Diarrhea Hell and Insurance Heaven

Well I have some good news and not so good news.  The not so good news first.  Emily has had diarrhea for well over 48 hours now.  Last night neither of us slept much, she was up every 1.5 hours or so.  I had called the vets yesterday and they had prescribed a probiotic for her diarrhea.  They did have a stronger pill in mind if that didn't work.  Emily's vet is hesitant to put another chemical in her body at this point so we went with the more natural probiotic first.  I do like this approach.  Unfortunately it was 9pm last night when I realized the probiotic hadn't worked so we had to wait overnight for the stronger pill, Metronidazole.  I picked that up this morning along with an appetite stimulant, Mirtazapine in case Emily doesn't eat today.  She has eaten the last 2 days but only a little and she's been very, very finicky.  This morning she showed no interest and I know that means she won't eat.  One the one had that's not a bad thing as her system needs the rest to heal but on the other hand since she is in cancer treatment she needs to keep her tank fueled up.  The vet did tell me she could have her anti-nausea pill daily if necessary so she had it again today making it 3 days in a row after her treatment that she's had the anti-nausea pill.  That was over 2.5 hours ago and she's still not keen to eat.  She keeps trying to lie down in the snow outside and we have to really work to get her inside.  It's too wet and cold to let her lie there for long.  She did attempt to chase her balls a little and she made a half arsed attempt to bark at the fence.

Now the good news.  Emily's PetCare insurance called to offer to up her insurance coverage.  Usually once a pet has a condition you are screwed, what you got is all you're getting.  Most policies will not cover any pre-existing conditions so if you try to change a policy even within the same company you lose coverage on any issues the dog has had before.  I had enough coverage for Emily to cover just under half of the estimated cost of this chemo protocol.  With the increased coverage I now have enough to cover the entire treatment for a premium increase of less than $175 total over the time period of the treatment.  What a relief. 

Currently Emily's have a nap and I think I may have to join her.

Just hanging in there,
CJ, Emily and the ever so patient Ollie (who's enjoying all the extra treats a bit too much...)

Some Important Tips!

So you think your dog may have Cancer and are sitting around waiting for a confirmed diagnosis.  Here are some important tips to not only help you feel proactive but can also have you well prepared for the decisions, care and treatments ahead.  I want to clarify that the choices I have made for Emily are my choices and you will need to make your own.  No matter what you decide to do as you journey through this keep in mind that you have made the best decision you could at any point.  I have already had moments where I have wondered if I'm doing the right thing or if I'm being selfish by making her go through treatment.  I'm sure I'll revisit this debate often.  There are no absolute rights or wrongs.

Tip 1:  Finances!  Do you have Pet Insurance?  Time to check what coverage you have.  It's nice to think money is not a component in your decision making process but let's be real.  I have insurance but when all is said and done it will only cover less than half of the anticipated treatment.  You'll want an estimate from the vet for the cost of the entire treatment but they won't do that until they have a confirmed diagnosis (obviously!) in the meantime you can get together your financial picture.  Emily's treatment is going to cost $6500 -$7000.  That is just the initial treatment, not including what it will cost when she has a relapse which all but something like 5% of dogs' with lymphoma do.  For those of us in Canada who never really worry about health care costs for ourselves, these costs for doggie treatment can be a real shock.

Tip 2:  Keep Current!  Welcome to the Internet! It is a great resource for information about treatment, symptoms, care plans, etc.  However you need to be sure the information is up-to-date!!!  When talking about cancer treatment even 3 years can be out of date.  Currently the amount of research going into canine cancer is phenomenal.  I can say for myself, once Emily is finished with her journey I won't be coming back to ensure my information is up to date.  One of the benefits of this being a blog is that all the entries are dated so you'll know when it was posted.  Some of the information on various websites is not dated and it is easy to get confused.  When in doubt, double check!

The next three tips are related.  They are all about organizing the incoming info.  One binder with some folders, notepaper and chart would work great.  The message here is keep and track everything!! 

Tip 3:  The Notebook.  This brings me to my next point.  You'll find a lot of information on the net.  Time to start a notebook.  Write down everything!  Every conversation with the vet no matter how preliminary it may seem.  Little things mentioned now will be important to revisit later.  One vet mentioned that the commercial Hill's ND diet was a little too high in carbohydrates for her liking.  It was a comment made in passing when I wanted to get Emily on the cancer diet while waiting for a confirmed diagnosis. I'll discuss diet in depth later but my point is that you think you'll remember everything but you won't.  You'll also want to track time lines, treatments, symptoms, etc.  Write it all down!

Tip 4:  The Chart.  To take your notes even further you should start a chart.  You'll want to track input and output.  This is not only useful if you change your dogs diet but is also helpful if there is more than one caregiver.  Your dogs meds are going to change.  The best way to ensure you giving them the right amount and when is to have a chart. You will also want to track treats, weight and yes, output. 

Here's Emily's Sheet.

Emily Daily Intake	Date
	Tues	Weds	Thurs	Fri	Sat	Sun	Mon
Breakfast
Food 1.5c Homemade
Meds
Omeprazole/Prilosec 2pills
Fish Pills 3/4
Digestive Enzymes 1
Gloucosamine 1
Flax Oil (1/2 tsp)
Yogurt
Sucralfrate 2hrs from other meds
Cerenia 24 hrs after Chemo		***	***	***	***	***	***
Weigh
Supper
Food 1/2can ND w/??
Meds
Prednisone 1.5 pills
Fish Pills 3/4
Digestive Enzyme 1
Gloucosamine 1
Flax Oil (1/2tsp)
Yogurt
Sucralfrate 2hrs from other meds
Water Intake
Pees
Poop
Treats

Tip 5:  The Folder/Envelope.  Get a folder or envelope going to track hand outs from the vets, drug info from the pharmacy, and receipts.  I track every cost including diet.  No matter what you decide, knowing the actuals as you go along helps.  You'll also find that certain drugs/treatments are revisited so you'll want the info at your fingertips.

The cancer diet is coming!  Just as a teaser - Emily loves, loves, loves her homemade food.  Loss of appetite is a big issue for cancer patients so it's a real joy to see how much she is currently loving her meals and treats.