chemotherapy

[Shannon's Mom]

Help, please! I have two cats and one has been diagnosed with Lymphoma. I have been reading about the effects of chemotherapy and the safety in administering it at home. I read I cannot touch the pills, the feces, urine or saliva of the pet with cancer. If this is true, then how would that impact on the second cat? Would I have to separate them? She would be taking the pill every other day so she would never be free of the chemo in her system. Could the second cat receive the chemo through his paws in litter or cleaning himself, or by eating from the same bowl, or wrestling as they often do? What kind of life is it for the cancer cat if it is locked alone in a room and we are unable even to pet it for fear of it licking us or biting us. I want to help one cat but fear jeopardizing the other. I can't bear the thought of never being able to cuddle her or love her or have her sleep in our bed. Can anyone tell me if you have dealt with this situation and how other family pets made out? I am agonizing over this.

[Tina B and crew]

Peg, I do think you are overthinking this a bit, but I'm sure Traci will have some good advice. In the mean time I found this:

Chemotherapy drugs are rarely excreted through your pet's skin; therefore it is not necessary that pets be isolated after treatment. For certain individuals (children, immunosuppressed or pregnant/nursing people), it is wise to avoid contact with your pet for 24-72 hours after chemotherapy administration. It is always wise to practice good hygiene, such as washing your hands after playing with or cleaning up after your pet and not allowing your pet to lick you on the face.

http://www1.vetmed.lsu.edu/VTHC/Shared% ... 43140.html

Don't jump to conclusions until you have all the info from the oncologist. Take a deep breath. Yes, you are agonizing and I totally understand. Please try to stay calm for Zoey's sake. She's going to pick up on your anxiousness over this. OK? We are here for you!!

[Shannon's Mom]

Thank you,Tina. I will try. I am given to panic attacks and want what is best for both cats. I just fear Pumpkin cleaning his paws after stepping in the litter if I'm not right there to grab her feces or urine. He may ingest the run off chemo from her. What if she regurgitates and he gets into it? He will eat anything! This would be a cinch with only one cat but two makes me nervous. Thank you for the link. I will check it out.

[Traci]

Peg, try not to worry.

Talk to the onco about the clearance time of the chlorambucil, I believe it is 12 hours - so, within those 12 hours after giving a chlorambucil tablet, you would want to be sure you or someone in the home is available to keep the litterbox scooped (urine and feces) impeccably.

You do not have to be seperated from Zoey as she is on treatment, and she does not need to be seperated from you or Pumpkin. You only need to wear gloves when giving the tablets, and when scooping the litterbox, or, when cleaning vomitis if she vomits. You can get a box or two of disposable latex gloves at almost any petstore online (Fosters and Smith, I think, some others, look in the medical care sections for pets - also ask if your vet has an extra box or two on hand they can give you, or you can buy at cost). Dispose of the gloves immediately after each use, and of any cleaning materials like paper towels, etc. Disposal only requires you put in a trash bag and seal, and taken to your outside trash bin. Even after removing the disposable gloves, then wash your hands, including after scooping litterboxes or if cleaning vomitis, use only regular hand soap, or dishwash soap, do NOT use antibacterial hand soaps.

It should be fine for the cats to share the food/water dishes, but if you're overly concerned, if you see Zoey drinking in the dish, when she's done, just rinse out the dish and refill with fresh water, I do not believe you have to be too concerned about this.

Do NOT allow Pumpkin to get near any vomitis that Zoey may produce. Clean it up quickly with soap and water (and again, wear disposable gloves when doing so).

While chlorambucil does have side effects like most other chemo agents, the side effects are not too common. IF any side effects are noticed by you, contact your vet immediately. Your onco or your primary vet will give you a list of side effects to watch for, and be mindful that for some cats, the dosing may need to be adjusted, IF they are experiencing a side effect. Example, an every other day dose might be changed to an every third day dose, or 3-4 times a week, or some other schedule. It is important that you notify your vet immediately if you notice any side effect or if Zoey does not seem to be feeling good. Also, you will have to be prepared for regular bloodwork (CBC) during chemo, to ensure immunosupression is not a serious problem, and to gauge if the dose is correct and working.

It may help to be prepared in advance and ask your vet to send home with you some anti-nausea medication like cerenia, which can most likely be given a short time prior to a chlorambucil administration.

You can pet, hold, hug and even kiss Zoey, just try to avoid her saliva directly after an administration of chlorambucil. If she licks your skin, wash with soap and water. Pumpkin and Zoey should be allowed to play together, it should be fine, but if Zoey is a biter with Pumpkin, at least allow a few hours after administration of chlorambucil before allowing rough play - you might want to run that by your onco and your primary vet for a more definitive answer, but I think they should be fine.

Try not to worry, the fears are only there because in the medical field, there is little documented about the risks between humans and pets and the pet's chemo, so doctors just want to practice over-caution as opposed to no caution, it's just good practice. Example, we don't want to touch chemo agents with un-gloved hands because they are cytotoxic and can enter through the skin, just normal precautions to take. In the clinic, we take many many more precautions when mixing, preparing, administering (intravenous, etc) because the situations are different.

[Shannon's Mom]

Thank you, Traci,

That helps a lot. If Zoey is a candidate for chemo, I will have trouble giving it to her. I was just giving her the prednisolone and she got her hind legs out of the towel, got a back nail on my eye and tore the corner of my eye open. She is not as good as Shannon was with her meds, that's for sure. I don't know how much of the pred she actually got. she will certainly be a handful if we get that far. I do appreciate your input. Now I know why I only had one cat at a time!

[Traci]

Peg, tell your onco or primary vet you're concerned about Zoey being anxious and fighting pill administration - they can give you additional tips for giving her the meds.

I kneel on the floor, put kitty between my legs, and bring legs together a little so they cannot escape (not too tight, just enough they cannot get away) - they are facing away from me. Then I use my left hand to hold up kitty's chin slightly, insert pill with right hand, close mouth and keep holding chin up slightly and gently rub neck to get kitty to swallow. Then release kitty.

[Shannon's Mom]

I will gve that a try. I wrap her in a towel like I did Shannon but Shannon never fought me. Zoey is very skittish and is so thin I am afraid to hold her too tightly. That gives her the way to wiggle loose. I think I will try it your way in the bathroom. There is less room for her to run and I can close the door. It's been over two years since Shannon left me so I am out of practice.

[Traci]

It just depends on the cat - some of my cats I can give meds to on the countertop with little effort, others I have to put between my knees on the floor, as described above. Just think of it as wedging them between your legs, almost sitting on their rear body, but you're not, you're just wedging them against you so they cannot escape.

[Tina B and crew]

I usually put Doc on the bed, with a soft blanket under him using the method Traci described. It's easier on my knees for one and I feel less like I'm squishing him. He doesn't try to escape but he does chomp so I use a pill popper. His big issue is the fact that he is a master at making it look like he swallowed the pill and then when I let him go he spits it out.

[Shannon's Mom]

I usually put Doc on the bed, with a soft blanket under him using the method Traci described. It's easier on my knees for one and I feel less like I'm squishing him. He doesn't try to escape but he does chomp so I use a pill popper. His big issue is the fact that he is a master at making it look like he swallowed the pill and then when I let him go he spits it out.

Poor Zoey just gags and then runs under the bed. Shannon could roll them out the side of her mouth if you didn't watch her. But she was so easy compared to Zoey. I tried it Traci's way tonight in the bathroom and had a little better control over her.