Well, here it is Monday already! Kely had her Internal Medicine appointment last Thursday with Dr Gisselman at the Hope Advanced Veterinary Center and I got a lot of information to help me decide on a treatment plan for Kely.
I went in with all her records, lab work, X-rays and previous heart scans and the doctor spent a lot of time gathering information from me about Kely. They then whisked her off to have an ultrasound, while I waited, distracting myself on my laptop, but not really being able to focus on anything.
The doctor went over the ultrasound report with me: diffusely thickened small intestines, enlarged mesenteric lymph nodes, a prominent spleen, a course liver and some gallbladder debris. Given her chronic vomiting, inability to gain weight despite a good appetite and the changes seen on the ultrasound, they feel she has either IBD or small cell mucosal GI lymphoma.
Without doing full-thickness intestinal biopsies, a definitive diagnosis can't be made, but I could elect to treat her on her symptoms and see if she improves. Having been through that with Disco when he was 7 years old, I know that knowing what he has is actually a comfort to me and he has responded very well to his treatment for IBD and at least at the time, I knew he didn't have lymphoma.
So now to decide on how to proceed with Kely, who is 15...
Because she has a soft heart murmur, I have elected to have her see a cardiologist. She saw one every year when she was a breeding cat, but her last heart scan was in 20005 and before starting her on steroids, it is best to reevaluate her murmur. So she has that appointment on Friday and then after talking to my vets about her treatment options, I will decide if to treat her empirically and see if she improves or take the big plunge and go for exploratory surgery and obtain the biopsies for a true diagnosis.
I am leaning towards not doing that, as I know small cell lymphoma responds quite well to a similar therapy that we did for Disco--steroids, metronidazole and leukeran. As hard as it is to say, money is a factor in my decision, too as she is not covered by pet insurance and any care with an oncologist would be expensive. As the specialist said, I can try treating her without the surgery and if she doesn't improve, then go for the biopsies after a few months of trying meds and a diet change.
I think I am comfortable doing that...but will know more after consulting with my vets. I will let everyone know next Monday how we will proceed...and til then, I am grateful for your purrs and good thoughts...I know we all love Kely and that makes me smile!