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Dr. B.
Dr. B., Board Certified Veterinarian
Category: Veterinary
Satisfied Customers: 21466
Experience:  General practice veterinary surgeon with extensive experience in a wide range of species.
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I need advice on my cat. She has either ibd or lymphoma, but

Customer Question

Hi, I need advice on my cat. She has either ibd or lymphoma, but it's looking like lymphoma. She is steadily dropping weight.
JA: I'll do all I can to help. What is wrong with your cat?
Customer: She has had an ultrasound, but now they want a biopsy to confirm. I don't think she could make it thru a biopsy, and it's thousands of dollars. Isn't there a way that she can be treated with chemo from a blood test or something?
JA: Where does your cat seem to hurt?
Customer: She doesn't seem to hurt. Just not eating great and losing lots of weight.
JA: OK. No obvious pain. What is the cat's name?
Customer: Jasmine
JA: Is there anything else the Veterinarian should be aware of about Jasmine?
Customer: All blood work completely normal.
Submitted: 9 months ago.
Category: Veterinary
Expert:  Dr. B. replied 9 months ago.

Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you today.

Unfortunately, unless the cancer had spread into the bloodstream (which can happen in advanced lymphoma cases), a blood sample usually would not give us the answer we need to use chemotherapy. That said, if Jasmine isn't a candidate for a surgical biopsy, you can speak to your vet about their taking a fine needle aspiration of the gut guided by ultrasound. This tends to be less invasive (since we only need to use a light sedative plus its a needle poke as opposed to full surgery) and can help us determine which is present. Of course, there is a risk they could get a non-diagnostic sample but again its a less invasive option we could try to get an answer for her. And based on a lymphoma confirmation from that, full chemo could be started. Otherwise, in both cases (cancer or lymphoma), you could consider having her put onto steroids. These are very good at reducing inflammation from IBD but also steroids have a cytotoxic effect on some lymphoma cells. So, it is a treatment option if further invasive diagnostics aren't possible.

Overall, while you could have her vet check a blood smear for lymphoma cells, it isn't very likely we'd find them unless she had a very advanced cancer. Still it can be tried but I would suggest a fine needle aspiration guided by ultrasound as a compromise since it is much less invasive and could give us the answers we need to proceed with her treatment.

Kind regards,

Dr. B.

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Customer: replied 9 months ago.
Hi, She had the needle aspiration in October, and nothing showed up then. She has lost over a pound a month since. She has been on pred since the end of October, along with cerenia and mirtazapine. Also getting B12 injections. Do you have any other ideas on what we can do? I'm so desperate, and I just don't want to lose her!
Expert:  Dr. B. replied 9 months ago.

Hi again,

If the previous aspirate was non-diagnostic and they feel that her gut changes are progressing, then this would be the time to resample and perhaps have them take a few to give her the best chance of a diagnosis here. Otherwise, if she is deteriorating despite Pred, you need to have them review her dose and see if it can be increased. As well, if she is eating poorly, do make sure they have her on an antacid (since high doses of steroids can irritate the stomach and affect that) on top of those other treatments. Also if the Cerenia isn't enough, then a stronger option (ie Zofran) should be considered here.

Finally, even if she has a reduced food intake, we need to make sure she is getting as much nutrition as possible. So, consider using a calorie rich diet like Hill's A/D, Royal Canin Recovery, kitten food, Catsure, or Clinicare Canine/Feline Liquid Diet. All of these are calorically dense, so a little goes a long way nutrition-wise and the liquid ones can even be used in temporary feeding tubes if you wished to have one put in for her. And if she has any loose stools (as they often do), canned pumpkin, Kaolin, and OTC feline probiotics (ie Fortiflora, Benebac) would all be of aid in increasing digestion and reducing nutritional losses (thus reducing weight loss too).

Best wishes,

Dr. B.

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If you have any other questions, please ask me – I’ll be happy to respond.

**Please rate me by clicking on the **stars** at the top of the page as this is the only way the site credits me for helping you!: )

Expert:  Dr. B. replied 9 months ago.
Hi Christine,

I'm just following up on our conversation about your pet. How is everything going?

Dr. B.