Frequently Asked Questions

Q

A

How do we know whether it is the treatment or the cancer itself that makes the cat appear nauseated and have a reduced appetite?

This is probably one of the most frequently asked questions by both veterinarians and owners. In order to answer this it is necessary to re-assess the remission status of the cat and to perform a thorough review of the previous treatment history in order to determine whether there is a pattern to the weight loss or whether the nausea might be associated with certain chemotherapeutic drugs.

This may require performing an abdominal ultrasound in cats with gastro-intestinal lymphoma and comparing the findings to the pre-treatment staging ultrasound. If the results suggest improvement or even clinical remission, the suspicion is that it is the chemotherapy that is the culprit. If this is the case, giving the cat a short break from treatment may result in a resolution of the problem. Continued chemotherapy should be initiated carefully with prophylactic anti-emetics and dose-reductions should also be considered. If the ultrasound shows persistent lymphoma or even worsening status, other chemotherapeutic drugs with concomitant anti-emetics may be needed.

Is my cat suffering because it is not eating?

It is reasonable to assume that a cat that does not eat does not feel well. There is a gradual scale from not “feeling well” to suffering. A temporary decrease in appetite or even anorexia may be acceptable in most owners’ and veterinarians’ opinion as long as it is assumed that it does not significantly impact on or interfere with other aspects of the cat’s life. However, severe prolonged anorexia and weight loss secondary to any terminal disease for which there is no treatment or palliation is a clear sign of an unacceptable quality of life.

What can I do to improve my cat’s food intake?

Appetite is affected by many internal and external signals. Many cancer patients may experience a reduction in appetite due to direct or indirect effects of the tumor and the treatment they are undergoing. Every effort should be made to optimize the patient’s wellbeing including addressing conditions such as dehydration, fever, pain, and nausea. Make feeding times as unstressful as possible. Try offering small amounts of a variety of tempting foods but be alert for signs of learned food aversion. Offering many small meals through out the day may meet with more success than fewer larger meals. Sometimes warming the food to body temperature will increase its appeal.

My cat’s appetite is very poor and he is losing weight despite a good response to chemotherapy. I have been told a feeding tube could help him through this period but I am concerned about the impact this would have on his quality of life.

Tube feeding is well-tolerated by many feline patients. Esophagostomy tubes, in particular, seem to cause little discomfort to the patient and provide access that permits the feeding of canned cat foods. Tube feeding is not possible in patients that have uncontrolled vomiting. However, when these conditions are not present or are properly managed, tube feeding will improve the patient’s nutritional status, energy level, and overall sense of well-being. Since the cat is in remission but still losing weight, the weight loss may be due to chemotherapy induced nausea and fatigue, minor dose reductions and effective anti-emetics should also be considered in addition to feeding tube placement.