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Medical History Last updated 22/11/2007 Bianca has been living in
an apartment in Rome since her arrival from Molise region in February 2007. She took 2 rounds of
Sinulox, which was enough to cure her cold and thankfully it hasn't come
back. Her white blood cell (WBC) count was high so she was prescribed
another round, making 3 rounds in total. This antibiotic also helped
treat the skin infections on her ears caused by the tumours, and thus
the itchiness greatly reduced. No more bloody ears! Though just in case
of any more bloodbaths, the plastic coverings did not come off the
furniture for a while... She was also prescribed an antiparassitic medicine called Stronghold. At the same time as the biopsy, Bianca had a blood and urine tests and other medical problems came to light:
Evidence for the renal
failure was in the very high values of some minerals in her system which
were not broken down properly, the most worrying being phosphorus. At the end of March the results of the biopsy were ready, and as suspected, it showed skin cancer (squamous carcinoma). Thanks to the treatment followed so far, her ears were much better, but her eyes were getting worse, and the vet prescribed eye drops called Tobradex. Dilemma: operate to remove the tumour or not? The ears could be surgically removed, as is often done for these kinds of tumours. But operating on the eyes is another story. At any rate, given her condition Bianca wasn't able to undergo any kind of surgery: she ate little, drank too much, urinated too much, vomited often and was obviously very weak. So began a course of therapy to help her get better:
From April to May 2007, thanks to this therapy, Bianca's appetite increased, and she stopped drinking and urinating so much. She became active and even a bit madcap, just like a cat should be! Further blood and urine tests at the end of June showed that Bianca no longer had anaemia (hence she was more active), her kidney's had improved (Creatinine from 3.16 to 2.58, Urea from 157 to 96) and the amount of phosphorus had gone down. Unfortunately, other problems had emerged:
The first problem was
probably due to small local infections caused by the tumours around
Bianca's eyes resulting in a sticky blackish secretion. To treat these
infections, Aureomicina, an antibiotic cream was prescribed, to be
applied directly on the eyes twice a day. This worked extremely well: it
stopped the secretion, and thus the infection. However, given that the
tumour is the cause, the infection comes back on a regular basis. But
you can't continously apply the cream, or the infection will get used to
the antibiotic and it won't work anymore. You'll see in Bianca's photos
that she often has blackish gunk around her eyes because we don't use
the cream unless the secretion is really bad. The ultrasound took place on 7 July, and showed that Bianca's left kidney was smaller than her right, which was not in good shape either, and that these problems were all contributing to her renal failure. Fortunately there was nothing wrong with her liver. Further urine samples were tested specifically to check the liver, but nothing unusual was found. Thanks to the help of Dr I, a colleague of our vet, D, and given that Bianca's other problems had been stabilised, we decided to go ahead with chemotherapy, which involved injections of Bleomicina. The therapy began with 4 shots for 4 days in a row, beginning at the end of July, then one every week for 11 weeks. Once the first 4 shots were done, we continued the treatment from home, in conjunction with an anti-inflammatory drug said to have a chemotherapeutic effect, called Previcox. At the end of August, Bianca had further blood test to see how the chemotherapy was affecting her, and unfortunately her Creatinine levels had risen which meant the renal failure was once again critical. On the other hand, her liver problems had disappeared. The vet decided that it was not safe to continue the chemotherapy, so the treatment was suspended and Bianca was put on a continuous intravenous drip for 3 days to help bring her Creatinine levels down. This meant she had to stay at a clinic in a cage for almost 4 days straight - she was not happy about that! On 1 September, she had another blood test which showed that her Creatinine levels hadn't lowered, even though the Urea indicator showed signs of improvement and phosphorus too. Once back home we had to administer a subcutaneous drip twice a day for two weeks, alternating with ringer every 2nd day. It was a difficult job: from the stress of all those needles, Bianca started pulling the fur off her back leaving areas of skin exposed. Thankfully it has since grown back, and further blood test showed that her Creatinine has lowered to 1.80, which is a very good result! It wasn't easy deciding whether or
not to start chemotherapy again. Was the Bleomicina the cause of her renal
failure relapse, or do Bianca's Creatinine levels go up and down for no real
clinical reason? A second attempt should help us answer this question. We have
our doubts, but the vets have advised us to try again, this time without the
anti-inflammatory/chemotherapy drug, Previcox, which might have been at the
bottom of it all.
Further blood and urine tests were taken after the fifth injection, and the
results were not as we had hoped. The Creatinine has risen meaning that
something must again be done to avoid a worsening of her kidneys. We had to
administer a subcutaneous drip twice a day, and slow down the Bleomicina shots
slightly from once a week to once every 10 days.
Documentation
[All documents are in pdf format - to open them you need Acrobat Reader]
NB:
Financial situation
Note:
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4Bianca © Alfredo Gagliardi 2007 - All rights reserved |
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Further blood tests at the
beginning of November show a stabilising of the Creatinine levels, as well as a
normalising of other values and a reduction of Bianca's white blood cells which
is a good sign.