Wednesday, 26 December 2007

Bad News

Shadow has his cancer back - at least, that's the strong indication. On Saturday just after lunch (and just after the vets close for the weekend) I stroked under his chin and felt soft marble sized bubbles where there should be no such thing.

I phoned the emergency vet and he said to bring Shadow in Monday morning, as he did not know what protocol Shadow's vet would want him to be put on. We could have taken him in to have his glands checked, but as we KNEW what the problem is, and there was nothing that would be done, we did not go in. Obviously, if he had become ill, or had begun to have trouble breathing, we would have taken him in, but he was bouncing.

We had Shadow sleeping on our bed that night - a first, but something I wanted to do, and something he really enjoyed. We got lots of kisses, and a few kicks, as he was so excited about it, but all in all he was very good. He didn't move about too much, but he does snore!

I knew that I had a morning bed cuddle with Shadow two days previously, and had taken the opportunity to feel him all over, and he was fine then, and of course I was berating myself for not feeling him down on the Friday - even though I worked a 7 1/4 hour shift and was running about sorting childcare, and shopping, before coming home and packing presents.

Shadow went into the vets Monday and we didn't see him until 6pm. He had been given one chemo. His bloods have been taken and some sent off for staging, some is being checked for his blood count. We were just pleased to have him back for Christmas day - though we had forgotten how tired he was after his first chemo, and thus unprepared for how flat he was.

The kids have taken this news quite lightly, I am sure they think that he will have the same treatment as before, and be fine, as before. We haven't spoken with them about the situation at all - we need to have a long talk with the vet once the results are back before that. My hubby is wondering if we should put Shadow through another round of treatment, but I am not prepared to think about that yet. It was only on Friday that someone asked about Shadow's health, and I was giving an upbeat answer.

Shadow is due a check up - and I keep thinking that we might have picked this up earlier if I had taken him in - but we were so busy in the run up to Christmas. I keep kissing his dear head. I have no aversion to him, as I did when he first was diagnosed - this event has made me familiar with cancer - I was fearful of it in itself before.

He is so tired he won't even get up for a treat - and he is back on the steroids. Last time it was only a few days and his lumps went down dramatically - they are not doing that this time. We heard the day before I felt the lump that the puppy we have been waiting for has been born. As if the puppy IS Shadow's replacement.

Finger's crossed that somehow Shadow is okay.

How he was

I see I have not posted here for a while. Shadow has been really well - his coat had gained its lustre and softness, and begun to grow - he has had more energy. About 6 weeks ago we had a check up and he had blood tests, which indicated that things were going well. I was suppoed to take him back in 4 to 6 weeks, but with christmas stealing time I had planned that we would take him in between Christmas and New Year.

Thursday, 11 October 2007

Recovery

It will be 4 weeks tomorrow since Shadow's last chemotherapy. It has been quite an anxious time. I had the thought in my head that the next stage we would see with Shadow's health would be us finding a new lump. It made me quite fearful of stroking him, I kept expecting to come across it, under his fur, under his skin. Often a stroke becomes an examination. Every touch of his dull coarse fur reminded me that he was ill.

Two things have happened though. His coat has begun to soften and to begin to glimmer and gleam again, and we have had the results of the blood tests taken 4 weeks ago tomorrow to measure the lymphocytes in his blood. The normal amount is anything up to 7. When we last had the test done, at the start of all this, his level was 37. The vet, who is very controlled, had an edge of excitement in his voice when he told me that the level is now 1.4. I didn't ask if this means he is cured, and the vet added that if Shadow got ill, we could have his blood measured (quicker) and if the level had risen, we would know why. Did you hear what he said though? He said "if". I know he was probably being diplomatic, but I am doing better with a little hope, playing more with Shadz, and noticing him playing more with the puppy. We danced our way around the kitchen the other day, Shadz and me, and though he dropped after a couple of minutes, it was great to see him enjoying the dancing. He has more energy in his walks as well.

My daughter had a school project, to write her autobiography. Shadow's arrival in our family featured, as did the news of his cancer, and his chemo. She wrote that now he had finished chemo we could hope that all would be okay. I said nothing to her. She has heard me tell endless amounts of people that there is no cure for lymphoma, she knows the score. She just wants to hope, so hope she shall. I have heard of dogs who have a couple of years in remission - why should Shadow not too?

Sunday, 9 September 2007

Back from Holiday

We have been on holiday for two weeks in France. Luckily we have already got a good relationship with a lovely couple who dog sit professionally, and have sat for us for some years now. They know and more importantly love Shadow, and we contacted them as soon as Shadow was diagnosed knowing that they would want to know. They visited him immediately, and sat for us whilst we I went to Dublin.

This trip was different as it covered a chemotherapy treatment. We checked out with our couple, and they were happy with the procedure. We kept in touch with our couple during our trip by text, and everything seemed to go well.

I had a shock when I came home though. We were very excited approaching the house, imagining the welcome that we would give and receive, and Shadow seemed subdued. His coat was noticeably coarser as well, and I thought his face looked a little swollen. My other half saw nothing different in Shadow than when we left, and with hindsight I can say that I have probably just seem him clearer after the two week separation.

Shadow has one more chemo to go, then he is done. At the moment if asked if all this treatment is worth it, I would not have a definite answer. Shadow is not himself; he is quieter, tireder, hungrier. The most he comes alive is when there is food about, and one of the things about him that we loved was his stateliness, his aloof sphinx pose, his distain for the common manners of the puppy who shamelessly begged for titbits. Now he stands gazing at the food his big eyes alight, and sometimes a little whine coming out.

Of course he is still here, he can still enjoy a petting, and a cuddle, and he can still keep us noisy company (he snores). Though I am glad of that, I am still grieving the amazing dog we have lost. Perhaps when the demands of the chemo are relieved he will gain strength and health and we will see some of the old Shadow back, but perhaps the cancer will leap back into activity and we will not.

Some sad news today. My sister-in-law phoned distressed to tell me that their Cavalier King Charles spaniel Suki died last night. She has had a heart murmur for a while, and yesterday she began gasping for breath – her heart was not pumping the blood around her body fast enough for enough oxygen to be circulated. She was just 8. My kids howled when I told them – earlier this year my sister lost her West Highland White terrier who developed a disease and died suddenly. All of us had recently obtained a second puppy – my daughter wailed that everyone who gets a puppy loses the older dog. I know they were thinking of how they would feel when Shadow goes.

Yesterday I phoned the breeder that we got the puppy from, and found out when she is next breeding. She will breed next month. Part of me is unhappy at making arrangements so soon for Shadows replacement, though actually we always intended to have three dogs. And part of me is aware that our existing puppy hates being alone, and so we need to make plans for the future. However I rationalised it, that phone call seemed like a betrayal.

Saturday, 28 July 2007

3rd cycle over

Shadow has been coming home with bandages on his legs for the last 3 or 4 treatments. One time the bandage was made of gauze, another of lilac bandage, and this time of blue. He starts to tear them off the minute he is home - or at least the minute he has finished his big drink, wee and poo. We laughed about the lilac bandage, on such a male dog - the blue was much more appropriate. However much we laughed, at his quick attempts to rip them off, or their colour, the bandages were an unpleasant sight. They may simply be holding a cotton pad against his leg where the IV line had recently been removed, but they were a sign of medical interventions, intruding on our deliberate forgetfulness about the reasons for his Friday absences.

I know in the back of my mind that perhaps it's not healthy for us to ignore the reality of the situation, but living with the reality is too hard. When the cancer was newly diagnosed I had difficulty stroking or hugging Shadow. That passed, and we were all over the dog, and then that passed, and we are back to a more normal relationship. It takes so little to throw us back into panic however. Shadow being under the weather - the vet saying, as he did after Shadows 4th chemo, 3rd cycle "His heart rate is a little up." Kevin discovering, as he did today, a small lump that appears to be in Shadow's skin, not quite in his underarm, but in that area.

And then there is Ozzie. I have been reading Ozzie's Lymphosarcoma Blog since the almost the day Shadow was diagnosed. Ozzie had his last chemo almost on the day Shadow had his first - and there were many times that I wished that Shadow was in Ozzie's position. Then Ozzie began to get unwell, and it was found that his cancer came back. I sent an e-mail to his owner, but avoided the blog - it was too much, making me face the fact that it is almost guaranteed that this is what Shadow has ahead - the cancer coming back. Ozzie's owner then e-mailed me to say that Ozzie had been euthanised - his kidneys were failing, he had spleen problems, and vetinary treatment wasn't producing a good response.

I feel for Ozzie's owners - we have previously lost a dog, and know the pain of the empty collar, the no longer necessary lead, the space where a dog bed or bowl should lie, the unacceptable quiet, the way it becomes necessary to listen for a doorbell - all the terrible reminders that a much loved companion is gone. Yes, I feel very much for Ozzie's owners. But I also feel afraid for us, for Shadow, for the dark future ahead. Suddenly I feel safe on the chemo.

I know that the chemo itself is killing him - it's killing him slower than it kills the cancer - but he could not be on it forever. When he goes off it though there is nothing except his own immunity that is fighting the cancer. And his breed are susceptible to cancer - the vets advice was that the cancer would be likely to return quicker in his breed. One more cycle, and we are on our own.

Sometimes I wonder why we didn't choose to have him euthanised at the beginning - why we chose this purgatory for ourselves, when there is no happy ending. But then he trots in, having been outside watching the rain fall (one of his favourite hobbies - having a waterproof undercoat), and throws himself down at my feet, grunting with pleasure, his wet neck leaned up on my leg so he can doze in his favourite position, with his head at a 90% angle to his body, and I recognise that he doesn't know he is ill - he is untroubled about thoughts of the future. He surprised us and the vet by accepting his chemo treatments in his stride, and recovering better than anyone accepted. And that makes it worth it.

Saturday, 7 July 2007

3rd Chemo, 3rd cycle

Shadow is coping so well with his treatment that I am left with nothing to say. He is having his chemo, he is bouncing with health - the routine of his visits to the vet has become the norm. We barely think about his cancer. The children have begun to include Shadow again when they talk of the future, and sometimes we do not remind them of the unlikliness of that - it has become unthinkable to imagine him ill. He seems in such exceptional rude health.

I am seeing his vet on Tuesday when we get our puppy innoculated, and it will be a chace to ask the dreaded question - does this enormous vitality have any reflection on the diagnosis, or are we still eating into Shadow's probable last year?

Sunday, 27 May 2007

Second cycle over

And Shadow still fine.

Tuesday, 22 May 2007

3rd chemo 2nd cycle

Not much to report. Shadow bounced into the vets, wagging his tail furiously and greeting all his friends in there, and bounced out so hard that the veterinary nurse had to let his lead go to avoid being pulled over (Shads did a humongous wee when he got outside which explains this uncharacteristic lack of courtesy). His hole is no more, leaving a tiny pink scar surrounded by a ring of white scar tissue. We don't know if hair will grow back over the scar, and if it does, whether it too will be white hair - I have heard of that happening - but it doesn't matter.

The fact that he seems to be so healthy, even though he is still having chemo, is fantastic. He has his last chemo on Friday, and then will get a bit of a break as each chemo will have at least a fortnight's gap until the next. He gained so much energy back on his last weeks break from chemo that I am hoping that the next two cycles will affect him less than these first two. Shadow was a very energetic dog - the chemo has had an affect on his energy levels, he is running at about 80% of his previous maximum (which is still quite a lot) but he does tire, and it will be good if he recovers some of his lost energy back.

Saturday, 12 May 2007

Second Cycle, second chemo

Shadow is doing fine. The hole is now just a small round scab with a ring of white scar tissue round it. It's about the diameter of a fat pencil, and scabs up easily. Shadow went in for his chemo yesterday, and the vets were really happy with him. His white blood cell count is good, and he's bouncy. The puppy wont leave his tail alone, and they playfight occasionally. Best of all Shadow can now be walked off the lead as his hole has healed so well.

The only thing that is different about Shads now is that he is quite brazen about wanting treats - he waits for a frozen chip when I get anything out of the freezer, and whines at me when I cook the kids their tea and he gets nothing. He has discovered that if he ignores the first treat I hand him, I will drop it on the ground and offer another. As soon as he wolfs down that one he hoovers up the one on the floor. It took me a while to catch on that he had so successfully trained me, but we are re-educating him that he doesn't get treats every five minutes. Now he seems to be bouncing about in rude health, we don't feel nearly so sorry for him.

Wednesday, 9 May 2007

Healing

Shadow is doing really well. Yesterday I came home and was surprised to see that the wound on his neck was raw and weeping again - I thought the puppy may have begun to lick at it. However, this morning the wound was dark with scab again, and had shrunk considerably. Shadow is more his old self - he isn't desperately hungry, but is quite happy about getting treats. He played with Sally again this morning - there is a bit of a disparity in their sizes, so when they playfight, Shadow lies on his back, with Sally darting at his throat, both of them making a lot of noise, and Shadow pushing her off with his paws. I had almost forgotten that they did that, it's so long since I have seen it.

Shadow was bounding about for a good five minutes, and whilst they have not repeated the fight, and it used to be something they did many times a day, I am very happy. Sally seems to know when Shadow is feeling better, and when not. She keeps away from him when he seems tired, so seeing her cuddled against him tells me that she knows he is feeling better.

Saturday, 5 May 2007

First chemo, second cycle

Shadow is doing well. The chemo on Friday went well, though it seems to have tired him, which is a shame as the day before he went in he was playing with the puppy for only the second time since his diagnosis.

His hole is also improving. Suddenly the hole can barely be described as such, it has got very shallow, and is trying to scab up. We are immensely surprised, and given that the vet thought his healing time would be increased from the normal 14 days to about 30 due to the immunosuppressant effect of the chemo, and things look so good - we are well pleased.

Shadow is definitely less hungry, and although that sounds like such a little thing - to have a dog that is always famished - it isn't. Not when the dog is mortally ill - we all know how unpleasant hunger can be, and it was stressful to be aware that the poor dog was suffering in that way, especially when we knew it was possible that each hungry day could be one of his last.

Now that is over, I am no longer troubled by guilt. Also, as we have been through a whole cycle of chemo and Shadow coped well, and the abscess seems to have been successfully dealt with, we are relaxing a bit, and enjoying Shadow more.

Tuesday, 1 May 2007

Getting better

Shadow is off the steroids, hurrah! He is not so altogether famished all the time, and the vets have said that 10 days after stopping them they should not be affecting his appetite at all. he also went for a check up, and the vet was pleased with how he is doing. The hole in his neck is healing slowly - as his immunity if reduced - but it is healing, and the vets was impressed that all the retained fluid in his neck has gone. His hair is even beginning to grow back over the shaved bits. We have a few more weeks of antibiotics, and we still must walk Shadow on the lead so he doesn't roll (which he does tend to do on walks) and rub foreign bodies into the wound.

Shadow isn't loosing his hair - in fact, he isn't shedding hardly at all - my carpets are normally black themselves after a couple of days without hoovering, but that just isn't happening. I know that with us humans a shock can stop the hair growing, meaning no hair is being pushed out by new stuff, and wonder if it is the same with dogs. Maybe the chemo has shocked him.

We needed the week without chemo, but Friday is advancing, bringing round two with it. I hope we have no more incidents such as this abscess, but who knows.

Friday, 27 April 2007

Codeine

I visited the vets today, saying Shadow was not happy, and wanting painkillers. We were told yesterday that he does not need them - but I cannot see how that is true. He can't have many painkillers because of the steroids that he is on, but he can have codeine, so I now have a prescription for the next 10 days. I was also told that Shadow may well be agitated simply due to all the disruption that he has had going back and forwards to the vets.

We have given him one tablet today, and he seems a little more relaxed.

Thursday, 26 April 2007

Holes


Finally Shadow came home yesterday, minus a little part of him. The abscess, which is what it's was, was cut out, leaving a hole in the side of his neck. It looks dreadful and I can't understand why he is not on painkillers. The swelling seems to have gone, and hopefully this will have put an end to it, though in a much more violent way than we were expecting.

Shadow is proving true to his name, shadowing us, which tells me he is in pain. We are waiting on a call from the vets about it.

Last night we wondered whether we should keep putting the dog through all this.

Tuesday, 24 April 2007

Back at the vets

Well, the lump seemed to be doing okay, until we realised that although the initial lump wasn't growing, there was an offshoot, diving into his fur lower down Shadow's neck, where it was happily bulging. That bulge was growing, so on Monday evening Shadow went back to the vets.

They explained that there were many fluid filled sacs in the lump, which were being individually drained (poor Shadow!), and that the culture was sterile - there was no bacteria in the pus, so more antibiotics wont help. Given that the lump was spreading and growing, they decided to keep him overnight with the idea of giving him a general and opening the lump to open all the sacs and clean it all out. Unfortunately it was a busy night, so he didn't have this op until this morning.

The op went well, but they have left an opening to the wound to drain it - or something like that - and they wanted to keep him in until the wound was not oozing as heavily, partially to oversee him, and partially to keep him away from anything that might infect the wound. They called us this afternoon to say Shadow is still oozing, and again tonight to say that he is oozing less. The vet might clean the wound out again tomorrow morning.

If this relatively minor problem, begun as a reaction to an injection, does not begin to resolve itself, I have no idea what we will do next.

Saturday, 21 April 2007

End of the first cycle of chemo


Shado had Doxorubicin Friday- and it went fine. He bounced out of the vets, came home to drink bowls of water, go outside pee and poo, and then throw himself on his bed with an audible sigh of relief, and crash. He is lying underfoot as I type.

His lump is not doing so well, beginning to grow again despite the antibiotics. The vets drained about 20 mil of pus from it yesterday, and have sent a sample off to be cultured. Funnily enough the puppy, who had begun leaping all over him in that annoying way that puppies do, has steered clear since he returned from the vets. We wonder if Shads smells different after his chemo, but as side effects go it is a good one, as he needs to rest and recover, something difficult to do with a puppy hanging off his ear.

Next Friday is a rest day - thankfully, as even though the chemo has gone well so far, it puts you in a constant state of anxiousness. If the vets find that there is bacteria in the pus, they may be able to prescribe a specific antibiotic that will sort this lump out one cna for all.

Fingers crossed.

Monday, 16 April 2007

3rd chemo


Shadow has sailed through the third chemo - the second lot of vincristine. He bounced into the vets Friday morning, and we had a surprising call to say he was finished just after midday. How a 24 hour drip can be given in about 6 hours is still a mystery, but when collected, Shadow bounced out, and came home full of beans. However, all is not quite as good as it seems, as the vets gave up some large pink antibiotics as Shadow's white blood count is low.

The vets had drained his lump again, but said now to leave it, and although it rose up alarmingly on Saturday, it seemed to begin shrinking on Sunday, and has stabilised. Hopefully this means that it is now healing. The antibiotics must be helping him heal.

Shadow was a little sick on Sunday - nothing major, and nothing all that unusual, he is on a fibre powder with his meals because he tends towards eating grass and vomiting on occasion, which the vets tell us is pica caused by insufficient veg in his diet.

Today I came home and was horrified to see five clumps of black hair on the kitchen floor. Of course I immediately thought that he was one of the few dogs that do suffer hair loss with chemo. But when I picked them up, the hair clumps looked chewed, so I wondered if our puppy had begun suckling Shadow's fur, something she did all the time until shortly before we realised that he was ill. Soon enough I realised that she was, she was attacking him mercilessly - at one point he rolled on his back and they had a short play fight - something he hasn't done at all in the last few weeks. I find it surprising that the puppy has known to leave Shadow alone when he hasn't been up to her antics, and when she decides that he is up to them again, he seems to be proving that she is right. It was lovely to see them rolling together on the floor.

We are hoping that the lump on Shadows neck will soon improve enough for us to put his collar back on. Because he could not wear it with the stitches in his neck, Shadow has not worn his collar since we took him into the vets, and somehow the collar has become a symbol of Shadow healthy. It is unreasonable to think that getting it back round his neck means anything, however, we are unreasonably looking forward to the day when he can wear it again, and will seem to be our old healthy dog.

Thursday, 12 April 2007

Baldy





We took Shadow to the vet on Tuesday - they took out the rest of his stitches, and expressed pleasure at how well his neck was healing. The lump on his neck was different. Despite us phoning to express our concern on Sunday and Monday, the veterinary nurse seemed surprised how big the lump had got. I said it was about the size of an egg, the vet said a ducks egg (I was thinking the actual lump, maybe he was including the skin covering it). The lump was drained, producing 15 ml of pus, described as "nasty" by the vet. I did not know that there were degrees of nastiness when it came to puss, I thought it was all horrid. Shadow had not seemed himself on Tuesday, and when I was taking him to the vet he seemed very unsteady on his feet in the back of the car. When the lump was drained, he was back to himself, and was absolutely relaxed and comfortable in the car on the way home. I began to think that the lump was pressing on something and affecting his balance. The vet said that the lump began as a reaction to the jab, but had developed as it has because the chemo had affected his immunity.

We were told we may have to return to have the lump drained again, and sure enough it had swollen again the next day, though thankfully not to the same size. I returned to the vets, who drained a further 7ml of puss. They also shaved his neck, though they asked for permission, as the chemo will probably stop his hair growing. He does look odd with a grey lumpy patch on the back of his neck. The lump has inflated again today, but the vets said not to bring him back in as he is due in for his next chemo in the morning. There is another lump starting to grow down his neck, attached at one end to the main lump. Shadow is quite okay in himself, still eating and playing, but I do hope that they do something to fix this problem - they may have to give Shadow a general and open the lump with a scalpel. I don't relish the thought of the poor animal having a third general in so short a time, but this does need to be sorted.

As for the chemo, well, he breezed through this week, no problems at all.

Monday, 9 April 2007

Lumps and bumps

On Saturday night, late, I discovered a bump on the back of Shadow's neck. I figured it was possibly a reaction to a jab, based on the location, but we rang the vets, who said to monitor the lump, but not to worry. The lump was about the size, and shape, of half an egg.

The lump has slowly grown, and is now the size of a full egg, and quite hard, but the vets are still sure it is due to a reaction to an injection. I have to take Shadow in tomorrow to get the rest of his stitches out, so will get the vets to check the lump over, but I am concerned that Shadow is uncomfortable - I was up late last night, and he whined gently a few times when he was lying in his bed. We have nothing in the house to give him, and being Easter everything is closed, so we are just making a fuss of him, and taking his mind off it by giving him treats.

The one thing about dealing with giving the dog cancer treatment that I find hardest (at the moment) is the knowledge that our much loved dog may experience all sorts of side effects, reactions, infections etc, over the next 6 months - and that is if the treatment does put him into remission. I have heard that approximately 80% of dogs achieve remission - although that was with slightly different chemotherapy protocols - which means of course that we have to steel ourselves for the eventuality that Shadow does not achieve remission, and that we may be living our last few weeks with him.

Personally, I find all this knowledge challenging. I can understand why people choose not to put their dogs or themselves through it, and there are two extremes of dealing with it that I find myself veering between - one is denial of the problem - which means that I suddenly recall it all and it is a body blow - the other is being totally aware of the situation, feeling overwhelmed by it, and withdrawing slightly from the dog to cope with it, and feeling horribly guilty. Many people have described the experience of their dog having chemo as an emotional roller coaster, and even though our experience has been positive and uneventful so far, I agree with that.

Saturday, 7 April 2007

2nd chemo

Shadz is home from his second chemo. It all went very well - he went okay into the vets yesterday, and they phoned to say the chemo went well. He was on a drip for 24 hours after to support his kidneys and liver, and ate his dinner fine. He bounced out of the vets this morning when collected, and came home happy to see everyone. Then he slurped up loads of water, had a poo and a pee, and flopped out on the bed as if he had been up partying all night.

It's been a nice day, and Shadow was outside with me later when I was gardening, rolling on the fresh cut grass and grunting in pleasure.

The vets took 4 of the stitches out, but have left the rest in until Tuesday. Shadow is still very hungry, and thirsty, but he has less steroids each day from today, so hopefully that will improve.

Thursday, 5 April 2007

Lying at my feet


There's a black furry rug lying peacefully at my feet, twisted between the legs of the chair, and the boxes and books piled up beside the desk. If I want to move out of this chair, I am going to have to be quite acrobatic to climb over him. I wouldn't disturb him for the world, because in the morning we have to take him into the vet for his second done of chemo, and I am worried about it.

Last time we handed Shadow to the vet, we believed that we would collect him the next day, and although we were concerned about him, we were full of hope that he had an infection. This time we hand him over knowing he is to be pumped full of toxic chemicals in order to delay a probably inevitable death from cancer.

One good thing is that his stitches are to be removed. We have a pup who we have had to keep apart from Shadow all week to prevent the pup introducing any infection of the wound. The pup - Sally, does not understand why she is shouted at if she manages to sneak near him. Shadow himself has not really been up to coping with her bouncing all over him. Normally when we are not here they are company for each other - play fighting, and chasing each other and when we walk them on the beach they run further when they are together than either do when walked apart. The day we can take them back to the beach and Shadow has the energy to race round in his normal exuberant way, that's the day I shall know that this treatment is worth it.

Wednesday, 4 April 2007

What lies ahead


The chemotherapy is to last 26 weeks. The first four weeks Shadow will receive chemo each week - the next is due on Friday. After those four weeks are up there will be a weeks break, then another cycle of four weeks. Then after another weeks break, he will start a four week cycle of chemo fortnightly, with a weeks break until the fourth cycle, again fortnightly.

Each cycle will be vincristine, twice (first and last I believe), cyclophosphamide (that's due on Friday), and doxorubicin. The vet has warned us that the doxorubicin may cause nasty side effects. Unfortunately we are due to go away for the weekend that he first gets that, what was to be our first trip away ever without the kids. It took some arranging to get the dog care and child care in place, and it seems likely now that we will cancel. Our dog people that sit for us when we go away are lovely, really lovely people and potty about dogs in general, and Shadow in particular. I have called them to let them know the diagnosis, and explained that if they sit that weekend there will be stuff that they have to do - mentioning the toxic wee and poo. They have said passionately that they will do anything required, but have not cared for a dog with cancer before. We also know that the vet can keep the dog in if he is not well after the drip - the last drug was given by drip over 24 hours, mixed with fluids, and I think they will all be given this way, which means an overnight stay for Shadow. Even with all this care, we will probably cancel, because what kind of time could we have constantly worrying about Shadow?

Shadow is finishing a course of antibiotics as well, due to the throat surgery and his lowered immunity, and is on a one month course of steroids. He is on 60mg this week, 45mg next week, 30mg the week after and 15mg on the final week.

We are concerned about how he will take to all these visits to the vet. Shadow did not settle well in the 3 and a half days he was there last week, proved by his reluctance to pee when he was there, causing the nurses to get very wet spending ages walking him outside in the rain. Or, of course, he worked out pretty quick that once he peed it was straight back in, so made sure to hold his water until he was tired of the fresh air and the smells. Shadow absolutely loves being out in the rain. He was shattered when he came home. That could be proof that he didn't sleep well there - or it could be a reaction to the surgery, the chemo, the steroids. His eyes were dead when he came home - and it took a while until a light began to glow in them again, could that have been a reaction to being kept at the vets so long with no understanding of why? We didn't visit him at the vets as they wanted him kept calm because of his breathing, and we all felt that once he saw us, not coming home with us would distress him.

Friday, we will have to take him in again - and it is going to be hard. If he walks in with the vet fine, it will be a huge relief, but if he is distressed, and we know how many of these visits will be ahead, that will be something to weigh against the possible benefit of the treatment.

Progress so far


Wednesday. In the evening, our dog, Shadow, who had been quiet most of the day, came to us, and we noticed that his mouth was swollen. His lower lips were swollen and turned out at the back, and his throat was puffy. He had been a little quieter than normal that day, but nothing to frighten us, just something to note.

We rushed him to the emergency vet at the dog hospital, who felt his throat that we had been too scared of causing pain to touch, and found a large lump. Shadow also had a temperature. We said goodbye to him, and he was taken into the hospital.

The vet said to be aware that it may be cancer, but that the increased temperature made that unlikely. He gave Shadow a couple of injections - one was a tranquiliser. I warned the vet that the pills we had once been given for Firework's Night had not worked at all.

Later, the vet called. He had done a needle biopsy, and there was no bacteria in the lump, blood work had been done, and these showed no bacteria either. There were lymphocytes in the lump, but none were observed to have split.

The house was too quiet.

Thursday Shadow was X-rayed and scanned, and an operation was done on his throat, as his breathing was being affected. A drain was put in his neck, as the lump contained fluid. Part of the lump was sent for histopathology, and smears were done.

Shadow is a big shedder, but I found myself unable to hoover his hair off the floor. We had a visitor, who came in looking confused "My goodness! It's quiet in here." before she noticed that Shadow was not there.

Friday, we were advised that the lump and smears had arrived where they were to be tested, and that we would get the results on Monday. The vet began to talk about chemotherapy in a more detailed way. The drain was removed, as no more fluid was draining from the neck. We stayed up very late talking about the chemo, and talking through whether Shadow should be put through it. We suffered from various sympathetic pains in our throats and neck over a few days as we battled to absorb what was happening.

Saturday we visited the vet for a one hour consult about Shadow. We were told Lymphoma was 90% likely, and that the chemo was a 6 month course, and that we should not expect it to extend Shadow's life for more than 6 months. We were told that the lump was still causing breathing problems, but was too close to the jugular to remove. We agreed to the chemo starting, and that went ahead immediately. He received vincristine through a 24 hour drip. Even though the prospects did not look good, the thought of Shadow being strangled by the lump was simply unbearable.

We went home and explained things to the children.

Sunday, we collected Shadow from the vets, a lot of pills (steroids and anti-biotics), a yellow clinical waste bag, and a short written advice paper, written in basic clear language, except for the word "inappetence".

Sunday and Monday, Shadow slept, on his bed. It was as if he was too exhaused to interact with us. He wanted to eat- even when he had just eaten his dinner, he was licking his lips looking for more - he had returned to us thinner than he left us. He was constantly drinking. We were told not to walk him for longer than 10 minutes. At first his eyes were flat and dead looking, but by the first evening that had improved. His poo, wee, and any other bodily fliuds are toxic for 48 hours following treatment, so we have to bag poo in the clinical waste bag to be returned to the vets, and sluice down or scrub away other fluids.

The lump was deflating daily, and the vet had warned us that the dead tissue in his system would make him feel bad. He looked like he felt bad. He was breathing fine by the time he came home though.

Monday the results of the histopathology came back - Lymphoma. The staging showed the cancer to be intermediate - an earlier stage than the vets had thought. The vets now predicted Shadow surviving for a year, and said that there was now the merest, slightest, best not counted on possiblility that Shadow would never go out of remission. Monday night he showed signs of wanting to play.

Tuesday he was more lively, barking at noises in the street, and coming up to us for strokes. He even chased his rope a few times when we threw it for him. He is sticking close to us. The carpet is again thick with his black hair, but now I wonder when I see it if he is shedding more than normal - if he is in fact losing his hair.

Today, he is still hungry. I cannot stop myself giving him odd treats. I know this is not too good for him so I give him small treats. We also recieved a vets bill today for over £1,700. Through an oversight we have not yet contacted the insurance company.