Devastating cancer diagnosis—please help!!

[jcanulla]

Hi everyone,
It has been a while! Hope everyone is doing well. Got some devastating news— looking for some advice.
I’m going to try to be as concise about this as I can. Lots to unload here. Julius is a handsome 7 year old male. He’s extremely smart, very spunky, and never misses an opportunity to wack something off the counter. He is the center of our lives— we love him beyond measure!
For the last four years or so Julius has been suffering from upper respiratory issues. Lots of sneezing, discharge, sometimes it’s clear most times, other times it’s bloody. The vet diagnosed him with allergies so he’s on antibiotics at times when they turn into infections. Most times they just prescribe the meds as bringing him in causes lots stress to Julius. Nothing to be super concerned about we were told, in terms of the infections, allergies and treatment.
Two weeks ago he woke up from a nap with a good size bulge on the top bridge of his nose. Obviously being very concerned we brought him to the vet. The vet did some bloodwork analysis and also pulled a sample out of his nose to be tested for cytology. Everything came back normal no cancer was found— all blood counts were normal except for his kidney test which came back a little bit elevated in values. Again, we were told nothing to be concerned about.

After we receive these results the vet thought it would be a good idea and prudent of us to also give Julius an ultrasound and an x-ray as well as a lymph node aspiration to further examine his body to see if anything else could be causing the swelling in his nose. An ultrasound was performed which showed a mass in his abdomen it also showed enlarged kidneys. The x-ray confirmed the same. The aspiration of the lymph node showed that there was inflammation but again no cancer was found. The doctor concluded that Julius likely has lymphoma. I am baffled by this diagnosis because his bloodwork, the aspiration and what was collected from his nose did not show any cancerous growth or abnormality.
My question here is has anyone ever heard of something like this happening? Am I just being overly optimistic in thinking that a mistake could’ve been made here? How can all of those tests come back normal and yet the doctor based cancer on the ultrasound and x-ray and conclude that it’s lymphoma. Wouldn’t cancer show up in any of the bio samples that were collected? Any advice here it would be very much appreciated. View attachment 27799 View attachment 27800

 

[Brigitte Cowell]

I'm so sorry! Poor Julius and poor you. It's interesting that your vet diagnosed Julius with allergies, when my vet insists that there is little evidence that cats suffer from hayfever and respiratory allergies as commonly as we do. When they took that sample for cytology was that during a sedated rhinoscopy? I do see that they are suggesting doing one now so wonder if there had been one done and what did they see then?

I agree that it was a good idea to do the ultrasound and xray, and it seems that they are suggesting aspirating the kidneys and abdominal lymph nodes to test to properly diagnose. I don't see mention in the attachment of the aspirated lymph node, was it abdominal or near the nasal swelling?

I don't know if the vet you've seen is a specialist or not, although I think that that hospital chain is a specialty/emergency chain... but I think that they are making their best guess given the information they have at this time. I'm not the type to just accept that and tend to do the further testing to confirm diagnoses as too many times in my pet owning past (especially with the Savannahs) I've found that they ARE the rare one not to have what the symptoms point to. I had a cat that a whole email board of specialists agreed had FeLV, turn out to be the rare exception with all the symptoms and not the disease. She has some rare immune condition they cannot name, but have ruled out every one they do have a name for. Last year, both Baz and Missy seemed to show signs of gastrointestinal lymphoma... and if you went by the old testing, the biopsies said lymphoma. But we now have a new PCR based staining method for biopsies and for both of my babies we could rule it out and treat it as the antibiotic-responsive gastroenteropathy it seems to be. IBD is still on the table for one of my cats... but both of them could easily have been "diagnosed" as having lymphoma if I hadn't been stubborn.

 

[jcanulla]

Thank you so much for your reply!! It gave me a glimmer of hope!

The fluid from his nose was taken during the first visit- which he was sedated for but it was not a rhinoscopy because they noted via physical exam that he had enlarged kidneys at the same time and thought that assuming it’s cancer in the nose it’s likely spread to the kidneys, thus the recommendation for US/X-ray before doing an invasive rhino. They suspected that the fluid collected from his nose may not be lymphoma at first but some other cancer that just didn’t show on the test. The lymph node was also tested was near the abdomen during that same first visit.

I don’t disagree that there’s something wrong with him— there definitely is and we can see his enlarged kidneys. But again the test said it’s “consistent with cancer process” no mass was seen. Also the bump on his nose has disappeared almost completely— I don’t think a tumor can disappear within 3 days of prednisone.

We will likely be seeking a second opinion.

We’re also happy your kitties were further examined and your persistence paid off! Hopping for same result here.

 

[Brigitte Cowell]

Tumors can shrink with steroids, mainly when the tumor is causing a lot of inflammation...so I don't think that rules it out but you are right, there is reason to hope. Miracles DO happen and cats do recover when we think there is no way they can... Savannahs seem especially good at defying odds <3

My regular vet encourages second opinions especially when something is out of the ordinary...and this situation would qualify!

 

[SV Dad]

I have a cat with inflammatory bowel disease and lymphoma. We went to a specialist to confirm the diagnosis. It can be treated. He is doing well at 32 months post diagnosis.

 

[jcanulla]

That’s amazing! So happy for you guys. What is his treatment? They offered chemo to us but Julius is terrified of going to the vet and I can’t imagine putting him through that every day for three weeks. He throws up in the car ride there. And the treatment has crazy side effects too. Please let me know what you guys are doing. So far our boy is still with us, getting spoiled rotten. I can’t see his condition deteriorating in 1 week— which brings us to when they said he will probably be gone.

 

[SV Dad]

The treatment is chlorambucil 2mg, 3 times weekly for both the lymphoma and IBD. Prednisolone daily in various dosing, more if it appears the IBD is acting up, less when controlled. Famotidine or omperazole to cover for the GI upset of the prednisolone. The chemo is rather inexpensive fortunately ($30 per month). Mayhem is very good at taking his meds. He leads a very normal life and has done a fine job of training his niece and nephew, who just turned 3 last week. The avatar is Mayhem with the then 4month old kittens. His nephew is just shy of a North American Spotted Moose. He is 18 pounds lean.

 

[jcanulla]

Thank you so much for this!!! This is so helpful. We’re calling our vet tomorrow. I never realized we may be able to administer this at home. Nobody told us this was an option! Mayhem is adorable. As are his little companions! Enjoy them all, and thanks again