Don’t start chemotherapy before proper diagnosis
My 15-year-old neutered male cat had bloodwork that revealed elevated pancreatic levels at 512. An ultrasound revealed irritable bowel syndrome. My vets told me that my cat has a good chance of having lymphoma. Now they are suggesting an endoscopy to confirm their suspicions. I don’t want to do anything unnecessary to a cat that has a mild heart murmur, especially when I’m told that the procedure won’t be definitive. The cat is currently getting B12 and Cerenia injections daily. The vet wants to start the cat on prednisone and chlorambucil. The cat seems to be doing well, running around and playing, with some days better than others. What I should do? I am not sure which blood value you are referring to. I suspect you are referring to the alkaline phosphatase number. If all of the other values are within normal limits, then your cat is doing well for its age.
Lymphoma is the most commonly diagnosed cancer in older cats, and that is probably why your vets suspect it.
While irritable bowel syndrome has been seen on ultrasound, without a biopsy, procured by endoscopy or ultrasound guide, I would not be so quick to start any medications. Besides, you note that your cat is acting normally. Usually a cat will present for vomiting or a mass will be palpated, precipitating the need to explore further. That is not the case here. I believe that with what you have described, your cat could be sedated or anesthetized to get a proper biopsy sample and then you could proceed accordingly.
Daily injections of B12 and Cerenia seem excessive, but I would defer to your veterinarians. I am sure they have valid reasons. If prednisone is warranted, I would prescribe prednisolone instead since it is safer based on the body’s metabolism of the drug. I would not start any chemotherapeutic drug such as chlorambucil without a definitive diagnosis.
Remember that your cat is a senior citizen and that anything is possible as far as changes in its health. I think it is wise to be proactive, but I would suggest proceeding wisely, deliberately and realistically. Good luck!