Cat Lymphoma: Symptoms, Prognosis, and Treatment for Lymphosarcoma

Cat lymphoma - symptoms and prognosis

You just got back with your cat from the vet. You are scared and you do not want to believe the words you heard from him:

"Your the cat has lymphoma

…

"

Your head is confused, you feel devastated and completely helpless. You wonder - what now? You have a lot of questions, a lot of doubts - the diagnosis fell on you like a bolt from the blue.

In this article you will learn what lymphoma is and what are its symptoms and prognosis for a cat with lymphoma. I also explain which cats are predisposed to cancer and how to deal with a pet when lymphoma is diagnosed.

In the clinic, you were not able to approach the subject matter-of-factly, to ask about everything; only now, as your emotions slowly fade away, do you begin to feel the frightening, hopeless truth

…

But are you sure? Does this disease really have to mean a sentence??

I will help you, dear reader, to get used to this undoubtedly an incurable disease that is lymphoma. I will guide you through the maze of questions and complexities faced by the caretakers of cats suffering from lymphoma. I will shed some light not only on the disease as such, but also on the issues that accompany it, and which are often downplayed or pushed to the background.

Belong to them:

• treatment of an oncology cat at home,
• diet and nutrition of a cat with lymphoma,
• precautions for chemotherapy.

• What is cat lymphoma?
• Is it really lymphosarcoma?
• Anatomical form of lymphoma
  • Cutaneous lymphoma in a cat
• My cat has lymphoma
• Chemotherapy
• What else could happen? What do I have to reckon with?
• What my cat should eat, or diet for bowel lymphoma
• Can I let the cat outside?
• Does the lymphoma hurt and my cat suffers?
• Is cat lymphoma curable?
• Is it worth fighting for?

What is cat lymphoma?

Lymphoma (Lymphoma, lymphosarcoma, LSA) is a malignant tumor of the cat. One of the most common in this species, it accounts for 50-90% of all hematopoietic tumors.

Lymphoma can affect cats of any age, but most often it affects young adult cats (about 2-5 years old) and older cats (about 6-12 years old). There are also cat breeds with an increased risk of developing the disease - these are Siamese and other oriental breeds.

Is it really lymphosarcoma?

Okay, we have a strong suspicion of lymphoma. Symptoms, the results of a clinical examination, imaging diagnostics, and blood tests (morphology) and urine inevitably suggest that lymphoma should be included in the differential diagnosis.

What will the veterinarian do to confirm or rule out the disease?

1. He will perform a biopsy of enlarged lymph nodes and / or a suspicious organ for a Pap test. It is worth noting that in cats, generalized or regional enlargement of the mesenteric lymph nodes is relatively rare in cats. Sometimes the cytological picture is not clear and it is very easy to get a false positive. Therefore, the most reliable diagnosis is provided by the histopathological examination.
2. Histopathological examination (often in tandem with immunohistochemical examination) of a tissue section. Histopathology will not only finally confirm or exclude the presence of lymphoma, but also allow to determine whether we are dealing with low-grade or high-grade lymphoma, and the immunohistochemical test will answer the question with which specific a type of lymphosarcoma we are dealing (e.g. derived from T or B cells).

Cat ultrasound imaging diagnosis

The selection of the appropriate method of diagnosis and collection of material for examination depends on the type and location of the lymphoma:

• If nasal lymphoma is suspected - diagnostic imaging:
  • x-ray,
  • computed tomography,
  • magnetic resonance imaging),
  • rhinoscopy,
  • rinsing the nasal cavity,
  • brush biopsy,
  • taking smears from the surface of the tumor and impression preparations.
• In cutaneous lymphoma - biopsy.
• With lymphoma of the lung, trachea - bronchoscopy.
• Gastrointestinal lymphoma - several methods are applicable here: percutaneous fine-needle aspiration or ultrasound-guided core-needle biopsy. Often, however, a diagnostic laparotomy is necessary, during which the doctor takes samples from suspicious lesions. Endoscopic examination (e.g. gastroscopy, colonoscopy) is very useful, but it is not always possible to collect the right amount of material with this method.
• Mediastinal lymphoma:
  • chest x-ray examination,
  • cytology or histopathology of the thoracic fluid or tumor material.
• Renal lymphoma - ultrasound examination of the kidneys combined with fine-needle aspiration biopsy
• Nervous form of lymphoma:
  • examination of the cerebrospinal fluid,
  • myelographic examination,
  • computed tomography,
  • magnetic resonance imaging.

Factors predisposing to lymphoma in a cat

1. Infection with feline leukemia virus - FeLV - causes a 62-fold increase in the risk of developing the disease. Lymphomas in cats developing due to infection with FeLV are most often located in the mediastinum, spinal cord, eyeball, gastrointestinal tract, and also take the form of multifocal. The disease is usually diagnosed at a young age. Currently, due to the growing awareness of pet owners and widespread vaccination, the number of cases of leukemia-related lymphoma is much lower than a few years ago.
2. Infection with feline immunodeficiency virus (FIV), other diseases associated with decreased immunity, as well as long-term immunosuppressive therapy - play an indirect role in the development of lymphoma. Infection with FIV contributes to 5-6 fold increased risk of developing lymphosarcoma in cats. The most common accompanying forms of FIV are gastrointestinal and extra-nodal (especially in the kidneys and liver). Attention! Simultaneous infection with FeLV and FIV increases the risk of the disease up to 77 times compared to healthy, uninfected cats.
3. Chronic inflammation of the lining of the nose, gut (IBD) and vaccine reactions may be associated with a higher risk, although the link is unclear.
4. Tobacco smoke. The risk of developing lymphoma in passive feline smokers more than doubled.
5. Genetic predisposition (oriental races).

Lymphoma is a disease of the lymphoid system, in the course of which there is neoplastic growth within soft tissues.

These include, among others:

• lymph nodes,
• marrow,
• organs of the body cavity.

Since lymphatic cells are present throughout the body, cancer can manifest anywhere. Hence the enormous variety of forms of lymphoma.

Anatomical form of lymphoma

Food form of lymphoma in cats

Food form of lymphoma is a neoplastic hyperplasia within the small intestine, less often the stomach, and the least frequently Lymphoma of the large intestine is manifested.

Clinical symptoms of lymphoma intestinal tract most often take the form of:

• chronic vomiting,
• diarrhea,
• lack of appetite,

Along with them, there is weight loss, weakness, enlargement of the outline of the abdominal integuments. Sometimes there is fresh blood in the stool, painful or unproductive urgency against the stools.

Mediastinal form of lymphoma in cats

This form of lymphoma in cats was once diagnosed most often. Currently, due to widespread vaccination against feline viral leukemia, the number of diagnosed cases of mediastinal lymphoma is systematically decreasing. The average age of cats with mediastinal lymphoma is less than 5 years; Oriental cats, especially Siamese, are believed to be ill more often. The neoplastic process is located in the mediastinum, especially in the lymph nodes (enlarged lymph nodes can be observed in a cat).

The symptoms of the respiratory system are dominant:

• cough,
• dyspnoea,
• the presence of fluid in the chest cavity,
• diffuse swelling of the head, neck and thoracic limbs,
• weakness.

Possible increased thirst and urination, including vomiting.

Multifocal and nodal form of lymphosarcoma in cats

This form of lymphoma is characterized by the generalization of the neoplastic process into many organs and tissues, usually:

• lymph nodes of the body cavities,
• liver,
• digestive tract,
• kidney,
• spleen,
• bone marrow.

Lymphadenopathy is rarely observed (4-10% of cases). In progress multifocal form of lymphoma there is an enlargement of a single node or (less often) a group of nodes in the head and neck, usually it is a submandibular node or cervical nodes.

Extranodal form of lymphoma in cats

A form of lymphoma confined to a single organ or specific area of ​​the body. Rarely diagnosed as the process generalizes quickly.

Kidney lymphoma in a cat

About 1/3 of lymphomas in cats originate in the kidneys and quite often the process spreads to the central nervous system. There is no breed predilection and the average age of cats with this form is approximately 7 years. In many cases it develops on the basis of feline viral leukemia (FeLV).

Clinical symptoms of renal lymphoma in cats result from renal failure, so the following is observed:

• weakness or lack of appetite,
• apathy,
• vomiting,
• increased thirst,
• polyuria,
• sometimes anuria,
• weight loss,
• features of dehydration,
• characteristic, ammoniacal smell from the mouth.

Intranasal form of lymphoma

Cat nasal lymphoma is a neoplastic growth within the nasal cavity, paranasal sinuses, sometimes extending to the throat area.

This character shows:

• dyspnoea,
• respiratory sounds,
• sneezing,
• purulent, haemorrhagic-purulent, or serous discharge from the nasal cavity (usually one-sided),
• excessive tearing or serous-purulent discharge from the eyes;

In advanced stages of lymphoma, facial deformity and exophthalmos can be observed.

Eye lymphoma in a kitten

Ophthalmic symptoms may appear both in the case of generalized lymphoma and in an isolated location.

The following are in the foreground:

• changes in pupil size and shape,
• strokes and abnormalities in the anterior chamber of the eye,
• cataract.

Symptoms such as:

• exophthalmia,
• drying out and changes in the cornea (inability to close the eyelids),
• thickening of the third eyelid,
• third eyelid cartilage dislocation and egg prolapse.

The nervous form of lymphoma

Lymphoma affects the central and / or peripheral nervous system. The nervous form of lymphoma it most often affects young cats, around 2 years of age.

The neurological symptoms include:

• seizures,
• Horner's syndrome,
• incoherence of movements,
• lack of appetite,
• disturbances of consciousness,
• aggression,
• paresis,
• paralysis.

Cutaneous lymphoma in a cat

In feline cutaneous lymphoma, the lesions may be limited or generalized, usually as erythematous nodules or plaques. It is accompanied by severe itching, sometimes symptoms of increased thirst and polyuria.

My cat has lymphoma

Treatment of cat lymphoma

Treatment of cat lymphoma is mainly based on multi-drug chemotherapy. In some embodiments of the lymphoma, surgery to remove the neoplastic lesion and / or radiation therapy may be used. Radiation therapy in Poland is unfortunately unavailable, and surgery is only applicable to certain types of lesions, so in the remainder of this article I will focus on the most commonly used form of treatment, i.e. chemotherapy for cats.

Its purpose is not to cure the cancer. Lymphoma always comes back

…

sooner or later, but it is an incurable disease.

The goal of any therapy, whether it is chemotherapy or radiotherapy, or surgery, or all these possibilities combined, is always to keep the patient as comfortable as possible with the greatest possible inhibition of tumor growth. Therefore, only on the basis of the results of all examinations, the patient's condition and the possibilities (time, financial or other) of the owner, the veterinarian - oncologist will select the appropriate procedure. And here a whole range of diagnostic and treatment options opens up, applicable to a specific form of lymphoma, its degree of malignancy, concomitant diseases and the patient's clinical condition.

Treatment for cat lymphoma also includes:

• strengthening therapy,
• combating secondary bacterial infections,
• careful patient care,
• properly selected diet.

Chemotherapy

Chemotherapy for cats consists in cyclic and regular administration of highly cytotoxic preparations to the kitten.

The drugs most commonly used in cats are:

• vincristine,
• cyclophosphamide,
• doxorubicin,
• methotrexate,
• L-asparaginase,
• lomustine,
• prednisone.

Chemotherapy substances are designed to destroy cancer cells; unfortunately, they have little or no selective effect. Drugs used in chemotherapy, through their actions, destroy cells that divide quickly (i.e. cancer cells, bone marrow cells and cells of the gastrointestinal tract). Hence, most of the side effects and side effects of chemotherapy are related to a reduction in the population of white and / or red blood cells and gastrointestinal problems (loss of appetite, vomiting, diarrhea).

Below is a video where you can see what it looks like chemotherapy in a cat with lymphoma.

Watch Ellie Get Chemo For Lymphoma
Watch this video on YouTube

Side effects of chemotherapy

They are there and you have to be prepared for them. Quite often, after administering chemicals, the following occur:

• lack of appetite,
• transient diarrhea,
• vomiting.

Depending on the medications, hematuria or symptoms of general intoxication may appear. This may be related to the cytostatics themselves, but may also be associated with the so-called tumor lysis syndrome. This is because after the cancer cells die, their toxins are massively released into the bloodstream - which can result in a temporary discomfort. Whenever deciding to start chemotherapy in a cat, it is worth contacting the attending physician and asking about possible help in crisis moments.

The oncologist doesn't just administer the chemistry. He also has to take into account the side effects of drugs, he must skillfully select the components of the therapy and monitor the entire duration of the therapy in order to properly react in a crisis moment.

What can we expect from the administration of chemicals?

1. Weakness.
2. Temporary loss of appetite, temporary vomiting or diarrhea.
3. Often there is a decrease in immunity.
4. Cats tend not to lose their hair, however they always lose sensory hair.

How much does chemotherapy cost in a cat?

Is chemotherapy for a cat expensive?

Yes.

Both financially, temporarily and emotionally. Cancer medications for cats are not cheap. In addition, additional costs related to visits to the clinic, tests, supplements, and diet should be taken into account

…

Despite the existence of several different therapeutic schemes, which also take into account minimizing costs, many owners decide not to fight precisely because of the price. Time required for visits, commuting to the clinic administering chemicals, unforeseen situations where the owner has to, for example,. take a vacation so as not to leave your pet alone - this is also a price to pay.

And finally, the stress associated with dealing with a cat. It cannot be denied that many caregivers are very affected by the illness of their charges. Cat lymphoma is a disease the whole family, its effects are felt by everyone closely related to our patient.

For some cat keepers, the cost is indeed prohibitive. Others consciously choose to bear it and, in most cases, do not regret it. They enjoy each day, they slowly get used to the inevitable and - as many of them later say - thanks to this decision they learn the true and conscious joy of communing with an animal.

What to watch out for with chemicals and how to deal with a cat?

This is a very important question.

Remember that chemotherapy is not limited to "pumping" the drug into the patient's bloodstream. They are also metabolites that are removed along with the feces, urine, secretions and excretions of our pet, and which, in most cases, are also biologically active. Due to the different half-lives of individual cytostatics, the periods of excretion of the poison from the body are also different. During this period, special care and hygiene should be exercised. I mean avoiding direct contact with urine, faeces, saliva and possible vomit. All "surprises" left by a sick kitten should be cleaned with gloves.

Drugs used in oncology are very dangerous for children and pregnant women, so it is always worth discussing the issue of additional preventive measures with the oncologist. Sometimes a decision is even made to refrain from administering chemicals, which is perfectly understandable. As a rule, this period of increased vigilance lasts about 2-4 days, but it is highly dependent on the type of medication the kitten receives.

What else could happen? What do I have to reckon with?

I mentioned the side effects and the threat to the environment. It may also happen that the patient does not respond to the treatment or chemotherapy additionally weakens him. This happens rarely, but remember that our goal is to improve our friend's comfort and quality of life, not to make him feel worse. All decisions and steps are always discussed in detail with the pet's guardian, because he knows his friend best.

It also happens, fortunately, very rarely, that the so-called. extravasation of the drug beyond the vein. This results in serious changes to the skin and subcutaneous tissue, including necrosis.

What my cat should eat, or diet for bowel lymphoma

Anything she wants to do. Sounds ridiculous? Let me explain.

Of course, there are special diets for cancer patients. Cancer loves sugar, and some B vitamins, folate and iron are thought to essentially "nourish" the cancer. Therefore, in these types of diets, the addition of certain vitamins is either highly minimized or completely excluded. In oncology, special dietary supplements are used, containing a lot of antioxidants as well as vitamins and minerals to strengthen the patient, not lymphoma. And if the purring patient does not mind eating this type of food, I strongly encourage you. It spectacularly supports the body in fighting cancer and tolerating poison. However, with many cats, the appetite may be severely impaired and they become picky. In such situations, it is most important that they just eat. We often have to adapt our nutrition to co-occurring diseases or co-infections. In case of kidney lymphoma for example, a diet that strongly restricts protein and phosphorus is irreplaceable. If you want to learn more about feeding your cat in cancer, I encourage you to read the article "How to Feed Your Dog and Cat With Cancer? ".

Can I let the cat outside?

Better not for several reasons:

1. The oncological patient may be weakened, more exposed to all kinds of infections (the already mentioned weakening of immunity).
2. Remember that the therapy does not stop at the clinic. In most cases, drugs and supplements are administered at home by the owners at certain times of the day. If our kitten is forgotten "in the city " and comes back after a few or several hours, it may affect his health and fundamentally change the effect of the therapy.
3. When our pet is not at home, we will not be able to observe possible diarrhea, vomiting or hematuria
   …

   We won't be able to tell the doctor if everything is going according to plan. And that could be fatal neglect.

4. And one of the most important factors why we should completely domesticate our cat. A large percentage feline lymphoma patients it is also carriers feline leukemia. This nasty virus is spreading like a plague in the cat population. If we are aware that our pet fell ill with lymphoma, most likely due to this disease, let's spare it from other kittens.

You will surely say, my dear reader:

But why should my cat stay at home? After all, he was supposed to have a comfortable life, and for him it is comfortable to go out every day! He will not stay home, he will tire!

Yes, you are partly right.

It is not fair that we deny him pleasure. However, taking into account the possible effects, I can categorically say that it will actually get better. Management of a cat suffering from lymphoma is not easy. It requires patience, consistency and many sacrifices not only on the part of the owner, but also the cat himself - after all, we deprive him of one of his basic needs: freedom. However, by focusing on the safety and greater effectiveness of therapy on the one hand, as well as minimizing the risk of spreading a very dangerous and tragic infectious disease for cats, and on the other hand, the momentary pleasure and psychological comfort of our patient - what do you think will prevail??

Does the lymphoma hurt and my cat suffers?

Yes and no.

Again, it depends on the form, location and clinical condition of our patient. Lymphomas in cats don't hurt as such, often owners report good health and activity in fur. However, when the enlarged lymph nodes are pressed or the neoplastic growth on the surrounding tissues, vessels or nerves occurs, the patient shows symptoms related to it, and this may not be comfortable, if not painful for the cat. After the introduction of treatment and achieving remission, most of these symptoms disappear.

Is cat lymphoma curable?

Unfortunately not.

We can weaken it, stop its development for a moment. During this time, the cat may behave as if it is completely healthy - it is happy, plays and has an appetite. However, the lymphoma will strike again. Usually after a few months, sometimes after a year or two. We are not fighting for a complete cure. We are fighting for extra time. A time of relative comfort and well-being.

How much time has he left?

It depends on several factors. First of all, on the type of lymphoma, its anatomical form and the degree of malignancy observed.

Also key are:

• general condition of the patient,
• the age of the kitten,
• immune status and resistance of the organism (e.g. feline leukemia virus infection significantly worsens the prognosis),
• treatment response,
• the moment of introducing the therapy.

As with other cancers, the sooner lymphoma is diagnosed and the sooner we start treating it, the better the chances of achieving remission. Unfortunately, most patients see a doctor when the disease is already advanced. It is comforting that it is quite sensitive to cytostatics commonly used in veterinary oncology. Disease remission with chemotherapy occurs in 65-75% of cats. When using a multi-drug regimen, the average survival time for most patients is 6-9 months, about 20% surviving more than 12 months. The average survival time for untreated cats is 4-8 weeks. It is very difficult to achieve remission in relapsed cats. Infection with FeLV significantly worsens the prognosis.

Is it worth fighting for?

Is it worth fighting for your cat?

This question, dear reader, is for you to answer for yourself. Is it worth spending this purchased time, even if it was to be very short, with your beloved friend?? Is it worth enjoying each subsequent stolen day during this period?? Everyone carer of a cat lymphoma patient sooner or later he asks himself this question. He does not know if he is doing well, and wonders if it would not be better to decide on euthanasia?

In such situations, it is worth recalling the key question that should always be asked after diagnosis:

What are we fighting for?

And the answer to this question is: for comfort, for a good quality of life, for relatively well-being, for one more day with a purring, smiling face right next to our face.

However, sometimes you have to throw in the towel

…

It is morally unacceptable to prolong the suffering of a cat diagnosed with lymphoma that does not respond well to chemotherapy or takes it very poorly, and the disease progresses.

When in doubt if it's time to say goodbye, ask yourself:

Is this the comfort and quality of life we ​​fought for??

Then talk to the doctor and if there is indeed no longer any hope of improving the kitten's condition, accept the inevitable and let him go with dignity. Remember, however, that a temporary crisis during chemotherapy happens with every cat, even the strongest. Caring for a cancer patient is an art, as is caring for your sick pet. The ability to observe and reasonably assess the situation is extremely important when making any decisions in the process treatment of lymphoma in cats.

What are the symptoms of intestinal lymphoma?

Clinical symptoms of intestinal lymphoma usually take the form of: chronic vomiting, diarrhea, loss of appetite, weight loss, weakness and enlargement of the abdominal wall outline. Sometimes there is fresh blood in the stool, painful or unproductive pressure on the stools.

What are the symptoms of mediastinal lymphoma?

In the case of mediastinal lymphoma, we observe respiratory symptoms: cough, shortness of breath, fluid in the chest cavity, diffuse swelling of the head, neck and thoracic limbs, weakness.

What could be the symptoms of cat eye lymphoma?

The most important symptoms include changes in the size and shape of the pupil, strokes and abnormalities in the anterior chamber of the eye, cataracts. Symptoms such as: protrusion of the eyeball, dryness and changes on the cornea (inability to close the eyelids), thickening of the third eyelid, dislocation of the cartilage of the third eyelid and eggs, prolapse are also possible.

Sources used >>