Brave Cat of the Month – Harley
Harley is a gorgeous 7-year-old domestic shorthair who over the years has had ongoing digestive problems including bloating, gurgling intestines and chronic intermittent diarrhoea. Harley’s owner had tried various treatments, but nothing seemed to help Harley and he continued to lose weight which was worrying for his family.
They decided to come and see Dr. Jeremy for a second opinion. These appointments are 40 minutes long, so we have sufficient time to discuss the issues and examine your cat. Prior to the appointment we need to get all the previous clinical records, blood and urine results, x-rays and ultrasound images etc. so we can go through all of this information to determine the next best steps and make a plan after the examination.
In Harleys case, we started with blood, urine and faecal analysis. The bloodwork came back showing he had significant issues with his intestinal absorption and pancreatic inflammation. One of the markers of poor intestinal function Vitamin B12 was very low so we started supplementation immediately. B12 helps the intestines function more normally but is also required for red blood cell production and a huge number of other vital processes throughout the body. We also shifted him on to a very specific ‘novel protein’ diet of venison, rabbit and quail to rule out dietary sensitivity as a contributor to the signs. His urine and faecal tests were all normal.
The next step in Harley’s investigation was an abdominal ultrasound which showed his pancreas was enlarged, his entire small intestine wall was very irregularly thickened and distended with fluidy faeces. The glands that drained the lymph nodes were very enlarged.
Given these signs it was decided to do upper and lower gastrointestinal endoscopy. Endoscopy is a minimally invasive way to evaluate the inside of organs such as the esophagus, stomach, intestines, urinary system, trachea, lungs, and nasal cavity. Additionally, endoscopy can be performed to evaluate the inside of body cavities including the abdomen (laparoscopy) or chest (thoracoscopy). During an endoscopy, an endoscope is inserted directly into an organ through a natural opening in the body or into a body cavity through one or more small incisions. An endoscope is a medical instrument that has a camera, microchip and light source at the tip, permitting transmission of a high-quality image to a computer monitor for your cat’s doctor to view and interpret the condition of the area being examined. In veterinary medicine, endoscopy of the gastrointestinal (GI) tract is most common. We can perform endoscopy of the upper gastrointestinal tract (UGI), which includes evaluation of the esophagus, stomach, and duodenum. We are also able to evaluate the colon, cecum, and ileum through endoscopy of the lower gastrointestinal tract
The images att show how irregular and inflamed his small intestinal wall looked. Multiple small biopsies were taken with the endoscope and sent for analysis including looking for specific cancer markers.
Unfortunately, the result came back as diffuse intestinal small cell, low grade lymphoma (cancer). This particular form of cancer carries a much better prognosis than many people think with long term chemotherapy. It grows at a very slow rate and the chemotherapy can keep it under control for many, many months to years. The chemotherapy itself is also very well tolerated and given as a tablet so no injections required!
Harley was started on his chemotherapy protocol and we started to notice a change immediately, within a month he was a completely different and much happier cat going outside more and being more interactive and most excitingly of all had produced his first formed stool in many months much to the delight of his owner!!
After 2 months of therapy he had a fabulous appetite, was incredibly high spirited, a genuinely happy, purring feline and his weight had increased remarkably from 4.4kg on the day of starting chemotherapy to 5.48kg! and he was producing lovely formed faeces on a regular basis now!! It was so exciting for us to see Harley responding so well and for his wonderful caring owner to have her Harley back again.