November 4, 2010 - All Is Well

Appetite, energy level and everything else is back to normal.  Her blood tests are also normal.

November 3, 2010 - Feeling Punky Today

I had to dip into the Immodium last night and she has no appetite this morning.  I hope this is a temporary thing.  My mental attitude towards these momentary setbacks have changed over the past few months.  I'm more accepting that this is part of the deal, unfortunately.  Just hope that she'll be able to take her meds.

November 1, 2010 - Keeping Our Fingers and Toes Crossed

CJ had her first checkup Friday since starting the chemo and everything looks pretty good.  There are no signs of the cancer and the lump on her lymph node appears to have disappeared.  She's a lot more lethargic that she used to be but we took a 5 mile walk yesterday and she was her usual bundle of energy.  So I'm very much taking this one day at a time and appreciating the time we have.

This may be of interest to other dog owners whose pets are on chemo.  Most municipalities require a current rabies vaccine in order to get a dog license.  I had to get a letter from the vet requesting a vaccination waiver on her when I renew her license.  Remains to be seen whether the city of LA will accept it.  I spoke to them on the phone and they said they would but it remains to be seen.  Call me un-trusting.

October 8, 2010 - Who Knew?

CJ is doing great.  Thank goodness she still thinks that the Pill Pockets are treats and anziously awaits them at the appropriate times.  But I've noticed two small bald spots on her back.  Guess I didn't figure that hair loss would be part of the deal.

October 5, 2010 - Feeling MUCH Better

Happy to say that CJ is doing great today!  She's back to her meal-scarfing self and I have no issue with her taking her meds.  She's bck to hanging out at my feet during the day (she was hiding under the bed) and her stools are normal.  I just hope this works but I feel hopeful.  We'll see what happens on her visit to Dr D on the 29th.

October 3, 2010 - The second day

Have you ever been in the middle of a dream and you "hear" something in the dream that wakes you up and, upon awakening, you find out that the sound was real and had been unconsciously been incorporated into the dream?  Let me give you an example.  Last night I was dreaming and in the dream a dog was barking.  I woke up and realized that CJ was barking.  There's only one reason that she barks in the middle of the night.  It's that she has diarrhea and wants me to let her out of the crate before she poops in it.  I always knew she was smart!  So I let her out into the back yard and she did her thing and went right back into her crate.

Today is not a good day for her!  She's got no appetite and vomited in her crate.  Thank goodness she took her morning pills.  I don't know how I'm going to get the chemo pills down her later today.

How Did I Get Here - Catching Up to 10/1/10

So, with much trepidation, I went to my appointment with Dr. D, the oncologist, preparing to be bankrupt.  I'd heard horror stories about the one vet cancer center in my area, and was glad Dr. D wasn't associated with them.  Dr. D was great and knowledgeable.

Essentially, she gave me 5 options.  I won't bore you with the details but they are:
1 - Prednisone and wait to see what happened.
2 - Conventional chemotherapy
3 - Radiation
4 - A new type of chemo that was approved in Europe but was in the last stages of FDA approval in the US.
5 - amputation

I loved the fact that she wrote out a detailed report for me in language I understood with all the costs, risks, success probabilities, side effects....pretty much everything you would want.  Words of wisdom - get it all in writing because there's no way your brain can fully take it all in.  And be prepared with a list of all the questions you can think of, whether they seem stupid or not.

Now I had to make a decision that would affect both CJs life and my pocketbook.  Between advice from others and my project management experience I knew that, before I could make a decision, I had to decide on what my "success factors" were.  How invasive did I want to be?  How much money was I willing to spend?  How much did I want my life to be interrupted?  How much did I want to consider CJs short term comfort?  Of course, being the perfectionist I am, I wanted zero impact on me, zero pain to her, zero cost and 100% probability of success.  NOT GONNA HAPPEN.  Turned out that the option with the highest probability of success was the most costly, the most invasive and the most interruption to my schedule.

So I did what any good 12 Step person would do.  I prayed about it, talked with my sponsor and tried to educate myself as much as I could.  After a few days, it came to me.

I chose option 4 but sought out a second opinion.  The second vet turned out to be the mentor of my vet in LA.  I consider it well worth the money spent to get that second opinion.  He reassured me that (1) Dr D was very knowledgable (2) my choice wasn't out in left field and (3) I was doing most of the right things

SO, here's what I'm doing for CJ:

1 - Benedryl, 1 25 mg tab twice a day.  Since MST is a cancer of the immune system and produces histamines, this helps keep the histamine level down.  It does make CJ a little drowsy but that's not the worst.
2 - 1/4 Pepsid twice a day.  Dogs are prone to stomach ulcers.
3 - Prednisone - 1 tab twice a day.
4 - Probiotics - helps rebuild the immune system
5 - DHA (algae-based) - 600 mg daily.  they recommended the algae-based as opposed to fish oil.  Helps the immune system
6 - 1 t brewers yeast.  We have a bad flea problem in Southern California and I chose to stop all chemical  flea medications.
7 - 2 chemo pills once a day

Dr D told me that I could use chemical flea control in moderation if it was really needed.  However, since it's getting into the winder months, I'm going to rely on natural topical flea spray instead and see how it goes.

So that takes you up to today.

How Did I get Here - Part 3 (The diagnosis)

24 hours later Dr. B called me with the results.  The clinical terminology was that CJ my 18 month old puppy  had a 2 cm grade 2 Mast Cell Tumor (MST) at an unknown stage.  Because of the location of the tumor they were unable to get much in the way of margins but the margins they did get were not clean (that means there were abnormal cells in them).  The only good news was that the mitotic index was only a 2, which means that the tumor wasn't growing very quickly.  Dr B then gave me the name of a canine oncologist and made himself available to answer additional questions.

I was numb.  I heard the wrods and kinda understood them.  The vet did a really good job of explaining everything but I just wasn't comprehending.  Was it cancer or not?  My interpretation was that maybe it was and maybe it wasn't but it probably was.  AARG!  This uncertainty thing again!  I wondered if the pathologist made a mistake.  After all, MSTs were common in old dogs but almost unheard of in puppies.  I was overcome by anger.  NOT AGAIN!  I hadn't even finished paying off the credit card bill from the last dog who died from an aggressive form of lymphoma about 6 weeks before CJ came into my life.  I couldn't bear going through the pain all over again!!

How Did I Get Here - Part 2

In late August the lump re-appeared as suddenlt as it had originally appeared thes first time.  I called the vet and insisted on seeing Dr. B.  teh first two times I went for my appointment I waited over an hour, hadn't been seen and walked out after re-scheduling.  I was livid because my time was limited and I was taking time from work Between the second and third tries, I made the mistake of looking at vet reviews on Yelp.  Now, don't get me wrong, Yelp has its place and I use it  a lot.  But the reviews for my vet were all over the place.  Dr B was either the best vet in the world or a heartless money-grubber who had no business being in existence.  But they said the exact same thing about my old vet and almost every vet on the Westside.  So once again I was forced to pray about it and follow my instinct.  And my instinct told me to give Dr B one last shot. 

He took one look at the lump and insisted it be removed immediately and biopsied.  I have NO idea why I went along with the biopsy idea, another one of those divinely inspired things.

How did I get here? - Part 1

It all started on July 16th, 2010. All of a sudden, overnight really, a lump appeared on CJs front left leg, right behind the second joint. By the way, CJ (short for Calamity Jane) is my 18-month old long haired Chihuahua-Labrador mix. (no jokes, please, at the visual. My dad had a field day with that one!) My daughter rescued her from the streets around USC around Hallowe'en, 2009. She called late on Monday night with that "Mom, can you do me a favor" little girl voice that reeks of faux-helplessness. Dara found the dog and wondered if I knew of a no-kill shelter. I begrudgingly volunteered to take her overnight and figure it out the next morning. Well, one look at that ziza punim (adorable face) and it was instant love. Needless to say, she never made it to the shelter.

Back to the lump. It wasn't there and then it was. Being the Jewish mother I am, I took her to the vet the next day. Dr. B (the head vet at the center I take her to) wasn't in so I took the first associate available. He said it was probably an insect bite, prescribed some antibiotic and anti-inflammatory and sold me this jar of "magic clay" that was supposed to have curative properties as well as mineral supplements. How could I have been so *%^&-ing gullible??? Well, CJ wouldn't abide by the magic clay (I always knew she was smart) but the lump went down. So I figured it was an insect bite.

However, in retrospect, there were other warning signs that I just attributed to other factors. Her energy level dropped but I just chalked it up to "growing out of puppyhood". her appetite decreased to almost nothing but I assumed she was going through a finicky period (not her first). I went through bag after bag of food samples (getting more and more annoyed by the day). The only things she would eat were EVO and cooked chicken and rice. Both of which I rejected because of their high protein content. Ironically enough, EVO and a high-protein, semi-raw diet are the ideal foods for canine cancer patients. So, in a strange way, CJ was craving what her body needed and the stupid human just didn't listen.

How did I get here? Prologue

I'm the kind of gal who reads the ends of books first to see how they turn out. I'm a project manager by profession so I make my living by looking at alternatives, weighing risks, putting hundreds of unrelated tasks in some semblance of order, planning for every possible contingency, resolving every crisis with a cool, logical demeanor and orchestrating a successful result. In my line of work, if you plan well it usually turns out well.

Needless to say, I'm somewhat of a control freak and it's taken me a long time to learn how to roll with the punches (thanks to my involvement in 12 Step programs). The past few months have thrown me an opportunity for me to roll with the punches once again. The event that gave rise to this blog is CJs and my fight against her recent diagnosis of cancer. If you're wondering who CJ is, read on......

This is a journey into the unknown darkness, an endless sea with no end in sight. A journey where the end point may be death or survival. There are no right or wrong answers, no guarantees. I can't do a cost-benefit analysis to come up with the optimal solution. This is a cosmic crap shoot. Which frustrates the hell out of me!!!!

This blog is meant to document my journey along with CJ. It's not meant to be an authoritative treatise on canine cancer in puppies. It will focus on the decisions I made and why I made them and, more importantly, the labyrinth of emotions that accompany each step.

October 2, 2010 - the first day

Well, she's still her old feisty self. She didn't die during the night, as my "worst-case scenario" mind feared. Her appetite was fine. However, she did have diarrhea. Things I learned: (1) take twice as many poopie bags as you think you're going to need and (2) wearing a latex glove may be dorky but it really works in picking up the diarrhea. I wonder if there are any natural anti-diarrhea formulas on the Internet.

I left a bunch of questions for Dr. D yesterday and her vet tech called back with answers. The jist was
(1) you can have the exterminator spray for fleas but don't go crazy about it. Especially since it's getting into winter and the fleas are going to die off as the weather turns colder, anyway.
(2) You can use topical flea treatments but use good ones and not unless you have to.
(3) Ditto for flea shampoos.

Shit, I've been using all 3 and have been phobic about fleas. Time to "use my best judgement" (How I'm hating to hear that! It means I have to make a decision....)

(4) No vaccinations while she's undergoing chemo with the exception of rabies.  The vet will give you a waiver if you need one.
(5) It doesn't matter when you give the chemo pills but give them the same time every day and don't do it at night in case she has to poop in the middle of the night.