Because 2020 is the year that just won’t quit sucking, we found a lump in Crick’s neck about two weeks that turns out to be (probably) feline Hogkin’s-like lymphoma. We took her to the vet to get the lump checked out and they did a fine needle aspirate (a.k.a., stick a needle in the lump to get some cells to look at under the microscope) and the cells looked suspicious. Along with it being a lymph node in her neck that was affected, it seemed to the vet like Hogkin’s-like, but it’s a pretty rare cancer in cats (this vet said he’d actually never seen a case of it before). It’s a slowly progressing disease, which is less bad than some cancers, but being so rare not that much is known about treatment or prognosis. The only way to definitively diagnosis this form of cancer is by taking the lymph node out and dissecting it, but all signs point to it being what she has.
We were given a bunch of options, one of which was to consult with an oncologist. I didn’t even know there was such a thing as a cat oncologist1! Given that this is such a rare cancer, we thought that was probably a good idea. Up to this point, Crick was acting just like she always had, but then last Thursday she got quite lethargic, her nose was super runny and stuffed up, and she wouldn’t even eat dinner. Eating is one of Crick’s favourite things to do! I even tried to give her a treat and all she could manage was to take a lick of it. It was heart breaking to see her like that. So on Friday morning when things weren’t any better, I called the vet, who was able to get her into see an oncologist at a vet clinic in Langley. They have an Emergency Department as well as oncology, and this way she could be brought in through emergency and the oncologist could look at the immediate concerns of her lethargy, runny nose, and refusal to eat, as well as do an oncology consult.
Taking one’s pet to the vet during a pandemic is weird, because no humans other than staff are allowed in the building. So you drive up (or walk up, if you don’t have a vehicle) and then call from the parking lot to check in, and then a vet tech comes and takes your pet inside. They do their check up and then the vet calls you to talk about it. So the parking lot is just full of people waiting for the pets.
It turned out that the lethargy and not eating was due to the respiratory infection that was causing the runny, stuffed up nose. Crick had been in to see the vet in February due to coughing and sneezing but at the time they said it was just a run-of-the-mill, viral respiratory infection that they couldn’t do anything about and it would just run its course. And she’s had that coughing/sneezing thing on and off since then. In retrospect, it was probably because she was developing lymphoma, which is a cancer related to the immune system, so her immune system wasn’t able to fight off the infection. Or maybe also because of this tumour growing in her neck pressing on her windpipe. So they did some X-rays and ultrasounds to see if the cancer had spread, and did fine needle aspirates of the lymph node in the other side of her neck and one in her belly, both of which looked enlarged, to see if they were suspect too. We got her on antibiotics for her respiratory infection.
The cytology of the two lymph nodes showed that the one in her belly was fine but the one in the other side of her neck was possibly affected. The X-ray results showed no sign of the cancer having spread, though did show that she may have a mild form of kitty asthma. So now there are three possible reasons for the coughing/sneezing: probably the respiratory infection and/or the tumour in her neck and/or (but least likely) kitty asthma.
The recommended course of action was to remove the two lymph nodes in her neck. That would immediately improve her quality of life because she would no longer have a tumour pressing on her throat and would typically result in 1-2 years of a good life and then it would show up again in another lymph node, at which point you could remove that lymph node and she’d get another 1-2 years before it popped up again.
So we went in for a surgical consult yesterday and since the antibiotics had cleared up her respiratory infection, she was good to go for surgery. Unfortunately, they weren’t able to get the whole tumour out. It turned out to be very vascular, so there was a lot of bleeding, and it was also quite adhesive to other tissues. And since the neck has other important things like the carotid artery, the jugular vein, and nerves that control important things, it was too risky to continue the surgery, so the surgeon got out as much as he safely could, and then sewed her back up.2
The plan now is to give her some steroids to see if that will shrink the tumour. They got a big enough chunk of the tumour out that her quality of life should be improved by not having it pressing on her neck; as well, it’s big enough to dissect and confirm the diagnosis of Hogkin’s-like lymphoma. So she’s home now – we have a bunch of meds to give her (two types of pain killers, the steroid, and the antibiotics that she was already on pre-surgery) – she’ll get two weeks to heal and then we’ll go back in to get her stitches out and see how well the steroids are doing. We may also consider chemotherapy at that time, if it seems like it is something that may be helpful. I’m hoping that the steroids will be enough, but we’ll just have to see how it goes.
I love this little cat so much. She is a snuggly sweetheart who loves to walk around with her favourite green toy in her mouth at night while meowing to announce to the world that she has caught her prey! She cleans her brother’s face after meals and loves to play with the laser pointer. She comes running when I turn on the tea kettle because she knows that she’s going to get a cat treat. She loves crunch treats and meat tube treats and fresh cat nip and cat grass from the balcony cat garden. At the end of the workday, she will often come walking into my office and will paw my chair to tell me that it’s time to stop working. She picks a favourite place to nap and will spend all her time in there for days or weeks, and then will suddenly decide on a new favourite place. Sometimes it’s one of our office chairs, then it will be a box, then the front hall closet, later the purple chair in the living room, and then under the bed. You never know what her next favourite place will be or when. I love this little cat and my goal now is to keep her comfortable for as long as she can have a good life.
- Well, I guess technically she’s a cat and dog oncologist. But still, I didn’t know that was a thing. [↩]
- Poor Scott got home about 2 seconds after I got off the phone with the surgeon telling me this news and when he saw that I was crying he nearly jumped out of his skin – he thought Crick had died during surgery! [↩]