My cat's GI mass shrunk after steroids. Is it lymphoma or benign?

IBD and GI lymphoma can look identical on lab work and ultrasound - the only way to distinguish the two for certain is to do an intestinal biopsy. Steroids can decrease the number of inflammatory cells and make diagnosis more difficult. Both can be difficult to manage, and each cat may need a different treatment plan. Often pain medications, nausea medications, anti-inflammatories, hypoallergenic diets, probiotics, antibiotics, etc are needed.

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.

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

Maybe and maybe not. You will need to talk to the doctor who is treating your cat as to whether or not he or she thinks that the poor appetite is due to the small cell or due to the leukeran. This drug can cause this side effect so it is important to discuss this with your doctor. If you are not seeing an oncologist your doctor can contact a local oncologist for advice on your kitty. I hope this helps and thank you for using Petco Pet Education Center, formerly Petcoach!

Given her age, steroid side effects from long term use tend to become less of a risk if the benefits are clearly improving her quality of life. Depending on the nature of the growth, low level chemotherapy medications may provide an opportunity to halt growth or even reduce the mass but this would require assessment by a specialist

Hello, and thanks for your question. I'm sorry to hear about Trixie's diagnosis! It's great that you're working with an oncologist; I can tell you're wanting to provide the best care for Trixie. Most cats do feel better and perk up on the medication. If her appetite was down, you may see her start eating a bit better, and if you had noticed lethargy you may see her perk up and act more social again. Often we can see an increase in both appetite and thirst, which leads to more urination as well. Generally we don't see too many other side effects from the medications, and your oncologist will want to know if you do have concerns with how Trixie is feeling on the meds, as they may tweak the dose based on how Trixie's responding. I have seen a few animals go into remission, but I would defer to the oncologist on the actual numbers, as they see far more cases than we do in general practice! Hope this helps. Hugs to you and Trixie.