Isis update

[feuervogel]

So, we braved the roads and took Isis to the vet school for her oncology appointment. (40 was clear, but getting there wasn't fun; the parking lot was half clear.) The vet student on rotation came in, talked to us and took some notes, then she went out and came back a little later with the intern.

Who started off by saying, "Yeah, I don't think it's lymphoma."

... That's probably the best thing we could hear.

Apparently, the PARR isn't sensitive for B-cell lymphoma. When it's in T cells, PARR is highly sensitive, but B cells not so much. (It had something to do with the test itself, and how you get cells from the spleen. I'm a pharmacist, not a histologist, Jim.)

Additionally, if she *did* have lymphoma, she would have gotten worse in the month we've been waiting on the test results, not better. And apparently there's usually vomiting even without a massive tumor, and she hasn't been doing that.

So they kept her for the afternoon, to repeat the ultrasound and spleen aspirates (and get repeat bloodwork to see how her liver is doing). I got a text from Ben around 2:30, saying that the ultrasound was IMPROVED from a month ago. Which means it probably isn't cancer, but they want us to come back in 6-8 weeks to repeat u/s and aspirates. Unless she gets worse, of course, in which case we go in RIGHT AWAY.

She also said that, if it *were* lymphoma, it's highly treatable with oral medications, and cats often live "for years" on maintenance therapy. I asked if we should cancel our travel plans, and she said no.

It's an emotional rollercoaster, y'all. If there weren't crappy road conditions for the foreseeable future, I'd have a celebratory party thing. My birthday's too far away...

Comments

[margaretdriscoll]

:D Congratulations! I'm so glad you guys finally got some good news.

[feuervogel]

Thank you! I am too.

Though if it were lymphoma (which I kept asking about, because I wanted to be prepared), the oncologist said it was highly treatable because of the type it was suspected to be. But improvement on u/s and no symptoms = no cancer. *faints of relief*

[madmanatw.livejournal.com]

Yeah, there was a whole lot of vomiting when Tzu's kicked in. (Though his was in the intestines, not the spleen.) I hope this is right and that she'll return to health.

[feuervogel]

They were concerned about her small intestine, because of some diffuse thickening, but getting biopsies would require open abdominal surgery, so they went for the spleen instead, because it was slightly enlarged on u/s. But I read the d/c summary, and there are marked improvements compared to the u/s from Jan 5.

*hugs and scritches* for you & Tzu and Mina

[leora.livejournal.com]

That's great. :) I hope she continues to improve.

[feuervogel]

I do too. *hugs & scritches* for you & Tzu & Mina (and Darch, if he wants them).

[amakarie.livejournal.com]

:) Glad to hear it! Tho...you'd think they would have waited to tell you for certain if it was or wasn't before scaring you like that. :/

[feuervogel]

The test is definitive *if* it's T-cell lymphoma. Apparently the ICU doc didn't know that.

[steuard.livejournal.com]

That all sounds very promising! The roller coaster aspect sucks, though; I very much hope that's behind you.

[eirias.livejournal.com]

I'm relieved for you all.

But man, this is why sensitivity/specificity matters, people! It's so cruel to give people news like this before there is someone there to put the numbers in context and tell you what a positive test actually means. (I know *you* know this, which is why I feel pretty confident that someone you interacted with before did something wrong and unfair to you.)

[feuervogel]

Yes! I spent what free time I had between the vet and writing this post (700 prescriptions in 5 hours, so, not much) trying to figure out whether it was low sensitivity or specificity or both for B-cell lymphoma, and whether it's alpha error or beta error or both.

God I suck at stats.

[eirias.livejournal.com]

Could be either one! But it sounds most likely to be low specificity -- that tends to be what gives lots of false positives. Or rather, what fails to give true negatives -- there is some tedious distinction there I don't remember...

I just found myself explaining sensitivity and specificity to Graham the other day and he really disapproved of the word specificity in this context. I say someone who studied math (like he did) has no grounds to complain about ordinary English being repurposed as jargon. :)

[feuervogel]

Ha, Graham should spend some time among medicos. I can't begin to remember how many times Ben stopped me in the middle of practicing a presentation to ask something about jargon. "MM is a 45-yo BW with a history of brittle asthma. She presented to clinic today with symptoms consistent with an exacerbation."

Every time I think I have a handle on a stats concept, someone explains it again and I get confused.

[listener.livejournal.com]

That's so great to hear. :)

[anacoluthon.livejournal.com]

Emotional rollercoaster is right! I'm amazed that they said "it's lymphoma" when they weren't actually sure, but VERY glad that that's not the case.

[ladydreamer.livejournal.com]

*hugs* Oh, best wishes for your kitty!

[doctorskuld.livejournal.com]

Phew, that is good to hear! I'm glad that things aren't as bad as they were made out to be! Here's to Isis not having lymphoma after all!

[rowena-zane.livejournal.com]

I'm so glad!

[thaisa.livejournal.com]

Hooray!

[thegreyghost.livejournal.com]

That's awesome news! ^__^

[agent-mph.livejournal.com]

That's fabulous news!

[smarriveurr.livejournal.com]

Brilliant! Here's hoping you're off the rollercoaster and on to more fun rides from here on out.