With this increasing variety of cases, Suter shared some proposed etiology for feline GI lymphoma, consisting of however not restricted to the following:
- A link might exist in between persistent cigarette smoke direct exposure (5 years or more) and lymphoma, however area of the illness associated to this direct exposure is not defined.3
- Chronic swelling from persistent irritable bowel illness has actually been connected to the advancement of alimentary LSA.2
- Siamese cats might have a predisposition (probably hereditary) to establishing mediastinal LSA.2
- Feline immunodeficiency virus infection and subsequent immunosuppression has actually been linked in feline lymphomagenesis.2
Diagnosis
“The big point of this talk is that GI lymphomas in cats are not created equal, but they do have similar clinical signs. The signs, when cats are presented at their local veterinarian, tend to be similar, [including] weight loss, chronic vomiting, diarrhea, and inappetence. [These] are the hallmark signs of a cat who has GI lymphoma,” Suter said.
“In physical exam, many times you feel nothing, and other times you can feel thickened, rope-like intestines. Many times, [the patient will] have an actual abdominal mass which is usually associated with a small intestine. You can palpate enlarged, especially mesentery lymph nodes, but not all the time,” he continued.
Suter advised participants that although they have comparable scientific indications, GI lymphomas can have really various treatments. “Figuring out [the] type of GI lymphoma is important because that will guide our treatment options when treating these cats,” Suter said.
Ultrasound-directed fine-needle goal (FNA) can be reliable for identifying this illness. However, Suter mentioned this technique can be challenging if the GI thickening/mass or local lymph nodes are not big enough to obtain cells from. “As with any tumor, biopsy is always a gold standard…and it’s very easy to [perform] biopsy [for] cats.” As an outcome, Suter suggested a biopsy for whatever in the GI system throughout stomach surgical treatment due to the fact that GI lymphoma can happen in all parts of the GI system.
Suter likewise suggested that total diagnostics need to consist of stomach ultrasound, transabdominal ultrasound-guided FNAs or needle biopsy of impacted organs, thoracic radiographs (which might or might not contribute any prognostic info however might recognize other comorbidities), total blood count, and serum chemistries. Staging in oncology determines the degree of the growth problem. This can help figure out whether regional, systemic, or combined treatment is required for the client, generally depending on where the illness provides.2
Treatment
Low-grade GI LSA is generally simpler to handle, according to Suter. “Most cats generally respond quite well,” he included.
Suter suggested utilizing chlorambucil (Leukeran) and prednisolone persistent dose plan, which is presently the requirement of look after this illness. This treatment has an 80% reaction rate for cats, with an average survival rate of 1 to 3 years.2
Intermediate- to state-of-the-art GI LSA needs an entirely various procedure for treatment. “As we always say in oncology, aggressive diseases require aggressive treatments,” Suter said.
Standard of look after handling this kind of GI LSA is CHOP-based chemotherapy, that includes 4 drugs: cyclophosphamide (Cytoxan), doxorubicin (Adriamycin), vincristine (Oncovin), and prednisolone. This treatment is administered weekly, however it can be challenging for some customers to carry their cat to the healthcare facility each time, Suter kept in mind. Surgery prior to beginning chemotherapy can be thought about if a big GI mass is seen or scientific indications associated with constipation/obstipation are seen. Response rate for this treatment is around 50% to 60%, with an average survival rate of 6 to 12 months.2
With these average survival rates, Suter advised veterinary experts to be cautious when informing customers the length of time their family pet is most likely to live. “I’ve seen cats live 2 years, [and] I’ve seen cats live 1 month. It’s difficult to define exactly how an animal is going to [respond to treatment]…but usually more aggressive treatments cause longer survivals,” he said.
References
- Kehl A, Törner K, Jordan A, et al. Pathological findings in intestinal neoplasms and polyps in 860 cats and a pilot research study on miRNA analyses. Vet Sci. 2022;9(9):477. doi:10.3390/vetsci9090477
- Suter S. Feline intestinal lymphomas: medical diagnosis and treatment. Presented at: Veterinary Meeting & Expo; January 14-18, 2023; Orlando, FL.
- Bertone ER, Snyder LA, Moore AS. Environmental tobacco smoke and threat of deadly lymphoma in family pet cats. Am J Epidemiol. 2002;156(3):268-273. doi:10.1093/aje/kwf044
