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.

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.

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.

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.

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.

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.

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.

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.

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.

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.