chemo Archives - Oh My Dog!

The end of chemo and other news

07•09•15

Guess who’s finished with chemo!

After last week’s debacle, we repeated his blood work locally, and he was good to go. So, back up to Purdue for his fourth and last round of chemo! And, once again, he did GREAT! Better than great, actually, because he didn’t flip out in the lobby despite it being crammed full of dogs, and the doctors all said he was a total gem in the back. His discharge papers say things like: “Lucas did wonderful as usual for us!” and “We look forward to seeing Lucas back at Purdue in just a few weeks!”

Emmett’s never gotten glowing notes like that… #justsaying.

I’m sure you can see my pride glowing through the computer screen. I mean, this is the dog who, when we still lived in DC, the vet staff would see us coming and ask all the clients waiting in the lobby to move to the other side of the room! They’d rush him back to a separate area to wait because he literally couldn’t keep his wits in the lobby. Now? A cool customer in the lobby and a big cheese for all the staff! Tears. of. joy. I’m just bursting.

Anyway, he goes back in three weeks for a repeat of the radiology to check for metastasis. Emmett’s due the following week for his quarterly radiology, so we’re going to try to get him shifted a week earlier so they can go together again. For Lucas, they sort of said the same thing: keep him on the NSAID for life (same one Em’s on) and repeat radiology every three months for life (same protocol as Em). It’ll be much more convenient–though much more expensive all at once–if they can go together for their radiology, and from now on, both of them can have their blood work done entirely at our local vet. Since they’re staying on the extra drug, and since both of them have lost a bit of weight, the blood work is important to make sure they’re not experiencing any serious side effects and to determine what dose they need for maintenance.

Whew.

So, Lucas got a big celebratory dinner last night because, coincidentally, we got some food in the mail to try for a review post next week, so I just had to stage a little fancy dinner for him. 🙂 You’ll see next week!

And, lastly, so no one’s left out: The Apoquel is, in fact, a miracle drug for Cooper. He’s been on it consistently (paired with Zyrtec twice/day), and his ears are clearing up. He’s far less itchy. He’s not chewing on his feet or shaking his head or pawing at his face. We are decreasing the dose starting today, so I’ll report back on how it’s going. A big huge THANKS to everyone who shared their allergy experiences–so helpful.

Thank you for all the kind words of support. It’s been a crazy few months, huh? Hopefully all will be clear in three weeks and we can settle into a “normal” routine of radiology every three months!

Happy Friday Eve, everyone!

Chemo round… more?

07•02•15

Yesterday Lucas was due for his fourth and hopefully final dose of chemo.

As you can probably guess, it didn’t happen.

He had a blood test on Tuesday, and both his platelets and his white counts were too low to administer the chemo. I’m thrilled it saved us the drive to and from Purdue–and all of Lukey’s associated stress–but I was really ready to put this behind me. They want him to get his chemo this week, though, to keep him active in the study, so we’re off to Purdue today because his oncology resident was *pretty* confident that his levels would be okay by today. Probably. So, a 2.5-hour drive each way to see. Please cross your fingers. (I actually wrote this in advance… by the time you’re reading this, we’re already on our way. His appointment is at 9. I’ll let you know…)

I am so. ready. for this to be over.

Our local vet recently suggested that, because they had to lower his dose after the first treatment, we may have to do a fifth treatment. We won’t know for sure until later. As of now, what we understand the next steps include: a repeat of all the radiographs in three weeks to check for metastasis, then repeats of all the rads every three months, plus he’s going to stay on the oral that’s part of the trial, basically, forever. It’s the same one that Emmett’s on, actually, and he’s made it longer than anyone could’ve possibly anticipated or predicted. Maybe it’s not the drug. Who knows. But, I’ll take my chances and keep them both on it!

As for Lucas… well, he’s been doing pretty darn great. I’m so forever grateful that Jackie warned us that the chemo effects can be cumulative because he sure has been tired this time around. Normally when we do walks, we take the dogs one at a time. By the time whoever is third in line gets a turn, that dog is clamoring–whining, crying, pacing, dancing–and if it’s Lucas, it’s amplified times a million! In fact, he’s usually standing at the door waiting, wagging, waiting, whining. Yesterday, he pretty much slept through Emmett’s and Cooper’s walks and didn’t ask for a turn when he was up. We skipped his walk. A clear sign that he wasn’t feeling well.

But, later that night, after he ate his dinner like normal, he tore around the yard, leaped over the fence around the wildflowers, and started to dig them up.

The question I keep getting from well-meaning folks centers around his quality of life. I will tell you this: He may be tired, but his spirit is intact. When he does get out for a walk, he takes lots of breaks. In between those breaks? He runs. After dinner last night, he and Cooper went bonkers running around the living room, knocking into furniture, and scaring the daylights out of poor Newt, who took to the mantle. I can say, without a shadow of a doubt, if I had tolerated chemo even half as well as he is, I would’ve had a MUCH better year!

We’ll see how today goes.

These Purdue days are killer: Leave the house no later than 6:30. We see the oncology tech at 9. He goes back with her and gets a blood draw. The blood is sent to the lab. He waits (boo.) there until the results come back. Once the results come back, if they’re no good, I take him home (again, cross your fingers, pretty please). If they are good, then he stays until he gets his infusion, then hangs out for a bit to see how he’s doing. Typically, he’s done after 3:30, though it varies. Then 2.5 hours home. Our average Purdue day is 6:30 to 6:30. If this could be the last? Whooo, boy. Lucas and I would both be pretty darn thrilled.

I’ll let you know how it goes! (Probably not here… it’s very hard to post from my phone… probably on Facebook… I’m really sorry for the inconvenience.) In the meantime, thanks for all the well-wishes and the kind comments and emails. You have no idea just how grateful I am for every positive message on these intense days!! Thank you!

Better behavior through… amputation?

06•22•15

Both Emmett and Lucas had their blood panels this morning at our local vet. Em’s is just routine; since he’s on oral chemo probably forever, they’re monitoring his levels every 10 weeks. Lucas’ is part of the weekly checkups he gets for his Purdue chemo trial. With both of them undergoing two different chemo protocols, it rarely happens that their schedules sync, but when it does it’s so convenient!

As you guys know, Lucas has always been a reactive dog. Over the years it went from reacting to, basically, everything to just dogs and occasionally strangers. And not all dogs either; he rocked doggy daycare but flipped at any dog passing him in the neighborhood. We took reactive dog training classes. We briefly joined a dog walking group. We practiced and trained and balanced counter conditioning with management. As for strangers, he was pretty much fine as long as he was left alone.

His annual vet visit always caused strife because it was just. so. stressful. For him and for us. But, luckily, he was the picture of health, so we really only had to deal with it once per year.

Until…

So, when Lucas got his cancer diagnosis, we knew it would entail numerous vet visits. Honestly, I had no idea just how many. His initial consults locally, his amputation, three days at the hospital after that, two wound check visits, getting his stitches out–all that before chemo–then consults at Purdue, weekly blood tests at our local vet, chemo appointments every three weeks plus one extra trip so far because his blood count was off… He still has another blood test next week, a chemo next week, another round of staging radiology three weeks after that if they don’t want to do a fifth chemo (we just learned of that possibility today), followed by radiology staging every few months after that…

Meanwhile, try taking a three-legged dog who’s as cute as Lucas anywhere! He gets stopped on the street and in the lobby at the vet and just about everywhere we go!

All this has given us far more opportunities to work on desensitization and counter-conditioning exercises than we could have ever dreamed of.

And you know what?

It’s working!

This morning, our vet remarked about how well behaved he is and how comfortable he is compared to how he used to be. He loves everyone and hops around greeting and licking. Of course, every single time he goes back for his blood test, I send the can of cheese with the tech. And cheese showers down on him in the lobby–and it becomes a downpour if there are other dogs nearby. He did snipe at a dog last week, but it wasn’t his fault. I made it clear that he needed to have distance from the other dogs, but as we were checking out, a woman wasn’t paying attention and her dog came right up to him. Not his fault, and it was only a small snipe, not a full-blown melt-down. Victory!

Clearly this progress would not have been made if he hadn’t received this diagnosis and a rigorous schedule that requires weekly or sometimes twice-weekly vet visits. It’s given us tons of opportunity to work on his training, and he’s made so much progress that others are commenting on it! As for strangers, he’s getting used to people coming up to say hi. He still whines a bit, but for the most part now it’s excitement rather than stress!

I suppose if you were a “silver lining” type of person, which I strive to be, this is definitely a shiny one emerging from this horrible situation. He’s becoming more confident and comfortable in places and with people, something we’ve wished for him since day one. It’s pretty awesome to see him navigating previously untenable situations with darn-near-ease (well, that plus cheese), and that’s one more thing we have to be grateful for!

On osteosarcoma and chemo

05•21•15

After I wrote the post on osteosarcoma and amputation, I wanted to write one about chemo, too. But it was such a roller coaster those first few weeks. I thought I’d wait until things settled down. And then I realized: Duh. Chemo IS a roller coaster. It’s not going to settle down until it’s over, so I might as well tackle it now.

So, here goes: on osteosarcoma and chemo.

By all reports, dogs tolerate chemo far better than humans, which is a huge relief because I know how awful it is. And, as a human going through it, at least you have the understanding of, OK, this is going to suck for a while, so just focus on the light at the end of the tunnel. With our sweet dogs, there’s no way to explain it. There’s no understanding. They can’t comprehend the tradeoff: sick now, live longer.

The protocol for this round of chemo is one dose – IV-administered carboplatin at Purdue – every three weeks for four rounds. In the interim weeks, he gets blood work done at our local vet. He’s enrolled in a drug trial that includes an oral dose of piroxicam, an NSAID, every morning. All the staging – ultrasounds, x-rays, etc. – was done before his first dose to see if there was observable metastasis. They kind of assume there is micro-metastasis – really super small spreading of the cancer – because osteosarcoma is so aggressive and has almost always spread before the first symptoms appear. They also wanted to check his blood work to make sure he was healthy enough for the chemo.

At his first dose, his platelets were low but not so low that he had to skip treatment. So, on April 21, Lucas received his first round of chemo. Upon leaving Purdue, we were given two prescriptions to fill as needed: one for nausea and inappetence, and one for diarrhea.

TIP: Go ahead and fill ’em. Like, right after you leave the vet.

Lucas got home, ate, and zonked. It was an intense, stressful day for him. He slept pretty peacefully all night, then got up in the morning, got a sip of water, and puked up everything. Followed by several rounds of “GI distress.” Of course we hadn’t filled those prescriptions the night before… so, off to Kroger, then wait for them to get filled. Thankfully, the medication fixed him up pretty quickly.

The protocol includes weekly blood work at our local vet, so the following week he went in for his first round. For the next two weeks, his white counts were low but were showing improvement. Plus, he’s becoming a pro at these tests at the vet, and everyone was remarking about how comfortable he’s getting! (Watch mes in the far corner + gobs of cheese are the keys to our success.)

Anyway, when he went for his second chemo dose three weeks later, his white counts were still too low to safely administer the medication. The oncologist indicated that he should be experiencing some effects from the low white count – lack of appetite, less energy, etc. – but he’s experienced none of those! But, she sent us home to wait another week. Rather than do the five-hour-round-trip drive again and have a repeat of that incident, we arranged to have his blood work done locally on Monday. It was back in the normal range, so John took Lucas up to Purdue for his second round of chemo yesterday.

Because of his GI issues the last time around, they lowered his dose yesterday. So far today, the day after, he hasn’t had any side effects. His appetite was normal this morning, and so far – fingers crossed – no vomiting or diarrhea. We have heard that the side effects can become progressively worse with each subsequent dose, so we’re being vigilant (and filling his prescriptions).

To continue the schedule, he’ll go next week and again the following week to have his blood work checked locally. We *might* have it checked here again on the Monday before his next chemo if it looks like his white counts aren’t coming up to save us the trip, but for now, he’s scheduled for his next, third round of chemo three weeks from yesterday.

So, we’re halfway through the chemo protocol, and he’s really doing great. Tons of energy. Tons of appetite. Tons (and tons and tons) of spirit!

As we progress, I’ll certainly share updates in the hopes that this will help someone else facing down this diagnosis. In the meantime, thank you again, thank you always, thank you so very much for all your words of support and kind encouragement. We’re so grateful!

Another day, another trip to Purdue

05•13•15

I’m starting to feel like we need to rent an apartment in West Lafayette.

Both Emmett and Lucas have appointments today, and I’m very grateful we were able to coordinate for them to go together. It’s usually a 10- to 12-hour door-to-door day, and Emmett was originally scheduled for next week – so two of those long days in two weeks. Yikes! Thankfully, they were flexible and Emmett got in today.

I’m also hoping that since they’ll be seeing the same oncologist, Emmett can help Lucas feel calmer. Though that didn’t work in the car ride up this morning, when Em slept the entire way (of course) and Lucas panted the entire way. (Sorry it’s blurry – hard to get a good shot in a moving car. And don’t worry! John was driving!)

So, Purdue. Here’s the thing about a teaching hospital: You very rarely see the same person from appointment to appointment. The residents rotate through the different departments, so today was the third doctor Emmett’s seen so far and the second Lukey’s seen. Check-in takes a while because you have to go through all the case details anew. Luckily, this time the big boys are able to be together for most of the day in between tests.

Emmett is having his blood work, chest x-rays, and ultrasound. That’ll be it for him unless they find any new masses or his spleen masses have changed, at which point they’d sedate him to do a fine-needle aspirate. Lucas is getting blood work done first, and then he’ll get his chemo infusion. His platelets have been low on his weekly blood work, and he’s lost a few pounds, so they may end up adjusting his dose this time. We won’t know for a couple hours, though, because they have to get the blood test back to make a decision first.

Whew.

I promise to write a whole post about the chemo situation and Emmett’s status, but today I’m preoccupied with an unexpected… situation… a conundrum, really…

This guy.

When we got this appointment for the bigs lined up, the first thing I did was book Cooper at doggy daycare for the day. We’re going to be gone the entire day, so daycare makes the most sense. But the daycare closes at 7 pm, and there have been times when I haven’t gotten back from Purdue until 7:30 or even a bit later. We usually know by around 3:30 if they’re going to be past 5 – getting us home after daycare closes at 7 – and our very sweet next door neighbors, Cady’s people, offered to pick Coop up and drop him at home. It’s a huge relief knowing we have that backup plan in case today goes longer than anticipated.

But.

All of this made us realize a striking, startling fact: In his 4.5 years with us, Cooper has never – never – been home by himself. Not once. If Em is at the vet, he’s home with Lucas and vice versa. Heck, on the rare occasions when both big boys were somewhere together, it was usually with John or I – never both of us – so the other was home with Cooper.

And, I suppose the reality of our current situation – Emmett with hemangiosarcoma, Lucas with osteosarcoma – is that Cooper needs to learn how to be by himself.

This is one of those things, you guys. It feels heavy, and if I start to dig down and really think it through – Cooper being home alone in the quiet, Cooper playing alone in the yard – it’s more than I can deal with while both big boys are currently in oncology. So, I’m going to take my usual tactic and focus on a plan. Steps. Action.

Anyway, that’s the current preoccupation: What is the best way to “train” Cooper to be comfortable alone?

We still have a couple hours until our first update from the vet, so I’ll be thinking through that plan in the meantime. I’d love any ideas or suggestions you brilliant dog-savvy folks might have. Otherwise, here’s hoping you’re all having a great week! I’ll post an update (either on FB or IG) as soon as we have one!