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Meesh · 02-18-2010, 09:50 AM

Hamlet is back down at Penn today for his third chemo treatment. The oncologist just called me with an update. Last week, his liver panel showed one of his enzymes – ALT – was elevated after everything else went down to normal levels. This week, the liver panel showed the same enzyme went up yet again but all other enzymes being within normal range and his liver function looks good. His blood work also indicated that his red cells have increased and the white cells are good. Since the single liver enzyme going up has everyone boggled

(I asked if they hadn’t seen something like this before and the onc said not really and the only time she had experienced it was in cats with glandular hepatitis), they said it could be due to several reasons: 1. the pred could be elevating it but that seemed unlikely since we actually reduced the dosage last week and had him on a liver protectant, 2. it could be that the lymphoma is just in his liver so much that that’s the reaction, 3. it could be an infection or glandular hepatitis.
The treatment, Vincristine, we skipped last week and were supposed to get this week metabolizes through the liver so the onc went over several options with me: 1. go forward with a lower dosage of the Vinc plus send me home with a liver antibiotic for the week, 2. do another ultrasound but she said she didn’t expect that it would show anything too different from what was indicated on the first one, or 3. do a liver aspirate which would require sedation. We both agreed to go forward with option 1 and if the liver enzyme still looks wonky next week, then we’d do the aspirate. Plus, if the enzyme elevation is due to the lymphoma, getting the chemo may actually be what’s needed.
Otherwise, Hammy’s been eating like a little pig and acting like his normal lovey self. He was wrestling with my parents' dogs Foxy over the weekend and even picked a fight with Rufus over a sofa spot last week.

So, we’ll just have to keep our fingers crossed that the liver thing is nothing additional to the lymphoma and that the chemo will address it.

02-18-2010, 09:50 AM	#1 (permalink)
Meesh Senior Member Join Date: Jan 2010 Location: Washington Township (Sewell), NJ Posts: 329	Hamlet's Weekly Update Hamlet is back down at Penn today for his third chemo treatment. The oncologist just called me with an update. Last week, his liver panel showed one of his enzymes – ALT – was elevated after everything else went down to normal levels. This week, the liver panel showed the same enzyme went up yet again but all other enzymes being within normal range and his liver function looks good. His blood work also indicated that his red cells have increased and the white cells are good. Since the single liver enzyme going up has everyone boggled (I asked if they hadn’t seen something like this before and the onc said not really and the only time she had experienced it was in cats with glandular hepatitis), they said it could be due to several reasons: 1. the pred could be elevating it but that seemed unlikely since we actually reduced the dosage last week and had him on a liver protectant, 2. it could be that the lymphoma is just in his liver so much that that’s the reaction, 3. it could be an infection or glandular hepatitis. The treatment, Vincristine, we skipped last week and were supposed to get this week metabolizes through the liver so the onc went over several options with me: 1. go forward with a lower dosage of the Vinc plus send me home with a liver antibiotic for the week, 2. do another ultrasound but she said she didn’t expect that it would show anything too different from what was indicated on the first one, or 3. do a liver aspirate which would require sedation. We both agreed to go forward with option 1 and if the liver enzyme still looks wonky next week, then we’d do the aspirate. Plus, if the enzyme elevation is due to the lymphoma, getting the chemo may actually be what’s needed. Otherwise, Hammy’s been eating like a little pig and acting like his normal lovey self. He was wrestling with my parents' dogs Foxy over the weekend and even picked a fight with Rufus over a sofa spot last week. So, we’ll just have to keep our fingers crossed that the liver thing is nothing additional to the lymphoma and that the chemo will address it.