Cat lymphoma - treatment without surgical biopsy

January 12, 2024 12:39 PM

I've read several accounts by people whose vets would treat feline gastro lymphoma on strong suspicion rather than requiring a surgical biopsy. Did this happen in your case?

Our cat most likely has small cell lymphoma (for the purposes of this question, please accept this statement). She is scheduled for an ultrasound with fine needle biopsy later in the month. Her intestines are palpably thickened.

I know that a fine needle biopsy is not a good diagnostic unless there is a mass or you're really lucky.

A surgical biopsy will run at least $3000. She is fifteen and has stage 2 kidney disease. We were hoping that we could manage her kidney disease for two or three years more.

The surgical biopsy cost will be a serious blow to us. (No pet insurance, didn't even know it existed until several years ago when symptoms started - vet thought it was developing hyperthyroid.) Ironically, without the biopsy cost, we could afford the chemo. With the biopsy, we really can't.

Everyone says cats bounce back well from surgical biopsy, but I know that anesthesia stresses the kidneys (it was anesthesia that stressed her kidneys enough to really start the disease process - it would have been coming anyway, but the anesthesia accelerated it) and I'm just worried about her general health at her age.

I would rather not wait for a prednisolone failure to fall back to chemo, since by then the cancer will probably be too advanced for it to work.

I've read online from a number of people whose vets were willing to start the at-home pill chemo on strong suspicion of lymphoma without biopsy. Did this happen to you? If so, what was the general situation?

posted by Frowner to Pets & Animals (3 answers total)

would rather not wait for a prednisolone failure

This isn't quite what you asked, but you will know if the steroids are working pretty quickly, and this is something that I've done (with two different vets) as a vet tech appointment (vs. a regular vet appointment) - unless you're located somewhere remote, you could likely find a vet to do this sometime next week, and you'd see the results (or not) within days. We discovered via X-ray a large mass in my then 14.5 year-old cat over the summer, and he recently made it to his 15th birthday. We can tell the steroid was working within 24hrs.
posted by coffeecat at 1:45 PM on January 12, 2024 [2 favorites]

Again, not what you’ve asked, but vets are willing to work with you on budget. If you call your vet and say “hey I can’t afford this diagnostic test and treatment, can we do something else”, they should be willing to work with you. I have definitely had vets swap higher cost procedures for lower cost ones before.
posted by shock muppet at 4:24 PM on January 12, 2024

I lost my 17-year-old cat about 18 months ago to small-cell lymphoma. I never did the surgical biopsy. I did an ultrasound fine needle biopsy to confirm what my vet felt during an exam and that served as the diagnosis. I treated him at home with a mixture of prednisolone and Chlorambucil. My cat lived reasonably well on the meds, although he didn't have kidney disease, and it was always hard getting him to eat enough. I did also get an appetite stimulant (Mirataz, helped a lot). He did have to go in for quarterly vet check ups and bloodwork for the chemo, but that's as invasive as his treatment got.

When we were going through diagnosis, I asked my vet if the biopsy results would change the way she would treat him, and she said no. So, I didn't need it confirmed. I knew at his age, if his condition got any worse, I would have to euthanize him.

He did survive for another year and a half after his diagnosis, but his decline was incredibly sudden and painful for him. I wish that had happened differently, but I was very glad that his treatment kept him at home with me and wasn't too difficult for him.
posted by gladly at 7:09 PM on January 12, 2024 [1 favorite]