Knox Knews

We went to the vet today for a monthly check-up for Knox. His white blood cell count was a bit low last month, so they wanted to follow-up with him to see if the counts have increased at all. (Otherwise, we would have waited two months before returning.) We won't know the blood results until early next week. In the meantime, however, the physical exam revealed a mass high up under his rib cage. It was difficult for the doctor to feel because of its location, but it was definitely an irregular mass. It could be enlarged lymph nodes or possibly the tumor on his stomach. What makes this a bit of a concern is that the doctor has not previously noticed this mass. He admitted that he could have just missed it before or it could be that the cancer has returned. We don't know if we ever really put Knox into remission, but if the chemo is going to work it does its magic within a few weeks, after which point you hope for some sort of remission that lasts (in our case, for a few months). Knox has only been on chemo treatment for 2 months, so the presence of the mass (either new or previously undetected) is not good. It means that the cancer has either become resistant to the chemo already or it never really worked in the first place. Because of the out-of-pocket way in which most (including Knox's) pet care is funded repeated ultrasounds to view changes in the tumor are a bit cost prohibitive (about $400 each).

We aren't necessarily surprised by the news. First, we never expected that we would cure Knox, though we did certainly hope for a longer span of disease-free time. Second, he has started vomiting a bit more frequently. Immediately following treatment the vomiting ceased. About two weeks ago we noted that he was vomiting a few times a week. This did coincide with his switch to dry food (by his own volition), but we know enough not to attribute the change in behavior to the food exclusively.

So, the bottom line is that together this is not good news. We are still processing the information and are sort of numb about it right now. We certainly know the day when we have to say good-bye is looming, but it's too painful to think about that point, so we just move through our days loving him as much as we can.

We are switching his treatment slightly by increasing the prednisone (steroid) by 50%. Cats tolerate it well and it's something we should do, according to the vet. We will return in 2 weeks to assess the tumor and then decide whether or not to switch to a more powerful oral chemo that requires more frequent monitoring. Knox hates the car (and we drag Madison to the appointments), so increasing the frequency of visits does adversely affect both cats' quality of life, something we are very concerned about maintaining at a high level.