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!)

Peace has been restored - to Emily's intestines!

We are finally on the other side of the diarrhea hell and other associated side effects of the Doxorubicin.  That was awful.  Emily had diarrhea for 4 days to the point where it was projectile and bright red.  Sadly this is not the first time in my life I have seen this and I knew it was to be expected due to the irritated state of her system.  Her anal glands completely let go on the morning of day 4(Sat) again not a surprise given how hard her system had worked up to that point.  Anyone who has dealt with anal glands knows how bad it is.  Needless to say, every blanket and mat now needs to be washed.  Emily was laying in it at one point so she's a stinky mess even though I did sponge bathe her. 

Emily didn't eat for 48 hours and barely drank at all on day 3(Fri).  That was the biggest panic, she wasn't drinking but she was still outputting fluid.  We watched closely for dehydration and thankfully she never got there.  We also watched her temp which never went outside the normal range of 99- 102F.  Last night Emily ate 9 saltine crackers and 5 chicken hearts.  You never saw a happier person then I was when she took that first cracker out of my hands.  This was after offering her everything (and I mean EVERYTHING) in the house.  I said a little prayer to St. Francis Assisi, the patron saint of animals cause I thought it couldn't hurt even though I'm not Catholic.  I figured he wouldn't hold that against Emily. 

The biggest fright during this whole episode was when Emily went outside and try to lay down in the cold snow and did not want to come in.  Dakota did that the night he died. She did this constantly for 2 days (including in the middle of the night) I kept tell her it was not her time but there was a little voice inside my head that wondering if we were fighting a losing battle.  I was laid off work a couple of weeks ago and I'm sure it was so I could spend time with Emily.  But was it to spend time with Emily and get her through this fight or to spend time with her as her time to go is near?  These are the things that go through your head when you are sleep deprived, stressed, scared and just plain freaking out. 

This episode got Mom on the internet researching things like the new med, what we could be doing and what to do in the future.  I've being doing that all along but Mom is not used to accessing the internet like that.  It was good to have the help.  Information is power.  Once we started researching and reading we added Pepto Bismal to the fight.  I checked my book "Help your dog fight cancer" by Laurie Kaplan.  It also recommended Pepto so I felt good about our decision to add it in.  And truthfully, I really think it helped push things in the right direction.

The Mirtazapine did nothing to stimulate her appetite so I think we'll forgo that one in the future.  She missed a Prednisone dose but once she ate the crackers and chicken hearts I got it into her. 

The next time she gets Doxorubicin on week 9, we'll be proactive and treat the side effects before they start.  I'll work this out with the vet clinic but we read that others have had better success by treating the side effects starting immediately after treatment instead of waiting to see if they happen.  The chances of her having less side effects next time are slim to none. 

Now we're going to celebrate St. Patty's day and be extra thankful.  Currently Emily is only eating beef and chicken hearts (her desire to eat crackers has thankfully passed since they are total carbs!) but that's fine.  I figure her body needs the iron and B12 that beef is full of to rebuild at this point.  We'll worry about veggies and supplements later.  She lying by me now and I must say... bath is high on the priorities list!  Yikes!  Today she rests, rebuilds and we all revel in the joy that she's feeling better (did I mention she went for her balls out in the yard, on her own like she does when she's normal?!?!).  Tomorrow we fumigate!

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...)

Post Chemo #4 Doxorubicin

So today neither dog is eating.  I do believe they would like to trade dishes which I would actually do if Emily's weren't radioactive.  Ollie does not need to be licking up her slobber the day after chemo!  Ollie refuses to settle for his plain old kibble while that's all Emily wants.  It's way too high in carbs for her but for some reason that's her comfort food when her tummy is upset.  She has had a decent amount this morning overall but she's eaten half or less of everything I've put down then walked away.  I'm hoping the Cerenia (anti-nausea) kicks in.  I'm not throwing out chicken, steak, veggies, supplements, etc!  So in the fridge right now is her regular mix in a bowl ready to serve, another chicken only with veg mix also in a bowl ready to heat and serve, and her chicken mix with kibble.  There are also containers of her protein mix, veggie mix, a container of brown rice, a container of pumpkin which she seems to prefer fresh from the can, not thawed from frozen, doggie only yogurt and doggie only peanut butter.  It's hard to find the human food in there.

Emily also has diarrhea.  This is the first time she's had it due to her treatment.  She has a little soft/runny poo before this treatment but I'm pretty sure that was due to her having cottage cheese for the first time ever in her life.

Overall her disposition is good, after she had her last diarrhea in the yard she then went for her balls for a little play time!  Now she's off next week.  Maybe she'll get bathed and groomed.  It's going to be a real treat to get to some good quality time in and know we don't have to drag her off to another chemo treatment because of course her best day all week is the day before chemo. 

Chemo Treatment #4

Today was Emily's fourth chemo treatment and it was the most dangerous one in the protocol, Doxirubicon.  She could have had an allergic reaction, her pee will be orange or red for the next couple of days and, most importantly, this one can cause heart damage.  There is a limit to what she can have over her lifetime and it has to be tracked.  This was one of the reasons why I was so eager to get Emily on the L-Arginine supplement.  It's good for cardiac health.  She did fine.  They gave her benadryl to manage any possible allergic reaction which she seems to NOT have.  So that's good.  We are just watching for a cough. 

We also came up with a possible recourse to deal with the nausea.  She has a post chemo anti nausea pill that she gets 24 hours after her treatment.  If she's showing signs of nausea the next day I can give her an additional pill!  I love a plan.

While Emily got her treatment and Nanny hung out with her at the vets (Emily is a serious Nanny's girl).  I took Ollie, who Nanny can't console at all when he want to be with his Momma, to the park for a big walk.  It was really nice to spend some time with him outside of Emily's cancer. 

Emily was in excellent spirits when we got to the vets.  She was cheerful, energetic and very social.  It's hard to pump poison in her system when she's feeling so well.  Big picture, trying to focus on the big picture.  This evening she's just tired.  And her Prednisone came down again so hopefully that will help again with a decrease in her appetite (She's still really whiny but only at one point during the day) and help with her steadiness.  She's also been panting a lot.  We're watching that. 

Supplements and Post Appetite Loss Update

Emily's appetite has returned to normal.  Now I just have to get her pill schedule back to normal.  Right now she's reversed, Prednisone in the AM and Prilosec (for her stomach) in the PM.  She had a huge breakfast with all her components, meat mix, veg mix and garlic turmeric mix, no problem.  Yesterday she got her supplements.  I've added a multivitamin, Centrum Forte, and 1000 mg of L-Arginine and 2 tsp of L-Glutamine in powder formula.  When she eats the ND diet she really only needs half of these but she's hit or miss on the ND diet so until I'm sure she's going to eat it I prefer to give her the full dose.  Thank god Santa brought me a mortar and pestle for Christmas.  The most use it gets is smashing up her pills to sprinkle on her meals. 

Aside from the Multivitamin, Arginine and Glutamine, Emily also get digestive enzymes with each meal, 1 glucosamine/chondroitin tablet per day, 10 wild salmon pills (yup, 10... plus she gets fatty fish during the day!) and 1 tsp of flax seed oil drizzled on either yogurt or cottage cheese.  Both yogurt and cottage cheese have active bacteria cultures which are not only excellent for digestive health but also general health overall, for both our dogs and us!  Watch for additional ingredients.  I like to see nothing else but milk and active bacteria cultures. 

There are a lot of options out there for supplements and you can make yourself crazy.  One important warning - You must be sure they don't interact negatively with the chemo or any other meds your dog is on.  Consult your vet.  But be aware, a lot of vets aren't well versed in supplements so do your homework if you aren't confident.  I have an entire vet office consulting and researching on Emily's case so I really like consulting them after I've done my research just to be sure I haven't missed something.  I'm sticking with the basics as recommended by Dr. Ogilvie years ago and still supported by conventional research.  Arginine, Glutamine and the Omega Fat pills in the form of Wild Fish Oils are the most important. 

Today Emily has had a raw from frozen, straight from the freezer beef marrow bone, 2 play session in the yard with her balls, a huge breakfast and is now enjoying a well deserved nap.  I need to get her in the tub but she's had such a rough week and is just now feeling like herself so I hate to torture her (or I might just be procrastinating...)  We'll see how the rest of the day goes.  Staying on top of her grooming while she is feeling okay really is the best idea.  She's just so damn peaceful and content at the very moment.

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!

Post 2nd Vincristine Treatment - Tired!

The only word to describe Emily post chemo treatment #3 is tired and maybe a little stoned.  She had the Vincristine which she also had on week 1.  Her appetite took a nose dive week 1 but we are yet to see that this time.  She lacks the energy to be constantly asking for more food like she has been as a side effect of the Prednisone.  The quiet is almost a welcome change as long as she still eats her meals and allows me the chance to cook up  her weekly homemade diet without her under foot, whining the entire time.  She did thoroughly enjoy her homemade breakfast.  Last night she was slow eating her can of ND diet but she did it in 2 sittings.  She turned her nose up at peanut butter this morning!!  First time ever.  And of course I had her sucralfrate (to protect her stomach) pill already buried in a wad of peanut butter.  I stuffed it in a chicken heart and she had it no problem.  You have to have a selection of tools in your feeding arsenal when traveling the canine cancer journey. 

One thing that may help her stomach and the impending nausea is cabbage.  Emily loves cabbage which is a shock.  She never had it before she got sick.  She loves the core to crunch on, loves it cooked up and she loves the leftover cooking juice to slurp up.  It needs to be cooked down quite a bit so the canine gut can digest it and absorb the nutrients.  That's why the leftover cooking juice is so valuable.  It has the nutrients!  I simmer all Emily's veggies and I keep all the leftover juice for her to drink.  Ollie loves it too. 

I haven't mentioned the importance of filtered water (when not slurping up leftover veggie juice).  I have read that the cancer canine can't handle the toxins in regular tap water like you and I can.  So we got a brita.  Truth be told... I'm loving the filtered water.  I'm a big water drinker but I don't like water kept in plastic containers because there has been a correlation between plastics and cancer.  But with this brita and using it to fill the dogs water bowl twice a day, water never sits in the plastic for long! 

Chemo Treatment Week 3

Here is the pic I promised.  Emily's got her St. Patty's day bandanna on!



 She doesn't pose like Ollie does.

Emily was energetic this morning and ready to go.  The vet was really pleased with how her blood count had rebounded to normal levels.  I had suspected they had.  So Ms. Emily got her treatment. 

I picked up some mats and put them around all the places Emily has been laying or having problems getting around like the bottom of the stairs.  Currently she is lying in the kitchen where there is no mat.... seriously I don't know why I bother.  Ollie was making use of one of the mats so I guess all is not lost.

We're in the process of investigating a multivitamin for Emily.  I'll do up an information post about food and supplement tips tomorrow. 

Ready for Treatment Week 3!

Well Ms. Emily is certainly a lot stronger and much more like herself than she was this time last week.  We should be good to go tomorrow for her 3rd treatment after having to delay it last week.  Her whining has decreased dramatically, her appetite has almost returned to normal(from ravenous) and she's interactive and more cheery.  She's still not 100% herself.  She's still having a hard time getting up and that hasn't really improved but I'm going to get some mats to put around the house tomorrow.  I have all laminate floors and in the last few weeks she's had a hard time getting her footing under her when she tries to get up from a laying down position.   

We've got cookies made for the vet office to show our appreciation for all the effort they're making regarding Emily's care and our whole family's well being.  This includes putting up with Ollie who goes into the vets with Emily each week for his weigh in and then leaves when it's treatment time.  I'm watching his weight because a couple of months ago he had gained weight for the first time in his life and since then he's lost 13 lbs which is great.  Don't want a beef boy and with all the different treats he's getting along side Emily we need to keep a close eye on it.  But he is a real attention hog and they have to deal with him before they can get to Emily.

I've got a little surprise for tomorrow, I'll snap a pic and share it later!

Kisses!

Yesterday I got some Emily smooches!  They were the first smooches in weeks.  Emily is not a big kisses kinda girl but in the last few years she has been known to give a polite kiss or two.  She was whining yesterday but had just been out and had recently eaten so all I could think was that she wanted to get up on the couch but Ollie was in the way.  I made him move (that never happens but he lately he's been spending all day on the couch which is odd for him) and she got up, ears went back and I got 3 of the most delightful kisses!  Sigh, there's hope...

Then last night she actually picked up her rubber lamb and flicked her indoor ball.  As you may remember we have had some outdoor ball play in the last couple of days which is huge progress but that was the first time she touched her indoor ball in weeks.  I almost cried.

And finally, the best part of her current state of being - she didn't wake me up at around 4am.  It was actually Ollie who got me up at 5:30am which is my fault because he was last out at 9: 30pm and he needs to go out later than that to make it to 6am.  Emily had a massive breakfast of her homemade food and we all went back to bed.  The only reason we got up at 8:45am was because Emily heard her Nan getting up. 

She is mostly just whiny with my Mom these last two days.  But she's always been way more whiny with Nan because when she whines Nan automatically gives her a treat.  Emily has her Nan very well trained.....

Ah quiet

Ms. Em is finally having some quieter days.  Earlier this week I thought we'd all go nuts.  I guess it takes a couple of days for her to feel the effect of the prednisone reduction.  Oh she's still hungry as a horse but she's not as all consuming ravenously hungry.  (yes, there is a difference)

Emily's energy level is a bit better too.  She's got a little pep in her step.  She's also a bit more steady although I did nearly knock her over trying to clean a back paw. 

Now if she would just take her duck for a walk, I'd say all was right in the world.  But she has cancer so all is not right in the world.  Hopefully her blood count will be okay for treatment on Tuesday. 

I've added some pumpkin to her diet.  Bit of vitamin K, a good dose of beta carotene and it helps regulate her poo.  Even though you'd think it's a sweet starch veg and therefore high in carbs it's not.  I only add a bit with her cabbage, cauliflower, brussel sprouts, broccoli, spinach, and/or red peppers.

Emily is napping now.  Somehow that seems like a good idea since she had me up at 4:30am, again at 8am and then again at 9am when I gave up all hope of ever catching up on my sleep.  I'll sleep when she's in remission!

Exhaustion is my middle name

The last two days I've been totally exhausted.  If Emily is awake, she's whining for food.  This is after her prednisone had been reduced by half.  And she is still really, really unsteady.  She wants to eat every couple of hours, day or night.  Since she only gained .2 lb last week I'm worried that her feeding plan is not enough so I've up'ed her intake and am spreading it out.  I'm out of the ND diet so I cooked up some brown rice to add to her homemade diet.  The ND diet is a bit higher in carbs than conventional wisdom indicates for lymphoma patients but it does give her some of that bulk so I'm trying to replace that and brown rice has polysaccharides which are thought to be beneficial for fighting the cancer.  The ND diet and Dr. Ogilvie both use rice.  Emily gets less than half of her daily intake from the ND diet so she's getting a lighter carb load.

I've also added a bit of pumpkin.  It's surprisingly low carb for a starchy veg and full of beta carotene and vitamin K, both of which are important in the cancer fight.  Although to be honest I really started using it because Emily had a case of the runs and then only had a very, very small poop and I'm afraid she's a bit constipated.  Pumpkin will absorb liquid, which she is still drinking buckets of, and regulate her bowl/poop production.

Right now when Emily naps, I nap.  And any food she does get in between meals I make into an event, take up her dish, freshen her water and serve her whatever snack/treat she's getting spread around her dish.  After she eats it, she has a drink and then settles for a bit. 

Just a week and a half left of the prednisone and hopefully the appetite will return to normal and she'll get some steadiness back.

Just hanging in there..

An Update on Emily's Last Update

We had ball play out in the yard!!!  Emily has this play activity she does where she holds one ball in her mouth and flicks another ball around with her paws.  Now truthfully this was the first day all her balls were not frozen into the ground and snow.  She chased them when I kicked them and pounced on them when she was batting them around.  I was thinking I really should get it on video.  It's hilarious to watch a Bouvier flick things like a cat!

She's still very food obsessed but it was nice to see a flicker of the old Em.