Because there seems to be a lot of confusion and curiosity on the subject, I thought I’d do a post here about what Quinn’s actual chemotherapy process - and her response to it - has looked like. It’s gonna be a long one, so… heads up. No content warnings necessary unless you get squicked by vaguely described medical procedures; I was not present for the cat’s actual treatments, so I can’t go into the gory details anyway. Brace yourself for nothing more graphic than general talk of vomit and poop, and oblique references to needles.
[::ahem::]
So. Especially when we first got started on this terrible little journey, I got a lot of commentary re: not putting an animal through this sort of awful experience; but these comments are based in what folks understand about how people respond to chemotherapy.
Cat bodies and people bodies are two very different things, and they process substances/experiences very differently.
The example I’ve been using as of late, is actually one for dogs. Did you know that dog bodies process opioids differently from people bodies? I learned this when Lucy had dental surgery a few years ago, and I saw that she’d been given a prescription for Tramadol that exceeded the dosage I was given for kidney stones. I outweigh Lucy by fifty pounds! I thought her RX couldn’t possibly be correct - so I called the vet like the nervous nelly I am, and they assured me that this was well within the dosage recommendations for a dog her size. Their biochemistry just handles it differently from ours, that’s all.
Bearing that in mind, here’s what Quinn’s actual treatment has looked like, and how she has responded to it.
[This post will henceforth contain discussion of small-cell GI lymphoma and its treatment for felines, in case you, gentle reader, are looking at a similar situation with a cat of your own - and are googling around, looking for personal experiences with the process. Your pet’s disease presentation may differ, their symptoms may not be the same, the drugs used to treat it may vary, and your cat’s response to those drugs may not line up with Quinn’s. In essence: Your mileage may vary. But here’s how it went for us.]
To make a long story short - over the course of a couple months, our cat began vomiting with greater and greater frequency. Before we knew the cause (it took awhile to nail it down), we started giving her Cerenia - an antiemetic that at least put the kibosh on her puking. But then her appetite flagged, and she began to lose weight. So we added Mirataz, an appetite stimulant goo that you smear on the inside of their ear/thinly furred skin of their upper forehead. With this, Quinn started eating again, but not much - and every time we tried weaning her off the Cerenia, the barfing resumed. We’d thought/hoped that she was merely in an inflammation/vomiting cycle that needed breaking, but we simply couldn’t make it happen.
After a couple of weeks on the Cerenia and Mirataz, the doc agreed that it was time to schedule an ultrasound. During this screening, he called and said they’d found a lesion in her stomach. He asked if I’d authorize a biopsy to check it out. I said “Sure.”
A couple of days later we got the biopsy results back and learned the grim truth: our cat had (intermediate grade) small-cell GI lymphoma.
Quinn’s first oncology appointment happened on March 14th, and that’s when we found out that her bloodwork was sketchy, her lesion was growing, she had some thickening around her intestines, and so forth. We also learned that over the course of the previous month, she’d dropped about a pound. She was down from 14-1/2 lbs to (I want to say?) to about 13.4 pounds. Still a good-sized cat, but yes. We could see that she was slimming down beyond her uh, peak performance.
[As an aside, Quinn topped out around 20 pounds approx. 3 years ago… but after her joint condition was diagnosed, we had to put her on a diet to improve her mobility. 14-15 pounds is her healthy zone.]
The diagnosis was confirmed, and we were given our options. In this particular case there were only a couple, really: we could either try to make her comfortable with steroids and such - then wait out the inevitable - or we could spring for a CHOP-type course of treatment.
Obviously, we went for the CHOP - a fact which initially horrified a few of my medical professional friends, because CHOP treatments can be brutal on the human body. And I totally understand! If I thought someone was essentially torturing an animal with medical intervention just because they couldn’t bear to lose it, I would have Opinions as well.
But this is not that.
Whereas people undergoing CHOP chemotherapy are likely to experience weeks or months of bruising, nosebleeds and other bleeding, hair loss, bladder problems, constipation, numbness in the extremities, vomiting, breathlessness/difficulty breathing, heart issues, and extreme lethargy… with one brief exception - Quinn has mostly experienced a nap and a snack.
Following her first infusion of chemo (also on 3/14), Quinn came home and took a nap, then ate a few treats. She downed a little dinner, hassled the dogs, lounged on the coffee table, and did her normal cat-stuff - which by then, yes, included some hunkering and hiding. But after a couple of days passed (during which she was also on daily steroids), she seemed to improve. Less hiding. More eating. More hollering for toys and snuggle-time.
So I felt really good about her next appointment on the 22nd, a state of optimism which led to a crushing revelation: over the course of the week, Quinn had gone from “a small lesion with some thickening around her intestines” to “all that, plus a 5-centimeter mass in her stomach and she’d lost another six ounces - down to (I think?) 12.9 pounds.”
We absolutely feared the worst. The vet oncologist agreed that this was not the ideal result, and said that if it was all right with me, she’d like to switch up the CHOP procedure a bit, and use this second appointment to do the “harder” infusion (rather than an oral pill, which Quinn had been scheduled for). She told me that if the new treatment didn’t work, nothing was likely to - and she was gentle but honest about the odds, which were not super-great.
[Another aside: I am not being coy when I don’t note which chemo drugs were used exactly; I don’t remember what they were called, or which bits were swapped around. I am not an expert on this - and I don’t feel like digging through four rounds of discharge paperwork for this info. I’m just telling you about our experience, here.]
After this stronger infusion, I took Quinn home and she seemed pretty much the same. Low but present appetite, some lethargy but not as bad as it’d been previously. She still wanted treats and still stole the dog beds. Still fussed at the Neighbor Cat through the storm door every morning. Everything was in a holding pattern while we waited for the next appointment, a week later… until Monday night, when something abruptly changed.
Over Monday night/Tuesday morning, Quinn began throwing up again despite the Cerenia - and she had two rounds of diarrhea in the living room, which was a godawful first. All day Tuesday I honestly thought perhaps she was on her way out, and we would not need that Wednesday appointment for her third dose of chemo. When she wasn’t in hiding, we found her lying in strange places, appearing only semi-responsive. I reached out to our local vet, who urged me to keep the next day’s appointment in Tacoma and then let him know the results - so we could begin to talk about palliative/hospice care for her, as needed.
Then something wild happened on Wednesday morning: we woke up to a cat standing on our bed, and she was yowling for breakfast.
But since she was scheduled for chemotherapy in a couple of hours, I couldn’t give her any. (She had to fast after midnight for these appointments.) Instead I gave her the usual steroids/gabapentin and packed her up for that trip to the oncologist 40 miles south of here…and upon this appointment, the news was unexpectedly good. Not great, but good. The abdominal mass had firmed up somewhat and shrunk by about 20%. Also, Quinn’s bloodwork had improved. Furthermore, her weight had held about steady over the previous week, at roughly 13 pounds. These were small good signs, but good signs all the same.
The vet oncologist said that she’d really hoped to see a more significant mass shrinkage, but based on some criteria which was unclear to me (as I am not a veterinary oncologist) she said she once again wanted to deviate a smidge from the CHOP protocol and do a different oral chemo on that day. Since I am 100% down to trust an expert in this ailment that is trying to kill my cat, I told her to go for it.
That was March 29th. Our next appointment would be a week later, in Seattle, for bloodwork through our usual local vet. Then, Quinn was due back in Tacoma on 4/13 for a 2-week post-CHOP assessment to determine our next steps.
I took my kitty home and crossed my fingers, prepared for the worst and not really daring to hope for the best.
For the first 24 hours or so, she held steady at her new normal…and then…uh, to borrow from Hemmingway: things changed gradually, then suddenly. By the time our local vet showed up on 4/5, we were living with a shouty, playful, bottomless pit of FEED ME feline who was downing about four meals a day - and waking us up earlier and earlier in case we could be persuaded to give her a fifth one to start her morning.
Bonus: Quinn had gained about two ounces over the previous week. Frankly, I was stunned it was so little, considering how much she’d been eating - but we were delighted all the same, and a day or two later, her bloodwork came back as “pretty much fine, actually.” I crossed my fingers a little harder, and began tapering her off the antiemetic and the appetite stimulant. (At this point, she hasn’t had either of those since last Friday - but we’ve had zero puking, and um, she’s already had two servings of breakfast this morning.)
But yesterday. Yesterday was that follow-up assessment in Tacoma and I had been dreading it all week. Quinnie seemed to be doing so well! I could even tell that she’d had gained a little more weight - not as someone who desperately wanted that to be true, but as the person who daily pulled her into my lap and flipped a pill down her throat.
[She’s decided that Pill Pockets are Of The Devil, so we are experimenting with other things right now. This is not a request for suggestions. I am good at pilling cats, and we already have one potential workaround.]
So yesterday, yes. I went through the usual routine: packed up the cat, strapped her carrier into the passenger seat, and drove to the south end of Tacoma while I was called everything but a Child of God the whole damn way, at top volume. I dropped her off at the vet in accordance with the office’s preferred procedure, and drove off to a Starbucks down the street - where there free wifi and snacks could be found. I set up my laptop and tried to distract myself with work while I waited for the call.
Then I got the call.
The mass was gone. The doc couldn’t find it at all, and Quinn’s bloodwork looked “Terrific!” She’d gained more weight, and was up almost half a pound over her previous visit 2 weeks before. The doc declared “Remission!!!” and we all did a little cheer, and the other people in Starbucks looked at me funny but generally cheered along, on principle.
So. Next up.
Next Thursday (4/20) our local vet returns for another blood workup, and then on 4/26 we return to Tacoma for an ultrasound - to confirm/specify the degree of Quinn’s remission (it might not be complete, after all) and/or sort out what happens next. We are probably looking at steroids indefinitely, and routine monitoring going forward, and so forth, and so on. But I’ll know more about the particulars on the 26th.
And now?
At present, Quinnie clocks in at 13.6 pounds, visibly less scrawny than a few weeks ago. She’s also resumed her regular grooming, something we’d slowly noticed she wasn’t doing anymore - and this morning post-breakfast and meds, she’s taking her typical late-morning siesta on a new cardboard scratchy slab under the coffee table. Her energy levels are back to normal and her appetite is great - but starting to settle back down to “normal great” not a “been on appetite stimulants for a couple of months” level. Which is good, because we don’t actually want her to pork back up again - for the sake of her elbows, if nothing else.
How long will this reprieve last? No idea. The lymphoma will almost certainly return, thus the future monitoring - and when it does come back, it’ll take her. This could happen in a few months, or it could happen in a few years, but here’s my takeaway for the moment: I have my cat back. She is happy and healthy, bright-eyed and bushy-tailed, and very much “herself” again.
At what cost? Well, money aside (and again, I am overwhelmed with gratefulness for everyone’s kindness and generosity on that GoFundMe)… it cost me the stress and time for four trips to Tacoma, three other vet visits here in Seattle (including that first ultrasound), and a lot of lost sleep. These appointments often took all morning or longer, as Quinn had to be lightly sedated for the infusions - so I was gone from about 8:00 a.m. to sometimes 2-3:00 in the afternoon, once a week for more than a month. (The round-trip took not quite 2 hours).
“But at what cost to the cat?” you ask.
I think if you asked her, she’d say that the worst part is the car rides and the fasting after midnight. Obviously she doesn’t enjoy having her blood drawn, but that’s over in about 90 seconds and then she gets treats, so it’s not the end of the world. Yes, she had one “bad” stretch where she was visibly ill and we were very concerned - but it lasted less than 24 hours and she mostly slept through it.
So at the end of the day, yes: I think it was worth it for both of us.
It cost $$$, yes. It cost time, yes. It cost the cat seven vet appointments over the span of five weeks, some blood draws, a single bad day, and a shaved tummy. But it resulted in a healthy, cancer-free cat who’s back to living her best life - though yes, ultimately we shall see for how long.
But that’s always the case, isn’t it? There are no guarantees for anyone, least of all engine-block cats who probably should’ve never survived their ride under the hood at six weeks old.
And even if we hadn’t wound up with this astonishing remission… even if we were preparing to lose her after all that trouble… I would have deeply regretted not giving it a shot, and I’m so, so grateful that we had the opportunity to try. Quinn has been my little buddy for going on eight years, and I’d like to keep her healthy and happy for a few more, if I’m able.
In conclusion, I send all my thanks and love to the fine folks who donated to Quinn’s Cancer Care (it’s fully funded! don’t give more, unless you want to donate to Pasado’s Safe Haven - and you can do that directly through them, if you like). Likewise, eternal gratitude to the team at Summit Veterinary Referral Center in general, and oncologist Dr. Candace Pagano in particular for her brilliant gut about these things. Furthermore, lifelong thanks, big ups, and tackle-hugs to our Seattle vet, Dr. Josh Montgomery and his team (::waves:: at Austin and Mindy!) - who have been so very patient with a deeply, obnoxiously anxious pet owner like yours truly, ever since we moved back to town in 2017.
And thanks of course to all of you for reading, and following along, and rooting for our ridiculous House Yeti during this difficult time. It’s been a hell of a year so far, but here’s hoping spring brings us all a fresh start and a healthy household <3