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petdrz
petdrz, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 7267
Experience:  Over 30 years of experience in caring for dogs and cats.
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I was informed by a vet hospital 2 days ago (that I was

Customer Question

Hi,
I was informed by a vet hospital 2 days ago (that I was referred to by my regular vet) that my 6 yr. old female cat most likely has lymphoma sarcoma. Tissue samples of her liver & nodes were not taken but they are very noticeably enlarged. She had pleural effusion & 150ml of fluid were removed from her chest cavity. It is clearly beginning to fill up with fluid again already.
My question is whether this could possibly be hepatic lipidosis brought on by something unknown as opposed to being brought on by lymphoma sarcoma. All of her symptoms seem related to HL. If she does have cancer I want to have my vet euthanize her so that she's not in anymore discomfort / pain but if it is HL I'd be willing to care for her at home in an attempt to help her recover.
Currently she is lethargic, jaundiced but is still eating & drinking (two 5.5ounce cans a day with encouragement from me - but I'm not really force feeding her - she eats & drinks a willingly) and even had fairly healthy looking feces this morning (first time in days that it's been like this). She also walks & she has bilirubin / pee accidents on floor.& is clearly uncomfortable with the fluid in her chest.
Her physical exam results: T=101.1F, P=200, R=50 MM=icterus, tacky CRT <2sec, BP= 110mmHg (systolic), Wt=3.78kgs, three enlarged mesenteric lymph nodes & hepatomegaly. Peritoneal & pleural effusion. Peripheral nodes normal.
Diagnostics: hypomagnesiumia (1.10), hyperglycemia (157), hyperlacetetemia (2.3), PCV=40%, TS=6.4.
Diagnosis: hepatomegaly with mediastinal & mesenteric lymphadenomegaly - most consistent with lymphosarcoma (lymphoma). Secondary pleural & peritoneal effusion.
We were given prednisone tablets. One every 24 hours.
Any thoughts?
Submitted: 1 year ago.
Category: Cat Veterinary
Customer: replied 1 year ago.
tacky CRT <2sec BP+110 mmHG (systolic) Wt.=3.78kgs.
Diagnostics: hypomagnesiumia (1.10), hyperglycemia (157), hyperlacetemia (2.3), PCV=40%, TS=6.4.
Diagnosis: Hepatomegaly with medistinal & mesenteric lymphadenomegaly - most consistent with lymph sarcoma. Secondary pleural effusion & peritoneal effusion.
150 ml. of pleural effusion was removed & she was given prednisone tablets (to be given once daily).I have an appointment with her normal vet tomorrow morning. I just want to make sure it's cancer & not something else more treatable. But her chest is clearly filling up with fluid again & is very uncomfortable.
Any thoughts?
Expert:  petdrz replied 1 year ago.

Hello and thanks for trusting me to help you and your pet today. I am a licensed veterinarian with over 25 years experience and would be happy work with you.

It sounds as if it is very possible that there is some degree of hepatic lipidosis and it is true that cats with HL often have an underlying cause that and it is not uncommon that the cause is not ever identified, but in her case, that seems very unlikely. The lethargy and jaundice cat certainly be explained by HL, but cats with HL alone do not have the other clinical findings such as enlarged nodes and pleural effusion. The enlarged liver is likely due to the lymphosarcoma and less likely due to HL, especially if she is eating. It usually takes days of anorexia for HL to develop.

If you wanted to have additional confirmation, a fine needle aspirate of the liver could be done. This is not as invasive as a biopsy and usually can be performed with a very light sedation (or in some cases, if the cat is lethargic, no sedation). Hepatic lipidosis is easy to diagnose with a needle aspirate and some cases of lymphosarcoma will also be confirmed with a needle aspirate. This may at least give you the assurance that you need to make your decision. Even if no abnormal lymphocytes were seen, if there was no evidence of HL on the needle aspirate, that would certainly keep cancer high on the list.

I hope that makes sense and is helpful. Please let me know if you have ANY other questions. My goal is to give you 100% satisfaction and if you are not yet satisfied, please reply so I can clarify for you.

My posted replies are for general education only and not meant as a diagnosis. Only after a thorough veterinary examination can a diagnosis for your pet be made and specific treatments be advised or medications be prescribed.

Dr Z

Customer: replied 1 year ago.
Hi,I should have clarified a bit better. We took our cat to our normal vet on Friday because she had clearly lost weight (turned out to be two pounds lost). We have two cats in our household & we believe that our other cat has been eating her food ( he wakes us up very early in the morning meowing for food so we usually get up and leave two bowls of food out for them. Our fear is that she perhaps wasn't hungry & he had been eating her food for sometime. She pretty much never cries or meows for food so we think we missed the clue that she wasn't eating. Once I realized that she was losing weight I began to sit with her throughout the day prompt her to eat again. She went gangbusters for the food & has been eating very well since I began encouraging her to. I believe that she could have had a period of not eating that we were unaware of.
My real question is....if it isn't cancer & is HL is there hope she could recover. I work from home so personally attending to her is not an issue.
Thanks again.
Expert:  petdrz replied 1 year ago.

I understand and I have seen HL develop in a cat who stopped eating because she didn't like the new food she was being offered and no one in the house noticed she was eating until her liver was then involved. So in answer to your question, if she didn't have cancer and only had HL, is there hope she could recover? Yes there is, but I think that it is highly unlikely there is not a significant disease process going on and cancer seems to be the strongest differential. I can't think of one other disease process that would lead to HL that would cause enlarged nodes and effusions in both chest an abdomen. Idiopathic (unknown cause) HL and other diseases that cause HL do not present with those findings. Of course, without a biopsy and histopath confirmation, one cannot say 100% that cancer is the cause, but as I have indicated, I can't think of any other condition that would lead to these findings. I am sorry.