(October 2003)

My vet said there was “good news and bad news.” The good news is that the aspirate analysis did not show any lymphoma. The bad news is that this doesn’t mean there isn’t lymphoma. Aremid isn’t getting any better, and the ultrasound had clearly shown significant organ damage.

One guess on what could be afflicting Aremid is inflammatory bowel disease. This could be treated with prednisone.

The only way to know for sure what’s going on is to get a biopsy of his intestinal tract. This can be done via surgery or endoscopy. Either one is pricey. Surgery is dangerous for an old, frail cat, so I think I have ruled out that option. Unfortunately, for a reason I didn’t quite catch, a biopsy would not be helpful if Aremid were to have already started prednisone. I guess it would change the cells in such a way as to make lymphoma difficult to detect?

So, the options are to either start him on prednisone, which is not a costly therapy, and hope that whatever ails him is helped. (I think prednisone might be a treatment for lymphoma, too).

Hmm…this link is pretty informative, but has some upsetting information:

Cats with intestinal lymphoma treated with prednisone alone have a life expectancy of 45 to 60 days

It is very difficult to distinguish inflammatory bowel disease from lymphoma without a full-thickness biopsy (a full-thickness piece of intestine) obtained via exploratory surgery. A less invasive method of obtaining a sample is via endoscopy, usually adequate for diagnosis but full thickness biopsy samples cannot be obtained this way.

Damn…the studies on lymphoma treatments are not very promising, referring to positive responses to treatments in terms of weeks, not years.

If I were recovering from a kidney transplant right now, I’d be away from home for a month, and I’m not sure how I would be able to deal with this, logistically or emotionally. (So there’s a silver lining from this past week’s transplant debacle.)

sigh…