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Does cat have cancer?

Species: Cat
Breed: DSH
Age: 11-15 years
Dear Dr Marie,
I am sending this letter in order to ask your advice about the course of treatment our vet has recommended for our cat, Mojo. To give you some background, Mojo has presented some unusual behaviour recently that prompted us to bring her in for a check up. She is a fifteen-year old domestic short-hair cat, who is spayed and who has always been an indoor kitty, with supervised outdoor time on a harness. She has received regular vet care all of her life, been fed quality, nutritious food, and always been treated with love and respect as a full member of the family. She has no history of physical illness, and we have had her since she was eight weeks old. She is also the only quadroped, non-human in the house. :)
My vet prescribed Metacam a couple of years ago to address some age-related stiffness that presented in Mojo, and she has since been on this medication. Following several inconclusive tests at Mojo's recent visit, our vet suggested that there was a possibility that she has cancer, but could only confirm this via a very costly ($1000) biopsy surgery. Our first concern is for Mojo's health and well-being, of course, but the trauma of such a surgery on her, combined with the unexpected expense (we've already spent $600 this week) of a procedure that is speculative and that is not guaranteed to resolve the cause of her symptoms has given us cause for concerned pause. Our vet recommended an alternate course, wherein it is assumed that Mojo has been positively diagnosed with cancer, and we treat her with new medication. He mentioned that we could no longer give her the Metacam he has been prescribing, because it would contraindicate with the new medications, specifically the steroid treatment he plans to begin next week. I’m not sure about treating a phantom illness, treating a cancer that may or may not exist. But my greater concern is about how her current illness may be a side effect resulting from prolonged use of Metacam, which I've only recently learnt can be so potentially dangerous for feline patients.

Because I was curious to know what new options might be available to treat Mojo's stiffness, I decided to do a little online research, with the intention of discussing whatever I found with my vet next week at Mojo's follow-up visit. I'm sure you can appreciate how devastated and shocked I was to discover the negative experiences so many other cats have suffered as a result of their well-intending owners dispensing Metacam to them.[1] I was further appalled to read that the American FDA has not yet revoked whatever permissions are required in order to produce, market, and distribute Metacam (at least for use in cats), despite allegedly gathering a tremendous amount of data that clearly demonstrates its deleterious and often lethal consequences when administered to cats. As I read anecdotal testimonies of cat owners whose pets had suffered and died as a result of using Metacam, I felt chills when I recognised the symptoms they described having witnessed in their own pets as similar to those which prompted us to bring our Mojo to the vet in the first place. Mojo's symptoms included sudden and severe loss of appetite; making a 'huffing' noise, almost as though she was sneezing multiple times in a row; disoriented behaviour, such as urinating or defecating elsewhere than her litter box, without apparent cause such as emotional upset, etc.; decreased urine and bowel movements; and sudden, increased lethargy (beyond what has been normal for her).
My recent attempt to seek advice from the College of Veterinarians of Ontario was unsuccessful, and was informed that they could only offer me the option of filing a complaint about my vet, which isn't what I want to do. I'm so happy to have found your website, and hope that you can offer some advice. I've also read your own article about Metacam and Cats. Based on the radio-station affiliation, I'm guessing you're in Ottawa; if you were anywhere near Toronto, I would love to bring Mojo to you in person for a second opinion. My mom has been in tears for the last five days about Mojo, and we don't know what to do.
At her appointment on Friday, the took her off the Metacam, and prescribed Tetracyline as a precaution, as well as Cyproheptadine, to stimulate her appetite. The appetite stimulant seemed to work, and Mojo ate voraciously over the weekend. However, my mom has had difficulty in giving Mojo her medication in the last two days, and she has once again stopped eating. My mom and Mojo share the primary bond, and Mojo has always trusted her -- she's like her shadow. In the last few days especially, Mojo has withdrawn and is sullen, prefering to hide. My mom's call to the vet yesterday morning has not been returned, which has also not done much in the way of assuring us that Mojo's needs are being best served. We're open to suggestions, and have even wondered about naturopathic options for Mojo.
I realise this letter is a little scattered, and the questions are not direct -- for this I can only apologise, and explain that I'm feeling emotional and confused while writing it. To make it a little easier for you to reply, here's a summary of what we're hoping you might be able to offer advice about:

- are Mojo's symptoms possibly a consequence of Metacam use? is there a way to positively confirm or refute this possibility? [1] On one of the websites I consulted, they advise a recourse treatment, but this seems specific to renal failure: "Dealing with Adverse Reactions to Metacam":

- are there specific tests we can ask our vet to run, in order to rule out Metacam as a potential cause for Mojo's current ill health?

- do you have any opinion about the alternate treatment proposed by our vet – that is, to treat a phantom cancer?

- in terms of her immediate medical situation, do you have any recommendations? (especially about administering the appetite stimulant)

- my mom's greatest fear is that we'll be advised to euthanise Mojo. Any words to soothe her aching heart?

Dr Marie, I realise that there are likely more questions than you intend to address in this forum you've so generously provided, but we're feeling desperate about our beloved, Mojo. Your consideration and suggestions about our situation shall be greatly appreciated.

With Sincerest Thanks,
Kimberlee & Mojo

[1] According to, “Metacam is known to have a narrow safety margin-there is little difference between the quantity of a safe dose and a toxic dose. Studies have shown that repeated doses of Metacam can result in death, particularly in smaller and older cats. An FDA study concluded that in a test including 305 cats on Metacam, 105 cases reported kidney failure resulting in death, while 35 cases resulted in euthanasia.”

Online vet, Dr. Marie

Dr. Marie replied:

Hi Kimberlee...I have never received such a detailed and well written out question! First of all, I want to tell you that I really sympathize with you on what you are going through with Mojo. Unfortunately this type of situation is all too common.

From what you have described, Mojo's current concerns are extremely unlikely to have been caused by Metacam. If Metacam is harmful to a cat it is because it causes kidney failure and this is very easy for a vet to diagnose.

I must say as well that I do occasionally prescribe oral Metacam for cats with arthritis when the benefits outweigh the risks. The big concern that I have with Metacam right now is that it seems that a single injection of this drug can cause severe renal failure in a cat. It is rare, but it does happen and I don't believe that many vets are aware of this. With all that being said, I don't think that Mojo's problems are related to Metacam.

Even though I don't know all of the details of Mojo's case I can picture exactly what is happening as I have had many cases like this. I see older cats that are just not feeling well and we do bloodwork and there is no obvious answer. Most of the common things we see in cats (kidney disease, diabetes, thyroid problems, etc.) are very easy to diagnose with bloodwork.

When we see an older cat that really isn't doing well and then the bloodwork is inconclusive then the next likely explanation is unfortunately cancer. The problem is that cancer is very difficult to diagnose sometimes. I usually recommend an ultrasound followed by a biopsy of any unusual looking organs but as you have discovered this can be quite expensive.

If I have an owner who does not want to go through with the expensive tests (which is the majority of owners) then I will often treat such a cat with steroids which is what it sounds like your vet is doing. Steroids help to shrink cancer and can help a cat with cancer immensely. However, it is often just a temporary help.

Unfortunately steroids and Metacam cannot be given together as this would increase the risk of kidney problems and could be very likely to cause a stomach ulcer. So, this is why Mojo has to come off of the Metacam.

The appetite stimulant is definitely what I would be doing as well. I often will prescribe a drug called Remeron (mirtazipine) but another common one is cyproheptadine.

In regards to your question about your mom, this is a tough one. From what you have described about Mojo I am definitely concerned and you may not be far from some hard decisions. If you are in Toronto, you are not far from Guelph. There is a wonderful pet loss support group that is run out of the University of Guelph. I do not have all of the details but you can ask your vet if they have the information or contact the university of guelph. There are also some really good online support groups that may help your mom as well.

I'm sorry for the hard times you are going through with Mojo. I hope my answer has helped to clear up a few things for you.

Dr. Marie.

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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.