FOUR …

Whelp, that went much better than I imagined. My faith in Dr. B. is restored. My confidence in Mina is unchallenged – she is tough, much tougher than the chemotherapy and all the things that go along with it.

The VIMP budgies but one ...

Here’re the highlights from the discharge report:

• Physical exam: bright, alert, stable weight, tiny popliteal lymph nodes, no other nodes palpable.
• Weight stable at 48.3 pounds
• CBC: normal WBC count (11,400), normal HCT (39 percent – not anemic), normal platelets – adequate for chemotherapy
• Brief Abdominal Ultrasound: Spleen appears normal size and texture with no masses, nodules, or mottled pattern. There are some slender mesenteric lymph nodes visible but not enlarged or irregular. Small intenstinal tract measures normally with no focal GI masses or obstructions. Stomach wall measures normally and is contracting well. No gastric masses or polyps seen. Colon measures normally.
• Vincristine was administered in the right cephalic vein today (0.37 mg IV).

Here are Dr. B’s notes about Mina’s gastro-intestinal issues:
Intermittent gastrointestinal upset (vomiting, diarrhea) – cause open. Possibilities include chemotherapy side effect, inflammatory bowel syndrome, diet related, stress, other. Dr. Birnbaum does not feel tht GI lymphoma is likely due to lack of severe GI signs and normal appearance of intestinal tract on utrasound. Cannot completely rule out microscopic cancer in the GI tract without a biopsy, however.

That said, Dr. B does not feel that a biopsy is necessary. I consider that last sentence the standard medical disclaimer.

On the diet related front, it’s possible that changing what Mina eats all the time causes her stomach a little trouble. This week, she’s eating a little chicken and is totally enamored of Yves Tofu Dogs. I have to come up with something else that’s yummy for her. Any ideas out there?

Allyson did apologize for the confusion and distress caused by Team Grim Reaper’s “different style.” They were wrong, plain and simple. She reiterated that Dr. B and her team know Mina because they’ve been treating her for four months now and they’re more familiar with her reactions to drugs, etc. I wonder if they rather resent the trouble caused by one poorly written, arrogant, and rude e-mail message?

Anyway, it’s a good report and Dr. B. is very pleased with Mina’s progress. Now to get through Vincristine week without any major problems!

s.

 

Mina Had Company This Weekend

Mina and I had a guest with us this weekend, my 16-year-old niece, Erin. She lives about an hour away – in good traffic – and Mina and I drove to pick her up on Friday afternoon.

I parked in front of Erin’s townhouse and let Mina out for a little bit. She went crazy! I’ll bet it’s been six years since Mina’s been in that neighborhood and she seemed to recognize it. She kept climbing the stairs to the front door, wanting to go inside. She also seemed pretty excited when Erin got in the car. It’s been four years since Mina saw Erin, who’s changed considerably but not to Mina, I guess.

All weekend long, Mina put on some aggressive begging around Erin. I told Erin that Mina must remember what an easy mark she was as a toddler for food snacks. While driving Erin home today, Mina attempted to take a bite of Erin’s peanut butter cookie – in a moving car!

We had a good time and Mina was in great spirits. I stopped giving her the Metoclopramide yesterday because she just doesn’t need it on the reduced dose of Vincristine. She’s eating very well, feeling pretty perky, and Erin commented that she looks good and seems very well for a cancer patient.

I’m hoping at some point to get a more balanced diet for Mina, but I think that’ll have to wait until after the the chemotherapy. We have the day-stay for Adriamycin/doxorubicin on Tuesday, then a rest week, then four more treatments and we’re done. I’m hoping at some point in the next five weeks that Dr. B. will announce that Mina’s in remission.

s.

 

It’s the Vincristine

Mina’s not feeling as good today as in previous days. It’s peak time for the Vincristine in her body. I suppose that means it’s everywhere in her body right now.

She ate some chicken for breakfast, but when I put out some mid-morning snack with the green organic baby food, she wandered off. Eventually, she ate most of the chicken. I threw out the green organic baby food.

I went shopping at Whole Paycheck and when I got home I discovered that almost every food item I’d bought was for Mina. Seriously, I have salad greens, grapes, Bing cherries, tofu, tempeh, and some onions for myself. It’s a miracle I’m staying so fat. Mina scored.

So, I boiled the sweet potatoes and looked up instructions on how to hard boil fresh eggs. No, I wasn’t an egg fan when I wasn’t a vegan. I’d occasionally scramble a couple of egg whites for breakfast, but one morning about six years ago I looked at the egg in my skillet and got nauseated. Last time I had eggs in my house until today.

I mixed the boiled eggs, sweet potatoes, and some chicken together and figured she’d love it. WRONG. I had to hand feed that mess to her for a couple of minutes and then she dove in and finished it off. She wanted more, so I gave her about half a serving, but she ate only a little. By then I had the beef thing in boiling water (after poking it with a fork for about 10 minutes) and when that was done I started to cut it into little pieces.

I need new knives.

She ate the sample of dead cow I put in her dish but ignored the rest. Mina hasn’t gotten sick, yet, but it’s pretty clear she’s not feeling top notch. This’ll probably last through tomorrow, unfortunately. I don’t think we’ll see a weight gain this week.

Tomorrow, I’ll cook some brown rice and see where that gets me.

s.

 

Third Quarter Chemo Starts Today

Rest week always goes by too quickly. Mina’s UTI isn’t bothering her any longer, but we still have 11 days of Baytril to go. Pray, cross your fingers, burn candles, sacrifice virgins, whatever you believe so this damned infection goes away for good!

Yesterday was fairly quiet around here. Mina napped a lot, ate a lot, went for a couple of walks, and had normal-looking poops. Last night I actually slept for SIX hours. That’s pretty normal for me so I’m hoping I can repeat that every night. I still have the headache but it’s a dull roar now.

Mina’s pretty good about eating the asparagus or tomatoes I hide at the bottom of her chicken, but this morning she flat out refused to eat it. I found organic grape tomatoes and chopped up three of them for her breakfast. They’re a new food so she’s always skeptical. I hand fed her some chicken, but she was still skeptical, until I hand fed her a couple of bites of tomato and then she was fine and practically pushed me away from her bowl!

I started her back on the Metoclopramide this morning, too, because it’s chemo time and she’ll need it. I wish the chemo didn’t affect her stomach so badly but it’s a fact that it does and we have to work with it. My goal this week is to keep her eating, no matter what I have to feed her.

She’s lost more hair, mostly from her undercoat, but she no longer has eyelashes and looks a bit odd. The hair on her muzzle continues to recede, too. Mina no longer looks like Mina.

Oh, and thanks to everyone who’s offered to send money or conduct a fund raiser to pay for Mina’s treatments. Y’all are amazing people to care so much for my best friend. I’ve suggested to a couple of friends that instead of sending money to me that I’d prefer you donate to one of my favorite causes because I can’t afford donations right now. If you’re so inclined, and I appreciate your thoughtfulness like you can’t believe, please consider helping the following organizations:

• Wildlife Direct
• Sea Shepherd Conservation Society
• Poplar Spring Animal Sanctuary
• Center for Great Apes

More later after our chemo appointment!

s.

 

Post-vet Update Stuff

Turns out Mina had a pretty good appetite yesterday, just later in the evening. She finished off her breakfast around 7 p.m. and as I’d just finished cooking a batch of Chow Now, I gave her some more. She gobbled it up in no time. Mina also ate a carton of plain organic yogurt and quite a few bison bites. She definitely likes eating when it’s cooler.

This morning I gave her a bit less for breakfast than usual, having learned my lesson about feeding her too much before a chemo treatment. She ate a few spoons full of yogurt and took all her pills – a total of SIX now with the Keflex. It’s getting expensive to keep giving her almond butter for pilling, and VIMP thinks it might be too rich for her tummy, so they suggested cream cheese or butter.

GROSS.

I asked if vegan cream cheese made of tofu was OK and VIMP said that’s fine. So today, I made her a batch of “Rich Tofu Cream Cheese” from the Uncheese Cookbook. It’s made of cashew butter, firm silken tofu, lemon juice, “mild sweet syrup of any kind” (I chose the Southern option – light Karo), fresh lemon juice, salt, and a pinch of nutmeg. Does it taste like cream cheese made from suffering cows? I don’t think so, but it’s pretty tasty. We’ll try it out on Miss Bean when she takes her afternoon meds – Meto and Keflex.

Today’s exam at VIMP doesn’t make me happy. Yes, Mina got her planned Vincristine IV at the reduced doseage but the popliteal and prescapular lymph nodes in her left leg are now less than 1 cm. Last week they were less than .5 cm, so they’ve grown. The LVT, clearly a member of Team Grim Reaper, didn’t have an explanation for why Mina’s spleen is still normal but she has a couple of peripheral lymph nodes that are getting larger. What the fuck, people? You must have some sort of explanation for this?

The VIMP budgies don't like the paparazzi.

Mina has lost another .6 pounds. Again, I seem to be the only one who’s freaked out because she’s BONY SACK. The TGR member told me that because her weight losses are incremental they think it’s just the cancer.

So. Her anemia is improved and her white cell count is normal. They did not know about her trip to PWEVC on Friday so I gave them the reports that I carry in Mina’s Cancer Notebook. The urinalysis today at VIMP indicated the specific gravity has gone from 1.026 to 1.015; PH from 8.0 to 6.0, some red blood cells present in Mina’s urine but no overt bacteria, so a likely resolving infection. A brief abdominal ultrasound revealed her spleen has “shrunken to normal size and the texture has improved as well. No overt abnormalities seen in the urinary bladder.”

Today when the LVT saw me pull out notes and charts from her e-vet visit, they must’ve been impressed because they gave me her urinalysis and CBC results with the discharge report. First time I haven’t had to ask for those documents. We report next Tuesday at 7:30 a.m. for her half-day stay and doxorubicin injection.

We’re gonna need a bigger notebook. And more money.

s.

 

Day Five After Vincristine, All Quiet

We had a quiet day yesterday. Mina wasn’t as frisky as the day before, but it was warmer outside and she doesn’t like the warm. I do, so I set about cleaning out my car and washing it while Mina waited in the air-conditioned indoors.

She ate normally, about 16 ounces or so of Chow Now, a jar of Earth’s Best organic baby food for a snack, a couple of nibbles of my toast. She drank a normal amount of water, not the gallons she was drinking while taking the Prednisone. She looks very thin to me. I honestly don’t care what anyone says, Mina is a sack of skin and bones. I don’t think she’s gained any weight this week and I’m not sure why.

This morning I dug up some information on milk thistle dosages for canines. I want to get her going on the supplements so I gave her about half a capsule mixed into some almond butter. I’ll call Dr. Lundquist today to find out the precise dosage for her.

Tomorrow, I’m leaving her for most of the day and the entire evening to see NIN at Merriweather Post. Thanks to my awesome friends and Sherrie of Prince William Paws 4 Claws, Mina will have company almost the entire time I’m gone. Her Auntie Sherrie will visit at 4 p.m., her Auntie Sue will visit at 5:30 p.m., and her uncles Joe and Robb will stay with her from about 6:30 – 11:30 p.m. I should be home around then or at least by midnight. It’s our first big separation in a while and I think she’ll be fine, if somewhat miffed at me.

s.

 

Vincristine Attack On Day Four

Yesterday I was keeping a close watch on Mina because her behavior seemed familiar from the day she got sick last time on Vincristine – perky, energetic, and hungry all day.

Mina ate two portions of Chow Now yesterday, about the 16 ounces she needs to maintain her weight, plus some pizza crust (I know she’s not supposed to have grains or flour or that shit but some habits will not die!), and the almond butter that hides her pills. She ate well, but I noticed around 8 p.m. that she was restless. She changed her position a lot and wanted my undivided attention. I knew then she wasn’t feeling good.

When she headed into the bathroom about 20 minutes later I followed her and, sure enough, she was getting sick. Bless her for choosing the bathroom where the tile is easily cleaned and I can throw the rugs in the wash. Same stuff as last time on Vincristine – chunks of partially digested food and a brownish liquid. When she got sick during the doxorubicin she only threw up food – never the brownish liquid.

I reassured her and took her away from the barf, and called PWEVC. I calmly told Christine what happened and she informed me that Dr. Smith was out of town this weekend. They know us! Her advice was to give Mina 10 mg. of famotidine since Mina had taken all her metoclopramide for the day, and to keep an eye on her and not feed her again until morning.

We hung out in the living room while I watched a movie through my eyelids, and finally went to bed around 1 a.m. Nothing unusual happened during the night.

Mina took a long walk this morning, everything was normal, and she ate her chow now after famotidine and metoclopramide. So far, she seems just fine, if not as frantically frisky as yesterday. She is, however, eyeballing my toast and tofu omelet rather like a raptor eyeballing a mouse.

s.

 

Friskies Ain’t Just Cat Food

This is the fourth day after the Vincristine IV. Mina is eating and behaving pretty much the same way she did at this time after the first Vincristine IV. I’m feeding her cautiously, not giving her too much at a time, because if she does get sick I don’t want her to puke another seven times.

We went outside this morning for a brief walk because Mina was more interested in coming home for breakfast. But, about two hours later, she started harassing me to go outside. I have the windows open to air out the place before it gets warm and I think she spotted one of her friends going by.

So we leashed up and went out and it was clear that Mina was on a mission. She sniffed and trotted until we turned a corner and I saw our neighbor downstairs walking Max, one of Mina’s new friends. She couldn’t trot fast enough to catch up to them. We finally did and Mina gave Max a play bow and the game was on. For the next 10 minutes we walked and they played and Mina was having a grand time. I finally forced a separation because her limping become very pronounced and we headed home. She’s resting in the living room where I expect she’ll be for a couple of hours.

Post-frisky

It is so great to see her being her old self again. Her moments of frisky playfulness are brief (she is, after all, about 63 in human years) but they’re a joy to watch.

s.

 

Why Is It That Vomit Always Taints the Good News?

Fact: Mina does not like going to VIMP any more. Our last two visits, today’s included, have made her nervous and stressed. So nervous and stressed, in fact, that on our way to our regular vet’s office for refills of Tramadol and Metoclopramide, Mina puked the entire contents of her guts into my back seat (safely covered by her Drs. Foster & Smith seat cover but still GROSS!).

I called VIMP and they assured me it wasn’t the chemo that she’d just gotten, but probably stress. They have noticed that she’s no longer comfortable with them and feel bad about it.

Today blue VIMP budgie gave me the side eye.

Anyway, I pulled over and got her out of the backseat and bundled up the seat cover and put it in the trunk. The rest of our trip to Warrenton was uneventful. She’s home now, had another dose of Metoclopramide and a jar of organic Earth’s Best baby food. I won’t give her any more Chow Now until later this evening. I am also to blame because I gave her too much to eat this morning before our trip to VIMP. Mina’s moving around a lot so she might still have an upset tummy.

Her appointment went well, despite her discomfort with VIMP. She weighs 50.1 pounds, that’s up from 49.3 last week. Her Vincristine IV went well and the dose was reduced 10 percent from the first time. She’s officially done with Prednisone, which may decrease her appetite, but will definitely decrease her pee. Mina is still mildly anemic and her white cell count is slightly elevated, which will bear watching.

Her ultrasound findings indicate a completely normal-sized spleen with no internal lymphadenopathy. She is not in remission yet. In order to determine remission they’ll need to aspirate another lymph node and Dr. Birnbaum doesn’t feel we’re at that stage yet. It’s the same old story, if you want a different answer ask a different LVT.

I have asked VIMP twice now why we continue the chemotherapy once Mina’s in remission. They have not answered my question at all. I’ve been told the equivalent of “because it’s a 19-week protocol” and “as the ‘owner’ (I do not own Mina, she’s my equal) you can discontinue treatment at any time.” That’s not what I asked! So I left a note for Dr. Cliver to call me when she has a minute and explain the need for more chemotherapy after remission. I just want to know the benefits of continuing the chemo. Sheesh.

s.

 

Chemo and Chow Now Tomorrow

Mina is frisky! She’s walking with a little bounce in her step, head held high, barking saucily at anyone she pleases, having a good time. She’s just her normal, old self on non-Prednisone days, and it’s wonderful to see her enjoying life again.

Mina on vacation at Grandpa's in October 2007

However, we have chemo tomorrow at 9:30 a.m. at VIMP. It’s the Vincristine, again. Remember that experience? This time if it makes her violently ill we’ll know it’s definitely the drug, not the cancer. I have no doubt in my mind that the Vincristine made her sick the last time she had it, but her cancer vets seem to have a few doubts. They should learn to trust me because I know Mina as well as I know myself.

We also get to meet Carole from Chow Now Petfood sometime tomorrow to pick up more lamb Chow Now. She is so understanding about my ethics, because she does share them, and told me that the lambs are never slaughtered before they’re a year old and they spend that year living peacefully. OK, so that doesn’t really work for me because they’re too young to die so Carole told me that the lambs they buy for Chow Now are spared going to auction where they’d not get much, if any, humane treatment. Colleen reminded me the other day that I can’t hold it against Mina and the other canines of the world because they’re carnivores.

My goal this week is to keep her on the Chow Now and Metoclopramide to try and prevent the raging vomiting. I know it will bring her down physically, but I hope it doesn’t last more than three or four days. We’ll see.

s.