Isabella, a 13-year-old Himalayan beauty, came to see me because she had begun vomiting and her appetite had decreased. Her human mom had been away over the weekend and she thought that maybe Isabella had gotten into something that had upset her stomach. Her mom even found something in her vomit that looked like something she could have chewed on. I treated her for an upset stomach with some different supportive medications. However, she did not improve much. She would take a few licks of her food and walk away. In addition, she started making unusual noises which sounded like she was clearing her throat. I was wondering if her upset stomach was actually causing acid reflux and added an acid reducer to her regimen of supportive care. Still, Isabella did not show improvement.
The diagnosis. Two?
Could she have eaten something caustic that had irritated her esophagus? At this point, it was time for more diagnostics. I suspected that there was a problem in her esophagus and sent her to a referral center for an endoscopy. In this procedure, the patient is sedated and a long tube is passed through the esophagus and further down their digestive tract to look for any abnormal tissue or foreign objects.
Well, fortunately, it seems that this was the right course of action because the specialists at the referral hospital found not one, but two reasons why Isabella had not been eating! First, they found very deep ulcers in her stomach which they were quite sure were causing immense pain. When they moved the endoscope further into the intestine, they found more abnormal tissue. They took samples of tissue from both locations for more answers.
The pathologist determined that Isabella had ulcers in her stomach that may have been associated with a bacteria called Helicobacter. This is a tricky bug because it can be found in healthy as well as sick felines. It’s difficult to know if the bacteria is just hanging around in already diseased tissue — or if it is the cause of the diseased tissue. The pathologist also discovered another unfortunate finding. Isabella had lymphoma, a type of cancer, in her small intestine.
Isabella’s treatment path
At the very beginning, Isabella had begun vomiting and her appetite had decreased. In order to avoid that Isabella’s stomach lining would be further hurt by chemotherapy, the specialist recommended they try to heal the ulcers first before going to an oncologist to treat the lymphoma. Unfortunately, Isabella had a very hard time tolerating all the medications to treat the ulcers (at least three medications multiple times every day). So, it was decided to go straight to the oncologist in the hopes that treating the lymphoma would also help reduce the ulcers.
We are all rooting for you, Isabella!
Lymphoma is the most common cancer in cats. Most of the time it shows up in the intestines, but it can be in almost any organ. The intestinal form carries the best prognosis, as it is the most amenable to chemotherapy. Isabella has been such a trooper (along with her very-worried human parents!) with the stressful trips to different doctors. She has a long road ahead of her, with good, and not as good, days.
We are praying for you and your family, Isabella. Be strong, help us get the lymphoma into remission — and be with us for many years to come!