week five

Dave is back to himself - we saw a marked improvement Sunday and Monday. He's back to his delicious kibble, rather than the delicious chicken, rice and sweet potatoes.

We were supposed to have an off week this week, but the opthamologist wanted to see Dave again. Mike took Dave for bloodwork, expecting to wait a short time. The nurse said that the bloodwork and oncology appointment would be about two hours, plus the opthamology consult, so he decided to come home.

Some good things:
-his oncology vet said again how well he's doing
-they confirmed that his GI issues this weekend were normal, and we'll be prepared for them next go-round
-his eye pressure has improved
-we can decrease his eye drops
-no more Prednisone

Some okay things:
-his white cell count was "mildly decreased," but this is another normal side effect of last week's chemo
-he has an ulcer on his cornea

Mike didn't get to talk to the opthamologist, but from what the vet said, she still doesn't feel that it's cancer. There was also mention today of the drops being prescribed to prevent glaucoma. So, there's still confusion when it comes to the eye. They said that he will have to see the opthamologist for a couple weeks, and then he'll have to see him every two to three weeks or so.

Next week's drug is elspar, which he had no problems with at the first appointment.

happy (half) birthday!

Dave is officially eight and a half today. I decided (Mike didn't necessarily support the idea - a little too dark for him) that we would celebrate Dave's half birthday. With his prognosis being nine months to a year or so, he should still be around for his ninth birthday. However, what's wrong with an extra reason to celebrate? Past birthdays usually include sugary treats like vanilla ice cream, iced dog cookies, ground meat or steak and new toys! The picture is from his seventh birthday celebration.


Considering Dave's GI issues yesterday, we're celebrating with boiled chicken and rice. Dave ended up eating after the addition of some warm broth, but got sick again. I tried to contact the oncology department, got bumped to the emergency line, and was on hold for quite some time. As soon as he got sick, he was acting normal again, trying to sneak food off of our dinner plates, and jumping up for attention. We decided to watch him and he was fine for the rest of the night. So far today, he's been more lethargic than usual, but ate the chicken and rice. He started his antibiotic today, and took that, his Pred and his nausea meds with peanut butter. I'm going to try to get in touch with the oncology docs again today, but am not too concerned as they stressed that GI issues and lethargy are a very common side effect of the Doxorubicin. Of course, "not too concerned" actually means worried, but trying to be positive...

Update: I called the emergency vet line, and they said we're doing the right thing. Boiled chicken and rice, and monitoring him if the GI stuff persists.

not a good day

I came home this snowy day to find that Dave had thrown up. It was quite a lot, and all over his favorite chair. I called his vet and left a message, but wasn't too concerned seeing as he was acting fine otherwise. We just tried to feed him, and he didn't want to eat, even with the addition of some oil to his food. He took treats earlier, so I don't know what's going on. I'll probably update a little later.

week four

Another week down, eighteen to go...

Dave received a new type of chemo yesterday, and it is supposed to have more side effects than the others. He had to have a baseline echocardiogram so they can monitor his heart for possible damage. He also saw the opthamologist again, making Tuesday's visit very long. Even though Mike was off and available to get him, we didn't end up getting to Philly until six. Dave needs a bath, as he smells like hospital.

He's still doing well, and we received mixed news. Yesterday, talking to the oncology vet, she said the "R" word - remission! She said several times how happy she is with his progress, and remarked that he responded very well very quickly. Good stuff. However, I spoke with her today, and she and the opthamologist are not in agreement on his eye. She said that lymphoma usually presents in both eyes, and considering that his lymph nodes are back to normal, she doesn't think it's lymphoma in his eye. The opthamologist feels that it is, based on the pressure on his eye not responding too well to the meds - it's still up and down. Another option could be a tick-borne disease, but because he's consistently been on flea and tick preventative, that he was just on a long course of antibiotics, and that he has no other symptoms, it's doubtful. So we still don't know. Week five was supposed to be a break week, with only bloodwork done by our regular vet, but we have to go back for an opthamology appointment. It's good considering we haven't actually spoken to an opthamologist, despite requesting it several times. I think they have banker's hours or some other sweet deal.

In what's becoming the norm, Dave is fine. Active, eating normally, and not showing any side effects. TMI alert!!! The chemo this week was supposed to make him have diarrhea and/or vomit. He's had two soft stools, but not diarrhea (the word explosive is in the paperwork). It also lowers his white blood count, making him more susceptible to infection.

His meds:
Doxoruicin IV (chemo administered at Penn)
Metoclopramide 5mg - 1/2 tablet 3x a day for nausea
Prednisone 5 mg every other day (last week on the Pred)
Trimethoprim/Sulfa 480 mg - 1/2 tablet 2x a day starting on Saturday (antibiotic)
Cosopt eye drops 3x a day
Xalatan eye drops 2x a day

this is what...

$100 of eye medication looks like. Ridiculous!! I added a penny to show the scale. The mini-bottle o' drops was not much more full when we got it - the box shows a line about halfway full.

Dave is still doing well. The past two weeks, we noticed a pattern of his eye doing well until Saturday, when it gets cloudy again. He got his last dose of cytoxan on Saturday, this week and last, but that shouldn't really relate to his glaucoma. We're hoping to actually speak with the opthamologist this week, so we can get a better idea of what we can expect with his eye. And, honestly, what we should expect as far as cost. We've already spent half of what they estimated the entire treatment to cost, in just three weeks!! The chemo is (dare I say it) affordable - last week it was less than a hundred dollars! That little bottle of drops was more than the chemo!!! So we will be talking about a payment plan with the vets this week.

One of the criteria of the trial was that we couldn't do a payment plan for the costs. That was fine, but the extra opthamology costs have added up quickly. We're hoping they'll work with us on those costs. The expense is the one of the first things that we're asked about. Not directly, but in a "wow, that must be expensive" kind of way. The chemo itself is not as bad as we thought it would be. Dave is definitely worth it.

The foggy eye:

His shaving from the staging, still not grown in. It's the back right leg (lymph node removal), the entire tummy (ultrasound), and the square on his hip (bone marrow aspriation). Three weeks of "growth"!!!

more eye issues

Ugh. Another loooong day at Penn. My mom came up to go with me, so she could learn the ropes in case she ever needs to bring him. We had a 10:30 appointment, and Dave was taken back around 10:50. The nurse said they were trying to get people in and out quickly, due to the forecast of snow and then freezing rain. She said that an opthamology consult wasn't on his chart, but said they could always get one, depending on how the vet thought his eye looked. We decided to wait, hoping it wouldn't be too long.

Three hours later, the vet called with false hope - Dave's bloodwork was good again and he did well with his chemo, but they were waiting for the opthamologist. We waited for another hour, and he came running out of the back, looking good.

His nurse reported that he did well. They removed his sutures, and he can get a bath! We've been squeezing the fish oil into his bowl, and it's been getting on his head when he's trying to lick every last drop, causing him to smell like the bay at low tide. He can also get his Heartgard tomorrow. He lost weight again - he's down to 28.4 lbs, but his old vet wanted him around that weight. He looks skinny to me, so the oncology vet gave us the go ahead to feed him more. They said that it's completely normal for dogs on chemo to be losing weight while eating normally.

The pressure in his eye was increased. According to the nurse, it is due to the glaucoma rather than lymphoma, which is good news, I suppose. The opthamologist recommended stopping the NeoPolyDex and gave him a new eye drop (also expensive) to be taken with his Cosopt. We were prepared for the cost of the chemo, but the opthamology tests, meds and consults are adding up quickly. The good news is that his eye looks clearer - maybe his new medicine will work.

His meds for this week:
Vincristine IV (administered at Penn)
Xalatan - 1 drop every 12 hours
Cosopt - 1 drop every 8 hours
Prednisone - 5 mg 1x/day
Cytoxan - 50 mg 1x/day for four days

I hopefully asked if we should expect the same (non)reaction that we saw last week. The nurse said that sometimes when people are expecting that, that the dogs don't react quite as well. We're hoping that we don't see too many side effects, if we see any at all...

Next week is another opthamology consult, more IV chemo (with an echocardiogram to monitor his heart's reaction to the chemo) and his last week on the Pred. One of the side effects of it is increased appetite, so it's yet to be seen if he'll still be as hungry as he is now. Then, after next week is a break week! Bloodwork only, no chemo!!

week three eve

This should be another good week. Dave's protocol for week 3 is almost the same as last week, but he gets half the dose of prednisone. We're cutting the pills into quarters now, so it should be interesting to cut it into eighths. They'll probably just give us lower dosage pills, because, really, what's another ten bucks in the grand scheme of things??

Dave's eye is still looking a little suspect. It's red (nothing new), but slightly cloudy. I guess the opthamologist is staying on his team of doctors for now. Go Team Dave!

We noticed that his hair is slowly and sparingly growing back in some of the places they shaved for the staging. It's pretty funny looking, but I don't know if my camera will accurately capture it. I'm repeating myself, but everything but the eye is looking good.

Finally, thanks for all of the comments! The Westminster Dog Show is on tonight and tomorrow!! Those damn Pedigree commercials get me every time. We donated to the Pedigree fund last year, but this year we're going to support the dogs and kitties in one of our local shelters by donating some things. If you'd like to do this, most shelters list what they need on their websites - and money is always good!

I'm awesome!!

Dave is doing great!! He says hi to all the ladies reading.

We're "cautiously optimistic" that Dave might be in remission. We'll see what the vet says in a couple days.

week two is great!

Dave went on Tuesday for chemo treatment number two. I took a half day from work so I could take him with Mike, since the vet and a nurse told us it would be two or three hours. We brought him in, updated the person we spoke to (she didn't identify herself as a nurse or doctor), and left him. He happily went with her. Three hours later, the vet called to say that he saw the opthamologist, who said his eye pressure is normal - yay! He also had normal bloodwork - yay again! But, he hadn't started chemo yet, and she said we could pick him up around three. I went to work, Mike was a little pissed and I heard Dave barking in the background the entire time I spoke to the vet. Typical Dave... don't keep him in a cage when there are humans walking around doing interesting things!!

His treatment went well, and Mike picked him up around 3:30 (six hours total for a supposed 2-3 hour appointment). He was unhappy with the nurse he spoke with, as she wasn't well informed and was in an obvious rush to leave. He had some questions regarding Dave's eye that she couldn't answer. They didn't remove his sutures, but said his wound looked good, and they'll do it next week.

Medication Information:
Vincristine injection
He was discharged with two additional medications:
Cytoxan (oral chemo) 25 mg tablets - 1 a day for four days (this is toxic and must be handled with gloves on!)
Metoclopramide 5 mg - give as needed for nausea (a side effect of the Cytoxan)

His vitamin A is done, and his pred dosage is now a quarter of a 50 mg tablet. The dosages of his eye meds also changed - 2 drops a day of the Cosopt and 3 a day of the NeoPolyDex. He is taking the oral meds with peanut butter with no problem! We've also been giving him two capsules of fish oil a day.

He is doing so well on the meds this week. He's still tiring a little more quickly, but has bursts of his "normal" energy. For instance, he'll run around at full speed with a toy, but will take a longer break before doing it again. His appetite is back, and he's been eating without hesitation like last week. He hasn't shown any of the side effects of the Cytoxan (diarrhea, vomiting), and hasn't regurgitated his food like he was doing last week.

My boy is back, at least for now. I am confident in our decision to go ahead with chemo. Several friends had no problem telling me their feelings on it - to just let the cancer take it's course - but if we get more months like this, it's worth the fight.

eye issues

One week down! We've been putting the eyedrops in faithfully, and were optimistic earlier in the week. Dave's left eye seemed to get much clearer initially, but yesterday I noticed that it appears to be getting a bit more cloudy. I hope that it's the glaucoma rather than the LSA, since I'd rather him not have to lose an eye.

He ate wonderfully again today, and his lymph nodes are barely noticeable. The change is unreal compared to his bad weekend. He's back to being Dave - here he is sniffing for crumbs on the floor! Over the last week, the only real differences are his slower eating and that he seems to tire a little more quickly. All in all, not too bad. His reaction to the prednisone is good - he's drinking a more, but hasn't had any accidents in the house. His dosage gets reduced later this week. We also started him on CVS brand fish oil caplets today, per the vet's recommendation.

Tomorrow is his second round of chemo, so we're expecting to see more lethargy. Maybe we won't, which would be a great thing.

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Here's a video of Dave snoring. Some not-nice-person gave him three out of five stars on You Tube. What an ass!

started the prednisone

Today was Dave's first day on prednisone, and so far, so good. He's taking his pills like a champ (a peanut butter loving champ), and is tolerating eye drop time. His eye is no longer cloudy, so hopefully he's not in danger of losing is any more. He was slow to eat again this morning, but ate everything after I added a tiny drop of olive oil and some water. It's on the list of things to mention to the vet, along with the regurgitating that he does in the morning. Other than those two issues, every day has been another day closer to his old self.

He had a visitor today - grammom!! He loves all of his grandparents, but enjoys my mom's propensity to walk him every hour. He was manipulating her today, as he always does, whining and barking to get his way. She was happy to see him in such good shape, and acting as hyper as ever.

Friday was a good day too. Nothing out of the ordinary, and he slept in bed with us again!!

This "cautious optimism" stuff is hard when he's doing so well.