Jimmy Had Chemo Summer 2025 Post Lung Surgery

In May 2024, when Jimmy’s left shoulder developed an egg size lump-which was later removed and found to be not cancerous-the CT at the time showed he had a small lump in his right lung that looked like a small “curved vessel”.  By March 2025, it was a small marble size nodule. He then had surgery April 2025 to remove it. Test results came back positive for cancer. 

But he had clean margins-meaning they removed the part of the lung lobe that had the cancer. Chemo was not necessary but I was afraid that if we were not aggressive when we could be while he was medically stable with his heart and kidneys, that the cancer could spread or return. 

So, in May, for once a month for four months, ending in August 2025, he had chemo. He had to be slightly NPO-he could eat a small amount in the morning but nothing past 10 a.m. He had chemo around 3 p.m. The process was less than 15 minutes but we were usually there for about 30 minutes as they wanted to make sure he tolerated it well. He never needed anesthesia although some cats do. In that case, he would have had to have been NPO-nothing to eat in the morning at all. I did have to make sure he was not vomiting once we were home and that he recovered well during the month. He never had vomiting or gastro issues like humans do and he ate well and moved around well. But he did become more exhausted as time went on but nothing that was concerning. 

He was given ondansetron to take twice a day-a medication that helps with chemo treatment nausea. He continues to take the drug still. He was expected to take it for a few weeks after his last session which was late in August but when we tried to remove it in December, he ate less. While a cat may not seem to be sick from chemo, does not lose their hair or vomit from it, they can still be nauseous, and are physically worn out. Listed below is the March 2025 CT report and the April 2025 lung cancer test results. 

His March 2025 CT scan report prior to surgery to remove the lung lobe and nodule:

“Mar 18, 2025

Thoracic CT, pre-contrast and postcontrast, transverse, dorsal and sagittal images:

Lungs: Within the 6th IC space ventrally, there is a well-circumscribed, mildly irregular nodule, approximately 1 x 1 x 1 cm, larger than on the previous study. This is suspected to be within the caudal aspect of the right middle lung lobe, previously thought to be within the right caudal lung lobe.This is near the pleural surface and adjacent to the cardiac silhouette. There is mild enhancement of the pulmonary nodule. 

Heart and pulmonary vessels: Definitive cardiac abnormalities are not identified. Unremarkable pulmonary vessel size and shape. Mediastinum: No masses. Unremarkable trachea and esophagus.

Sternal lymph nodes are mildly enlarged with mild contrast-enhancement. Tracheobronchial lymphadenopathy is not identified. Pleural space: Significant abnormalities are not identified. 

…

CONCLUSION:

Solitary right mid-pulmonary nodule, increased in size compared to the previous study, new sternal lymphadenopathy. This is suspected to be within the caudal aspect of the right middle lung lobe, less likely cranial aspect of the right caudal lung lobe. Metastatic neoplasia is the primary differential. A primary pulmonary tumor or granulomatous mass is not ruled out.

…

CONCLUSIONS:

Nodular hepatopathy. Rule out vacuolar hepatopathy, chronic hepatitis, less likely metastatic neoplasia. Subjective focal small intestinal thickening...

Discussion: Jimmy's CT scan revealed that he continues to have a single pulmonary nodule that has increased in size now measuring ~1cm. There are no other pulmonary nodules noted. Mild sternal lymphadenopathy is a non-specific finding. Although a single nodule of this size could be consistent with metastatic disease (unknown primary), I am more suspicious of a primary tumor. If this represented metastatic disease I would expected more nodules over the last several months. The most common primary lung tumor in the cat is called a bronchoalveolar carcinoma and arises from the cells that line the lung. The majority of bronchoalveolar carcinomas in the cat are high grade and tend to grow quickly and metastasize quickly. My suspicion therefore is that if Jimmy does have a primary lung carcinoma then it is more likely to be low grade given that it is growing relatively slowly (~1mm monthly). However, the reality is that we never know the answer to this question without removal of the mass and histopathology. This may represent a less common tumor or even a benign tumor (although this is considered less likely in the lung). 

The treatment of choice for primary lung masses is surgical removal via lung lobectomy. I did have our surgery service evaluate the CT scan and they would approach this tumor laterally (approach between the ribs) versus having to perform a median sternotomy. If surgery is something that you are interested in then we can set up an in-house surgical consultation where the surgeon calls you at home to discuss the surgery. They can provide an estimate and can even schedule him if you would like. 

Alternatively, if surgery is not desired then we could continue to monitor this mass with pulmonary radiographs to continue to assess its growth rate over time. This is a more palliative approach but not unreasonable especially in cats as they age.

…”

Lung Cancer Test Result:

“ Jimmy's histopathology results were consistent with a diagnosis of a pulmonary adenocarcinoma that has been removed with complete surgical margins. The removed lymph node only revealed evidence of reactivity (lymphoid hyperplasia) and multifocal lipogranulomas; no evidence of any lymph node metastasis which is great news. There is no consistent grading system for pulmonary adenocarcinoma in cats however based on the mitotic rate (9 per 10/hpf) and mild/moderate atypia I would consider this tumor to be of low/intermediate grade. 

Per our original conversation; there is not a lot of information on low/intermediate pulmonary adenocarcinoma in cats since most cats diagnosed with this cancer have rapid progression. The overall metastatic rate of this disease is thought to be >50% in cats and many cats have evidence of metastasis at the time of diagnosis. 

In Jimmy's case; we watched this mass grow quite slowly over a several month period and there was no evidence of any movement therefore it is reasonable to believe that surgery may be curative or provide long term local control. At the same time, it would not be completely wrong to consider further intervention with chemotherapy since we are definitiely in a position of the unknown. I think both are reasonable directions. 

If we decided to consider a monitoring schedule then our plan would be to perform a physical exam and recheck thoracic radiographs once every 3 months for 1 year and then twice yearly. This can be performed here or with your primary veterinarian (whichever is most convenient). 

If further intervention is desired then I would recommend that we consider using a drug called carboplatin. Carboplatin is an IV chemotherapy agent that is given once every 4 weeks in cats for a total of 4 treatments. Carboplatin tends to be well tolerated in the cat with a side effect rate of ~10-15%. Possible side effects include: lethargy, inappetance, nausea, diarrhea and/or bone marrow suppression. Side effects usually occur 3-5 days following therapy, persist for 1-4 days and then resolve. Medications can be provided if needed and dose adjustments can also be made (most side effects are dose related). An estimated cost of carboplatin is ~$900 per treatment. Recheck thoracic radiographs are performed at the time of the 4th treatment to look for any evidence of metastasis in spite of therapy. 

Overall, I am very happy with these results. We know that this mass was growing quite slowly and has been removed with complete surgical margins. We are just hampered by the lack of data in cats for this type of cancer therefore it is hard to predict the future in Jimmy's case. He may do absolutely fine without further intervention and he is an older cat with other co-morbidities. At the same time, I cannot be completely confident that metastasis will not form in the next 6-12 months. Please do not hesitate to call with any questions or concerns.”

We began carboplatin chemotherapy protocol May 2025 until August 2025. He had follow-up xrays in August. 

“We are so proud of Jimmy! He looks amazing! His physical exam was unchanged and his recheck thoracic radiographs did not reveal any evidence of regrowth or spread of his pulmonary carcinoma which is great news! Jimmy's complete blood count from yesterday was ok for chemotherapy and Jimmy received his fourth and final carboplatin treatment in the hospital today as planned. At this time I recommend that we place Jimmy on a monitoring schedule consisting of a physical exam and recheck thoracic radiographs once every 3 months until we hit the year from surgery and then twice yearly after that. Please do not hesitate to call with any questions or concerns.”

There was one concern on the xray:

“ Aug 20, 2025 

Three-view thorax, three images:

There are metallic clips near the hilus associated with lung lobectomy.

Discrete pulmonary nodules are not identified.

Within the right mid thorax, there is a poorly defined soft tissue opacity…

CONCLUSION:

Right sided lung lobectomy.

Pulmonary nodules are not identified.

Poorly defined right mid thoracic soft tissue opacity. Rule out atelectasis, fibrosis. Poorly defined neoplastic re-growth is not highly suspected. This can be re-evaluated at scheduled follow-up imaging with the oncology service. **This is most suspicious for fibrosis.”

We were concerned that this was a return of cancer or fibrosis. Fibrosis is when tissue in the lung is damaged-from disease, the environment, or cancer-and scar tissue builds up. If too much tissue builds up, the lungs cannot produce oxygen and the patient eventually suffers from not being able to breathe nor send oxygen to the rest of the body, heart, kidneys, muscles, etc. 

However, his recent February 2026 checkup with oncology showed that the fibrosis is decreasing and healing so that it is likely post-surgical scaring that will hopefully improve but it is not yet worsening. When I spoke to his cardiologist about this in September 2025, she said that the lung-the rest of the lung and the other lung lobe-can compensate for fibrosis as long as there is enough of a lung remaining that is not scarred. And that she has seen cats with far worse fibrosis than Jimmy’s and do very well. 

So, as of February 2026, we are breathing a sigh of relief for now regarding his lungs. He returns in May for another checkup with oncology at which time they will schedule another CT with contrast if he is able to have anesthesia. And he will have a cardiology checkup prior to that to determine if he can. 

March 2025 Jimmy Had Cancer Surgery to Remove a Lung Lobe and Nodule

Well! Once again, I find that I have not updated the blog in a year! Although I have posted updates to the Facebook page. 

The last blog post of March 2025 stated that Jimmy has lung cancer and would need to have the lump removed. I will explain the process, how we came to find out, what happened afterwards, and the medications we have been using.

His xray from March 2024 showed a speck of dust on the film. Six months later, it was a tiny dot. A year later, it was a small marble size. A CT showed it was cancer. Surgery was scheduled for April 8, 2025. I dropped him off at the hospital where he stayed overnight and came home later the next day after recovery. He had a wonderful surgeon, and an oncologist that took care of him. They removed about one third of his right lung lobe, then stapled it closed, then sewed up the incision. He came home with a fentanyl patch that was on him for four days, and 2ml of gabapentin every four hours for weeks. He was to be restricted to “bed rest” in the small guest room without much movement for a week. We then slowly allowed him to move about the hallway, then into the other bedroom during the day after two weeks. After a month, when fully healed, he was allowed to use the stairs and go downstairs and have normal access to the house.

We bought cat stairs to have around the beds-the tall wood stairs was tall enough for the regular queen bed that is tall; the short foam set of two I bought fit perfectly around the lower guest bed in the room where he and I slept and spent most of the day. This allowed him to move easily on and off the bed without jumping (although he did that as well despite my attempts and furniture blocking what I could of the bed.)

I set up the room for food and water, a low to the ground litter box, a scoop, litter bags, cat cleaning wipes, wipes for me, paper towels, tissue box, bandage pads and bandage tape (the type that looks like an ace bandage that doctors use on humans), and plastic10ml syringes and 3ml syringes to give food and water if needed.) I did not need to change the bandage every day and one was removed after a couple days. And the sweaters and new born onesies he wore covered the incision very well. The incision site was along the side of his right chest, slightly below the shoulder. I also moved out some furniture so that he wouldn’t get under and be difficult to retrieve. And I put down blankets all over the floor so that he could walk without sliding since he would be weak and on heavy pain meds. Here's a link about post-surgical care information.

Since he did not bother it-and we had to monitor him-he did not need it covered all the time with a bandage nor needed to wear a cone. Cats do not bother their stitches as much as dogs do. If your vet says the cat needs a collar, perhaps a shirt will suffice. But we had to monitor closely. His surgeon did not allow us to use Benadryl anti-itch lotion if he did bother it. The incision had to remain dry. We had to monitor the site for bleeding, swelling, redness-all of which was present when he was first home. BUT after a couple days, the red line of dried blood along the incision cleared up, the slight swelling decreased, and the redness was light bruising which also quickly faded.  After the first two weeks, I took the shirt off for a couple of hours at a time, then eventually longer; monitored him for bothering it, and put the shirt back on if I was not in the room with him, or when we slept at night. After a month, his vet said the site was well healed, and that he did not need the shirt, and that he could move freely about. 

Regarding movement-after three weeks I began to do light physical therapy with his front legs because to remove the lung nodule, the surgeon cut deeply into his chest cavity. They were able to get at the lung through the ribs without breaking them but they did cut through muscles. We had to monitor for loss of use of front legs and any swelling or numbness due to any surgical issues. He did flick his legs for the first few weeks as if something bothered him. This ended after a month. He was able to move about so there was no loss of movement or strength. But it was still worrisome because there could have been tingling or numbness that we were not able to appreciate. So, after two weeks, once up and moving around more into the hall and down the hall to the other bedroom, I began light therapy. I recalled the therapy I did with Bette (who died May 2023 of brain cancer from her tumor of the spine-see those posts. She had lost the use of her back leg but maintained blood flow through therapy.) I gently held him, then gently extended a front leg-one at a time-stretched out front, then to the side, then got each joint to bend towards the chest as if mimicking jumping. I got him to resist-to push against my hand-by pushing his foot joint towards him. I rubbed his front feet. I did five sets of this at three times a day. I thought it would help the chest ligaments ease up as well as help his leg muscles. His vet said as long as it didn’t hurt, it was a very good idea. Of course, I had to make sure his incision was not being bothered by my actions and that I was not working the chest. 

The food and medicine remained in the kitchen and I would get it from there when I needed to feed or administer his meds. He was not on a full supplement regime except to receive Renal K, a vitamin paste, lysine gel for the first two weeks because he was not that physically active and I did not want to stress him out attempting to hold him for a lot of supplements.

The fentanyl patch made him bonkers. This was not like getting neutered, or when he had the shoulder lump removed in 2024. He was not himself for a week.(I’ll explain in a moment.) I thought something was wrong. I called his surgeon the next day and was reassured he was normal. I texted daily with his regular vet. I thought we should cut his gabapentin because he was not normal. But she said not to reduce his pain meds because his DEEP surgical site is causing more pain than we can imagine (unless you’ve had such a surgery); a reduction in pain med increases the pain; and an increase in pain causes stress on the body, the heart, the kidneys, etc. And such a response can cause the opposite of healing and cause his body to go into a pain response that would become too hard to manage and he would need to be hospitalized again. If he was in pain, breathing would increase as well as signs of agitation and being uncomfortable. The fentanyl patch was worn until Saturday and once that was off, he was able to move about more freely.

To know if he was healing well immediately after surgery, we had to monitor his litter box use-was he able to pass anything? At first, no-the first couple of days there was nothing. I was a little worried so we began to give him 9ml of water by mouth every three hours. Finally, he passed urine easily. ( We added water to canned cat food that he was eating and cats get a lot of fluid from canned food.) We monitored his eating (he was ravenous and that was never a problem.) And then his BREATHING RATE-was that normal, too high, too deep? Any signs of CHF?  (To monitor breathing rate-one up and down chest movement is ONE COUNT. How many in 15 seconds? Six and the cat is normal. Over ten and the cat might be in CHF-congestive heart failure. Count, give a minute, and count again. If over ten and does not calm down, count again after 10 minutes of rest, then give DIURETICS if you have them; if not go to the vet/ER vet immediately. A cat in CHF does not have the luxury of time. A post-surgical breathing issue could be a sign of CHF or other complications. A cat with heart disease can too easily get CHF. Better to go to the vet to find out instead of waiting it out at home.) No, all was normal. Those, his vet said, were signs that he was doing well despite seeming bonkers. 

Regarding food-He ate every hour a large spoonful for the first week or so. Then a can of 3oz every three hours after that until after a month, when he was back to normal. No-he did not gain weight. Post-surgical recovery needs a lot of calories so let your cat eat what they can and want to BUT DO NOT LET THEM STUFF THEMSELVES because anesthesia, fentanyl, and high levels of pain meds can cause nausea and vomiting which can be a dangerous thing for a cat. They can lose fluids and electrolytes BUT ALSO THEY RISK INHALING IT and that will kill them. 

Why was he bonkers? He spent the two days sleeping in the litter box. Not near it but in it. I kept removing him but he refused to sleep elsewhere. (HOW DID I PICK HIM UP? Very carefully with one hand on the left side where there was no incision, and the other hand on the back legs of his right side., then pulling him to my chest.) He had two cat beds on the floor, the regular bed, and blankets. But no. I tried putting a towel under his head as he rested it on the edge of the box (we used a low flat box for easy access) but he kept putting his head in the litter. And I had to gently pick up him to scoop the box and then wipe him off without touching the surgical site. I kept changing his shirt a couple times a day when it got wet with urine. He slept all day. But he was ravenous when he ate. He was also wide eyed. But breathing normally. After a couple days, he moved to the floor, then a cat bed, then to a footstool next to my bed and slept there all day and night when not using the box or eating. Then he moved to my bed. Then he moved on to me when I was sleeping-literally on my head and chest. Those were the best four days because he wanted to be on my chest and head and to cuddle, and this was a cat who never cuddled and who to this day STANDS on my lap when he wants to be petted. After the first two weeks, we put up a baby gate at the top of the stairs and he was allowed to spend a couple hours sleeping in the hallway. Then eventually, the next week, to the larger bedroom. 

We did not use a surgical cone or collar. Instead, I used two cat sweaters and a pack of newborn onesies from Target that fit perfectly. The neck was wide enough to get over him gently, and the body was long enough to cover the incision site. The sleeves were too long so I trimmed them up leaving a short sleeve. He kept chewing on them for some reason so I had to cuff them and sew them in place. Between the sweaters and onesies, all went into the washer and dryer easily. 

Aside from gabapentin 2ml every four hours, he also had his regular buprenex at .3ml twice a day, his daily Prozac .60ml, half a cerenia twice a day to help with post-surgical nausea. 

His Prozac did get reduced when the gabapentin was given in such high amounts that first month because Prozac and gaba and contraindicated. Not knowing what might happen, I slowly reduced the Prozac from .60ml to .30ml after the first week and a half; then increased it again once the gaba was reduced to 1ml q 8 hours after a month (gaba was reduced over time to .50ml BID or twice a day until fall of 2025 when he needed it .50ml q TID or three times a day for UTI and litter box use-a different blog post soon.)

After a month, his vet declared him healed and he was free to go shirtless and move about the entire house as normal. 

He did have cancer, and needed chemo-a separate update soon.

Here are some Facebook posts from that time at Cats With Hypertrophic Cardiomyopathy:

4/9/25 Jimmy Stewart had lung surgery yesterday. He’s doing well. He had the marble size nodule removed along with a portion of his lung yesterday. They will test it and likely it is cancer and he’ll start chemo treatments after healing at some point. But we will know more in a week. He comes home later today. I’ll take more pictures and post them later. He’s not allowed to climb run or jump. He will be on pain meds, which hopefully keep him quiet for a few days at least. We took all the bedroom furniture out of the small guest bedroom except for the bed and the desk. So he’s got plenty of room to lay comfortably around, and I have two sets of pet stairs around both sides of the exposed sides of the bed which hopefully he uses. He hasn’t used them yet when climbing around the bed in the past because he doesn’t like using them; his sisters, however used them without any issues. So hopefully he uses them. I’ll take more pictures and post more later. We are praying for a smooth recovery. 

4/11/25 Jimmy is doing well. He’s eating moving and resting. He was sleeping in his litter box most Wednesday night and Thursday but Thursday afternoon he decided to start sleeping in the bed. And then on the floor. And he even climbed up into the regular human bed. And he finally started using his litter box. He hadn’t gone since he got home Wednesday. And I realized Thursday he wasn’t drinking water so I started giving him water by mouth. And so a few hours later, he used his litter box and then a few hours after that he used it again. So we will continue to give him water by mouth just to help him. He had of course, gotten fluids at the vet until Wednesday afternoon when I picked him up. And he had been chowing down food. He was ravenous and eating wet food almost every hour through Wednesday night into Thursday. So he was getting probably a lot of water through that but maybe not enough. So we will continue to give him water by mouth with a syringe. I give him three of 3 mL syringes. Small syringes are easier to handle for water. He’s on meds, of course around the clock. And he has a fentanyl patch that can come off Saturday afternoon. And then the white onesie will come off and he’ll just wear his regular onesie. And then he can venture out into the hallway for a little bit, but not go down the stairs. I put pads up on the wall and around on the floor in case he had accidents and couldn’t use the litter box. But he’s been able to get in the box. So, some of those might come down on Saturday when I let him out of the room and I clean the room. 

4/12/25 Jimmys tail is moving like a cat clock. (I had posted a video at the Facebook post.) We removed his fentanyl patch today and so now he can get out a bit. We put the gate up at the top of the stairs and let him have the hallway. And then we let him eventually into the larger bedroom. He wanted up on the trunk so because we can’t allow him to jump up or down we put him up there. And he has been up for about 40 minutes. (There is a window in the photo at the Facebook post.) I’m sure he’s enjoying the change of scenery. He will go back into the nursery soon enough. But for now it’s not that cold and its sunshine and he’s doing well. He’s breathing well. He’s eating. He is sleeping a lot. But I checked with his vet – that is still normal. Of course I was concerned. 

4/13/25 A three pack of newborn onesies for $9.99 from Target fits Jimmy perfectly. The sleeves are too long so I will have to trim the sleeves on the other two. I put this one on him to see if it fits and it does so I’m not taking it off. I did roll up the sleeves. Time will tell if he’s able to get it off or get to the stitches under the sleeves. It’s cheaper than buying a onesie surgical shirt or pet shirts. But we’ll see if they work. The purple shirt that he was wearing since Wednesday needs to go in the wash. I was waiting for to remove his fentanyl patch, which was yesterday, and then I couldn’t find any more pet shirts that would work because he needed sleeves to cover his stitches, and then I thought of the baby onesies to try.

4/13/25 With the baby gate up so he can’t go downstairs and the door is closed to the other rooms because there’s too much he can climb Jimmy gets to stretch his legs for a while and have the hallway to hang out in. 

4/19/25 Jimmy is recovering well from his lung surgery last week. We now let him stretch his legs and go into the larger bedroom down the hall. Again using the baby gate at the stairs and closing off the other rooms. We have pet stairs so that he can get up on the trunk next to the window and onto the big bed. He is wearing a new shirt. Isn’t he the cutest? 

4/20/25 When your little boy is recovering from surgery and decides that he no longer wants to sleep in the litter box and begins to sleep on the bed and then finally decides that you would make a great cushion-you don’t remove him and you don’t budge. You just put up with the fact that his paw is pressing into your cheek. And that he at some point wants to bury his head into your neck and your hair. And then he wants to sleep on your neck cutting off your air supply. You just make one tiny little adjustment so that you can at least get a modicum of oxygen.

4/22/2025 Jimmy’s pathology report came back positive for cancer, but they got all of it out in the nodule and he has clean margins which means no cancer was found in the material around the nodule. So this is primary and not secondary and we know from the CT that he has not metastasized. I think we will go ahead and do chemo. Chemo is a once a month infusion. He might be sick for a few days we’ll see. They say cats don’t get as sick as humans do. If after a couple of months, I think he’s not doing well on it we can stop. They said chemo actually is recommended but not necessary. We could take a wait and see policy. But I think because they got it all out and he’s doing so well and he’s still young and strong even at age of 16, he’s not really that old of a man at 16, I think now is the best time to be more aggressive. Because later who knows. And I don’t want to take the risk of it coming back. I don’t want to take the risk of it being some speck of dust on an x-ray that six months from now is the size of a marble and in a year it’s the size of a ping pong or something. Tomorrow I will call his oncologist and we will discuss further details. He’s still healing. He goes next week to see his regular vet for a check up. And then sometime I assume in late May or June we will begin treatment. We’ll see how it goes. I’ll let you know. 

4/23/25 Jimmy gets to go without a shirt now that it’s been two weeks. I will have him wear one at night. And as long as he doesn’t bother his stitches he can go without a shirt a little bit more each day. We are also cutting back on his gabapentin starting today, which means an increase in Prozac so hopefully he doesn’t have accidents out of the box. I don’t know what’s on his back. But the hair on his back above where they shaved him is goopy and dried, and when I tried to comb it out, he did not want me messing with it. We will leave it for now. Maybe I’ll trim it with the scissors. (I did.)

There were no more Jimmy posts regarding recovery after this.

Jimmy in one of his shirts.

Jimmy in a onesie.

The other sweater.