wow... its been awhile!

well here it is 2013....  A new year and Ernie is still here with me.  I cannot believe that its been over 3 months since we started this journey.  It has been a series of ups and downs and ups and downs.  A true  roller coaster.

Ernie is still doing chemo - and today he had his 4th treatment of doxorubicin.  He does okay with the drug.  He isn't hungry tonight...  But we have gone through so many episodes of not hungry that I am almost used to it.  We spent some time outside playing fetch with the stick and he was happy and interactive and enjoyed himself.  So we will try more food tomorrow.

His lymphoma appears to be in check for now.  And while he did have some times when his kidney values were high, they seem to have gone back to normal.  And his liver values are good as well.  yesterday he went to see his holistic vet Dr. King for acupuncture and an overall assessment and she said she was impressed.  That was really great to hear.

However ....  for that past week or so Ernie has had more period of acting weird.  He hasn't been sleeping well at night and will wake up and seem disoriented and try to lay down in weird places like right on top of charlotte's bed.  I had to put Charlotte's portable bed on the regular bed for her to sleep in because he would sometimes wakeup and almost step right on her.  He likes to be on the bed, and if he is on the floor and is pacing, then all I hear is tick, tick, tick, tick tick of his nails.  so it was working having her just sleep in her little "house" until he now tries to climb on top.  This morning at 3am he actually climbed in.  So today I called Dr. King to see what she thought about what's happening.  We  have also been in the car a few times where he climbs up on whatever is in the back seat and sits there in what appears to be a very uncomfortable position.  We don't really know what's going on, and both my holistic vet and oncologist don't feel its related to pain.  So we are wondering if perhaps if nausea.  Not sure.   But the not sleeping at night is getting really hard to deal with.  There are times when i fall asleep at 4am and still have to get up for work.  sigh ...    We are going to try a chinese herb to see if that helps balance him out a bit.  My holistic vet studies Chinese medicine and she said that when there is imbalance like with what he has it will manifest at night.  So I will pick that up this weekend and we will see how it goes.

the other thing is that he has spent the last few weeks eating things!!  he ate half a shirt, 20 or so pages out of a book, a cardboard box, a washcloth, and i can't even remember what else....  So i have removed anything he can pick up and chew.  The one annoying thing was a favorite pillow that he chewed the edges on ..  sigh.

Emotionally, well....  what can I say.  There are some days I want to cry and scream at the same time.  The level of frustration, worry and sadness that sometimes overcomes me can be unbearable.   But I really try to move forward.  I know that there will be plenty of time to cry when he is gone, and I am really learning not to sweat the little stuff. I am so aware now of moments of emotion that will pass.  Situations will change, nothing really ever stays the same.  In fact I continue to learn more about myself every day from Ernie.  So grateful.

Its a very good day.

Today we had an appointment with Dr. Beaver, Ernie's oncologist.  We went over the bloodwork results from yesterday's appointment with his holistic vet Dr. King.  His WBC was up and appeared there was a bacterial infection.  he ended up getting another skin infection and is on antibiotics for that - so it could be that or his bone marrow doing wacky things.  But she has seen this with other dogs and also so things go back to normal. So no big worry right now.  Also, the kidney values were a bit off and that could be due to the higher amount of protein he is getting in his diet.  The PCV is remaining stable, so no worsening of the anemia.  AND the very good news - his liver values went way down.  Yay!! From the 900s down to the 200s.  He has been taking milk thistle and SamE and recently switched to something called Denamarin.  It is actually both the milk thistle and SamE in one pill.  Believe it or not, this is commonly used and recommended by vets.  I guess I was surprised to hear that herbal and other remedies are starting to become more commonplace in veterinary medicine.  This is a very good thing.  Especially if that is what assisted with his liver values getting closer to normal so quickly!  

Ernie relaxing while we wait for Dr. Beaver

Because Ernie had such a weird week or so following the vincristine treatment, we discussed how to proceed with his chemo.  As I have said before there is a very rare side effect with vincristine and it appears that Ernie was one of the rare dogs that experienced it.  So I don't want him to get that drug again, and Dr. Beaver agrees.  He unfortunately did not have a response to two of the other drugs in the protocol and now the vincristine is out.  So, we decided to just move forward with the power packed chemo drug - doxorubicin.  Also because he had a not so great week last week, I wanted to see about waiting another week for his chemo treatment.  He hasn't put a lot of weight on, and being that the doxorubicin is a power packed chemo drug means Ernie loses his appetite completely.  At least he did the last time.  And he has just started in the past couple of days to get back to his normal self which has been very nice to see.  Dr. Beaver examined him and felt the lymphoma for now is under control and that it would only be a very small risk to wait a week.  We both decided that it would be in Ernie's best interest to delay.  Phew and yahoo.  This whole thing is really about balancing disease treatment and quality of life.  

Tonight we went to Petsmart and he picked out a new toy - well he took it from the sales guy!  :-)  So of course he got it.  And then we found another one he liked.  AND they had stuffed dogs that were only 5.00 and went to support veterans.  So we got that too!  He scored.!!

Tonight I was able to give him his meds/supplements in meatballs.  He also ate some spaghetti with turmeric And he ate chicken and broccoli.  Chicken and broccoli!!  I am praying that the appetite continues through the week.  One day at a time :-)

A new elf to welcome in the holiday season

Toys toys and more toys.  Oh and Charlotte!

 

Ernie gets acupuncture!

Today's visit at the vet went very well! I really like Ernie's regular vet - Dr. King. She practices standard veterinary medicine and also does acupuncture, chinese medicine and other holistic modalities. She has a very calm presence, which is great because Ernie tends to get very nervous at the vet. Today he did very good while getting his acupuncture.  The Chinese believe that one reason disease occurs begins there is stagnation.  So the acupuncture helps with moving energy again among other things.

Charlotte came along today and just patiently waited.  I also had an opportunity to weigh the fatty and she had gained less than a pound.  I was quite surprised!!  

 When Ernie was done Dr. King gave him a new Xmas bandana!  He is hoping that its almost time to leave.  :-)

Dr. King and Dr. Beaver (Ernie's oncologist) discussed Ernie and how he was doing.  Dr. Beaver said that Ernie has not presented like any other dog she has treated.  All of his symptoms have been very unpredictable and different from other dogs.  While I like to think my dog is super special and unique, this is one of those times that I really wish he was just average.  He hasn't had the vomiting and diarrhea that other dogs have had, but he has had other things like the rare side effect of the vincristine.  So we just manage as we go along. But it makes things very frustrating at times.  He has been doing really great this week (except for the brief episode Tuesday morning).  Dr. King prescribed some chinese herbs to use to help with the cleansing his liver.  

Ready to go!!  

And guess who else was here today visiting the vet!

Another episode

Monday morning started out great. And Ernie was back to his normal self. I came home Monday night and he wasn't really that hungry. He had been eating pretty ok for the past few days. Not super fantastic - but he was eating here and there. I decided to head off to the park to play a bit of ball. While tossing the ball he stopped and was breathing heavy and was not himself. We stopped for a bit and then I decided we needed to go home. Once we got home he was tired and laid down and went to sleep. I got ready to go to bed and covered him up and went to bed. Tuesday morning he got up and was still not himself. We went out and he had another wobble episode. I carried him for a bit and then we went in. So now I am super stressed out.... Even if its from the vincristine, it is becoming so super hard to see him like this!! boo. I called the vet and talked to her about maybe increasing the pred. Even though I still feel that its the vincristine, I want to manage these symptoms. I was also freaking out about him maybe having cushings disease - but that is my hypochondriac nature transferred to my dog .... She apologized for not having any answers for me. And the whole thing with him is so weird. But I have read about other dogs having this even though its rare. And actually this side effect does happen commonly in people receiving treatment for lymphoma who are treated with vincristine. Anyways, she said that if it was something neurological then the prednisone could definitely help and said that he would still be on what would be considered a low dose. So I decided that I would up it that night. I left and came home at 3:00. He got up and greeted me like normal. I had brought home 2 Jack in the box breakfast sandwiches. He likes to eat the eggs from them. So he ate two eggs and some lasagna. he was normal again. I left for work. Got home Tuesday night, and still back to normal. but I decide to go ahead an up the pred. But instead of a 1/2 tablet I went with a 1/4 to see if that would make a difference. We went to bed around 10:30pm and he slept through the night. This morning he woke up and went out and all was well. He did great through the day and ate well too. Tonight he was himself again and ate a good dinner. Tomorrow we see his regular holistic vet and he will get acupuncture. I am really looking forward to seeing Dr. King and getting some thoughts on some more herbal supplements. I also want to get her thoughts on his episodes and check his hips and arthritis. crossing fingers, toes and paws that all goes well.

Friday - still not great

So last night I slept on the floor with Ernie until about midnight when he woke up. Charlotte was on the floor next to me for a bit, but she kept scrounging around looking for food... I heard her stealing treats from a bowl i had out for Ernie and then going under the couch to eat them. I never realized how loudly she eats... anyways, I finally did fall asleep. And when he woke up, we went outside. I brought the ball to see what he would do, and he ran and chased it. Whaaaaaat? A few hours ago, he was barely able to walk in a straight line and now ... Back to my thoughts of a reaction to the vincristine. How could he be acting totally drugged, and unable to walk straight and then back to himself? So weird. We went back in and he was ready to play... He finally settled down at 2am and I went back to sleep. When we woke up this morning, he was still fine. We went out and he brought his ball. When my neighbor drove up, Ernie ran up to him and followed him into the house. They invited him to stay for the day. I left for work and called later to check on him. George my neighbor said he was sleeping, but would let me know when he got up and went out to go to the bathroom. he called back and said after Ernie went to the bathroom he laid down and it took some coaxing to get him to come in. I got home at 5 and went to get him. He was completely crashed out. I went home and got his ball. He heard me squeaking it and got up, but was wobbly and drunken acting. So we walked home and he laid down. I had called the vet earlier to give and update and she called that night. I talked to her about what was going on. We talked about adding in the pred, and starting the gabapentin (I hadn't started it yet) but also we wanted to try and figure out if it was the vincristine causing this or what. And adding in too much would prevent us from really knowing. I had done some research on vincristine side effects and peripheral neuropathy is a rare side effect seen in dogs. Others on my list serve have also seen the 'wobble' post vincristine and there was a study on a 14 year old golden retriever who had the same symptoms as Ernie. Gabapentin has been used as a treatment so I decided to start that. Since i was still quite worried and unsure what was going to happen w/ him I slept on the floor again. He was on the carpet so I took the dog bed. Its actually quite comfortable :-) He slept until about 4 am. We went out and came in and I went back to bed. Saturday morning he woke up back to normal again... And was great all day long. I had to leave in the afternoon for a bit and when I got back - still ok. And then Sunday was again a great day. We spent time outside and went to the neighbors for dinner. He didn't have a single wobble all weekend. It was such a huge relief and a big weight off that things had improved so much!

the 29th of December... another collapse

Wednesday we had the collapse and recover ... And then Thursday morning we had a repeat. I was in the bathroom early in the morning and Ernie walked in and fell over and then started urinating. I got up and grabbed a towel and then got him up. We went outside and he was wobbly and weak again. He defecated and wobbled really bad. I picked him up and carried him to the back door and he struggled to walk in the house. Crap. I gave him his iron supplement and a bit of food, his pred and anti nausea. And waited. But he didn't seem to be 'recovering' like he did yesterday. So i showered. When I got out, more of the same. This time I was worried and called the vet. They said to bring him in. I had to drop him off so that my oncologist could see him between appts. While waiting for them to call us, I was waiting for him to fall over. There were other clients in the waiting room and I felt like everyone was staring at us. I know that sounds weird, but most people are in there for cancer treatments of some sort and I feel like people look at you and your dog to see how you are both handling things. Or maybe that's what I do - and I just think everyone else does that. I don't know, but it seemed like it took forever. The tech finally came out (but really I was only waiting maybe 10 minutes) and got some info. Then we went to the dreaded scale. But he had lost less than a pound. I had thought he had lost tons of weight because I so easily was able to carry him. But he was still at 61 lbs. I think an angel was on my shoulder and gave me the strength I needed. So I left him there. Its always so horrible - he never wants to leave me and puts on the brakes. I just have to go - because standing there telling him its ok just makes things worse. It needs to be no big deal. Later that day Dr. Beaver called and said that she would like to do blood work, and also and EKG. She said that she had taken him for a walk and observed the 'drunk walking' like I was talking about. And had also checked his paws for a response, and he had proprioceptive deficits. Basically you flip the back paw over and when the dog doesn't reposition the flipped paw w/in a number of seconds, they have proprioceptive deficits. The reasons for this could be all sorts of things. Lymphoma in the spine, a problem with the spine itself, a herniated disk, etc. And no one at this point was sure what was going on. Part of me was still thinking that this was a reaction to the vincristine (a chemo drug he had gotten) but I was also concerned that it was something much worse. We ruled out the lymphoma in the spine because the episodes come and go - and were not constant. So that was a relief. His heart looked good, his blood pressure was good, the blood values came back good except for the liver values still being elevated. However, they were lower than before and I guess I took that as a positive because they had lowered. Hopefully that meant the Milk thistle and SamE were helping with that. But there was still no reason that could be found as to what was happening. She said I could have him see a neurologist, but I didn't feel like I wanted to go that route just yet. So we decided to start him on Gabapentin which is for neuropathic pain and for treatment peripheral neuropathy. It was also suggested to increase the pred, but I didn't want to do that just yet. I picked him up and when we got home he was very tired and still very 'out of it' and wobbly and went to sleep. I was really worried. My mind was filled with him losing the use of his legs and what would I do. Get a wheel chair? Carry him? Oh my GOD he is going to be paralyzed. My mind was seriously going crazy..... Friday night I was supposed to do my yearly Superstition Mountains Gong/fire circle thing. How could I possibly go?? So I called the woman I was doing it with and shared what was happening. I said that he is going downhill fast and I can't possibly be away from him she understand. I hung up the phone and got blankets and made a bed on the floor.

21 November 2012 - Wednesday

Ernie has been eating sooo much better for the past two days. It is such a weight off when he eats! He likes the new Weruva food - and I mix it with some dry kibble. He won't eat the grain free which is what is recommended for cancer, but its more important that he keeps weight on. Yesterday he ate some breakfast, lunch and dinner too. Tuesday night we went to the park and played ball for awhile and the fatty (charlotte my chihuahua) even got some exercise. Its very funny to watch her tried and run fast through tall grass with her short little legs. :-) I have talked to the oncologist about increasing the amount of time between treatments and see how he does. Ernie has always been super healthy so medications and vet visits are a new thing to him. Its more important that he has more good days than bad, otherwise what is the point? I have also been able to step down his prednisone and he might be off of that completely by next week depending on how he does. yay. The one yucky thing about cancer is that when there is a good day my mind thinks yay he is cured. But its not like he has an infection that will go away with a round of antibiotics. So we manage it day by day and continue to be grateful for the good days and pray for our continued strength.