Not my favorite day….

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I took Rio in this morning for her 4 month ultrasound recheck.  If you’ve been following my occasionally very rambling posts, I will  apologize in advance for their lengthy nature.  This one may very likely take on a life of it’s own….  Enter at your own risk.

The outcome of a 4 hour wait at the vet’s is that her cancer has come back.  Given my less than sunny nature, I can’t say that I wasn’t sort of anticipating the worse, especially given how AWFUL (no drama here, seriously) this entire year has been for our whole family — in fact, I  spent several hours googling like crazy yesterday in order to prepare myself should the worst occur.  But it still was a punch in the stomach when the vet tech took me into a room to hear the outcome of the results…

At Summit, most of the interaction between the client and the dog-ters and techs takes place in the waiting room.  Symptoms are discussed, courses of treatment, surgical outcomes, etc. — quite fascinating to me, an unabashed people watcher — but if it’s really bad news, they take you into an exam room.  They don’t tell you going in that its gonna be bad news, but trust me, I’ve spent enough hours here to know, watched enough comings and goings, seen the devastation on people’s faces.  I know that if you go into the room, nothing good is going to come from it.

As usual, I digress (or maybe its just stalling tactics.  If I don’t type it, then it isn’t true…. but, sadly, it is…..).  Rio’s cancer has reemerged in the form of an enlarged lymph node and “suspicious” activity in her spleen.  For Mast Cell cancer, this is “normal.”  This is what it does.  It moves to the spleen, the liver and then into the bone marrow as a form of basophilic leukemia.  Some of the niggling little things I’ve been noticing lately — the persisant cough, her being out-of-breath following any sort of activity, the weird, lumpy bruise along her scar that a quarter-sized piece of skin peeled off of — these were starting send up red flags in my little pea-brain.  Enough to send me running for my computer and re-reading a lot of my original research.  Turns out, most of these “nothings” were actually symptoms that could be contributed to mild granulation — when the mast cells start breaking free of the tumors and moving about the body.  And while they “could be,” I held on to the hope that they could also be symptoms of other less life-altering things.  The cough, it could be allergies.  It’s been a weird summer weather-wise.  We planted a new garden.  There could be more/new dusts, molds, plants, etc.  The bruising could be a spider bite or other insect.  I was hoping, hoping, hoping that I would be able to post this evening:  Rio’s Ultrasound Results Were Clear!!!!  But this has SOOOO not been our year….

I was still thinking positive and was actually quite cheerful when the vet tech came and said the doctor had my results and would go over them in the exam room, and then I faltered.  I looked down at my little girl, and she looked up at me and said, “Come on, mom!  They have cookies in that room!”  And the whole time the dog-ter was giving me the run-down on options and treatments and time lines and quality of life, Rio kept shifting in the room to catch her eye.  “Did you not see me sitting here?!  Why are you NOT giving me cookies?  Hellll-llo!!!”  Even while the tears were falling, I kept laughing at her and her less-than-subtle begging!  That’s my Woo…  She never forgets a place that someone may have given her a cookie!  It might have been years ago!!!  And even if, in my opinion, it was less than optimal circumstances that put her in said place.

As a wrap-up, I could apologize for the lengthy nature of this blog post, however, let it not be said that I led you into it without a warning.  I had a boss once who always got impatient with my project updates (not sure why…), and would always ask for the “net-net.”  Well, here it is:  The enlarged lymph node was aspirated, and we’ll get cytology back shortly (hopefully before the end of the week), but our oncologist is pretty certain that it is metastatic MCT.  The “grainy” texture of her spleen has gotten worse, and her adrenal gland has a “mass.”  Because the lymph node has changed since her last US (April), the change has either occurred while she was still on chemo, or has appeared post-chemo (in the last month).  Neither of these situations is optimal.

My take on these findings:  She’s always had a somewhat grainy appearance to her spleen, and has had cytology done every single time she’s undergone an ultrasound.  I’m hoping that this is just more of the same.  Her adrenal glands were different sized last time around as well, and although they usually see both of them enlarged with pituitary Cushings (and this is what we’re assuming Rio has), they weren’t overly concerned with their appearance last time ’round.  I’m hoping that when they measure and compare, it won’t be too much more concerning this time.  As for the lymph node, you can be certain that I have used my share of expletives (no children were present).  Rest assured that we are still fighting!!!  The options keep getting slimmer, but I’m not giving up on my girl!  Mainly because that would constitute acknowledging that I am coward and life has beaten me, and I’m not quite there yet.  However, I can use any and all support that you might feel inclined to shoot our way.  I am certain that Rio will fight her way through all of this, as she has managed to do for the past 4+ years, however I am only human, and I am struggling to be as strong as my little rock(head).

Give your pups an extra large hug for us tonight!

Rio’s momma

 

PS:  If any of have any firsthand knowledge about Kinivet (masitinib) and/or chlorambucil, please send me a PM.


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The dog days of summer — a rambling missive

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So June and July were a whirlwind of activities — sadly, most of them not doggie related.  We volunteer with the Kitsap Arts & Crafts Association, and our big festival/fundraiser was the final weekend in July.  This was our second festival as volunteers, but the 52nd annual for the organization.  We are struggling to keep it afloat with a tiny group of workers, and so it was complete madness for about 3 weeks!

I’ve been neglecting the Tripawds team somewhat lately, and I feel guilty about it — you’ve been so supportive to us, that I feel I owe the same support to others on the site.  But as I log on with trepidation only to find the thing that I dread the most — that another of our dear friends has left us — it gets me thinking about the fragility of my own little friend a lot more than I’d really like.  She’s no spring chicken to begin with, but this past 8 months has been really tough on her, and she’s visibly not the same dog she was as we ended 2010.

And while part of me tries desperately to enjoy every moment with my little friend, I can’t help but watch her like a hawk for any sign or symptom, with my heart catching in my throat if I think I might, maybe, perhaps see something.  I’d rather not think about it at all, but I find myself running my hands over her, not just giving her lovies, but searching for the one thing that I really don’t want to find.  So far, no signs of what I fear, but that doesn’t stop me from looking again in a little while.  And unfortunately, the losses of our compatriots just serves to remind me a little too much that one day it will be my Rio.  So although she’s enjoying life and she’s happy, this old dog (me) is having some trouble learning how to live in the now!

After several months of worrying (but not really wanting to know, if it was gonna be something bad), I finally broke down and had her cough checked out.  We did a couple of chest films last week, and while they show some bronchial inflammation, there are no shadows, no evil lurking mets, no cancer.  (I can’t remember who on Tripawds called them Boris and Natasha, but I LOVE that!)  So phew!  As we were at the vet for everypawdy’s annual check ups, we realized that Rio hasn’t had a “normal” vet appointment in so long, that she was 6 months late on her rabies vaccine!  (If we lived in a less rural environment, and if Rio didn’t feel the need to kill all of the little critters that live in our yard, I probably would just forego any future vaccinations, because she really isn’t exposed to most of the “bugs” that they vaccinate against.  But we do, and she does, so she got the shot.)

The monkeybutts got check-ups, too, and Tosca didn’t bite anyone!  Yay!  She also needed a rabies vaccine, although her’s was right on schedule.  Zeffy got super tiny when the vet was examining her.  She’s such a big baby at the doctor’s!  It could be because when I first got her, she used to eat a lot of stuff she wasn’t s’posed to and we had to go to the vet a few times — for stomach pumping, for x-rays to check the intestines — experiences like that when you’re a tiny pup, and I guess you could be scarred (or just scared) for life.  Plus, she’s not the bravest girl to start with….

We got to talking about how different all three girls are as patients, and how fortunate (if you can call it that) that it was Rio who had to have all the doctor visits.  She is a model patient — she doesn’t bite, doesn’t squirm, lets them do everything they need to do without even so much as a “Hey, now!” when they take her temperature — the only trouble they ever have with her is that she doesn’t want to leave me, so they have to lure her into the back room with food.

Tosca, on the other hand, has a red flag in her chart because she tried to eat a vet tech’s hand, and has snapped at the doctor a few times.  I have to really watch her closely, because if she’s not in the mood for it, somebody is going to lose a finger.  And Zephyr, little Nervous Nell, goes completely limp or tries to hide under the furniture.

But, overall, everyone had a good check up — Tosca got lots of props for weighing in at a svelte 83 pounds.  A few years ago, when I was in Ireland for a month, dad let T get as heavy as 103 lbs.  Let’s just say, he got a bit of a WTF when I got home, even though, by then she was down to 98 lbs.  She has been in the high 80’s to low 90’s for a while, and looks good at that weight, but she’s had a lot more energy and zip at this lower weight, so we think that we’ll keep her there.  Zeffy was a healthy 74 lbs, down from her low 80’s weight, and Rio was her tiny self at 59 (pre-amp, she weighed in between 72-76 lbs).  I think a lot of the weight loss that we’ve seen on all three of them can be directly related to their dietary changes over the last 8 months.  So yay, me, for a healthier diet for the dogs — now it’s time to work on my own extra lbs!!!

Oh, and I have to say, it’s really nice to have a vet bill for once that didn’t give me a heart attack when I got it!  3 annual exams, 2 rabies vaccines, 2 chest x-rays (a little peace of mind), stool sample, urinalysis = $300!!!!!  Granted, it’s still a lot of $$, but the x-rays alone probably would have been that much if I’d gone to Rio’s specialists for them.  Which leads me to my next little quandary:  to continue to see the specialists now that we’re past the chemo and have gotten the Cushings under control, or should I just get the abdominal ultrasounds, ACTH stimulation tests, etc. done by my regular vet?  Cost-wise, it will be a lot less money, and since I doubt that I will put Rio through anymore chemo/radiation/etc. treatments — although I do reserve the right to change my mind should the need arise — do we really need the specialist’s expertise going forward?  Rio is due for her abdominal ultrasound next week, and the last time I went, it was a 6 hour visit.  That’s the other part of the equation — if I get the US done at a local clinic or with my regular vet’s traveling US tech (which may very well be the same one as what the specialty clinic uses), I get an actual appointment, whereas at Summit, they don’t schedule you — you’re supposed to drop the dog and pick up later.  Since we drive 60+ miles to get there, it doesn’t make sense for me to drop Rio off and come back later to get her.  What would I do?  Where would I go?  So I just bring the computer and hang out…  Not exactly the best use of my time.

But the upside of having the oncology specialist, she’s treated Rio through all of this, and there’s a continuity and knowledge base  to both her records and her care that is comforting.  And her internal medicine specialist is in the same clinic as her oncologist, and they regularly consult with each other on her care (although that should have preempted what I like to call the Prednisone Debacle, but didn’t).  So, is this worth the extra cost, the extra gas, drive time, TIME time, etc.?  I don’t know…

Anyhow, to wrap up this brain dump, life is moving forward — often at a breakneck pace — and Rio is still kicking butt!  Rio’s mom is a little worse for wear, though!

Done with chemo!!!

June was insane, and July was beyond insane.  But I promised more details about how Rio’s been doing.

She finished up her last chemo on Wednesday.  I expected fireworks or champagne or something for our trouble, but it was very anti-climactic.  Rio didn’t even get a “Cancer Survivor” bandanna like she did the last time.  I was joking with the vet tech about it, and she said they’d been talking about ordering some, but just hadn’t yet.  I told her, navy blue on a black dog didn’t really work all that well, and that bright pink was really more Rio’s color…

She’s really doing well with the chemo this last few doses.  No nausea, no lethargy to speak of.  We haven’t even needed the Cerenia or metronidazole the last couple of times.  Her appetite is still really good, too.

On the other hand, she had another urinary tract infection and had to go back on the antibiotics for three weeks.  We’ll do another check next week to see if it’s cleared up.  She’s also been having a heck of a time getting around.  I’m not sure if she tweaked her knee or if Zeff knocked her down and hurt it, but I had the doctor look at it and she said there doesn’t appear to be any “structural” damage.  She’s on an NSAID to see if it will help.  Five days now and she’s a little better, but still having troubles.

Her hair has grown back on her hiney, finally!  She’s a little patchy still where the worst of the calcinosis is, but it’s so nice to see her shiny black furry butt again!  Her numbers looked really good on the last ACTH stimulation test that they did a few weeks back.  Exactly where the doctor wanted them to be!  Her muscles are starting to beef back up, and the bloated belly has gone away!  So we don’t have to retest that for another three to four months!

Rio will have an ultrasound in a month as follow-up, but for now, she’s got a clean bill of health!

One more thing, and maybe this is something worth asking in the forums:  Rio’s lipomas have mostly all disappeared.  I wonder if it’s the change in diet or if the chemotherapy took care of them.