Furry Friday

Conan was such a brave boy at the vet on Wednesday. Here he is with his daddy, awaiting his last chemotherapy treatment. He got a special celebratory dinner of nearly a pound of steak mixed with some chicken and broccoli -- yum!

 

And here's Lily, helping me knit a little shawlette yesterday.

Conan's Canine Lymphoma: Rough Patches and Sunny Spots

Today Conan receives chemo treatment number seven and he's doing really well. His weight has stabilized, we've cut his prednisone dosage back to one pill every other day so he has astoundingly more energy and pep, and he's hardly had any chemo side effects the past two weeks. He's been much more playful, trotting along on walks and running to his heart's content at the beach.

But we went through a major rough patch at the beginning of October. We had always figured the doxorubicin would give us the most trouble and, oh, were we right! It's the most dangerous, harsh drug of Conan' regimen and he actually had to get a cardiac ultrasound prior to the treatment because doxorubicin is known to cause heart failure. It can also leave permanent, unhealable tissue damage if it leaks out of the IV.

We were nervous going into the treatment but relieved coming out -- the vet said Conan did great, and he came home and wolfed down his dinner. All was well until Saturday morning when Conan ate breakfast, then promptly puked it back up. Things quickly went downhill from there. He threw up several times, refused to eat and hardly drank any water. By Monday morning he hardly had the energy to move off his bed and we were certain he was dehydrated.

Off to the vet it was Monday morning, and our fears were confirmed -- Conan was in need of fluids and his blood counts were approaching the dangerously low mark. In the end, the vet recommended we hospitalize him until his condition improved, and poor Conan stayed at the vet for three days and two nights (with a lovely price tag of over $1,000). Adding to our stress was the fact that we were supposed to be heading off for our Kauai vacation on Tuesday morning! We debated whether to postpone the trip, try to leave later in the week or just go, and ultimately we chose to go ahead with our vacation. The vet assured us that there was nothing we could really do by staying here, and the friends who had planned to dog-sit Conan were amazingly kind and flexible about the whole thing.

Next week is week eight -- the second doxorubicin treatment. Our vet said she plans to use a lower dose this time (I was thinking 50% lower might be good but she plans to decrease it by 10%) and at least now we're prepared for what might happen. And there's a light at the end of next week's tunnel: Conan will start the every-other-week portion of the chemo plan. It'll be so nice to have more of a break between treatments, both for Conan and for us!

Conan's Canine Lymphoma: Chemo Day 4 + My Hungry Hungry Hippo

Famous last words, blogged on Thursday, September 13: "Today Conan will receive a vincristine IV. That's what we had the first week and he didn't seem to have any issues with it, thank goodness, so perhaps I'll get a week off from worrying."

Reality: "Hahahaha. A week off from worrying?! What planet do you live on, silly girl?"

Conan seemed to be in pretty good shape when I dropped him off for his chemotherapy treatment last Thursday. But shortly after we got home, as if by magic, we were suddenly afforded the lovely opportunity to get acquainted with the not-uncommon chemo side effect of bloody diarrhea.

Whenever I'd seen bloody diarrhea on the list of potential side effects in the past, I always breezed over it and assumed it'd just be regular diarrhea with a little blood. No, nonono. Bloody diarrhea can also apparently refer to a river of straight blood -- sans poop -- its only relation to actual diarrhea that it's coming out of your dog's behind. Naturally, I was terrified. And after an evening of wiping blood off Conan's butt half a dozen times and getting yet another terrible night's sleep because of the pit of anxiety in my stomach, I called the vet first thing in the morning Friday. They didn't seem concerned and told me to give Conan an anti-diarrhea pill (;sidfh;) and call back later if it persisted. When I came home from work on my lunch break Conan had another rather gruesome episode so I called the vet again. They still didn't seem concerned. Apparently bloody diarrhea is a fairly frequent side effect of chemo since the drugs target any and all rapidly regenerating cells regardless of whether they're good or bad, and the cells in intestines just happen to fall into that category. (So do bone marrow cells, which could be a whole other issue at some point.) Luckily, the "diarrhea" finally cleared up that night, though I've continued giving him the SDGDH every 12 hours to avoid another bout.

We finally got past that hurdle, and suddenly Conan -- who's always been pretty ambivalent about food -- has become ravenously, insatiably, frantically hungry, which is a side effect of prednisone, the steroid pill he's taking. In his former life, Conan would gently take a treat out of my hand, then chew it into pieces, spit the pieces out and eat them one by one. Now, in addition to literally inhaling his food, he will hoover up anything remotely edible he comes across including vast quantities of cat litter, cat food, tissues (both used and unused) and bits of fluff on the floor. I can't tell you how many times he's knocked Lily's food dish down in the past few days and snarfed up her kitty kibble. And it doesn't matter how many times I yell at him -- he's going to keep eating and eating and eating because his body is telling him he's famished. All the time, without respite. I know it's absolutely not his fault, but I have to admit that it's hard not to be frustrated with him. My poor, sweet boy.
To top all that off, today's chemo treatment is the scariest drug of the regimen -- doxorubicin. Thank goodness he only gets it four times. Doxorubicin has been known to cause heart failure so Conan had to undergo a cardiac ultrasound to make sure his heart was healthy enough to handle it, and it's so harsh that if it leaks out to the IV catheter or vein it is likely to eat through Conan's flesh all the way to the bone. Our vet even told me she gets nervous administering it. So tomorrow promises to be a nerve-racking day.

But if we can survive today, we'll be rewarded tomorrow with pure happiness when Jarrod/Daddy comes home from his six-month deployment. It promises to be the best day of Conan's life and I'll be sure to record the blissful reunion.

Conan's Canine Lymphoma: Chemo Day 3 and WTF?!

Today -- Chemo Day 3 -- did not get off to a great start. Last night, my normally sane and not particularly naughty boy got into the cat's litter box, made a stunningly large mess and ate god knows what. And then he nosed around in the bathroom trash cans and ate some tissues! He hasn't done either of those things in a long while and he usually only acts up like that when he wants attention and isn't getting it. But he got plenty of attention last night. WTF, Conan?!

This morning I woke up before my alarm with a pit of anxiety in my stomach, just as I do every Thursday. Conan ate his breakfast and we left for the vet about 7:40 a.m. Then we had the pleasure of sitting there for 20 minutes waiting for one of the receptionists to inprocess Conan and a vet tech to come out and retrieve him... which is pretty ridiculous, considering Conan and I were the only people in the waiting room. To top it off, another receptionist was on the phone with a client talking about the cost and options for euthanasia and cremation. That's pretty much the last thing the mom of a cancer dog needs to hear! When the vet tech finally appeared, I asked to weigh Conan since I've noticed he's looking a bit skinnier. And the scale revealed that he's lost a startling 10 pounds! I need to consult with the vet about that when she calls this afternoon, but in the meantime I'm fretting that Conan's home-cooked low-carb cancer diet is responsible. He gets at least a pound of meat a day, though, and it's hard to believe that he's being underfed... but if he's not lacking for food, that means something else -- probably worse -- is causing the weight loss. After all that, I almost had a mini meltdown on the drive home but managed to hold it in. WTF, vet?!

Here's a bit of a sidenote rant: I hate our vet office. We go to a VCA, and it's insanely busy and chaotic. There are upwards of 10 vets who work there and tons of receptionists. At any given time, there are usually three to six receptionists working at the front counter. Because the vet office is so large, they have terrible customer service. Not only do most of the vet techs and receptionists not know me or Conan -- even after seeing Conan many, many times in the past year and a half -- but we inevitably spend a ridiculous amount of time sitting in the waiting room, which is a marked contrast from the small "mom-and-pop" vets we're used to visiting. Waiting for 20 minutes to simply have someone take Conan to the back is not abnormal at our vet. And I'll most definitely sit and impatiently jiggle my foot for at least 15 minutes this evening when I go to pick up Conan -- and at that point the vet office will be crazy busy and there might not even be a chair for me to sit in! In addition to all that, their prices are very high, even compared to other vets on Oahu (which all are more expensive than Mainland vets.) I can tell you that we will never again go to a vet office run by a national for-profit veterinary company. So why do we stay now? Because, rather unfortunately, we've become attached to our actual vet. In short, she's great. And, coincidentally, she went to Colorado State University for her bachelor's and vet degrees, which is where I went!

Anyway, today Conan will receive a vincristine IV. That's what we had the first week and he didn't seem to have any issues with it, thank goodness, so perhaps I'll get a week off from worrying. For his second treatment this past week he was given cyclophosphamide, which comes with lots of potential side effects -- especially stomach issues. I woke up every 30 minutes or hour last Thursday night to check on Conan because I was so afraid he'd start violently throwing up -- which is not uncommon with that drug. He didn't look great after breakfast the next morning, so I gave him an anti-nausea pill and he has been fine stomach-wise since. I did notice this week that Conan has had a lot less energy than usual, but I've read that fatigue is the most common chemo side effect for dogs. And that's really small potatoes compared to the acute vomiting, heart and bladder issues, wasting and tissue damage that are possible, so if having a dog who'd rather snuggle than play is the main issue we have to deal with I'll feel like one lucky mama!

Conan's Canine Lymphoma: Chemo Day 2 and Unsolicited Advice

What a week it's been in cancer world! Conan had to be sedated for his first chemotherapy treatment last week because he wouldn't hold still enough for the vet to insert the IV catheter (and who could blame him? The mere thought of an IV makes me queasy!) But apparently they really doped him up because my boy was a total zombie last Thursday night and refused to eat or exercise for two days, until Saturday night. But then, all of a sudden, he was perfectly fine -- great, in fact! So today when I dropped Conan off for his second treatment, an IV of cyclophosphamide, I asked that they try to use a lower dose of sedative. We'll see if they actually listen to me! (For what we're paying the vet office, you'd think they'd listen to my every whim. Ah, if only...)

After doing some research, we quickly decided it would be wise to switch Conan to a home-cooked "cancer diet" -- high protein and good fat, low carbs and sugar -- and I prepared his first batch of food last weekend. Making his food has been quite an adventure. Let's just say liver and I DO NOT get along. At all. When Jarrod gets back from Afghanistan, he will be taking over liver duties immediately. I have to admit, cooking Conan's food is a lot more time-consuming than I thought, and one batch (and an hour and a half in the kitchen) is only good for three days' worth of food. But I know when Jarrod is home it'll be much quicker to prepare Conan's meals, and honestly the work is all worth it when Conan starts chowing down. I've never seen him eat a meal with such gusto. He loves his food, which is full of beef, liver, cottage cheese, oatmeal, veggies, and little extras that I add on like blueberries, garlic and egg whites. This week I'm going to open up a can of one of his all-time favorite foods -- pumpkin. It probably has more carbs than we necessarily want to give him, but he certainly deserves a treat one in a while. And I'm sure the fiber will be good for him.

Some pet owners (not many vets, though) advocate raw feeding in general and particularly as a cancer diet. One of my good friends feeds her German shepherd a raw diet and I've actually gone with her to Chinatown to buy a pig head and all kinds of delicious/disgusting organs for her dog. Jarrod and I considered trying the raw diet at the get-go but decided to start off with home-cooked meals. Truth be told, I really thought Conan would turn his nose up at raw meat. But no -- he loves it! I've given him a few small pieces of raw steak when preparing his meals this week and he gobbled it down! Perhaps a raw diet is in Conan's future.

So, since Conan is looking and feeling great and my picky eater is scarfing down more than I've ever seen him eat before, it kinda took me by surprise when someone essentially told me that we were doing the wrong thing by prolonging Conan's imminent demise through chemotherapy -- and suggested that we go out and get ourselves a puppy so we won't be so heartbroken when our beloved boy dies. Nevermind the fact that Conan is likely nowhere near dying, that his cancer is in a very early stage, that canine chemotherapy is not as harsh as human chemo, that he's only 6 years old (as of yesterday), and that it's not really anybody else's business what we "put him through." But I wasn't really in a position to argue with this undoubtedly well-intentioned advice-giver, and I just had to swallow my words.

Unless they're expressing sympathy, I really don't care what anyone else thinks about Conan's cancer -- Jarrod and I have done our research and we're confident that we've made the right decision for Conan, though we definitely didn't make it lightly. Sure I've had the occasional doubt, but there's no right answer in these kinds of situations; you just have to get your facts straight and then go with your gut.

Conan's Canine Lymphoma: Today We Start Chemo

What a whirlwind week it's been for us. After some research and very little debate, Jarrod and I opted to go with the intensive (and expensive) five-drug, 25-week chemotherapy treatment plan for Conan's stage 2a lymphoma. When I first heard the words "chemotherapy" come out of the vet's mouth and through the phone, I instantly thought of human chemo and the hair loss and nausea and general crappy feeling that seems to accompany it and my initial thought was, "There's no way we can put Conan through that."

But it turns out that most dogs tolerate chemo pretty well. The dosage is drastically decreased from human chemo and many dogs only experience more minor side effects like fatigue and some vomiting. Still, last night when I was Googling the names of the five drugs Conan will be receiving over the next six months, my own stomach churned in nausea. Side effects (for humans, at least) include such fun as mouth sores, finger and toe nails coming loose from nail beds, stomach cramping and painful urination, not to mention the ubiquitous hair loss and loss of appetite. If any of the fluid happens to leak out of IV catheter or his vein, it would likely cause extensive tissue damage.

I'm horrified at the thought of these harsh chemicals that sound like they could strip paint off a wall running through my beloved Conan's veins. If I were the one having to undergo these treatments, I'd be scared out of my mind. I'm terrified of needles, for one thing, and just the thought of Conan suffering through an IV treatment every other week makes me blanch. But the only other real option was to simply let the cancer run its course and lose Conan in a few short months. And that wouldn't do either. So paint-stripping chemicals it is.

With all that running through my head, it was pretty hard to drop Conan off at the vet this morning. And even harder because he was clearly anxious, and when it was time for him to head through those evil swinging double doors he kept jumping up on me as if to say, "Please, Mom, don't leave me here!" Perhaps he could sense my own worry, though I tried so hard to keep my own emotions at bay for his sake.

Today Conan is scheduled for a chest x-ray to check for any additional swollen lymph nodes or tumors and to receive his first chemotherapy treatment: an IV of vincristine, an injection of aspariginase, and the oral steroid prednisone. But Conan might not even be able to start his chemotherapy this week because the incision on his neck from his lymph node biopsy may not be healed up to the vet's satisfaction. And, obviously, it's not a good idea to kill all of Conan's immune defenses while he has an open wound.

I want to get Conan started on the treatments ASAP, so I'd be disappointed if he wasn't able to begin today, but I'd also be relieved -- it would mean I get one more week of my sweet Conan as he is, without the impairment of drugs or cancer.

Furry Friday: Screw You, Lymphoma

On Wednesday night, I got some heartbreaking news from the vet: the results from Conan's recent lymph node biopsy came back positive for lymphoma. Conan has cancer.

Somehow I managed to hold it together through the entire 10-minute phone conversation with the vet, but as soon as I hung up I disintegrated into a sobbing mess. And my sweet, sweet Conan patiently licked the tears and snot off my face as I balled into his fur for half an hour.

Lymphoma isn't curable -- the best we can hope for is a lengthy remission. And, according to the vet, lengthy in this case means a year. If she's right, our dear Mr. Nub most likely won't make it to his seventh birthday.

I've done some research in the past two days (and so has Jarrod in Afghanistan) and tomorrow we'll convene on Skype to discuss the treatment options the vet laid out for us. Option 1 is to give Conan prednisone, an oral steroid, which will help with the symptoms but not do anything to ward off the cancer's progression, with a likely prognosis of three months. Option 2 is a one-drug chemotherapy program. And Option 3 is an aggressive five-drug, 25-week chemotherapy regimen in which Conan would spend one day a week at the vet and hopefully attain a one-year remission. Option 3, which may be the most likely candidate at this point, comes with a gasp-inducing price tag of $5,000 to $7,000, not including costs for any "complications" Conan may have along the way.

During the small bit of research I've accomplished, I've learned that a diet makeover will likely be in order for Conan. Carbs and sugars feed cancer cells -- bad! -- and we'll want to cut those out as much as safely possible. Conan already eats a grain-free kibble (Blue Buffalo Wilderness) but I'm going to get some information from the vet on a home-cooked protein-based diet.

Apparently lymphoma is an aggressive, fast-moving cancer. It's just astonishing to me that Conan, who seems to have no symptoms whatsoever other than an enlarged lymph node and is still as happy and energetic as ever, could deteriorate to the point of death in just two or three months without chemotherapy treatment.

As devastating as it was to learn that our Nubby has incurable cancer, I have hope that we'll make the right decision treatment-wise and give Conan every ounce of love and TLC we can for however long we're lucky enough to have him with us.