Xanadu's Journey

February 24, 2011

We arrived at UC Davis at 9:30 and were met by a vet student who took Xan’s history and did an exam to see if he would qualify for the research study that uses both IV and inhaled chemo.  She then took our records and xrays to go over everything with the researcher, Carlos Rodriguez.  They came back about 30 minutes later. Dr. Rodriguez said that Xan was the “ideal candidate” and then told me more about the study.  A lot of information, but the main points were:

• Study is to benefit dogs and kids with OS
• He’d like to enroll 19 dogs and has 6 so far
• IV ifosfamide every three weeks (administered in 15 minutes, but will also give him 5 liters of fluid over 6 hours and some form of protectant)
• Inhaled gemcitabine to be administered by me at home twice a week for 45 min-60 min – this has to be done outdoors, I wear a “bug mask” and Xan wears a clear bag over his head that is hooked to a nebulizer and he breathes it in through the bag.
• This will go on for 6 months!!!
• Average survival rate 8 months (when the inhaled chemo was given alone in an earlier study it only gave the dogs a 75 day survival rate because it still metastisized and no chemo was given to treat the other parts of the body)
• Dogs have tolerated this really well, with very few side effects. Does not appear to harm the lungs.
• I have to pay for the ifosamide every time and xrays every other session
• I can’t stay with him for the 6 hours because of university policy (an owner had an accident and the university stopped the practice of owners staying with their pet…), he will be in a small x- pen in the main room where he can be monitored.

My reservations:

• Putting a plastic bag over Xan’s head (although I put it on him for 10 seconds and he didn’t object) and wearing a bug mask
• Xrays every 3 weeks
• 6 months of chemo
• I was given zero paperwork or details about the study (although I admit that I didn’t think of this until after I left) – not sure if studies are usually so informal?

If I decide to go for it, he is to report on Monday at 8am for his first IV treatment.  Does anyone have thoughts about or experience with doing this level of chemo for 6 months?  Meaning, is it going to effect Xan’s quality of life so much that the last 6 months of his life will be crappy? I want to do what is best for Xanadu, not what is convenient for me. So if this is his best shot, I am all for it.

February 23, 2011

Xanadu had his 2-week post-op visit today. Incision is healing great and Xanadu is finally feeling like himself. He brought me a tennis ball yesterday!  Today we had the “chemo talk” with our oncologist. I shared a UC Davis research trial with her and she got very excited. She recommended trying to participate in the trial – it deals with inhaled chemo, something uncommon at this point.

Goal of study: To evaluate the efficacy of Ifosfamide IV in addition to aerosolized Gemcitabine in dogs with relapsed gross metastatic disease.

I emailed the researcher and received a return call within an hour. Our first appointment is tomorrow morning!  We will start with lab work to make sure Xan is fit for the trial.  If he is, it is a 6-hour process.  I will have a chance to ask lots of questions before anything begins.

Anyone have experience with inhaled chemo? I’d be very curious to know of any experiences out there.

Wish us luck!

February 12, 2011

Just when I thought the only problem was the side effects of the fentynal patch, the battle of the pills began.  I think that Xanadu must have bit into a nasty antibiotic, because he went from happily eating his cream cheese balls with the magic filling to turning his nose up at them. 

This wouldn’t have worried me so much if I hadn’t removed the fentynal patch a day early. I decided to remove it because it was making Xan incredibly anxious and he was whining incessantly. So much that he couldn’t sleep and if he wasn’t sleeping, his nurse wasn’t sleeping.  I posted the question to my favorite Bone Cancer Dogs Yahoo Group  and learned of other dogs having a similar reaction.  Since he had been willingly taking his tramadol and gabapentin, I wasn’t worried about losing the this medication.

But then Xan caught on to my tricks.  So at 12:00 AM, I was cooking hamburger meat. No dice.  At 12:30, I made melted cheese balls. Yeah right. At 2:00 AM, I was scrambling eggs. Nope.  So I resorted to the old fashioned method of forcing pills.  I hate doing that. I’ve decided that dogs are the worst patients. They totally don’t “get” why you are making them eat pills and they are just big enough that forcing them really isn’t a good option (they do have teeth after all). At what point will a perfectly docile dog that is miserable bite its human mom? I hope I never find out.

Needless to say, removing the fentynal patch helped Xan (and me) have our first 4 hour stretch of sleep since he came home on 2/10.  I feel so energized this morning!  Although it is only 50 degrees out, Xan and I are already in the backyard, hanging out, listening to the birds and watching the squirrels play.

I’m going to buy pill pockets today (they worked in the past and it has been a few weeks since he last had them) and some other meat mixtures to try. But if anyone has a good pill trick up their sleeve, please share!

Thursday was a whirlwind. The vet’s office called Thursday morning with an update.  Xan had a good night, and had been up on three legs and out to go potty.  But he wasn’t interested in food.  We were told to come in the afternoon for a visit to determine whether he’d come home or stay another night. We visted with Xanadu at 4:45 pm and the surgeon met with us.  When I first saw Xan, I could tell how medicated he was. He had two techs assisting him and he was having a hard time standing. But as soon as he saw me, his tail started going. Good sign #1.

Dr. Staatz is great. He is one of the nicest vets I have ever met and he is excellent at his job. Xan’s incision looked clean with very little seepage. He had a fentynal patch on in his rear leg and a catheter in his front.  We went into a carpeted room where we could comfortably visit with Xan. He laid down and placed his head in my lap with a big sigh. Good sign #2.

I brought some ground turkey in a small bowl thinking I would hand-feed him and he inhaled it all on his own. Good sign #3. 

Dr. Staatz gave us the option of leaving him for a second night. He explained that Xan would need a lot of extra care for the next 24 hours. We talked it over, but I knew what I wanted to do – take him home.  So he was discharged!

 We brought Xan home to get him settled.  The kids and Zoey (our 8-year-old Lab/Great Dane) were at my mom’s house so we had some quiet time, which I really appreciated. Thanks, Mom! I gave him some chicken breast and rice, which he gobbled up.  We took him outside, but he wasn’t ready.  The rest of the night was so-so.  I set up my aero bed next to his ex-pen and tried to get some sleep. Around 12:30 am, he woke me up. I thought he was hungry so I went into the kitchen to get some more chicken. I heard a commotion and ran into the dining room. He had gotten up on his own and was standing!  I put on his harness – the Webmaster is awesome!!  I know tripawds.com recommends not using it until the area is healed, but the surgeon thought it would be fine and I needed help getting him outside. We went outside and he went potty.

He had some trouble between 1:30-3:30am. Some whining, and restlessness, but I expected that. I gave him 2 tramadol to help him sleep.  We went outside again at 4am and then he finally settled down and slept until 6:30 am when the kids came barreling in. Lucky for Xan, he is deaf, so he doesn’t hear most of the craziness.

Xan’s incision this morning, day 2.

I am so glad he is home!!

Today I dropped off Xanadu at 8:00 am, expecting to hear about his recovery by about 3:00 or so.  Instead, at 3:00 I received a call from a nurse, and was informed that due to a few unexpected emergency surgeries, Xanadu’s amputation was put off and he had not even started yet and wouldn’t start for at least an hour.  I was surprised by this news; and felt terrible that Xan hadn’t eaten since 11pm last night and had gone without his usual 6-8 hour dosage of tramadol and 12 hour dosage of rimadyl and gabapentin, all day long.  To think of him waiting all that time not knowing why he was there was heartbreaking.

At 4:15pm, I received a second call informing me that he had been anesthesized and was being shaved and I would hear from Dr. Staatz in about two hours.  By 6:30, I started getting nervous.  By 7:00, I was jumpy and had butterflies.   At 7:15, the phone rang and I nearly jumped out of my skin.  It was Dr. Staatz – Xanadu had made it through the surgery just fine and was in recovery! Hooray!!  After some post-surgery acupuncture, Xanadu is now resting comfortably with a fentynal drip.

The hardest part of today was waiting for news.  I was totally comfortable dropping him off and I felt good about the decision to amputate, but at 12-1/2, Xan is no spring chicken.  I just wanted to know that he made it through the surgery.  I heard from the nurse around 10:15 tonight with an update.  Xanadu is very groggy, but is awake and has opened his eyes to acknowledge those who pet him.  I’ll call for an update in the morning and he will likely come home tomorrow afternoon.

Now for the recovery….

Xanadu arriving at the vet’s early this morning

Surgery day is finally upon us.  What a mixed bag of emotions!  I am very relieved to say that I haven’t cried. This tells me that I am making the best decision for Xanadu.  He started out the day confused when he didn’t get breakfast. I have been feeding him only the tastiest foods – chicken breast, steak and salmon – so he wasn’t very happy when I ignored his appetite. 

I am very hopeful and optimistic about the outcome of his amputation. I just want him home where I can attend to his every need. His buddy, Zoey, our 8-year-old Lab/Great Dane knows something is up. We don’t usually come home without Xan. I wish I could explain it to her. I feel bad for her because she has not received as much attention as Xan these past few months. I hope that after he recovers we can get back to more doggie outings.  And I am trying to shower her with attention today.  I need the distraction.

I look forward to the vet’s call this afternoon. I just want to know that he made it through the surgery with flying colors.

Good luck, Xani. Be brave! You have a lot of people pulling for you today. 

XOXO.

I can’t believe Xan’s surgery is tomorrow. The last 5 days have flown by. I am glad that I had some time to prepare for his amputation. I am feeling optimistic and so ready for him to be home recovering. I know that he will face an uphill battle with the cancer and lung mets, but I truly feel that this is the best course of action for Xan.  We will take it one day at a time – the same we were doing before, but now the leg pain will be gone.  I should hear from the surgeon early tomorrow afternoon and will write more once I hear. 

Thank you to all you pawparents out there – your comments and stories mean a lot.

Lisa & Xanadu

Really, I have three kids.  Xanadu is 12-1/2, Trooper is 4-1/2 and Finley will be 2 in two weeks.  My three boys have a great time together.  Finley can be a bit rambunctious for Xan’s liking, but since he is the first to give him a cookie every morning, Xan tolerates him.  Trooper understands that Xan is sick and he has been wonderful – the other day, he sat next to Xan and said, “Don’t worry, Xanadu. It will be okay.” 

The amputation is tomorrow.  I am going to believe my son – everything is going to be okay.