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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 28425
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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Our cat is on chlorambucil, .21 mL daily, in addition to -12

Customer Question

Our cat is on chlorambucil, .21 mL daily, in addition to B-12 shots and prednisone. Having problems: blood in stool this morning; odd stools; lethargy; spotty appetite. Only symptom at the start was minor weight loss; tests showed low B-12. Decided to avoid biopsy, presume low-level lymphoma & treat that. But we're concerned about her condition. Can we skip doses of clorambucil until we can see her vet?
Submitted: 1 year ago.
Category: Cat Veterinary
Customer: replied 1 year ago.
Fuller version of the question: Our cat, Hailey, is on chemo for possible low-level lymphoma. We're concerned about the affect on her and wonder about the impact of stopping a medication. This morning, we found blood in her stool atop odd stools, lethargy, and spotty appetite.She is on chlorambucil, .21 mL daily, in addition to B-12 shots and prednisone.She is under the care of the Feline Health Center in Morristown, whom we quite like. The only symptom she had at the start of this was weight loss. With testing they found low B-12. So there were problems with absorption. The doctor said it was likely either lymphoma or low-level lymphoma; she presumed the latter and that led to this course of treatment. We wanted to avoid a biopsy.The cat is 15. Every visit to the vet's stresses her. We really do not want to take her to someplace new this weekend. But we are also concerned about her condition now.We also had to take her off painkillers for her arthritis for fear of the affect on her stomach. That might also have some impact.
Expert:  Dr. Michael Salkin replied 1 year ago.
Aloha! You're speaking with Dr. Michael Salkin
I'm sorry that your question wasn't answered in a timely manner. Yes, both chlorambucil and prednisolone should be stopped at this time until you can contact Hailey's vet. Chlorambucil's adverse effect profile includes gastrointestinal toxicity as evidenced by inappetence, vomiting, and diarrhea and persistent diarrhea may cause the hematochezia (blood in the stool) you've seen. Prednisolone can cause similar symptoms and so concomitant administration of these drugs is more likely to result in adverse effects. This is problematic, of course, because chemotherapeutic regimens usually include both drugs and so adding an antacid such a famotidine plus a gastrointestinal "bandage" such as sucralfate to Hailey's therapy may be indicated.
Please respond with further questions or concerns if you wish.
Expert:  Dr. Michael Salkin replied 1 year ago.
Hi Jeff,
I'm just following up on our conversation about your pet. How is everything going?
Dr. Michael Salkin