Cat with Lymphoma will not eat

[rubytuesday29]

I have a 8 year old male (neutered) indoor only cat, diagnosed last month with lymphoma (confirmed through rads and outside lab cytology). He is on 1 ml of prednisone once a day and recieving vincristine injections, once a week, for the last 3 weeks. He has had intermittent vomiting, mainly from the pred, since we switched from liquid pred to pills, the vomiting has decreased. Rads show that the tumor, in the thoraic cavity, has shrunk significantly since beginning the vincristine. He is FELV negative, retested after the lymphoma diagnosis.
My question is that he will not eat, he has lost about 2-3 lbs since the diagnosis, every week he is 1/2-1 lb lighter. He has been offered everything i can think of for food, wet food (i tried every can for sale at the local grocery), dry food, treats, etc. He is not interested, won't eat anything. Other than not eating, he appears in good spirits, appears to be drinking (he is not dehydrated), using the litter box, eyes are bright, he is his normal affectionate self. My husband and I wonder if he is eating at night when we are sleeping (we do not free feed because we have 3 cats total but we leave the measured food out overnight if it hasn't all been eaten) but he is losing weight at a rather rapid pace. Further rads do not show any evidence of lymphoma in the digestive track, and CBC looked good, all taken 5 days ago when he continued to lose weight. What can I do? Is this from the lymphoma? He is supposed to get his last weekly vincristine (then goes to once every 3 weeks) and start on Cytoxan (i think its cytoxan, i could be using the wrong drug name) this week.

[Aleda M Cheng, D.V.M., C.V.A]

There are many oral anti-nausea medications.  Ask your vet about Cerenia.  I have used it safely in cats, although it is only labeled for dogs.  I called the manufacturer to make sure that it was safe in cats before I used it.  It worked well but can only be used for 5 days, than you must skip a few days.  

If all else fails go the holistic route.  There are Chinese and Western herbal preperations that really help for appetite.  Look for a holistic vet at the American Holistic Veterinary Medical Association, or the Chi Veterinary Institute websites.

[Aleda M Cheng, D.V.M., C.V.A]

I would ask your vet to prescribe Reglan, an anti-nausea medication to be given twice per day; because the inappetance can be due to nausea, since chemotherapy medication commonly causes nausea and GI side effects.  I would also request cyproheptidine, an anti-histamine medication that acts as an appetite stimulant.  If cyproheptidine is ineffective than request Remeron (mirtazapine), an anti-depressant that causes marked increase in appetite.   Pepcid should also be given.  Pepcid can be purchased over the counter and you can give your cat 1/4 tablet twice daily.  This will help settle an additional stomach issue caused by the prednisone.

If your cat refuses commercial food than make your own food.  I have a cancer diet hand-out that I give out for all my cancer patients.  The feline cancer diet consists of 75% meat or fish gently cooked (just seared on the outside) in olive oil and chopped garlic.  In a seperate pan saute mushrooms (shitake, maitake, portabello) and broccoli in olive oil, than chop the meat and vegetables very fine.  Mix the meat and a small amount of the vegetable/mushroom combo together and after cooling to just warmer than room temperature give to your cat.  You also need a vitamin/mineral supplement if you are only feeding a home-made diet.  Missing Link is the supplement I recommend, you can order it online.  If you are unable to make food for your cat, than purchase baby food meats in a variety of flavors and serve them gently warmed.

[rubytuesday29]

Thank you. We tried the Reglan in the beginning and that did not appear to help. I will request the cyproheptidine, start the pepcid, and get the baby food this evening.

[Aleda M Cheng, D.V.M., C.V.A]

Opps!  Sorry about the double posting.

[Aleda M Cheng, D.V.M., C.V.A]

I would ask your vet to prescribe Reglan, an anti-nausea medication to be given twice per day; because the inappetance can be due to nausea, since chemotherapy medication commonly causes nausea and GI side effects.  I would also request cyproheptidine, an anti-histamine medication that acts as an appetite stimulant.  If cyproheptidine is ineffective than request Remeron (mirtazapine), an anti-depressant that causes marked increase in appetite.   Pepcid should also be given.  Pepcid can be purchased over the counter and you can give your cat 1/4 tablet twice daily.  This will help settle an additional stomach issue caused by the prednisone.

If your cat refuses commercial food than make your own food.  I have a cancer diet hand-out that I give out for all my cancer patients.  The feline cancer diet consists of 75% meat or fish gently cooked (just seared on the outside) in olive oil and chopped garlic.  In a seperate pan saute mushrooms (shitake, maitake, portabello) and broccoli in olive oil, than chop the meat and vegetables very fine.  Mix the meat and a small amount of the vegetable/mushroom combo together and after cooling to just warmer than room temperature give to your cat.  You also need a vitamin/mineral supplement if you are only feeding a home-made diet.  Missing Link is the supplement I recommend, you can order it online.  If you are unable to make food for your cat, than purchase baby food meats in a variety of flavors and serve them gently warmed.