Here’s the e-mail message that I sent to VIMP just a while ago.

Hi,

You know by now that Mina’s had diarrhea today. It’s 5:15 p.m. and she’s had four bouts of it, one of them indoors. This morning she was fine; normal, if small, stool and she ate breakfast with gusto. I did notice some loose stool on her last potty break before I left for work, but since she seemed to be otherwise well, I didn’t give her any Immodium.

Between 6:10 a.m. and 10:30 a.m., she had diarrhea indoors and my petsitter found it. Her second petsitter reported that Mina hadn’t eaten and seemed sorta down. By the time I got home at 3:45 p.m., Mina was perky, very ready to go outside, and energetic. She had another two rounds of runny stool that looked sorta like gelatin over the next hour. Right now, she’s resting after taking an Immodium dose, and seems hungry.

Kristy called and advised me to give Mina the Immodium. She mentioned that it’s been nine days since Mina’s last chemotherapy treatment, that this diarrhea may be caused by the cancer. That makes twice that this
gastro-intestinal cancer possibility has been raised. What I’d like is
something clinical, factual to back up this hypothesis and some idea
of what this means for Mina and how we’re going to treat it, please.
If last week’s weight loss was not a product of the
Adriamycin/doxorubicin and if this bout of diarrhea is not caused by
something she ate or her ongoing IBS (my own anxiety-related IBS has
been quite active for more than a week now), then I need to know what
we can do about it. I’m confused by the reports that she’s doing well
and then when she loses a pound and gets diarrhea, cancer is the
culprit.

Thanks for your understanding. This is really eating a hole in my gut
right about now and that doesn’t help Mina one bit. We’re very
connected and she knows, no matter how much smiling I do, that
something’s wrong.

Sheryl

s.

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Mina was pretty lethargic yesterday, which I blame on all the excitement from Saturday, our late night, and the overwhelming gloom of Sunday. She didn’t eat very much, as I expected, just a few jars of baby food and maybe a handful of beef and chicken. Normal bowel movements, no vomiting, just not feeling like herself, I guess.

This morning she was pretty sleepy so we walked only as far as she needed for a poop. When we came home, I offered her some beef and chickens and she ate a little from my hand and one jar of baby food. I’m finding that Mina is very sluggish now in the mornings and doesn’t really seem interested in food until later in the day. So, I left a note for her sitters to give her baby food if there’s still breakfast in her bowl. She cannot survive on damned baby food, it has the nutritional value of air, so I’m hoping she improves today. I did give her the Mirtazipine before bed and she went to sleep pretty quickly afterward.

Tomorrow is her rest week exam and CBC and I fully expect a weight loss. Not a huge one, but she may have dropped a half a pound this week. If all goes well during rest week she’ll gain it back.

s.

*UPDATE* I’ve called VIMP. Mina won’t eat the baby food, either. I just had a nice, fat panic attack during which Mina got a large piece of my mind. I gave her a Mirtazipine that I have left over from last time she refused to eat. I can’t find a way to handle this and I’m not going to apologize.

Mina isn’t eating her chicken or beef – at all. I can’t coax her into it any longer. She ate a little oatmeal this morning but that’s all. She’s hungry, too, but nothing tastes good to her. This is the one aspect of the chemo that no one seems to know how to conquer.

So, in about 15 minutes I’m leaving to clean out Safeway’s shelves of little jars of organic baby food. It’s not ideal but she likes it and I’m hoping this aversion to her “regular” food is temporary because of the doxorubicin. I’m going to cook the chickens and cows I have in the fridge today and freeze them for next week – rest week.

Colleen said something that totally opened my eyes: “Try and stay calm and don’t stress her out trying to feed her … T won’t eat if she thinks you’re desperate for her to do so.”

Therefore, I shall dump little jars of baby food into her dish later on and let her discover it on her own. She’s going to post a weight loss this week and that worries me only because of her vets’ proclivity to declare a weight loss as HIDDEN CANCER OF DOOM. I don’t need them going all Grim Reaper on me again.

s.

I wish Mina were sailing through this doxorubicin week like she sailed through the last one. But it’s always different with chemotherapy and I’m doing my best to roll with it.

Mina clearly wasn’t interested in eating much yesterday after breakfast. Auntie Sherrie fed her a jar of baby food, Uncle Robb said she was perky during her walk but there was still food in her dish from earlier in the day. When I got home after stopping at Whole Paycheck for more carcass and veggies, I tried to hand feed her but she wasn’t interested.

The weird thing is that she was very perky on our walks and very interested in meeting canines and humans. She met a little sort of chihuahua mix, named Puppy, on our way home from an afternoon walk and was genuinely engaged. I didn’t notice any drooling, but later in the evening I started to notice that she was changing her positions a lot. I just needed that one indication that she might be nauseated to whip out one of the two remaining Zofran tablets and dip it in peanut butter for her. About an hour later, while I was still dismembering chicken corpses, she came out the to kitchen asking for some fresh food.

I had toyed with the idea of adding some pureed organic squash to her beef mix, but nixed that idea because it’s also possible that the chemo drugs are messing with her taste perceptions again. So figured we’d better keep it simple for a while longer. I mixed two local farm eggs, some dried parsley, and garlic powder into the ground cows and baked it. She seemed to really like it.

This morning we took a short walk, just long enough for Mina to find a place to poop, then I put some shredded chickens into her dish. Not interested. I sat down beside her on the tile entryway and, at first, she turned her head away when I offered it to her. But after a few more tries she was eating it out of my hand, then she got up and moved to another spot in the living room. I sat next to her and kept feeding her until she’d eaten almost everything in the bowl. I doubt she’ll eat again until I come home this evening.

Tomorrow, I’m taking her out to the Sanctuary with me to meet up with everyone after they finish the chores. I’ll take along a treat, too, but I really want them to meet Mina because they are so kindly asking after her every week. It’ll be a stimulating outing for Mina on a day when the doxorubicin will peak in her body, so I’m hoping she’ll be able to enjoy herself without noticing any nausea or other bad feelings. I have one more Zofran that I’m saving for tomorrow if she needs it. I’m sure I can get another prescription for the last quarter of chemo that starts on August 11.

s.

Mina is typically sort of lethargic and generally down the day after a chemo treatment, but yesterday proved the exception. She was bright, energetic, she ate everything she was offered (including some small bites of the crust from my vegan pizza), and we even took a long walk around 8 p.m. – something she hasn’t wanted to do in a while.

Mina resting at my Dads last May. She was a little chubby then.

Mina resting at my Dad's last May. She was a little chubby then.

I noticed last night that her skin is peeling – like you have a sunburn, that kind of peeling. I’m not sure what’s causing it but it’s not the yeast shampoo because I haven’t given her a bath in weeks. I’m considering giving her one tonight and hoping the shampoo will help her skin. I’ve also added eggs to her stinky beef-and-rice stuff because I hear that helps a non-human animal’s coat and skin. It’s probably just another lovely side effect of the chemotherapy and a symptom of her compromised immune system.

Another thing about Mina that I noticed is that her paws are all white now. See her paws in the photo taken last May in Florida at my Dad’s? The hair on her paws is a pinkish-brown color because she constantly licks her feet and the iron in her saliva changes the color of her hair. I rarely see her licking her feet now. Whatever she was allergic to is no longer in her system and I strongly suspect it was something in her diet. The last commercial food she ate was EVO by Natura Pet. It’s free of wheat and grains, which can cause allergy problems, but it uses factory-farmed carcasses from animals fed high-grain diets as well as antibiotics and hormones. Mina gets her carcass from Whole Foods and the dead ground cows are grass-fed and free of antibiotics and hormones, and the chickens are fed a natural grain diet with no antibiotics or hormones. I have no idea if that’s the reason she no longer licks her feet, but it’s a possibility.

Mina no longer eats grain-based snacks, either. In fact, she does very little snacking because her diet is now more satisfying for her. The only treats I currently have for her are freeze-dried cow’s liver bites. I rarely give her one but I know her Auntie Sherrie and Auntie Lolo like to give her treats when they visit.

Another factor are the supplements I’m giving her every day. There’s a complete list under the Drugs & Doses tab. I’m looking for a stronger mushroom immune system booster, so if any of you know of one that you believe works particularly well, please let me know.

s.

Mina is finally home after seven hours at VIMP. I’m so glad to have her here ’cause it’s just Weird when she’s away.

Chatting VIMP budgies

Chatting VIMP budgies

Thanks to Auntie Sue, I sent an e-mail to VIMP explaining what I need in the way of detailed estimates for the rest of Mina’s modified Wisconsin protocol. When I got there at 3 p.m. I told the receptionists about it and she promised to print it and put it on top of Mina’s file and get one of the LVTs to work up the estimates. That should help me plan because right now I feel like Mina’s chemo is a runaway train.

Here’s the report from today’s doxorubicin/Adriamycin infusion:

Physical exam: bright, alert and responsive; no palpable splenomegaly; prescapular lymph nodes are small but palpable at about 1/2 cm; two left submandibular lymph nodes are palpable at 1/2 cm.
CBC: stable mild anemia at 35% with a normal white blood cell count.
Urinalysis: Specific Gravity 1.025, pH 9.0, trace protein, trace blood, sediment revealed many white blood cells (15-20/hpf) but no red blood cells. Questionable cocci bacteria/coccoid debris. Appears infected.

Adriamycin infusion (21 mg) was administered IV in the left cephalic vein today; administration went very well.

Ultrasound findings: Spleen is normal size and texture had improved as well. Internal lymph nodes are small in size. The urinary bladder wall is thickened and slightly irregular in appearance, consistent with a urinary tract infection. Cardiac ultrasound before her Adriamycin treatment was within normal.

If after 10 days of Keflex treatment Mina still has a UTI then Dr. Birnbaum will order a urine culture. So, if that becomes necessary it’ll likely happen next Tuesday when she goes in for her rest week CBC.

I asked the LVT about the palpable lymph nodes and she explained that “palpable” does not mean “enlarged.” All of Mina’s lymph nodes are normal size (about the size of a pea) and Dr. Birnbaum believes that she’s making good progress.

Mina lost another pound, so she’s down to 47.7. The LVT assured me that if she’s not eating better in a couple of days there are other anti-emetic drugs we can try to keep Mina from being nauseated. This chemo drug really makes her feel crappy, but I’d like to keep her from dropping below 47 pounds!

I saw Dr. Smith as he was leaving, having worked all night at PWEVC and then all day at VIMP, and he’s very pleased with Mina’s progress.

They ate all the homemade vegan doughnuts.

doughnuts_chocolate

It’s a good thing Mina is popular with all of her vets because I am certain they’re not so fond of me.

I called VIMP this morning because Mina just won’t eat anything in her bowl and she didn’t show much interest in my breakfast this morning. She slept most of yesterday but we did take three walks around the property. I don’t know where she gets any energy on the very few calories she’s taking in.

Dr. Birnbaum’s LVT explained that when Mina came in for her staging appointment that she was already down to 50 pounds. So to VIMP, she’s only lost a little more than a pound and it fluctuates back and forth. That’s why they’re not worried about her weight loss. I explained that in late February when Mina first started rejecting her food regularly, she weighed 54 pounds so, to me, she’s lost six pounds overall. At least now I understand why VIMP is so casual about Mina’s bones sticking out all over.

Dr. B. also called in a prescription for Mirtazapine again, so I’ll pick that up today and start her on it tonight. That’s the anti-depressant known as Remeron, that she takes before bedtime and wakes up ready to eat. It helped her appetite back in May so I’m hoping it will help again. Can’t hurt if it takes the edge off of Mina’s anxiety, either.

This morning we walked for nearly 25 minutes! Not bad for an arthritic cancer patient of 12.7 years. She wasn’t interested in her breakfast, which I served in a ceramic bowl inside her regular metal bowl because my dear friend, Jill, explained that chemotherapy leaves a metallic taste in human mouths and it might be the same for canines. So, I should cook and serve her food in non-metal dishes.

Then, she figured out there are pills in the tofu cream cheese that I made. She spit them out on the carpet, I retrieved them and pushed them down her throat, and Mina promptly heaved ’em back onto the carpet. I lost my temper and yelled at her and grabbed the pills and pushed them all the way down her throat. Then I sat at my desk and fumed for a bit until Mina came over, tail tucked, eyes wide and sorrowful, nudging my leg with her nose.

I petted her for a few minutes and then decided I needed to get out for some fresh air. I went to the Battlefield Park but that mission turned out to be a bust, so drove to the only store around that sells Earth’s Best Organic baby food and nearly cleaned them out of second year chicken and turkey jars. That was only eight jars, BTW.

When I got home we went outside for a quick pee and then I fed her two jars of chicken and sweet potatoes and a jar of turkey and vegetables. It keeps her from starving but it’s not the nutrition she needs. I noticed she’d been scratching the wound on her face so we cleaned that up with some iodine and Neosporin and I put more Vagisil on her ears.

Today we’re going to drive out to Amissville again to pick up our order of Chow Now. Tomorrow, Mina is going to visit Auntie Sue, Uncle Robin and feline cousins Amber and Pearl while I attend a friend’s vegan wedding. Auntie Sue has crafts planned for Mina, which is usually pretty cool. Last time Mina stayed for the day they made a plaque of pink homemade Play Dough and pressed Mina’s paw into it, inscribed it with her name and the year and it’s hanging by a ribbon above my bookcase.

Crappy cell phone picture - it really is pink!

Crappy cell phone picture - it really is pink!

I feel like I’m not sitting inside the roller coaster car sometimes, but hanging on to the last car for dear life.

s.