Samba's Case Study  

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Other Diseases/Conditions: None AT DIAGNOSIS: FeLV+ (contagious feline retrovirus which often causes feline lymphoma), Splenomegaly (enlarged spleen - due to lymphoma), Lymphadenopathy (enlarged lymph nodes - due to lymphoma), Dehydration (due to lymphoma), Febrile (fever - due to lymphoma), Icteric serum chemistry (biochemistry showed developing yellow jaundice - due to lymphoma), Leukopenia (low white blood cell count - due to lymphoma,) Neutropenia (low neutrophil count - due to lymphoma). AFTER DIAGNOSIS: Possible development of concurrent Irritable Bowel Disease (IBD) suspected later in 2004/2005. At this point we do not think it is linked to the lymphoma. Definitive diagnosis cannot be made due to contraindication for surgical biopsy, which is required for IBD diagnosis. Story: Samba was diagnosed on January 26 of 2004 at the estimated age of 3 ½ years young. He was a neighborhood stray who adopted us in May of 2001, at which point we were informed that he had Feline Leukemia Virus (FeLV+). We kept a very close eye on him and made sure he had regular veterinary work-ups, but he lived a pretty normal life as a beloved indoor kitty for the first 2 ½ years we had him. Then one week in January of 2004, Samba became very ill. He started acting lethargic, he became very depressed, and his appetite (usually voracious) reduced to the point where he literally would not eat. By the end of that week, we had made an emergency appointment with our regular vet. Although the most respected feline practitioner in the area, knowing Samba's FeLV+ status, unfortunately she suggested we "do our best to make him comfortable in his last days." This was not good enough for our furkid - not THIS time. We did some research on our own and to our horror, discovered that cats with lymphoma can be treated with chemotherapy. I say this was a horrible revelation because we had lost our two beloved kittens, Happy & Leo, in 2002, both most likely to feline lymphoma. We rescued them as tiny babies from the Humane Society, as they also had FeLV and were scheduled to be euthanized. When they got sick in 2002, one right after the other and neither of them a year old yet, we were told they had lymphoma caused by their FeLV and there was "nothing we could do" to help them. In both cases, we were told this by our regular vet as well as the local "cancer specialist" who was in fact an internal medicine vet at the local referral hospital. We lost them both about a year and a half before Samba was diagnosed with the same thing - feline lymphoma. Once we discovered that we could help Samba with chemo, and that we had perhaps lost our other babies needlessly, due to our own ignorance and blind obedience, well there was no stopping us. Samba was diagnosed by ultrasound-guided fine needle aspirates of his spleen and peripheral lymph nodes with accompanying pathology. The diagnosis was Stage IV (of V) Multicentric Feline Lymphoma. The cancer had started in his spleen and spread to the surrounding lymph nodes on both sides of the body cavity. His spleen was swollen with cancer cells, was hugely enlarged on ultrasound, and it didn't look good. No one really wanted to bother treating him because he has FeLV, which is the leading cause of lymphoma in cats. FeLV+ cats can be a little more challenging to treat, but they have a good shot at remission, just like every other cat! Samba received chemotherapy from a great oncologist at the closest university veterinary teaching hospital. He went into remission. Then in April of 2004, while undergoing chemotherapy, he was struck with chemo-induced sepsis, which is a deadly systemic blood infection. Chemo-induced sepsis is a rare but known possibility, and is even more of a threat for a severally immunocompromised cat with FeLV. My baby almost died - but he didn't. He SURVIVED. We waited until he was fully recovered about a month later to consider putting him back on chemo. We did another abdominal ultrasound, thinking his cancer would be back as he had been off chemo for several weeks. The ultrasound was clear. His organs looked great. He was still in remission. The chemo he had received thus far should not have irradicated his aggressive lymphoma. But still, it was nowhere to be seen and he acted 100% healthy. His medical team was puzzled. We decided to wait another few weeks before going back to chemo as he appeared perfectly healthy. We did another ultrasound, again expecting to see his organs swollen with cancer after not getting chemo - but nothing. It was clear. Still, he was in remission. We've been checking him on a regular basis now for a year and a half. Still - no cancer - complete remission! As soon as we see signs of cancer again on ultrasound, we will resume chemo, although in smaller doses and keeping very close watch on his neutrophil counts. We know he is at risk for chemo-induced septicemia again if we are not very very careful. That is why we are waiting to treat him until we see the cancer come back. We want to save the strength of the chemo (which diminishes over time as resistance is created) and the risk to Samba for when it's needed. We won't wait until we see behavioral changes in him, as that could be too late. We will continue doing ultrasounds on a regular basis and as soon as we see his organs plump up or anything else change we are back to chemo. In the mean time, it's been almost two years since he was diagnosed and we've had over a year and a half of fantastic remission. Samba is extremely active, happy, and has literally no idea he's sick! This time with him has been such a gift. If we could ask Samba if going through the chemo and the pain of the sepsis was worth it to get this year and a half of such happy times with our family - I KNOW in my heart he would absolutely say YES… So, it's been a rocky road, but our results have been fantastic, and so very worth it. In the end, quality time together is the only thing that matters and we have certainly been given that… I truly believe that the recipe for success with feline lymphoma takes: 1.) The right veterinary team including at least one board certified oncologist 2.) Aggressive medical treatment 3.) Speed speed speed (time is the enemy) 4.) A very informed, very involved, zealous parent(s) as the cancer kitty's #1 advocate! I believe this combination will give your furkid the best chance possible of achieving remission and gaining some quality time with their family. In Samba's case, I could not have come this far without the extraordinary knowledge and support offered from the other members of the Yahoo Feline Lymphoma Support Group. If you are not a member - join the group! You'll be glad you did. If anyone reading this has a kitty with lymphoma and would like more information on Samba's case or just needs some support, please feel free to email me. You can also view Samba's day-by-day symptoms, treatment, reaction to treatment, test results, in some cases cost of treatment, behavior, etc since diagnosis in 2004 on his online calendar at the following address www.sambacalendar.com. Outcome: Samba is still going strong so please, if your FeLV+ kitty has been diagnosed with feline lymphoma - don't give up! Help is available if you want it and your cat should not be excluded from treatment just because he/she has FeLV. Yes, they have their challenges and need to be treated with extra care, but they can achieve remission just like any other cat, so find the right vet and give them a chance … - By Stacy Samba's Mom -

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