in his lymphoma. I feel that they create energetic entanglements which are associated with cellular dysfunction and dis-ease.

On the cellular and energetic level this makes your job of deciding what to. do a bit easier.

Why? Because you already have the most powerful healing and energetic force at your disposal.

That is the power of love.

We all love our pets, and how we can focus it on healing is what HA! is all about (if you didn't already watch or listen to Dr. Palmquist's HA! webinar last week, I highly, highly recommend it).

When combined with true veterinary homeopathy as Dr. Pitcairn will discuss tonight, they are exceptionally effective.

However, with that being said, I agree with Dr. Jean that Punkin may just feel that his job here is done.

I'd highly recommend Häna Makinen for both expert animal communication as well as for the contextual emotional support and grief counseling:

could use some guidance regarding any possible treatments, what I should feed him or anything else!
Thanks for asking Lisa! What used to be Punkin's very favorite thing to do and eat?

Are you able to get him outside to just sit in the grass (or maybe even sniff around)?
I want to feel like I've done all I can for him
Yes! It sounds like using Nate the cat's protocol would help you feel that way. As long as it does not further affect his appetite or any remaining joy in eating, then it is fine to us.
also urinated about 6-7 times - in the span of a few hours - what could this mean?
Physical symptoms like this (or of any kind) are a result of cellular changes that reflect the dynamic equilibrium and always fluctuating energy flow.

As long as a symptom doesn't worsen BEAM, then it is primarily his body's way of "speaking" to you.

The_4_Ps.jpeg

Drs. Alvarez and Seo are both experience holistic vets in this area:



You might also want to consider adding a trained and experienced vet homeopath to the vet care team.

Virtual vet homeopathy (which deals in energy imbalances and not primarily physical stuff like supplements) is very, very effective at optimizing energy balance, BEAM and quality of life (even at end of life).

Feel free to reach out for any further support.
 
Hi, yes I was thinking an animal communicator could talk to him about further treatment. The difference is that Nate had a solid tumor and the primary was removed; Punkin's is diffuse. Those forms behave differently.

Personally I tend to err on the side of not putting them through too much. But he chose you, and your paths travel together. It has to be something you both "agree" on (however that manifests!). Hope that makes sense!

Pred does make them drink and pee more, but also eat more so we like that part!

Meanwhile, just love the heck out of him! That's your main job! ❤️
 
...and give serious thought to working with a homeopath. One never knows if a total remission is possible, but it certainly could make him feel better and give him more good days.
 
@Dr. Christina @Dr. Jean Hofve @Dr. Jeff
Hi all, I really appreciate your replies. I've been so overwhelmed and busy, that i haven't had time to reply and update. I wound up going to see Dr. Seo at Smith Ridge. He put Punk on a vitamin C drip and is currently taking many supplements. I will say he's had fewer moments where I thought he might not make it through the night. His energy seems pretty darn good and he's eating. He's also accepting all these supplements like a champ, except for one that must be super bitter because it makes him drool. But I accompany these all with lots of kisses, etc. He's such a great, resilient boy.

However recently, his constipation has worsened. I took him to Dr. Seo Nov. 8 because of that, but of course, that morning, Punk went to the bathroom at home and at Dr. Seo's...But, since then, NOTHING except a couple of milk dud size drops...I took him again to see Dr. Seo on Wed. Nov. 13 who said it was all pretty soft and diagnosed it as a lack of peristalsis and put him on Metoclopramide Anhydrous. He's been on it since the evening of Nov. 13 and today, evening of Nov. 16, there is no activity.

Dr. Seo didn't want to give him an enema, but I'm not sure what to do at this point. And, I don't really want to give him supplements if he's not packaging up the toxins with bile and eliminating...

His tummy is full, yet more often than not, his appetite is good, but not sure if it's even safe to give him solid food at this point. I found some Weruva pate and some foods from Tiki that have broth in the food. I was set to make him fresh food a la Dr. Seo. Dr. Seo didn't recommend raw food since Punk had two rounds of chemo, (CHOP) but lightly cooked.

Not sure what to do. Any suggestions? And thanks so much ahead of time!
 
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He also took an XRay and ultra sound and there seem to be no blockages. He's just full up...
Thanks again.
 
If he's willing to eat, feed him. If he gets too constipated then he won't want anything. Hopefully things will just slowly move along. Can you palpate his tummy and see how it feels? If it's all still soft then no worries. You might even want to ever-so-gently massage his tummy if he tolerates it. Encourage him to move around, too. That will help.
 
Thanks so much for getting back. BUT...SUCCESS! Tonight I got home earlier than usual. We got into bed together and we had a talk...;) And while I told him why he really needed to poop, I gently rubbed his belly, which was sure distended and not as soft as it should be. I spent a lot of time with him tonight and he purred a lot. Then I decided to just put him in the litter box. He tried, but nothing. The second time I put him in he stood for a minute, then assumed the position and, voila. Then a bit more in the living room, but hey, I'm not complaining. The then threw up a tiny amount...

My question is, what can cause the peristalsis to become compromised? Why could he have thrown up?
 
Yay, well done Punkin!!

The lymphoma may be thickening his intestines, making it hard for the small muscles that produce peristalsis to get it to move. And what doesn't go down, may come back up. Nothing odd about any of it, given his condition. Just keep loving on him!! Good job!
 
Punkin says, thanks!
Your explanation makes sense. Thanks very much.
Dr. Seo recommended along with a particular diet, spleen and calf or chicken (fattier, so he preferred calf) liver.
Can anyone recommend a place where I can find pasture raised, organic spleen and calf liver? Maybe I'm being too picky, but trying to not put any toxins into him.
Thanks again!
 
...and give serious thought to working with a homeopath. One never knows if a total remission is possible, but it certainly could make him feel better and give him more good days.
I did consult with someone virtually a couple of times. Dr. Seo in Fairfield County has given me some homeopathic remedies...Thanks.
 
Yay! :snowman: 😻💩
My question is, what can cause the peristalsis to become compromised? Why could he have thrown up?
As Dr. Jean said, the lymphoma, or any cellular inflammatory condition, can affect the intestinal musculature. It's the musculature in the intestines that creates the contractions of peristalsis.

Straining to poop can trigger the vomiting reflex in cats..

The emetic reflex and causes of vomiting​

Vomiting in cats is a complex reflex involving the gastrointestinal system, respiratory and abdominal muscles, and changes in posture [2b36]. Some of these coordinated reflex events are a reduction in gastric motility, retrograde movement of gut contents from the proximal intestine to the stomach, and relaxation of the gastro-oesophageal junction followed by expulsion of gastric contents brought about by forceful contractions of the diaphragm and abdominal muscles, and closure of the glottis [2b3,513] [OEG B].
Vomiting may be triggered by peripheral stimuli, such as afferent neural input from the gastrointestinal tract or other visceral organs, or central stimuli, such as circulating toxins that activate the central nervous system (CNS) via the area postrema (AP) [2b8,13,14]. The AP is a bilateral structure adjacent to the fourth ventricle, considered to be outside the CNS because it lacks a blood–brain barrier [2b15]. It is a chemoreceptive area that triggers vomiting, and its ablation abolishes the emetic response to most (but not all) emetogens [2b1619]. Vestibular stimuli (motion sickness) can also cause vomiting in cats, although susceptibility varies between individuals [2b20,21]. The AP is not involved in motion sickness [2b22,23]. As in other species, input from midbrain or forebrain structures also may trigger vomiting [2b6,13] [OEG B].
 
You're welcome Lisa!
 
Ok, it's Saturday night. I had Punk on Metoclopramide and it worked for 2 days. Truth be told the 3rd day, I thought my husband gave him the first dose and he thought I did (we now have a chart) so he missed one dose. Since then, he has not moved his bowels. Last one was around Nov. 17. He's been eating, although much pickier - I made some chicken broth and last night and he ate the chicken and had some of the broth.
 
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whoops, that seemed to send on it's own. Dr. Seo now seems to think that a stone might be lodged in the bile duct.. This is more emergent I think, than his horrible cancer. Dr. Seo reluctantly prescribed Ursodiol. Most recently, he had me giving Punk Guna Lympho Detox, Christopher's S-INFX, Bark and Whiskers's Detox Support, Magnesium Citrate which I stopped, but will start again because he had an entire day of diarrhea, little bits leaving, or watery and urgent, but not particularly substantive. Recently had me stop Sekking Health's Gallbladder Nutrients. Dr. Seo has seemed to resist giving him an enema - he said it wasn't constipated because it wasn't hard, but it sure wasn't leaving him either.

1.At what point is not going to the bathroom alarming?
2. I read an AI post that said giving Ursodiol with a biliary obstruction can be dangerous - is this actually true?
3. At what point since it's the weekend, do I take him to the ER.
I feel like we're getting closer to the inevitable...but we're not there yet - he still purrs, still enjoys catnip, and just this morning ate. He is lying next to me instead of the closet...we had a great brush with his tail flicking around....he still has some life in him.

Any thoughts on a Saturday night?
 
addendum: This past week, until the last 2 days - he tried t go to the bathroom, get into the box and bear down and try. Does this mean peristalsis is working?
Last 2 days, he's stopped even trying. Is he just shutting down? What can this mean?
Thanks...
 
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