Greyt Matters

On Wednesday, Sarge had his eighth chemo treatment, which means we are half way done!  And…we move to an every-other-week schedule.  Woo hoo!

Instead of the Adriamycin, he ended up getting Epirubicin, which the discharge instructions calls  “an analog of Adriamycin that has similar effectiveness.”  Adriamycin is on national backorder.

I had mixed feelings about this turn of events.   On the one hand, I was glad that Sarge was not going to have to deal with the “cumulative cardiac toxicity” of Adriamycin, but on the other hand, I don’t know how he is going to react to this new drug, Epirubicin.

But, so far, so good.  Today is Friday, and Sarge has been doing really well.  He was not interested in his Kong yesterday afternoon, so his appetite might be a little affected, but he has been eating other stuff, e.g., a Hebrew National hot dog and chicken, to make up for it and also going on really long walks.  🙂

I am extra nervous about dealing with adverse side effects this time because my car is out of commission.  😦  While driving home from Sarge’s chemo treatment, the check engine light came on and the car would not accelerate above 30 mph or so.  Luckily I was almost home when it happened, and I was able to get off the interstate and limp home.  I called a neighbor and she graciously agreed to be on call in case Sarge needs to make a run to the animal hospital.

But, hopefully, that will not be required.

Me and My Pack

I hope everyone had a great Thanksgiving yesterday.  I did, and I am especially grateful that my is boy is doing well!

Another round of Vincristine for Sarge today.  (Of the seven treatments so far, four have been Vincristine…seemingly the most benign of the 3 drugs).

He has been snoozing most of the day, although we did take a long walk mid-afternoon and he enjoyed a frozen Kong afterwards.

I was afraid his white blood count would be down this morning because of last week’s Cytoxan, but apparently all was well.  I will be checking his temperature in the coming days though to make sure there is no return trip to the hospital.

The only other new development is that he may not be getting the scary Adriamycin next week.  The vet tech said both the Adriamycin and its generic are on back-order nationwide (affecting humans and hounds in chemo).  She said Sarge would get a dose of Epirubicin if the Adriamycin is not available.  She said this drug is like Adriamycin but it is not toxic to the heart but there is a slightly greater chance of G-I issues.  I will, of course, be Googling Epirubicin this weekend so I can torture myself some more as I learn of the nasty side effects that are possible.  :-0

I questioned the vet tech about the cumulative cardiac toxicity of the Adriamycin this morning.  She claims that it is not a big deal for dogs since they are getting a much smaller dose than humans (unless the dog comes into chemo with heart problems).  But I would prefer to get my information from someone who went to vet school.  Unfortunately, he is more elusive than the vet techs.

The good news is that we are almost half way done with these scary chemo treatments!!!

Sarge got the dreaded Cytoxan yesterday.  This drug is given in pill form, and the oncologist did reduce his dosage from 5 pills to 4 (50 mg each) given Sarge’s bad reaction the last time he had it.

So far, Sarge has been doing fine…a little low energy yesterday and today.  Hopefully, he will bounce back by this weekend.  And, God help us, please no fever (for which we need to be on the lookout for the next 7 – 10 days).

I’m definitely struggling with whether I am doing the right thing or not.  While Sarge is eating enthusiastically, going on long walks, and seemingly not in pain, he just seems to have lost his spark.  The personality I fell in love with has been diminished.  I miss the kisses, the smiles, the purring during a belly rub…

Plus, I am really starting to freak out about the cardiac toxicity side effects of the Adriamycin, which he is scheduled to receive for a second time on the day before Thanksgiving.

My regular vet gave me a document to read concerning evaluating a dog’s quality of life.  I am going to spend time with that this weekend.  I think it will help for me to learn how you can more objectively evaluate this very, very emotional process of dealing with end of life issues.

Sarge is scheduled for his second dose of Cytoxan tomorrow, assuming his white blood count is above the minimum number.  That would be the Cytoxan that ultimately put him in the hospital the last time because it hit his white blood count hard, and he ended up with a bacterial infection and a raging fever.  Waaaa!  😦

Plus, I just made the mistake of reading another blog about canine lymphoma where the writer posted an official looking description of the side effects of adriamycin, which Sarge has had one time…side effects that include cardiac toxicity.  I had seen mention of this particular adverse effect in a document my vet had given me for another purpose, and it called the cardiac toxicity a “cumulative problem…typically arising after six doses.”  Sarge is supposed to have four.

Chemo is really a scary thing.

As of this morning, Sarge has made it through five rounds of chemo.  🙂  Eleven more treatments to go.  :-0

Of course, I had to talk to the oncologist before they went ahead and did anything beyond checking his blood counts.  My regular vet, Dr. Fowler, had given me the results of Sarge’s Friday CBC, and he was starting to get concerned about Sarge’s ability to fight off infections.  He was more concerned about the number of neutrophils in his blood and not so concerned about the WBC number.

But Sarge showed no signs of fever over the weekend or on Monday or Tuesday, and when we went in this morning, no fever either.  The oncologist said Sarge’s blood counts were better than the Friday counts, and he was not concerned about white count, red count, or neutrophils.  Overall, he thought Sarge was in fine shape.

When I brought up Sarge’s loss of energy, i.e, that he was wiped out for a good solid week after the last treatment, he said that Adriamycin was the one that typically hits them the hardest.  He was not concerned by Sarge’s loss of energy since the main concerns with this drug are vomiting, diarrhea, and loss of appetite, and Sarge had only a minor problem with his appetite, which we were able to overcome.

I stressed that, while Sarge’s overall energy level has come back pretty well over the past few days, he still seems to have lost his spark.  His joy of life seems diminished; that means, no kisses, no smiles, and no purring when his belly is rubbed.  Which seems to indicate that he does not feel well on some level or maybe he is depressed.  I know it has been depressing me.  😦

Pensive Sarge

The oncologist just said that he has no clinical reason why Sarge would be “withdrawing.”  He thinks Sarge should be acting fine.  He seemed a bit dismissive of my concerns, but that may just be his unintended body language.  We chatted a little while longer about where Sarge is at, and then he went back to the lab and gave Sarge his injection, and I sat in the waiting room slightly annoyed by the conversation.

The good news is that today’s Vincristine injection seems to have perked Sarge up a bit.  🙂  Several times he did the play barking and spinning around thing that he likes to do.  I also got a couple of little kisses, which made me feel better.

Sarge is an important component of my anti-depressant therapy.  If he ain’t happy, then I ain’t happy.  Maybe he is getting a little happier.

And not to be missed, Daphne had a birthday yesterday.

She Wore a Rasberry Beret

My little princess is now 10 years old.