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Manny was such a sweet little guy who won all of our hearts here at Perth Cat Hospital.  We thought we would share his brave journey.

Manny presented to us with a large swelling above his nose, severe nasal discharge and sneezing which had not responded to previous symptomatic medical therapy.

At Manny’s initial consult we performed a thorough physical exam and collected blood samples for health screening on our in-house machine and a blood sample to send away to the pathology laboratory for testing for the fungal disease Cryptococcus.  The results of these tests were largely unremarkable so the next step was to book Manny in for a general anaesthetic and full nasal disease workup. 

Our dental x-ray machine was used to take intra-oral radiographs of the nasal sinuses. A soft tissue opacity was observed bilaterally obscuring the nasal turbinates (tiny bones within the nasal cavity) and the nasal septum also appeared irregular indicating a process causing bony disruption (generally as a result of a fungal or bacterial process or neoplasia).  

Our video endoscope was then used to thoroughly examine the naso-pharynx from the inside.  We were able to visualise a cream-coloured mass to the caudal aspect of the left nasal cavity and degradation of the soft tissue to the front of the nasal cavity.

A biopsy of the affected tissue within the nasal cavity was collected and sent to the laboratory for histopathology and culture.   Manny was treated with antibiotics and pain relief whilst we awaited his results. 

Unfortunately the results did not reveal good news.  Many was diagnosed with low grade intermediate to large cell lymphoma and also had a secondary bacterial infection. 

Lymphoma in Cats

Lymphoma is a cancer of the lymphatic cells which is a type of white blood cell. The nearest similarity in humans is Non-Hodgkin’s Lymphoma.

Symptoms

The most common form of lymphoma that we see in cats affects the lymph glands of the intestines. Clinical signs normally seen in these cases are chronic vomiting or diarrhoea. Other relatively common sites in cats are the external lymph glands, the kidneys and the chest cavity. Rarer forms of lymphoma can affect the spinal cord, the nose (like in poor Manny’s case), the eye, the skin and other organs.

Diagnosis

A diagnosis can be made by biopsy and further “staging” of the cancer is normally indicated, as was performed with Manny. Staging is the process by which we make sure the cancer has not progressed past the original diagnosed site. Depending on the initial site of the lymphoma, these procedures include blood tests, ultrasounds, aspirates of other lymph glands or organs such as the spleen or liver,  x-rays of the chest and occasionally bone marrow biopsies.

Treatment and Prognosis

Once staging is completed, we will have a complete picture of your cat’s lymphoma and treatment and prognosis can be determined. Lymphoma is the most responsive cancer we see in cats and up to 70% of cases undergoing treatment will experience complete remission with minimal side effects. Most treatments involve the use of a combination of chemotherapy drugs called a “protocol”. Cats do not tend to experience the array or degree of side effects that humans do, they do not lose their hair and very rarely experience nausea or vomiting. In most cases, one wouldn’t even realize your cat was going through chemotherapy. We do however sometimes see the whiskers become brittle and can break and fall out.

Without treatment, most cases of lymphoma can only expect a survival of around two to four months from the time of diagnosis. With treatment however, up to 80% of cases can remain in remission for between 8 to 24 months. These figures are very variable in cats as the duration of response can be very variable and is also dependent on the type of protocol used and the form of lymphoma treated. Response to initial treatment is a very goof indicator or prognosis. We generally expect longer survival times from the more advanced protocols using a wider range of drugs. Treatment can range from just palliative where no remission is attained but there is some relief from clinical signs of the cancer, to mid-range and more advanced protocols. Protocols are generally tailored to suit budget, logistics and the individual patient. Some protocols will require weekly visits, whilst others can be less frequent.

The main aim of treatment for lymphoma is to reduce all clinical signs associated with the cancer in order to provide an excellent quality of life whilst on treatment and during remission. If there is a relapse of the lymphoma, either the same protocol can be used again or in most cases, a slightly different one is used.

Costs of treatment vary tremendously and will depend on which protocol is most suitable for you and your cat. With the advanced protocols, treatment usually goes on for about 4 to 6 months with visits initially once weekly, then decreasing to fortnightly and monthly. Patients are usually dropped off in the morning, kept in hospital for the day and then discharged home in the afternoon. Each patient will have a complete blood count performed before each treatment.

Manny’s family decided to pursue chemotherapy and this allowed Manny a significantly improved quality of life for almost 6 months post diagnosis.  During the time we saw Manny for his treatment, it was so lovely to see him breathing comfortably again and hearing stories of him running around chasing his brothers and sisters at home!

Sadly after a brave battle, Manny passed away peacefully in June this year after coming out of remission.  He will be greatly missed by all here at PCH and his beautiful family at home.   

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