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2013年9月25日星期三

Fighting Lymphoma - An Update on Spot the Dog

Ever since his diagnosis of lymphoma in September, Spot the Dog has been going to the Be’er-Sheva Animal Hospital for chemotherapy. He is on the multi-drug protocol where his initial treatment was a different drug weekly for 8 weeks, followed by biweekly treatments for six months. He also takes prednisone daily with his lunch of challah and dog food.


His appetite, always big, has become huge and he eats enough table food at each meal for a healthy adult and then consumes 3-4 cups of dog food per day on top of that! So, I finally found a way to get Spot’s vet to stop making me feel guilty about over feeding him and his over weight problem.


“Ok,” says Dr. Marganit, “I’m not going to fight with you over a dying dog.” :)


Fortunately he has not had any serious side effects from his treatments, no nausea or vomiting. His body hair has gotten a bit thin and the hair over his rump isn’t growing back well since his haircut in October, but other than that his side effects appear minimal.


For his chemotherapy a small catheter is inserted into a vein in his leg into which his medecine is injected. His biggest problem is that he has old veins which are very small and hard to use, so sometimes he has to get punctured in each leg during a treatment to find a vein that will work. Dr. Marganit, his great vet, has to use a needle made for a kitten, his veins are so small! But she always manages to make it work.



Dr. Marganit and team prepare Spot the Dog for his chemotherapy. (Click for full size image.)

When he was first diagnosed he was very sick, sleeping all the day, high fever, anemia. Since his treatment began, his blood work is back to normal, although there are still nasties circulating in it. Now he is more like his old self, although he refuses to go on walks. He was even frolicking a bit the other day. He still sleeps alot, but now he is much more alert and engaged, especially at meal time. He doesn’t like to be touched and petted much any more, and Donny is the only person he will let do that.


Yair is still on the outs with Spot, and sometimes when he doesn’t think we’re looking, he will try to give him a kick. Spot just moves away. Spot’s external lymph nodes were very swollen when he first began his therapy, and now all but one have returned to normal. But just this week, that remaining swollen gland has shrunk alot, so we are quite encouraged by his response to his treatment.


Spot the Dog says “Arf” to all of his friends who send wishes for good health and a speedy recovery.



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2013年9月22日星期日

The good news and bad news update

To sum up, the good news is great and the bad news could probably be worried about later.


The good news: Elliott’s ‘nadir CBC’ — the blood test showing his maximum reaction to the doxorubicin, the strongest of the chemo agents — was excellent.  No anemia, no lowered white blood cell count — it was the CBC of a perfectly healthy dog.  And he definitely got the doxorubicin, and he got the standard (max) dose, so this is great news.  Now that he’s had the three types of chemo and shown decent tolerance, it is very likely that he will do well with the rest of his treatments.


The bad news: The abdominal ultrasound (sonogram) he had last weekend showed that his spleen was still large and mottled-looking.  The ultrasonographer thinks that it isn’t as large as before, and looks a little better, but it is still oversize and abnormal.  This is bad news because some dogs with lymphoma will go into remission everywhere *but* the spleen, and in those cases the spleen needs to be removed as it just serves to harbor the cancer.  Obviously, surgery isn’t ideal in a dog with advanced cancer in the middle of a chemo series, and removal of the spleen can compromise the dog’s ability to tolerate the chemo in general.  So this is bad news.  However, the oncologist wants to wait for a few more treatments before throwing in the towel on the spleen so I am saving this worry for another day.  If the spleen continues to look abnormal they will do some aspirates to look for lymphoma; if the aspirates are positive, the spleen will have to go.


She did say that, apart from this report on the spleen, she would consider Elliott to have achieved his first remission (yes she said ‘first’).   It is also possible that he is in remission and has a remnantly-ugly spleen, but I will save that celebration till it can be confirmed.