Gastric Lymphoma and Chemo
-
LoriC
Gastric Lymphoma and Chemo
My kitty was just diagnosed with gastric lymphoma and we have decided to begin chemo. So far she is doing extremely well. Just wondering if anyone else out there who has been through chemo for lymphoma can give me some idea of what to expect. The vet said it is often like a roller coaster ride. Right now everything seems to be going well. Casey did extremely well during and after surgery and so far has handled the chemo very well. Thanks!
Lori, you've started already? Do you know what protocol your vet is using?
My Cayci had b-cell (plasma cell) lymphoma, (not intestinal or gastric), and we treated with the COP protocol (cytoxan/oncovin/prednisone aka cyclophosphamide/vincristine/pred)...we were going to add adriamycin at week 6 but unfortunately, Cayci developed complications and we had to discontinue chemo.
I wanted to list a few helpful hints for you as you persue chemo and what to expect,...keeping in mind that each kitty reacts differently, and that complications can develop, but most generally tolerate chemo fairly well.
1) Be sure to get a CBC prior to every chemo session (if neutropenia is a concern, or low platelets, may need to halt chemo for a week, then recheck CBC before proceeding)
2) Be sure you are on a schedule that allows for direct observation in the clinic after a chemo sesssion. Your vet will monitor her IV, and for any signs of skin hematoma or skin necrosis (rare, but can occur with chemo agents at IV injection site). I would recommend leaving her at the clinic for observation for at least 2-4 hours post chemo, then taking her home, and monitor her for signs of vomiting or lethargy (in which case your vet will direct you further)
3) Check Casey's weight EVERY time you take her in for a chemo session, very important so that you know whether or not additional dietary concerns may need to be met
4) Discuss with your vet a dietary approach tailored to Casey's needs. Some kitties may suffer vomiting or diarrhea during chemo treatment, so for this reason, ensure that you have on hand a correct diet you can force feed should it ever become necessary. Because Casey is diagnosed with gastric lymphoma, you might fair better with a bland diet such as I/D or P/D, but if she is tolerating food well, no vomiting or nausea, then her regular normal diet may suffice. I always keep on hand a few cans of A/D, Nutrical, baby food (nothing with onion or garlic, a no-no for cats), as well as Laxatone for any constipation problems, and metamucil for any diarrheal problems, your vet can advise you accordingly if these problems ever develop.
5) Be sure to keep a copy of the protocol schedule and a log of events. The schedule ensures you won't miss a chemo appt and can get your CBC done prior. The log helps to record: medications given outside of chemo (like pred), food amounts eaten, recording her attitude and behavior, appetite increases vs decreases, urination and bowel habits, recording any adverse effects during medication or chemo, etc. Should Casey ever develop problems, you can quickly go over your log and see potential problems to correct before they get out of hand.
6) Discuss with your vet about medications given outside of chemo. Prednisone, for example, is often required to be adjusted or tapered according to her CBC or response to chemo, etc. Never adjust pred on your own, ever, for it is likely to cause severe adverse effects. Your vet will adjust or taper accordingly. Other medications should be discussed with your vet: reglan for vomiting or nausea (can be given by injection for immediate relief or oral tabs/elixor for maintenance), cyproheptadine for appetite stimulant, sucralfate for gastric ulcers if applicable, and other supplemental care such as diet, laxatives if necessary, etc. Note: Ensure that your vet is available to you after hours in the event you might need an emergency medication, or if you need to discuss a potential side effect that cannot wait until your clinic's normal business hours. Always best to discuss these things so you know in advance what to expect.
7) Regarding medications, if Casey requires them at home on a maintenance schedule, ask where appropriate if most of them can be compounded into an elixor (oral suspension). Because most cats dislike the bitterness of tablets, ask for suspensions instead if possible. This reduces a major stress in the treatment. Because some kitties require more than one medication daily, it helps to have oral soultions rather than tablets, because fighting your kitty to give a tablet can cause them undue stress.
8 ) The following signs/symptoms necessitate immediate contact to your vet:
vomiting, especially directly after a chemo session, anorexia, diarrhea or constipation, blood in urine or stool, increase/decrease in drinking (pred can increase appetite and drinking, so take that into consideration, but if excessive, contact vet to rule out dehydration, etc), panting, lethargy, signs of brusing or darkened area near IV injection site after chemo session
The following site is an excellent read to help you with supportive home care...
Pets With Cancer/Supportive Care ...use the links directly under the title to navigate care tips.
Hope this helps, hang in there and kiss Casey for me......
My Cayci had b-cell (plasma cell) lymphoma, (not intestinal or gastric), and we treated with the COP protocol (cytoxan/oncovin/prednisone aka cyclophosphamide/vincristine/pred)...we were going to add adriamycin at week 6 but unfortunately, Cayci developed complications and we had to discontinue chemo.
I wanted to list a few helpful hints for you as you persue chemo and what to expect,...keeping in mind that each kitty reacts differently, and that complications can develop, but most generally tolerate chemo fairly well.
1) Be sure to get a CBC prior to every chemo session (if neutropenia is a concern, or low platelets, may need to halt chemo for a week, then recheck CBC before proceeding)
2) Be sure you are on a schedule that allows for direct observation in the clinic after a chemo sesssion. Your vet will monitor her IV, and for any signs of skin hematoma or skin necrosis (rare, but can occur with chemo agents at IV injection site). I would recommend leaving her at the clinic for observation for at least 2-4 hours post chemo, then taking her home, and monitor her for signs of vomiting or lethargy (in which case your vet will direct you further)
3) Check Casey's weight EVERY time you take her in for a chemo session, very important so that you know whether or not additional dietary concerns may need to be met
4) Discuss with your vet a dietary approach tailored to Casey's needs. Some kitties may suffer vomiting or diarrhea during chemo treatment, so for this reason, ensure that you have on hand a correct diet you can force feed should it ever become necessary. Because Casey is diagnosed with gastric lymphoma, you might fair better with a bland diet such as I/D or P/D, but if she is tolerating food well, no vomiting or nausea, then her regular normal diet may suffice. I always keep on hand a few cans of A/D, Nutrical, baby food (nothing with onion or garlic, a no-no for cats), as well as Laxatone for any constipation problems, and metamucil for any diarrheal problems, your vet can advise you accordingly if these problems ever develop.
5) Be sure to keep a copy of the protocol schedule and a log of events. The schedule ensures you won't miss a chemo appt and can get your CBC done prior. The log helps to record: medications given outside of chemo (like pred), food amounts eaten, recording her attitude and behavior, appetite increases vs decreases, urination and bowel habits, recording any adverse effects during medication or chemo, etc. Should Casey ever develop problems, you can quickly go over your log and see potential problems to correct before they get out of hand.
6) Discuss with your vet about medications given outside of chemo. Prednisone, for example, is often required to be adjusted or tapered according to her CBC or response to chemo, etc. Never adjust pred on your own, ever, for it is likely to cause severe adverse effects. Your vet will adjust or taper accordingly. Other medications should be discussed with your vet: reglan for vomiting or nausea (can be given by injection for immediate relief or oral tabs/elixor for maintenance), cyproheptadine for appetite stimulant, sucralfate for gastric ulcers if applicable, and other supplemental care such as diet, laxatives if necessary, etc. Note: Ensure that your vet is available to you after hours in the event you might need an emergency medication, or if you need to discuss a potential side effect that cannot wait until your clinic's normal business hours. Always best to discuss these things so you know in advance what to expect.
7) Regarding medications, if Casey requires them at home on a maintenance schedule, ask where appropriate if most of them can be compounded into an elixor (oral suspension). Because most cats dislike the bitterness of tablets, ask for suspensions instead if possible. This reduces a major stress in the treatment. Because some kitties require more than one medication daily, it helps to have oral soultions rather than tablets, because fighting your kitty to give a tablet can cause them undue stress.
8 ) The following signs/symptoms necessitate immediate contact to your vet:
vomiting, especially directly after a chemo session, anorexia, diarrhea or constipation, blood in urine or stool, increase/decrease in drinking (pred can increase appetite and drinking, so take that into consideration, but if excessive, contact vet to rule out dehydration, etc), panting, lethargy, signs of brusing or darkened area near IV injection site after chemo session
The following site is an excellent read to help you with supportive home care...
Pets With Cancer/Supportive Care ...use the links directly under the title to navigate care tips.
Hope this helps, hang in there and kiss Casey for me......
..........Traci
-
LoriC
Re: Gastric Lymphoma and Chemo
Traci, got your list. WOW, thanks for all the info. Fortunately, as I went down your list I was able to say "yes, we're doing that" to most of them. I will try to be succinct in responding.
They are using the Univ. of Wisc. protocol and yes we've started already.
1.) Yes, blood work is being done specifically for the reasons you gave.
2.) Yes, she does stay there for a time after each treatment
3.) Yes, they are recording her weight each visit and it prints on my
receipt so I also have the info.
4.) So far, no adverse signs of any kind....she has been very active and
very affectionate and has been eating really well. Normal litter box
habits.
5.) Yes, I've already started a log. I went through a much different illness
with Casey's sister 2 yrs. ago and found it helped tremedously
6.) Yes, we just started the pred. also and do have a plan to taper off to
lower doses.
7.) Right now we are giving pills for both the pred. and her atenolol.
will ask about oral suspensions. Sounds easier.
8.) We are being given documents about each of the chemo treatments which
explain all aspects of the drug, including
They are using the Univ. of Wisc. protocol and yes we've started already.
1.) Yes, blood work is being done specifically for the reasons you gave.
2.) Yes, she does stay there for a time after each treatment
3.) Yes, they are recording her weight each visit and it prints on my
receipt so I also have the info.
4.) So far, no adverse signs of any kind....she has been very active and
very affectionate and has been eating really well. Normal litter box
habits.
5.) Yes, I've already started a log. I went through a much different illness
with Casey's sister 2 yrs. ago and found it helped tremedously
6.) Yes, we just started the pred. also and do have a plan to taper off to
lower doses.
7.) Right now we are giving pills for both the pred. and her atenolol.
will ask about oral suspensions. Sounds easier.
8.) We are being given documents about each of the chemo treatments which
explain all aspects of the drug, including
-
LoriC
Re: Gastric Lymphoma and Chemo
sorry about that
anyway, the documents explain how the drug is used, how it works and possible side effects.
Looks like we're doing all the right things and so far, she's done well.
Keeping our fingers (and paws) crossed and saying lot of prayers.
Thanks again!
anyway, the documents explain how the drug is used, how it works and possible side effects.
Looks like we're doing all the right things and so far, she's done well.
Keeping our fingers (and paws) crossed and saying lot of prayers.
Thanks again!