Hi everyone,

At the encouragment of Tripawds member Jerry, I'm posting some info about our family's journey with Feline Injection Site Sarcoma.

My beloved kitty Maceo is 11 years old, and way too smart for his own good. He's handsome too, and he knows it (we are fairly sure he is part Bombay, given his vocal and domineering nature, plus the eyes and face shape). Maceo slowly developed a lump over his left shoulder blade, and unfortunately we didn't notice it until it had become very large -- it was hard to pinpoint due to its location over the shoulder hump, and under fur etc. Now when we look back on pictures, we realize it had been growing for at least 6 months before a friend came over to our house and said, "What's that thing on his shoulder??" 

We took him to the ER the next morning, had a needle aspiration, and determined it was fibrosarcoma. After seeing 5 different medical oncologists, 2 different surgeons, and 2 different holistic vets (yep!! small fortune in fees), we finally got an appointment at UC Davis, one of the top veterinary facilities in the country if not the world. 

Last week, we began definitive radiation (20 total treatments across four weeks of time) and completed 3 sessions since they could only fit us in for a Wednesday start (on July 19, 2017).

The very fine CT scan machine at UC Davis detected two small nodules on his right lung -- one that's 5 mm and one that's 3 mm -- but no one is sure that those represent metastasis, and in the meantime, the primary fibrosarcoma tumor continues to get bigger and bother Maceo, who is now limping. We didn't want to "condemn" him for the inconclusive two nodules, so after much debate, we decided to go ahead with definitive radiation and eventual amputation, with our fingers crossed and lots of hope. 

One radiation oncologist at Davis actually told us a story about his own dog who had two nodules in the lungs, which (after his death some 5 years later), eventually disappeared and were not cancerous. Another radiation oncologist at Davis told us that, since chemo has rather low efficacy for cats (and low side effects, but still low efficacy), and sometimes even if there is metastasis it spreads slowly, the radiation and surgery combo was likely the best way to go with the limited information we have.

So that's where we are! In the meantime, I am using extensive supplementation to help prevent any potential spread of the cancer.  

I would love to get more supplements in him, but we are limited by a couple of things:

1. Have to be careful how much we 'doctor' up his food, for fear of creating a food aversion, which cats can develop very quickly after negative experiences with food. They remember.

2. He will not take pills OR liquids squirted into his mouth. Yes, we've watched ALL the cat pilling videos on YouTube and even had our expert cat sitter come over and do a lesson... he won't have it. So, everything has to be delivered via edible formats.

3. While he used to be a VERY food-oriented cat, his appetite has diminished significantly over the past three months so we have to balance supplementation with fundamental food intake. He was an overweight 14 pounds in January, which we got down to 13 pounds by February, and then down to 12.5 pounds in March. He is now at 11.75 pounds, which I believe is too low for his body type. His ideal is right around 12.5. 

Here are the supplements we are doing every day:

1. Turkey tail (coriolus versicolor) pills from Host Defense.

• We are giving 4 pills a day (2000 mg of Turkey Tail, of which 55% is polysaccharides)
• The human dosage on the label is 2 capsules per day.
• But, I'm thinking of upping this to 6 a day for Maceo as there seems to be no upper limit and you have to remember only 55% is the active agent. (Yesterday he took 5, no problems.)
• I've just ordered some Turkey Tail from a brand called Oriveda, in case it's better. Who knows with all these supplements and lack of regulation (the supplement industry is multibillions in the United States, and much of it is a racket).

2. Stamets 7 mushroom blend from Host Defense.

• We are giving him 2 pills a day.
• A serving of 2 pills  contains 143 mg of Royal Sun Blazei, 143 mg of Cordyceps, 143 mg of Reishi, 143 mg of Maitake, 143 mg of Lion's Mane, 143 mg of Chaga, and 143 mg of Mesima.
• The human dosage on the label is 2 capsules per day, I guess that is for maintenance purposes.
• This one is more bitter because of the Reishi, so I'm not planning to increase the dosage.

3. Transfer Factor "Classic" from 4Life.

• We are giving him 2 pills a day (400 mg as each pill is 200 mg).
• The human dosage is supposed to be 3 capsules daily.
• I read one research study on transfer factor that says moderate doses seem to work best, so I'm sticking to two per day.
• It says it is from cow colostrum.

4. Transfer Factor Feline Complete from 4Life.

• This is a cat specific product from the same brand, that was recommended by our holistic vet up in Santa Rosa, Lisa Pesch.
• We were giving 2-3 scoops per day (one serving size for his weight is 1.5 scoops, but the package says it can be doubled for extra support).
• There are two things I don't like about this product: (1) it contains wheat and (2) you have to use a lot of volume -- those 2 to 3 scoops a day represent a TON of dry powder -- like a full tablespoon of dry powder -- and I don't know how much of it is filler. 
• My doubts were the reason why I decided to buy the regular Transfer Factor (Classic) to try to get some of the same effects with less additive powders.

5. IP6 with Inositol, from IP6 Gold.

• We are giving him 2 pills a day, which is 800 mg of IP6. They are big pills, so also lots of powder! 
• These are given with food to hide it, but minimal and away from full meals, since it's supposed to be taken on an empty stomach.

6. Chai Hu Shu Gan Wan (bupleurum blended with some other stuff that I can't see on the label).

• This was prescribed by our holistic vet.
• It is in "tea pill" format -- round, shiny pills that are standard for Chinese medicine. 
• I have to crush the pills because they are too round, heavy, and smooth and kept falling out of Maceo's mouth when he would try to eat them from pill pockets.
• My current method is: crush the pills, then embed the small crushed pieces into Pill Pockets (Duck grain free flavor, supposedly for dogs but works fine for cats) and serve it alongside a quarter cup of Origen grain free kibble. Note: I normally do not feed dry food, but I do this because the kibbles and the Pill Pockets with pill chunks seem to resemble one another and it is the ONLY effective way to camouflage it. He will not eat the Pill Pockets on their own, or if they're mixed with any other texture of food. Only kibble serves as a camouflage.
• 2 - 3 tea pills per day. The prescription was for 2, but I put an extra one because often he doesn't finish them off, so if I put 3 he usually eats at least 2.

7. CBD -- human-grade medical cannabis product 

• Our other holistic vet recommended using human-grade CBD, not made from hemp, because she said it's better regulated since it's "medical marijuana."
• It is a 20:1 CBD to THC formulation that the guys at the dispensary swore by, and said has been helping his 6 lb chihuahua.
• I give 3-5 drops per day and it really relaxes him! Not sure about any appetite effects, but it has been extremely useful in getting him to relax and not fuss with his catheter IV on radiation days.
• It is from the brand Treatwell, which also makes a pet-specific product with salmon oil that I haven't been able to find locally. But, the human 20:1 CBD has the exact same ratio and seems to taste pretty inoffensive, so we're going with that for now. 

Other supplements we've tried (that failed)

Our kitchen looks like an explosion of supplements. A lot of them haven't worked out. It's sad because of how much money we've spent on these, but I guess it's tough lessons learned. Here are the failures:

1. Artemisin

• Caused nausea at 50 mg per day
• It is very bitter so must be carefully concealed within a capsule, then inside a Pill Pocket.
• But, when he bites the capsule, it explodes all the bitter powder into his mouth, which seeded a great suspicion of Pill Pockets. We had to switch Pill Pocket flavors to get him to take them again.
• I really wanted this to work, but just can't get him to tolerate it. It's a fine balance between the "right" medicine and things that are realistic. Patient compliance is one of the biggest issues in healthcare in general, same for cats 🙁

2. Curcumin (Curcubrain product from NOW Foods)

• Again, looks like a fantastic product, but turmeric and curcumin are bitter. So, it was a no go in the taste department. I could not get him to take the pills because he is un-pillable and will only accept a certain number of Pill Pockets per day. I'd rather spend those on the Chinese Medicine for now.
• I did try some turmeric cooked in home made organic ghee, which he enjoyed for about a day, then got tired of. I've decided to let this one go for now, especially since antioxidants like turmeric are contraindicated during radiation therapy anyway.

3. Vitality Science Advanced Immune Restoration for Cats

• This looks like a great product, albeit expensive at $125, and I bought it right away https://www.vit.....storation/
• Unfortunately, I could not get him to take a single speck of it. He doesn't like the flavor, and the amounts required were quite large. So this one is sitting on the counter / fridge completely unused 🙁 

How I get him to take all those supplements

As mentioned, Maceo will absolutely NOT permit himself to be "pilled" forcibly, and won't even accept liquids squirted into his mouth. He is a very strong willed and opinionated guy, in a nod to his Bombay / Siamese roots, and he has a lot of pride also -- especially in contrast to our other kitty who is a complete goofball and foot soldier to Maceo's General. 

Chinese medicine pills

To get him to take the Chinese medicine pills, I follow the method described above -- crush the pills, then embed them in Duck Pill Pockets, and serve it alongside similar-sized kibbles so it is hard for him to tell what's a pill and what's a kibble. I have to feed this dish first thing in the morning when he is most ravenous and meowing for food, because it's the hardest to get him to eat. I do half a Pill Pocket (they are really large for dogs) to hide all three pills, and I put about 1/8 of a cup of Origen dry food, plus half a block of Primal freeze-dried chicken & salmon to make the whole thing more nutritious. I leave all of it dry because if I mix any moisture into it, he won't eat the Chinese pills. No idea why, but this is what I've discovered via trial and error.

Mushroom pills, IP6, transfer factor, and CBD drops

For all of the powdered supplements, I open the capsules and mix the powders in with two godsend ingredients:

1) raw pureed chicken liver (organic, and costs about $1.50 from the Whole Foods butcher section for a two weeks' supply. You do have to puree it at home, which is disgusting but brief)

2) Gerber baby food in chicken or turkey flavor.

There are issues with both of these mixers.

The chicken liver contains tons of Vitamin A, which can cause toxicity in cats (especially under 10 years old) if given every day like what I'm doing. But, this is a risk I'm willingly taking on as a cost of fighting the cancer.

The Gerber baby food contains cornstarch, which is really not ideal for cancer patients. But, it is the only Stage 1 baby food that is pure meat and has this smooth texture which is lick-able. I've also tried Beech-Nut brand, which has no cornstarch or additives, but its texture is kind of grainy, with tiny meat chunks, and Maceo just won't eat it -- plus it's not great for blending powders and the few CBD drops.

Timing

6 am -- I give him his kibble+Primal meal with the Chinese medicine pills around 6 am when I get up and he is meowing for food.

3 pm -- I then wait till he is nice and hungry around 3 pm to give him all the mushroom powders, IP6 and transfer factor with baby food and/or liver. I usually end up using one full jar of baby food per day, and try to keep the pureed liver to a teaspoon per day.

8 pm -- I feed him his evening meal of Primal mixed with grain free wet food (We used to do home made raw + primal, but he has gotten pickier and pickier and now chooses the wet food. Calorie intake is important, so I've given in)

9 pm -- I try another round of powders + baby food, and these two sessions usually get us to our target daily intake of 4 turkey tails, 4 Stamets 7s, 2 IP6s, 2 Transfer Factors, and a couple of scoops of the Feline Transfer Factor.

Other nutritional supplements -- homemade bone broth and kitten formula power

I've also experimented with giving him home made chicken bone broth instead of water to hydrate his Primal, and also Kitten Formula (it's like a milk powder with fermentation and probiotics, supposedly good for building weight). I like the chicken bone broth best, but it is not as easy to carry around since it needs to be refrigerated. 

The bone broth is very easy to make. I just toss in a few chicken necks and a few chicken feet that I get from Whole Foods, totaling about $2 in cost, with totally purified, distilled water, and cook it on low for 6-8 hours unattended. I figure it adds good calories and is more nutritious than plain water.

We have had him on this protocol for about three weeks, and he is doing well. Good poops, normal peeing, no vomiting, and eating between 250 - 300 calories per day. Stable at 11.75 lbs.

I hope this helps others, and would love to learn more from the other experts in this forum. 

What are you giving your cats, and how well has it worked?