Good news and...uncertain news?

[kyrielle]

The uncertain news first:

Babe's biopsy results are in. No sign of cancer, but as I noted before, that doesn't mean it's not a lymphoma, because the prednisolone could have pushed that back down and obscured it. But it could also be the very unlikely, bizarre possibility of some lymphatic condition (there was definite signs of that, anyway), which could be autoimmune or infection-related. No way to tell at this point and no further diagnosis that can reasonably clarify it. We can either treat her for cancer she may not have, or continue and see what happens. That's an easy choice; the vet's recommendation is perfectly matched with my own gut feelings. She continues on the pred and we see how she does. If it is cancer, she'll probably start showing clinical signs again (not counting her vision, which never recovered; but the nasal discharge and/or eye discharge we saw before could return) within a couple weeks. If she's still fine after a couple weeks, we can begin to hope - and try tapering the pred to make sure we don't have her taking more than she actually needs. Whether she'll be able to stop altogether or will have to stay on some dose of it forever...who knows? If it IS cancer and comes back, we'll have to make a decision to treat or not to treat. That will depend on what they tell us, but I suspect it will be "palliative only" if it comes to that - I don't know for sure, as we haven't had the discussions in depth, but...most treatments for cancer that I am aware of don't sound like anything I'd want to put a cat through. But hopefully...hopefully, Babe has one of the weirdest cases they've seen in a while, and the pred will do it. I'm not sure what the odds are, but I don't suppose that really matters much. The odds were she had a fungal infection - 'til the tests came back negative. The odds were she had brain cancer - 'til the MRI and spinal tap came back clear for that. Those were the only two "likely" options at that point. Nasal cancer was a possibility only after the MRI, with a lymphoma being the most likely because it had responded to pred...but just because it's the "most likely" doesn't seem to mean much with this cat. I'm hoping it may be likely but it isn't what she has, that instead she has something else going on that will either remain okay after removing the medicine or remain controllable with the medicine, because the pred twice a day is very, very doable.

Good thoughts for her, please. That she is lucky, that she does better than the odds and is okay for a long time to come - the next two to three weeks will be important, mostly in judging whether she is that lucky. It doesn't look like she will get her sight back but she seems to do fine without it.

Babe is still happy, cuddly and purry. She asked to get up on my lap the other day when I was in my chair, and I scooped her up and she cuddled. Just now she's back on the bed on the floor, midway between Scott's chair and mine; earlier she was curled up between us as I napped and he read. She's still playful when teased with a toy (in fact, when she's lying there and not purring if I pet her, it's a good sign I should try the toy - I can no longer watch the dilation of her eyes for a mood cue but I can find others!).

The good news is much lesser, but I'm still happy; my latest Fantasy Bath shipment is here. Whew! You could smell that box from several feet off. Everything inside is fine, it's just that I ordered three pounds of the mango tango and it has a very strong scent. I'm happy, it got here. I could have used it last week, given the stresses, but I had other bath scenty things at the time and now I have my mango (and some new scents to try) so that's okay.

Comments

[grey-lady.livejournal.com]

I'm glad to hear that she's coping so well without her sight - her other senses must be serving her well. I wish her all the best of luck.

[kyrielle]

Thank you.

[katbyte.livejournal.com]

So glad to hear about the kitty.

Now, be very careful of the Pred. That is what caused all the major problems with BeBe and made her stomach bleed and she almost died a couple of months back. The consensus is that they gave her too much, but it is a tough medication. It is known as 'a wonder drug with bad side effects'

[kyrielle]

Yes, I know. But it seems to be the thing that's helping her, which makes the risks worthwhile. Plus she's been on it for a couple weeks or more now, so I think we're in the realm of an acceptable dose. We want to wait two weeks more because if it's cancer, it will probably come back in that time even on the same dose - if it doesn't, we can start fiddling to find the lowest dose that will work for her.

I actually have had a tiny pred prescription for years, on a "take as needed" basis. The warnings in humans are just as scary as those for animals. (High dosages or long periods of usage both up the risk - my prescription was a little nothing and not prone to the risks, since it was a single 10-mg pill on an as-needed basis. Right now, of course, I cannot take it at all! The risks for pregnancy are much higher and nastier, and just to control aggravating allergies is NOT worth it.)

So she'll have a month or a bit over a month on 5 mg/day, and then if she's still doing well we'll try a drop to 2.5 mg/day. I know the threshold for "serious" worry in a human is ongoing usage (over a month) at 40+ mg. I doubt the ratio in cats is identical, but Babe weights 13.5 pounds or so, so call it 4 mg as the risk level (inaccurate, but hey). In that case, she's in the risky zone for side effects right now but will be much better off if we can step back one layer (there are no guarantees with pred!).

So...we'll see. Given that either cancer or the lymphatic thing it otherwise might be could result in having to put her down, the cancer probably sooner rather than later, given its impact on her comfort and quality of life, and given the pred has made a difference - I think it's our best choice right now. The good news is, she's only one dose off from the taper-off (that is, if she didn't need it at all any more, she'd go from 5 mg to 2.5 mg a day, then to none). Fingers crossed that in a couple weeks she is still doing well and we can lower the dosage - and that she'll keep doing well then.

[canyoncat.livejournal.com]

That sounds encouraging. I will continue to send good thoughts as usual.

Has there been any further discussion on the vision? Any chance that may still improve?

[kyrielle]

No, there's been no more discussion of it. At this point, since they're taking wild guesses about what's going on and don't know exactly why the vision would be affected if it was cancer, I'd imagine no one has any idea. My guess would be that the answer is "probably not" but how can you be sure when you're not even sure of the diagnosis?

If it's cancer and did something to the optic nerve, that would make it less likely - and in any case the cancer will come back. If it's something else, it depends on what else and what it did, and they don't have a clue other than something lymphatic.

At this point, I'm a lot more interested in whether or not she'll be alive at the end of this year. I would love for her to get her vision back, but I'm assuming for the time being that she won't.

[canyoncat.livejournal.com]

I am hoping for "not cancer" since there is no sign of it yet. I am also hoping that she will get at least some of her vision back, though I don't think that is nearly as traumatic to animals as it is to humans. Animals are much better at coping with these things it seems.