Primary branch → Decide whether this case is stable, urgent, or deteriorating first.
Second branch → Differentiate primary hematologic disease from primary solid-tissue disease.
Third branch → Match diagnostic next step with stage, spread risk, and owner logistics.
Final branch → Choose an intervention sequence that preserves monitoring and safety thresholds.
Clinical mechanism — only what matters
Lymphoid disease behavior → Lymphoma can be systemic with multi-organ clinical cues and high risk of rapid destabilization.
Sarcoma pattern → Sarcoma tends to be locally destructive and often requires urgency in referral planning.
Workup overlap → Several neoplastic and inflammatory conditions overlap on initial imaging and CBC findings.
Owner-impact branch → Clinical counseling must include burden, timeline, and welfare considerations early.
Manual-review caution: confirm staging and treatment boundaries from current feline oncology references before clinical application.
Pattern recognition
Core pattern
Progressive weight loss with declining body conditionDeep or fixed masses with progressive interferenceAnemia, lethargy, or unexplained systemic changesImaging findings that suggest invasion or metastasisRecurrent or refractory inflammatory-like presentations
Supporting clues
Signalment and previous malignancy historyRate of progression over days versus weeksPain, neurologic deficits, and functional compromiseFeasibility of safe sampling and staging plansOwner ability to return if deterioration develops
NAVLE trigger: Clinical reasoning checkpoint: prioritize deterioration, progression, and treatment feasibility before closure.
Decision core — what NAVLE actually asks
Urgent branch
Deterioration, structural compromise, or suspected infiltration requires immediate stabilization pathway and urgent escalation planning.
Diagnostic branch
Stable candidates move to structured diagnostics: cytology, imaging, and baseline staging before definitive therapy choice.
Monitoring branch
If intervention is delayed, define strict return thresholds and repeat-assessment triggers.
Counseling branch
Treatment conversations should include welfare, response uncertainty, and referral pathways for owners.
Key interpretation
Staging risk
Escalation discriminator
Rapid spread indicators should move to urgent escalation branches.