Oops. Sorry. It's all my fault.

Well I screwed up royally this past weekend.  I had taken out some chicken thighs to de-skin and boil for Emily.  Things defrost super slowly in my fridge so I had left them out on the counter.  By the time I went to cook them the skins where almost room temperature to my touch.  The thighs themselves where still a bit frozen inside.  I took the skins off and had to keep sticking my hands under warm water just to get the skins off all the thighs.  I was taking the skins off so that when I cooked the thighs they would be a little leaner for Ms. Em. 

However........  I have always given the dogs fat and skin bits when I've been breaking up big pack, big pieces, deskinning or deboning meat.  So I put the skin aside to put in Ollie's meals.  He sees what Emily is getting and his plain old kibble just won't do.  I have to add a little something to make it more interesting.  Luckily it only takes a little tidbit of something yummy or a bit of meat juice and he thinks he's got a feast! 

So I had this leftover chicken skin and Emily wasn't eating any veggies since her last chemo session on Tues (already know where I'm going with this??) so I thought, "hey, how about I mix some of this raw chicken skin with some veggies and maybe she'll eat it".  Guess what? She picked out the chicken skin and left the veggies behind.  (and you know she was thinking - "I'll show that crazy bitch!" cause she's a bouvier and I'm pretty sure that's what they think all the time anyway.)

So that was Saturday.  Sunday she has some runny poo.  I gave her some Kaopectate which is liquid and a nightmare to give.  More ends up on Emily, the floor and the walls then actually gets down her throat.  And then we had more runny poo.  Notice how I'm calling it runny poo and not diarrhea?  Yup, denial.  It ain't just a river in Egypt.

She ate fine and everything else was good, including her mood.  Monday morning I got up and Ollie had the runs too.  Kaopectate for everyone!  He had one more bout and he was done.  Emily got worse.  Still in denial.  I should have called the vets by this point but I half assumed they were closed for Easter Monday.  Monday night she went downhill fast, needing to go outside about every half hour, unsteady in her hind end, trying to lay out in the cold, damp yard.  It was amazing to see how easily Ollie's healthy system could handle the bacteria versus Emily's immuno suppressed cancer system trying to handle the same thing.  This is why we cook Emily's food or she gets fish directly from the freezer.  The one exception is her chicken wings which go right from the freezer to the fridge to defrost, only a couple at a time and she's limited to 2 per day.  So far they haven't cause her any problems and I had been watching that for the first couple of weeks. 

We went to the vets Tuesday for Emily's week 7 treatment and agreed with the vet that it was not wise to overload Emily's system that was already dealing with diarrhea by subjecting her to chemo.  So due to my stupidity Emily has to wait a week for her next treatment. 

Moral of the story is Cancer dogs are immunosuppressed.  All the precautions I've read about are worth taking.  Period.

Luckily one dose of the Metron and she's doing great.  So we caught it soon enough that her system hasn't been totally taxed.

Trying not to add to the dog's suffering,
CJ, Emily and Ollie

A Normal Sunday!



We're enjoying a peaceful, relaxed Sunday afternoon around here.  It's so nice to have a couple of 'normal' days.  

 

Emily enjoying a nap.  I realized she should be wearing a yellow bandanna for cancer.  I'll have to get some fabric and make her one.  Note she's lying on a mat!  I think she's starting to embrace the mats which not only help her get up although that steadiness is greatly improved, they also help her with pressure points where the fur is gone.

 

Ollie is waiting for his cup of tea and a cookie (not really but I always think that when he sits on the couch and hangs out with us)

Emily is eating everything at the moment.  She's getting all her supplements.  I'm trying to get her well fortified for her next round of chemo.  I hadn't really thought of the chemo treatment as occurring in rounds, I was seeing it more as one continual treatment.  So when she crapped out week before last I was in a panic as I saw it as a reaction to her treatment overall instead of her body being in overload as we finished the round. 

I really had no idea what to expect.  I had read a great book ("Help your dog fight cancer" by Laurie Kaplan) and numerous sites but I still wasn't prepared to see Emily so sick.  Like I mentioned in my last post, they say dogs handle the chemo much better than humans.  Which is a whole level of hell I simply can not imagine.  I've never been around anyone actively going through chemo.  At least as we go through this round I'll be more prepared and not think this is the end of Emily's time on earth.  I'll remember how she has bounced back this time.  She's still not 100%, she does still have cancer after all.  She tires more easily and occasionally she looks at me like she's a little confused and she's not completely steady on her feet but she's Emily and I can clearly see her in there.

I had a thought today.  Emily has huge cataracts on top of the fact that her eyesight has never been great.  She seems to lack a degree of peripheral vision.  I looked into her eyes today and said "Emily you're going to live to a ripe old age, blind and a bit confused".  I don't know why I thought that.  I guess because she'll be 10 by the time this treatment is over and if she lives another year that will put her at 11 which is a good for a Bouvier.  Anything after that will be gravy.  I have always worried that she'd end up blind or with a significant loss of sight as she ages.  Today I just had a strong feeling that we'll see that, that she will be here long enough.  I just hope the chemo treatment doesn't leave her with too many long term effects.  I know they have refined it over the years but still... 

Enjoying the good days and preparing for the next round of ups and downs,
CJ, Emily and Ollie (who still doesn't know what all the fuss is about!)

Sheeee's Baaaackkk

Well almost.  After 4 days of projectile diarrhea, then a day of nothing, then another bout of diarrhea now it's been over 3 days with nothing.  I'm worried she's constipated but it is normal for her not to have any bowel movements for a couple of days after the massive diarrhea she had.  So I'm now on poop watch.  Seriously.  This is my life.  And I wouldn't trade it for the world.

I did manage to get her bathed and groomed so at least she looks good.  She's balding in spots.  I clipped Ollie and made one of his nails bleed.  Bouviers have a notoriously high threshold for pain so I never even knew I got him until I saw all the blood.  It keeps bleeding so after finally getting the house and the dogs cleaned up after Emily's anal gland debacle, now there are blood spots everywhere. 

The house is also a state (newfie expression) because every night I have to cook up a can of Emily's Hill's ND Diet.  It's a commercial product developed by Hill's with Dr. Ogilvie, the original researcher for the canine cancer diet.  It's pretty gross right from the can.  Emily has never, never had can food before so that alone is a big change.  After a suggestion from the vet office (thanks Andrea!) I discovered Emily will eat it quite eagerly if I spread it out in a pan and cook it until crispy.  The smell is disgusting!!!  I mean nasty!!  I'm doing this nightly to help ensure Emily is getting the supplements and balance she needs.  She's still getting over half of her daily diet from my homemade mix.  So on top of the food I'm cooking already....

I have a question.  If chemo is supposed to be so much easier on dogs than humans than what kind of hell is it for humans?  3 more rounds to go but this week we're off and it's such a nice break.  4 more full days of happiness and joy before we pump her full of poisons again. 

Just hanging in there,
CJ, Emily and Ollie

Emily's First Bout with Appetite Loss

Well it's been a stressful 17 hours.  I think we're on the other side now but Emily experienced her first solid bout with appetite loss.  Yesterday afternoon she had a snack and her antibiotic around 1:30.  She was very tired, lethargic and uninterested.  Although she did follow me around, laying down where ever I was.  Supper time she didn't even go into the kitchen.  Nothing interested her.  I had salmon, sardines, smelts, chicken wings, her cooked homemade food, just the meat mix out of her food, just the veggie mix of her food, cooked cabbage, cabbage juice.  She totally went off fish and still isn't interested in fish.  Thank goodness there is none in her meat mix!  In fact, moving forward I think I'll do one protein at a time instead of a mix of 3 or 4.  Her veg mix is also just veggies.  I did up a egg white mix with the turmeric and garlic so all of her food is separate components.  This is proving to be quite beneficial as at this point Emily will only eat the meat mix and will turn away from the dish if the veggie mix is present at all.

Late last night we managed to get a bit of her kibble in her.  This would be the kibble that she no longer gets because she's on the special canine cancer diet.  Guess what - what they eat doesn't matter one bit if they won't eat.  I was so worried that this was the start of a slippery slope.  So I was so glad she was taking a bit of the kibble.  She only ate a little but I guess to her it's comfort food.  I had defrosted and cooked a plain chicken breast which is also her traditional comfort food but no dice.  I didn't dare try and give her any of her pills but I was stressed that she was missing a prednisone dose because it is not a drug you should abruptly stop. She also wasn't drinking which was an even bigger concern.  However she was still peeing a good bit.

This morning after her morning bathroom outing she headed to the kitchen.  It took some trial and error but she finally settled on some cooked chicken and brown rice warmed up a bit.  She ate the whole bowl which was a 4oz chicken breast and 1/4 cup rice.  She also had some kibble.  I ran and got another chicken breast out of the freezer and microwaved it but she was done.  I popped in her Prednisone and counted it a successful breakfast.

She is now going to the kitchen occasionally and we pull out everything we can think of until she finds something she likes.  She managed to get her Sucralfrate which I really should have popped in her last night since it's one of her stomach pills but I was totally dumbfounded that she wasn't drinking I really didn't want to shove anything down her throat.  Today that fear is gone!  We even managed her antibiotic mid afternoon after another snacking session where she ate the meat mix.  Her current favorite food is thawed chicken wings.  It's her first choice but we were able to persuade her to munch away on her meat mix (ground pork. turkey leg meat, beef round, beef liver). 

What a horrible, scary experience.  After her chemo session she gets an anti-nausea pill.  After her first session one of the vets and I had a discussion about how aloof she seemed.  In hindsight she was still recovering from her massive GI bleed that she had right before her first chemo treatment.  On top of that she had her first chemo treatment.  Her poor system was struggling to get ahead of itself.  I kept saying "there was no joy in mudville" as she seems to have no joy in her.  So the vet
recommended only giving her half of the anti-nausea pill.  This week I thought that was a good idea because clearly the chemo treatment had left her tired and lethargic and I didn't want the anti-nausea pill to make it worse.  Yeah, never again.  Better tired, lethargic and a bit stoned then not eating!!!!!  She can't regain her strength without fuel. 

By the way, the only 'trick' to get her to eat that worked was the warming of her food.  But it wasn't just any food, it was her comfort food, chicken breast and rice.  Leftover cooking juice from the meat, veggies, cabbage didn't work.  Frozen fish treats didn't work.  Note to self - always, always keep chicken breasts in the freezer!

Chemo Protocol Week 3

Well it didn't happen yesterday.  Emily's bloodwork came back with her white blood cells too low.  Her platelets were down and so were her red blood cells.  So no Chemo this week, we'll try again next week.  It's just as well, she really has been lethargic and quiet.  Although that's probably all due to her blood count being so off.  I still believe this is all tied to the massive GI bleed she had 4 days before she started her first chemo treatment.  She had started on Prednisone and an antibiotic at the same time, 3 days later - massive vomiting of blood and then tarry stool.  When I say massive I'm not kidding.  I don't freak out easily but if she had been a 200 lb human I still would have been freaked at the sheer volume.  Her stomach has since settled.  One thing I discovered is that cabbage has vitamins and minerals that are excellent for the health of the stomach lining.  She's been getting a good dose of cooked cabbage which she loves! 

While she didn't get her chemo treatment yesterday she did get her scheduled reduction in Prednisone. Thanks be to heaven!!!  All the side effects we are seeing are most likely related heavily to the Prednisone.  She's thirsty, pees a lot, unsteady on her feet, tired, moody (aloof and not as happy) and ravenous.  When I say 'ravenous' I mean there are times when there is absolutely no way to satisfy her hunger.  I was worried she had gained 5 lbs just in this past week but luckily she only gained .2lbs and she has some room to gain a couple so she's fine.  There are times I've actually run out of ideas as to what to offer her to try and satisfy her hunger.  Luckily she seems to find the ND diet satisfying when she's in that 'ravenous' mode.  Quite a change from the week before when I couldn't get her to eat the ND diet. 

As I mentioned on two days ago on Monday, Emily has started playing out in the yard again.  She's still doing that and today she had a nice, pretty energetic bark at the neighbor dogs and then the neighbor, who she loves but still doesn't like it when he gets too near the fence.  Now she's tuckered out. 

So far today she's had 5 smelts, 2 sardines, a chicken wing, piece of carrots, a treatball with a handfull of kibble in it, couple tablespoons of her homemade diet mixed with yogurt.  And that's besides her 1.5cups of homemade food she had for breakfast.  I'm really hoping she'll start to feel the reduction in her Prednisone soon....

The Canine Cancer Diet

After the initial shock that Emily might have cancer, I remembered hearing something about a cancer diet years ago when I was researching canine diets in general.  I've always been big on nutrition for myself but I became a doggie nutrition expert when Emily got really sick from her kibble at age 6 months.  We are what we eat!

I discovered there has been some really successful research spearheaded by Dr. Greg K. Ogilvie.  The short version is that cancer cells live off sugars but can't process fat or protein.  So the canine cancer patient needs a diet low in sugars and carbs (another form of sugars) and high in protein and the good fats.  Once you know where the carbs are, it's pretty easy.  You want a ratio of 3/4 protein and 1/4 veg.

If you want to feed this to a non-cancer dog add some brown rice and blueberries.  I may start adding brown rice to Emily's if she continues to lose weight.  She's lost a little and I'm keeping a very, very close eye on it. 

This diet is cooked.  We could have the raw diet debate but here's where I stand.  I love the raw diet.  The only reason I had not moved my dogs on to the raw diet had been cost.  I had 3 large dogs and it would have been over triple the cost of their kibble which I've been happy with.  Thing with kibble is that it is all too high in carbs for Emily at this point.  I wanted something natural where I could control the carbs as well as the quality and quantity of all the ingredients.  As a cancer patient, Emily is immuno-suppressed which means she needs to avoid all infections, bacteria, virus, etc.  While there is evidence to suggest that the canine gut is immune to the standard raw food bacteria, etc, I have seen her get a nice case of the runs from raw bones over the years.  So I'm much more comfortable cooking her food.  Most experts, unless they are hard core raw diet feeders, agree it's better for a cancer canine to cook the food.  Even raw feeders will freeze the food first to kill at least a layer of bacteria.  The veggies must be cooked or pureed for the dogs gut to digest them.  So this is where I am on the topic of raw.  As you'll note some of her treats are raw but frozen first, I'm not strict with the cooked idea but for her large, multi-protein meals I do think cooked is safer.

I am trying to get Emily to eat Hill's ND diet.  Dr. Ogilvie worked with the people at Hill's to develop it.  It has been scientifically proven to improve the prognosis in dogs with cancer but Emily is iffy about it.  There are some important ingredients in it and if Emily continues to struggle with it I'll have to dissect what those supplements are and see if I can source them to add to her homemade diet.

Emily's Homemade Diet (75lb dog 2 cups a day for a week, + Hill's + treats!)
Ingredients:

• 1 lb each, beef, poultry, pork
• 200g or about 1/2 lb beef liver (organ meat is really important!)
• 2 cans of sardines or some other fatty fish like salmon (use only wild, not farmed) mackerel, smelts, etc.
• 4 eggs, separate the whites and yolks.
• 3 cloves garlic, minced (use fresh, not from a jar, I just read the additives that come in some of the jar versions... you don't need any additives!)
• 3 tsp turmeric
• 1 1/2 -2 cups diced fresh tomato
• Mix of broccoli, cauliflower, brussel sprouts, cabbage, spinach. 
• Digestive Enzyme
• Yogurt
• Fish oil (Emily is 75 lbs, she gets 10,000 mg per day.  It's a lot but probably the single most important thing you can do for your cancer canine's diet)

Instructions:

1. Set a pot of water on to boil.  I do the poultry first, bringing it up to a simmer and cooking it for 15 - 25 minutes depending on the size, until cooked through.  You only want a simmer.
2. Remove the poultry and add in the beef, unless it's ground you only need to simmer it to a rare.  Ground meat should be cooked through.
3. Remove the beef and add the pork, simmer until just cooked through.
4. Remove the pork and add the liver, simmering to a rare, you only need to cook the outside.
5. Remove the liver and chop everything up.  If you have cooked meat on the bone, remove all the bones.  They are cooked and will crack and could choke your dog.  Never give cooked bones.
6. Toss in the egg yolks, the heat from the meat will cook them and make a nice creamy sauce.
7. Toss in your fish.  If I'm using some salmon fillets, I do cook them but you can do that in the microwave.
8. Cook the garlic and egg whites in a bit of the leftover meat broth. Pour it over the meat mix.
9. Sprinkle turmeric on the mixture. Stir well. 
10. Sometimes I simmer the leftover meat broth down, let it cool, skim off any fat and then pour it into ice cube trays to have on hand if Emily is finicky about her meals.  I can defrost a cube in the microwave and pour over her food (especially if I'm trying to get her to eat the Hill's ND diet)
11. I use a separate pot to do the veggies.  I like to save the veggie juice for Emily to drink.  She loves it and cabbage juice is really good for the health of her stomach lining which can only help her appetite and it takes a beating during chemo.
12. For the above amount of meat you want at least 4 -5 cups of veggies.  Simmer them until well cooked.  Dogs don't digest veggies well so having them well cooked gets the job done before they enter the dogs system.
13. Measure out the meat mixture into your storage container one cup at a time.  I measure 3 cups meat mix and then add 1 cup veggie mix.  I continue doing this until the container is almost full.  Then mix it up and you're ready to go.
14. If there is more veggie mix then meat mix, I just freeze the leftover veg mix for next week. 
15. Before serving I add a dollop of yogurt and break open a digestive enzyme capsule and sprinkle it on top. 
16. Emily takes her fish oil pills out of my hand before her meals.  You can toss them into the meal or you may have to break them and drizzle them on the meal.

Treats are important.  Here are some of Emily's favorites

• Smelts!!  Frozen right from the freezer.  Both dogs love these and they have cleaned their teeth! 
• Sardines, canned
• Chicken wings, frozen then thawed in the fridge
• Veggies; peppers, cucumber, the occasional carrot (carrots are high in carbs for veggies. Emily used to have a 5lb a week carrot habit... but we've found some good substitutes)
• Hill's ND diet.  Seriously, if she's keen on a snack we'll pull out a can and start feeding it to her by the spoonful. 
• Frozen Wild Salmon fillets
• Once a week she gets a frozen raw marrow bone.  I have to remember to reduce her diet a bit as this is almost a meal for her. 
• Boiled Chicken Hearts.