Oliver Fights Rare Cancer

Hi everyone! I'm Jamie and I want to tell you about my cat Oliver. For starters, Oliver is The Best Cat Ever™! Oliver and I met way back in October 2007 when he showed up at our local Humane Society where I volunteered my time during college. In the eight years I volunteered there Oliver is the only animal I adopted. And I am the very definition of "crazy cat lady" which should give some indication of just how special he is. During his stay in the shelter he was overlooked because he was already an adult (1.5 years old) and most people who interacted with him said "he's great, but we're going to get this kitten instead." Well, after a few weeks of trying to help him find his forever home with anyone else I realized I was totally in love with him and I adopted him instead. Ever since I brought him home Oliver has acted more like a dog than a cat. Specifically he acts a lot like an American Pit Bull - he's super lazy and generally just wants to cuddle or to be petted.
 
As he's gotten older he's developed several health problems. Beginning in 2018 he stared showing symptoms of lower airway disease. Eventually this turned into full blown asthma triggered by environmental allergies. Later in 2018 he was diagnosed with the early stage of Chronic Kidney Disease (very common in cats as they get older).
 
In May 2020 Oliver received a surprising diagnosis of Collapsing Trachea. This is super weird because it's a DOG disease and is almost never seen in cats. Every vet and tech who sees that diagnosis on his records is dubious about it until they see his xrays which clearly show that he has it. Unfortunately, the only treatment that worked for controlling his symptoms from collapsing trachea was to put him on a corticosteroid (this is important later). And, as expected, his steroid use also caused him to develop diabetes.
 
And then 2021 happened...
 
TL;DR: Oliver has hemangiosarcoma. A cancer that's incredibly rare in cats, though common in dogs. He's started treatment for his cancer now, but because it's so rare in cats we have very little in the way of documentation about what outcome we can possibly expect from treatment. But this rareness works in his favor because he is being given VIP treatment by the vets involved in his care. Eventually they're even going to write a paper about him so that his case can be used to help other cats with this diagnosis in the future. Treating Oliver's cancer was delayed by nearly 2 full months from the time his spleen was removed because his past medical history and long-term use of corticosteroids made it very difficult to correctly diagnose the type of cancer he has. It took multiple tests over the course of that 2 months, and a handful of expert pathologists reviewing his tumors to come up with the diagnosis. His case was also shared with a handful of oncologists and internal medicine specialists across the US to see if they could help identify the cancer and come up with a treatment plan.
 
Oliver's cancer is almost definitely terminal. But because there's no solid information available about this cancer in cats we don't know how much longer he has left or really even what that time will be like. I've already committed to focusing on quality of life for him rather than length of life. We do know that there's very little chance (close to zero) that his cancer will go into remission. So for Oliver I'm focusing on keeping him happy and pain free for as long as possible. All of his treatment decisions are based on how he is acting and feeling and not based on my desire to have him live forever.
 
The total cost of his treatment (as of October 2nd) is $17,388.48. I'll post copies of those bills in updates for anyone interested as soon as I've redacted my personal information. Oliver does have pet insurance but unfortunately I did not put him on a plan with unlimited annual reimbursement, so the most I can receive back each year for his care is $5,000.
 
Here's the longer version of his story:
July 16: I took Oliver to see his regular vet because he was lethargic and had very little appetite. According to his blood tests that day he was anemic and had signs of an infection. He was put on antibiotics for 10 days and seemed to return mostly to normal during that time.
 
August 3: I had an appointment scheduled for a different cat of mine to see the vet in the late afternoon. About 1 hour before that visit Oliver came inside from his catio and was panting heavily. I called the vet immediately and was given permission to bring him along to that visit. And that visit is where this entire cancer journey starts.
 
Blood tests showed that Oliver was severely anemic, which explains why he was panting. He was struggling to get enough oxygen. And abdominal xrays showed that his spleen was enlarged and had irregular shape. His physical exam also showed that he was having a lot of pain in his abdomen and that his spleen felt lumpy and squishy in a bad way. My vet coordinated with one of our local emergency hospitals and Oliver was admitted to hospital within about 1 hour of leaving the regular vet's office.
 
His first night in hospital Oliver was given a blood transfusion to replace red blood cells and platelets. He was dangerously low in both. The plan was to do an ultrasound-guided aspiration of the cells in his spleen the following day to send off to pathology. Well, that plan changed as soon as they saw his spleen on the ultrasound. They realized immediately that his spleen needed to be removed immediately and that an aspiration sample would be useless for pathology. So he received a second blood transfusion to prepare him for surgery. Then, early the next morning he had surgery to remove his spleen. During surgery the vet confirmed that the cancer had already spread to his liver too. Oliver was given an esophagostomy tube (feeding tube implanted through the neck) and a final blood transfusion. After 2 more days in hospital Oliver was finally discharged to come home and we began the long process of waiting to find out exactly what kind of cancer he had.
 
August 6- Preliminary pathology results are in, suspected Mast Cell Disease. More testing is needed.
 
August 10: just 3 days after his release from hospital he had to go back and have his feeding tube checked. He was beginning to show signs of possible infection around the tube site. Oliver is immune-compromised between the diabetes, long-term corticosteroid use, and the fact that he no longer has a spleen, so every infection or possible infection must be taken seriously.
 
August 11 - August 18: was pretty uneventful for him, but on the 18th he was able to have his abdominal sutures (stitches) removed.
 
August 13 - Pathology results are in. Giemsa, Toluidine Blue stains: negative. This is NOT Mast Cell Disease, probably. Two additional pathologists reviewed the slides and now they think the diagnosis will be some type of lymphoma. More testing is needed.
 
August 21: Definite infection around the site of his feeding tube. Back to the hospital for minor surgery to debride the area, take samples of the infection for culture & sensitivity tests to find the best antibiotic, and to re-stitch the tube in place.
 
August 22 - September 8: Also pretty uneventful. On the 8th he had a second culture & sensitivity test done to see if his infection at the tube site was completely gone.
 
August 26 - Pathology results are in. This is NOT lymphoma. An additional pathologist has reviewed the case and has decided this is a round cell tumor of some sort. But there are many "flavors" of round cell tumors (including Mast Cell tumors, which were ruled out in the last set of tests). More testing is needed.
 
September 13 - More pathology results are in. Many of the recently ordered tests came back negative, one inconclusive, and one as an error in how the tumor cells reacted to the immunostains. The error test needs to be repeated. So far results are inconclusive.
 
September 15: Culture results came back and the infection was still there, but much weaker than it was before. Added some topical antibiotics to his treatment plan. But his weekly blood test showed that he was suddenly 5 percentage points more anemic than he was the previous week. He was bleeding internally again. We didn't know for certain, but assumed that the tumors on his liver were the source of the bleeding. That made the most sense to me because the tumors on his spleen had ruptured and been bleeding when his spleen was removed in August. It stood to reason that if the cancer in his liver were the same type that those tumors would eventually bleed too.
 
September 17: I legitimately thought Oliver was going to die this day. He was lethargic and totally uninterested in food. He also didn't want his customary cuddles. I took him to the vet for blood tests expecting the absolute worst and assuming he would be euthanized that evening. Luckily, although he was still anemic, he hadn't dramatically worsened since his visit on the 15th, so I decided to wait and see if he would stabilize or improve before making any decisions.
 
September 18 - 21: Major improvements in his energy, appetite, and attitude. Oliver was even playing with toys again.
 
September 22: Weekly blood tests showed that he was even more anemic!!! This made no sense to me at all because of his energy levels. But he was now back to severe anemia. He was basically at the point where the best options are either another blood transfusion or euthanasia. But, because of how he was acting I again took him home for the "wait and see" approach.
 
September 22 - Pathology results are in and we have a diagnosis! But it's late in the day when this information is received by the vet's office so none of us learn about it until tomorrow
 
September 23: We FINALLY have a diagnosis!!! Oliver has hemangiosarcoma. This cancer, though common in dogs, is incredibly rare in cats. So rare that there's very little information at all about treatment options and outcomes. In fact, there's basically zero useful information about it. There are case studies of a few cats with this cancer, but nothing that provides any real detail on how well they responded to treatment or whether treatment was done at all.
 
September 24: Oliver had his first visit with his oncologist and first chemotherapy treatment. Blood tests before his treatment showed major improvements in his red blood cell counts and he was back to being almost not anemic. Between Tuesday and Friday in the same week his HCT (measure of the red blood cells he has) jumped from 15.7% all the way to 27.5%. This is officially the least anemic he'd been since July 16th!
 
October 1: Oliver has his 1 week follow up visit with the oncologist. They check his blood counts again, and for the very first time since July 16th he is officially not anemic at all! At this visit they also did some xrays and an abdominal ultrasound to get a baseline for the size, number, and locations of his tumors. This technically should have been done the week before, but because of timing and doing everything as soon as possible after his diagnosis the radiology tech was not available before his first treatment to get the imaging we needed.
 
October 2: Today, the day I'm starting this GFM. Oliver is bright, happy, energetic (when he's awake), and acting like he did when he was much younger and healthier. He's currently scheduled to see the oncologist for his next chemotherapy treatment in 2 weeks (October 15th). If you met Oliver today the only outward signs you'd see that he's sick are the shaved spots on his belly, neck, and legs from his surgery, ultrasounds, and various IVs and blood draws. Otherwise he's just a happy, healty-seeming cat living his best life.
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Jamie Houle 
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Tucson, AZ