Whispers health – part 3

After exploratory laparotomy Whisper needed entire weekend to get back to normal after anesthesia. Luckily later, she got to her normal routine quite easy. Considering how invasive the surgery was, samples collection and Whispers age (in April she turned 10), I was really surprised that she didn’t have any problems. To be honest I was rather expecting that recoalescence will take longer and I was afraid for complications. And it was a surprise – my fears derived from knowing what might go wrong – nothing of that happened. Since recovering from anesthesia, Whisper behaved like a normal, healthy cat. She was running around the house with other cats, fetched toys to bed, drank water in the sink and begged for snacks.

Urine results arrived pretty quickly and showed mild inflammation and nothing more serious.

According to results and renal biopsy precautions, she got antibiotics from fluoroquinolones group. Control tests of renal parameters from blood improved. We decided to keep her treatment until they come back to normal – both creatinine and SDMA. We were still waiting for blood smear results. Histopatology of collected samples was still in progres.  

I was having very busy time at work that was taking my mind away from worrying for just one more moment. I assumed I will find our next Monday. On Saturday, in late evening, I got some time to check and answer my emails. That’s when my heart stopped when I noticed Patological Anatomy Department message. I looked upon Tomek who was right next to me and opened the attached result.

It said that it was “small cell lymphoma with probably infiltration on mesentherical lymphonodes. “

It was really hard to read out the diagnosis. My voice chocked with first words. It sounded like a sentence. My thoughts screamed that Whisper is dying, that I will have to say goodbye to her. I couldn’t imagine euthanasia, she was suppose to be with me for many more years… I was terrified, panicked, sad, angry, disorientated… Many thoughts were going through my head and I didn’t know what to do with them. What should be next?…

Whisper is not the only cat in our house. There are four other feline members of the family, we run a cattery. Back then we still had boys from liter T, that were only one month old at that moment. I was afraid that this diagnosis means the end of cattery. That we would have to quit our work in that matter. I felt like the whole world was collapsing on me. Everything we achieved in past 9 years would have to end with this?

I remember that later I cried a lot, hysterically. Even my parents came to check on me, alarmed by the noises downstairs. It took me a longer while to calm down enough to be able to talk.

By the very end I was really hoping for this to turn out to be IBD (Inflammatory Bowel Disease). But somewhere inside I felt that it won’t be that easy. Lymphoma, a type of cancer, was scary to realise. I feared such diagnosis long before it came. That’s why I did some research about it before. About symptoms, types, treatment etc. Small cel lymphoma is a mild form of the disease but this is not a complete diagnosis. Next test that needed to be done was immunophenotyping to evaluate what kind limphocytes make it – T or B. When I’ve send samples for histopathology, I also asked to run this test if it comes positive for lymphoma. Unfortunately for these results we had to wait another while.

I knew that falling asleep after such news, will be immposibble for me as I will think about what to do now. Some owners starts to say good bye and consider euthanasia, when they hear such diagnosis. With some cases of cancer this is reasonable thinking. Considering Whispers condition and behaviour – this wasn’t a situation like that. I wasn’t gonna give up without a fight. I knew I will decided to start her on chemotherapy to prolong her life. But so far I’ve had little experience in it. This was also due the reasons mentioned before – not every owner decides to go with that kind of treatment.

I wanted to get help – a professional consult from a specialist. When I suspected it may end up as lymphoma, I contacted dr Bartłomiej Hutny and arranged that I will get back to him If I get this kind of diagnosis. In the end I talked about it with dr Estera Zawłocka – Hutny – his wife. They run a veterinary clinic together and specialize in small animal oncology.  Despite late hour I managed to set a start up therapy for Whisper until we get full results of immunohistochemical test.

Thanks to the conversation we had I calmed a little bit. It turned out that this type of lymphoma is characterized by good respond to treatment if there are no signs in blood tests yet. Additionally, chemo is not that aggressive with this type. For Whisper it would mean administering chlorambucil tablets every two weeks. The drug is called Leukeran. It’s not cheap to buy but with Whispers body surface and weight, one package should be enough for the whole treatment. She should receive 12 doses and with mentioned intervals it should take around 6 months of therapy.

­­We decided with dr Hutny, that if it turns out to be B-cell lymphoma (the more aggressive form) we will consider additional meds. But according to Whispers condition, her actual blood tests, we stood up for T-cell lymphoma. Before we start with the treatment she was supposed to have hematology done and it was to be repeated after the first dose. All to monitor her state and influence of the meds on her organism.  

My other concern regarding chemotherapy, was the risk for our other cats. That kind of meds can influence pregnancy and embrio development. This excluded breeding during treatment period. It was a moment when we decided to suspend our cattery until it is over. Suspend, not quit. We’ve blocked Helen and Elma with melatonin micochip (because of complication risk – also in breeding – I’m not fond of hormonal progesterone cycle block). There was also Cody. Melatonine doesn’t work on males when it comes to breeding. We decided tu use Suprelorin instead and remove it after few months. Unremoved it can block the male for over 2 years.

There was also issue with exposing other cats for meds that Whisper was about to receive. Chlorambucil is a drug, that is secreted with saliva, mostly 2-3 days after administration. It’s decomposition in the environment can be speed up by UV light. Thanks to this knowledge from dr Estera, I started to know how to organize everything.

Cat room turned out to be a practical idea once again. This time as a separation of Whisper for those 4 days after administering chemo. I also ordered UV lamp right away. It was to be used to disinfect and clean up the room after Whisper leaves it. Because the drug is mostly secreted with saliva I figured out the easiest way to get rid of it will be to bath her afterwards. Cats spend around 5hrs a day on washing and licking themselves so the remains of the drug will be on her coat.

Thanks to merythorical support and experience of dr Estera, I knew what we were facing and how to prepare for it. I was a bit more calm, knowing that I’m not alone as vet and have someone who knows this disease. I was even able to fall asleep that night. Unfortunately, it turned out later, that we had more complications in this plan…