beautyfoodnerdrunningshoptravel

April 6, 2016

mallory in budapest - update

this is going to be very long

i've held off on this post, probably for superstisious reasons. i'm afraid any update will cosmically turn everything down hill. but here we go...

mallory update cats wanderlust budapest hungary helping
she likes to help me work

shortly before we left for budapest mallory was diagnosed with small cell lymphoma. to put it mildly, i freaked out. all i was hearing was "cancer" and tho obviously not genetically related, that didn't bode well as the women in my family don't have a great track record with cancer.  i mentioned i'm slightly supersticious right?

thankfully the problem solver in me imediately went into research mode. i googled the shit out of the diagnosis and found an amazing feline small cell lymphoma support group online and began filling them in and asking any questions i could think of. they were incredibly understanding and helpful, it didn't feel like such a black cloud after all. (this is a private group but if you have a cat with scl or idb, i highly reccommend joining)

the plan seemed really simple in the beginning: start her on steroids for a month, begin the oral chemo after 30 days, check her blood work monthly, give a full check up every 6 months. and for those living in the states, it is that simple. but we were in budapest, the following is gonna make you want to hug your healthcare provider.

mallory update cats wanderlust budapest hungary snugs
she's so cuddly

finding a hungarian vet: a lovely co-worker had found a place with an english speaking vet, excellent. downside, she only works a 4 hour shift 1 day a week and it's not a time when i can get out of work. they did have 3 open hours on sunday evenings and all i really needed was blood work so i figured we would be ok. i had my us vet (santa monica pet medical for anyone in the area looking for rockstar service at a good price) to give me specifics for what tests needed to be done as well as emailing me the prescriptions for chemo and anti nausea medication that would then be translated by the hungarian vet. easy right?

haha, fools!

the medication: prednisolone (steroid) and zofran (anti nausea) were easy, they don't mind giving these medications to pets, leukeran (chemo) was a whole other beast. in hungary the disease is treated via chemo injection, not oral medication. leukeran, the name brand medication, is not available in hungary and needed to be imported. a call to the import pharmacy resulted in another road block: this is a human drug, we can't fill a vet prescription. what?!

i felt like jerry seinfeld at the rental car place, everyone could write the prescription, but no one could fill it. it's useless. there was another vet i was on a waiting list to get in to see who specializes in oncology, but they were referral only and i was 2 weeks behind getting mal on the chemo, and freaking out.

luckily the doctor service my company has hired was very understanding about the situation and was able to import the leukeran for me. success! now to give her the meds.

one of the great pieces of information i received from the scl group was something called "pulsed dosing." pulsed dosing is giving a higher dosage of the leukeran at larger intervals. i sent their research to my vet in the us and she agreed to begin with this protocol instead of her initial instructions.

rather than a 2mg pill every 72 hours, mal receives 6mg every other week. for a kitty who is not a fan of taking pills, this was a blessing. i ordered some chicken flavored size 3 gel caps from capsule depot, based in the us but shipped internationally. i cram the leukeran into the capsule and she loves it.

mallory update cats wanderlust budapest hungary cat sofa
she has her own little sofa

that was a lot of information, so here's the breakdown of mal's medication schedule:

everyday: morning 5mg prednisolone, evening 5mg prednisolone

every other wednesday add: morning 2mg zofran, evening 2mg zofran and an hour later 6mg leukeran

mallory update cats wanderlust budapest hungary
zofran on the bottom, prednisolone on top

mallory update cats wanderlust budapest hungary
leukeran

mallory update cats wanderlust budapest hungary
chicken flavored gel caps

it seems like a lot, as mal isn't fooled by pill pockets, i do have to force the prednisolone a bit. but she's sort of accepted it's a daily thing before i'll give her food so, she doesn't fight it...much.

mallory update cats wanderlust budapest hungary
post meds reward

for those lucky enough to be stateside, there are online compounding pharmcacies, like roadrunner, who will make the bitter steroid pill into a tasty chew treat. i had my beau mule a pack over when he came to visit. i save these for when i'm going out of town and need someone to look in on mal. i plan on having every visitor bring them over.

a word about leukeran. if you've made it this far you either are about to begin treatment for you cat or have already gone thru it. you've probably seen the cost of leukeran and thought, f that trash! believe me, i did to. i did convince my vet to prescribe chlorambucil which is the compound version of the drug. calling it "generic" isn't technically correct, but i feel it's basically interchangeable. if i was back home, we'd be compounding. one of the up sides to living in a country still recovering from socialism is the medication is cheap! i'm paying $150 for 25 2mg tabs, that's i think about a 1/3 the cost of in the us. when i'm back stateside, provided there's no ill effects, we're going the compound route all the way.

so how is mal doing? well, pretty great i think. the only lethargic change i've noticed is she doesn't do the random spazz out, run around the aptartment like she used to, but she also turns 12 this month so, i feel that's to be expected. she has stopped throwing up. she used to have what i thought was the odd hairball here and there, but she hasn't been sick once since we moved to the new apt in budapest.

she took her first does of chemo like a champ. she was a little sluggish the next day but she didn't get sick or stop eating, so that's a win in my book.

mallory update cats wanderlust budapest hungary sunshine naps
naps in sunbeams

we did have a food issue, at least i've concluded it's the food. mal has been eating science diet since she was a kitten. not for any reason other than that's what we always fed our dog so i just stuck with it. in addition to some medications not being available locally or allowed to be shipped, the specific line of science diet wasn't available here. i found the closest thing to it, still science diet, still for senior cats, but then i noticed her stool was a bit soft. she would have one normal poo and then a clump. this was not normal. my friends who have cared for mal always comment on how "dainty and lady like" her poops are. when we first arrived she'd had to eat purina as that was the best the grocery store could offer and i had no way of getting to the one real pet store in town. i put her back on the purina and her poops are back to normal. must be the formulation here doesn't agree with her.

a week ago i noticed a lump on her right side while petting her. i freaked out and began googleing, it's my go to. luck was on my side because the oncology vet finally had an opening. i took her in and they took a sample, determined it was i fatty lipomas and to just keep an eye on it. they also recommended she go on a bit of a diet and are going to get me some royal canin for digestive issues for her. hoping it'll be good for her poop and her overall health. this also means i'm in their system so when it's time for the 6 month check up, i'll be able to get an appointment. until then we'll get the blood drawn and labs done by the slightly creepy weekend vet.

mallory update cats wanderlust budapest hungary vet
yeah, i'm not coming out

so that's the long version of mallory so far. i'll keep you posted of any other changes. if there's any questions you have, about traveling with her or her small cell lymphoma treatment, leave a comment and i'll do my best to answer them.

mallory update cats wanderlust budapest hungary snugs
love from budapest!

update 5.13.16

mallory had her first round of blood work since beginning the treatment and our california vet says her results are good/normal, a huge relief!