My senior cat has GI pain. Does cortisone affect lymphoma diagnosis?

His response to the steroid injection may be more indication that he does have lymphoma. Prednisone, a steroid, is commonly used in conjunction with a chemotherapeutic agent to treat lymphoma in cats. The steroid will decrease inflammation which may reduce his symptoms. Consider a consult with a veterinary oncologist to discuss testing for a definitive diagnosis after which treatment, if you choose, can begin.

Poor Kitty! Since she is already 17 years old and she is having such a tough time with her inflammation in her GI tract, I think steroids will be the best choice for her. If her blood work looks okay now, then I think she can tolerate the steroids. Unfortunately, if you don't put her on steroids the lymphoma or IBD may continue to get worse. It is true the steroids will not CURE lymphoma, but it certainly give her a better quality of life right now. It could keep the IBD under control and eventually you may be able to decrease her steroid dose to a lower dose. The concerns of long term steroids are much lower since she is already geriatric. If she was 4 or 7 years old, then I would be much more worried with starting her on long term steroids at that time. At the age of 17, our goal is to give Kitty are good quality of life. If you want more options about the lymphoma and interested in seeing an oncologist, I would ask your vet for a referral for a oncology consult. I hope this helps!

1. Some cats can maintain a good quality of life with prednisolone (a metabolite of prednisone used more commonly than prednisone in cats) managing lymphoma for a year, but others may only maintain a good quality of life for a few weeks to months. The response is highly variable depending upon the type of lymphoma present and severity of clinical signs. Most cats will begin to show a response to prednisolone within the first week. 2. Yes, performing endoscopic biopsies with prednisolone treatment will make the results less reliable. Biopsy samples will be altered, preventing an accurate diagnosis. If endoscopy and biopsies will be performed, I always wait to start prednisolone until after this procedure. On another note, if chemotherapy may be performed, it is best to wait to start prednisolone until other chemotherapy drugs are also started. Starting prednisolone prior to other chemotherapy drugs hinders the effects of chemo.

I'm so sorry that you are dealing with this with Cosita. Thank you for including a picture. She is adorable. I am attaching a link below to a handout on IBD. https://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=598 The end of that handout specifically addresses your concern. The problem with doing steroids is that it decreases the inflammation in the intestines and will likely make Cosita feel better, but if her disease is due to cancer (lymphoma), putting her on prednisone will make it harder to diagnose and treat her cancer later. "Lymphoma is temporarily responsive to prednisone but better responses can be obtained from stronger chemotherapy agents. Exposure to prednisone will make the lymphoma much more difficult to diagnose should biopsies be obtained later. Plus, exposure to prednisone can lead to resistance to other medications. (This is less of a problem for cats, but in dogs even a few days of prednisone can make a lasting remission impossible to achieve.)" There is nothing wrong with starting her on steroids, but you have to understand that it will limit your treatment and diagnostic options in the future if the steroids do not help. Good luck! I hope that was helpful and answers your questions. Thanks for using PetCoach.

Dexamethasone is 7 times stronger than prednisolone and has an increased rate of GI upset or stomach ulcers. Typically on prednisolone is used in cat because prednisone is broken down to prednisolone--so it is easier to start with the broken down form already. Prednisolones are specifically used when talking about lymphoma due to the potential side effects of dexamethasone. Dr.s chooses one over the other base on preference or what you are treating -- specific diseases have research to back the use of one--lymphoma does better with prednisolone. You will not see a fast improvement with just prednisolone or even if you added stronger chemo. It is a slow progress no matter what. Just using prednisolone you can see a good appetite, no change in diarrhea, no added weight gain. It merely suppress the cancer cells temporarily and helps them feel better. Even with other chemos, it is long term process with slow results---2-4 months to see improvement with the diarrhea in severe cases. They stay on the medicine long term and the doses can be alternated based on how each patient responds

I'm sorry you and Oscar are going through this. My honest opinion? In talking to pet parents about cancers, intestinal cancers in cats are one of the instances where I almost always urge people to go for it, and try to treat them. Why? Because they can do so well for so long. I'm assuming your vet is thinking this is either intestinal lymphoma or inflammatory bowel disease. Those two diseases cannot be distinguished from each other on ultrasound, and we often just see thickened intestines, so biopsies are needed. IBD is very treatable, and at 5 years old that is the more likely diagnosis. Some of these guys do great with just a diet change to a hypoallergenic diet. Others need immunosuppressive therapy in addition to diet, but there is an excellent drug called budesonide that has minimal systemic side effects, and works primarily in the gut. I've managed IBD cats well for 10+ years. If it's lymphoma, those cats respond well to prednisolone therapy (another, stronger immunosuppressive drug) and sometimes the addition of a well-tolerated chemotherapeutic called leukeran. I've successfully managed cats with intestinal lymphoma for 3+ years. If it's not lymphoma, and more of an issue with a focal intestinal mass, that's a whole different ballgame, but again, treatable in many cases. And I would have expected that they would have seen a mass on ultrasound, so that seems unlikely. I think the best thing about getting biopsies is having a definitive answer, and knowing what you're dealing with. Best of luck to you and Oscar in getting this figured out.

Whether a long acting steroid or daily oral steroids are better will depend on whether one works better than the other for your kitty's condition. This is something that will have to be tried out. The good thing about short acting budesonide is that it can be stopped anytime if needed. The long acting steroid can not be stopped from working until its activity is over. Depending on the tyoe of long acting steroid this can be up to three months. Trust your vet to do the right thing and prescribe the proper treatment for your cat. If you have problems with pilling your cat there are ways to compound the medication into either a transdermal medicine or flavored chews (tuna, sardine, etc) which can be given like a treat.