Howl if you feel good

Anyone who has spent any time with Emmie knows that she loves to howl. Typical Beagle! We live very close to a fire station and there are frequently emergency vehicle sirens that set her off. My mother is probably the only person who loves it more than me.

I wasn't able to get a video of her tonight (3 fire trucks were headed deep into our 'hood) but Ron did take a funny picture of us singing a few nights ago. We were celebrating Em's energy level after this last dose of Chemo. Howl if you feel good...let's make sure Cancer can hear us all loud and clear.

Final Chemo - Arrivederci Cancer

It was an exciting trip to the vet today. Emmie’s CBC came out great and we took our Chemo to go. It was the last ~$200 treatment and now we only have two more appointments. One for a follow on CBC and another for a 1 month checkup. I think I will have to start taking Emmie with me on little roadtrips to run errands. I’m actually going to miss our quality time in the car.

It really is an amazing transformation that Emmie goes through during this treatment. One minute she is excited about her chemo sandwich (pictured without the bread) the next she is sacked out on the ottoman feeling yucky. The only good thing I can say is that I know Cancer is getting a final beat down, if it’s even still around. Wish her luck!

Dear Cancer

RIP

Love,
Emmie, Gir, Kathy & Ron

Tomorrow is the big day...

Emmie's final chemo appointment is tomorrow at 3:00. I really can't believe what a blur this has all been. Tomorrow's treatment will be the Lomustine "freaky radioactive looking" pills that we give at home. I see a nice, big chemo sandwich in her future. She is looking strong, healthy and full of energy today. Her white blood cell counts may take a hit but I know she will do great.

Since the team of people at the CAVS have taken such great care of Emmie I decided to bring them some cookies for Valentine's Day. Since the cookies won't survive a photo with Emmie I decided to shoot them solo.

One treatment to go: Real Time

It is at this point that I start to put real thought into how we know if the cancer is really gone. Throughout the treatments I would find new lumps under Emmie's skin and I always had them checked out. So far they were just small fatty deposits but I don't want to assume everything will be. I know I will keep a close eye on anything external but knowing what is going on in the lymph nodes is another story.

I have a lot of questions for the vet after our final chemo appointment this Thursday. I am anxious to hear about our next steps as Emmie moves on from Cancer Patient to Survivor.

Keep the prayers and positive thoughts coming. It really does help keep us hopeful (doesn't she look it?). Also, now that I am caught up with real time I plan to post progress and pictures as it comes.

Treatment 7: January 29

Treatment 7 of 8 was now over. It was hard to believe that we were nearing the end of the Chemo. By now things were feeling pretty routine and there was light at the end of the tunnel. I was hopeful that the worst was behind us and Emmie would have full recovery. Go Emmie!

One thing I hadn’t planned on was our Oncologist leaving Austin. Dr Hintermeister was moving back to Chicago. I was a big fan and was sad to see him go. Even though we only had a few actual meetings (most of our interaction was with the oncology techs) I had a huge amount of trust in him and didn’t want to start over with someone else. The specialty practice had another oncologist ready to take over and she started on this treatment. At least we could stay in the same office.

Dear Cancer,

How did you like that? These treatments are becoming a piece of cake. Suck it!

Love,
Emmie
P.S. Does this picture make my head look big??

Treatment 6: January 13

It was only a week and a half after knee surgery and it was time for another chemo treatment. Emmie was continuing to improve but was still not putting much weight on her back leg. She was getting around fine again on three legs, the challenge was keeping her from overdoing it. I really didn’t want her to injure herself further so we restricted her movement as much as possible and kept doing her exercises.

Dear Cancer,

I hope you are enjoying the beat down you are currently taking. Our routine was temporarily on hold but we didn't forget the need to finish you off. Chemo #6 is done. 2 more to go.

Love,
Emmie, Gir, Kathy and Ron

Water Treadmill

Emmie's first rehab appointment went really well. I learned a few different techniques for encouraging Emmie to put weight on her leg and got to see her work out in the water treadmill. I wasn't sure it would be worth the time but did see results.

Here she is working hard at the gym. Doesn't she look cute?

Knee Surgery: January 4

It was officially time for the dreaded ACL surgery. Emmie was used to her visits to the vet but she didn’t know what was in store for her (neither did I). I dropped her off early in the morning for the surgery date and overnight stay. I was really starting to feel that she had been dealt an unfair hand. Chemo & Knee surgery – it was too much! Venting aside, negativity wasn’t going to get me anywhere. My girl is tough and I knew she would do well. Thankfully, later in the day, I got a full post-surgery report from the vet. All went well but in addition to the Extracapsular Stabilization they also repaired a tear in her cartilage. Knowing that she was well medicated & cared for I didn’t mind leaving her in the vet overnight.

I was able to pick her up late on January 5th. I was anxious to see her and knew she was ready to be home. When she came out of the back room she looked rough, pathetic is a better term. Her entire back leg was shaved in addition to a patch above her tail and on her front leg. She was clearly in pain and didn’t give me any trouble when I carried her out to the car. As many of you know, aside from the occasional not eating, Emmie is a go with the flow kind of dog. She was far from herself after the surgery and I was feeling so bad for putting her through this. I was hopeful it would be fine in the long run but was doubting my decision to do surgery now rather than wait until post-chemo. Once home, she was very slow going but thanks to the pain meds she started gradually moving around. Our vet schedule was about to get busier as we added in the rehabilitation appointments. Water treadmill, fun!

Treatment 5: December 30

We spent Christmas at my in-law’s ranch in Westhoff, TX which is about 2 hours south of Austin. It was a packed house of 6 adults, 2 kids, 5 dogs, tons of good food and way too many presents. We were able to sleep in and get in some exercise to burn off a few Christmas cookies. It was a nice vacation from our normal work routine. While we were enjoying ourselves I felt bad because Emmie was having a rough week. She wasn’t eating (with the exception of stealing the other dog’s food) and had to visit the local vet for her weekly CBC. As expected, her white blood cell counts were low and she needed to be put back on antibiotics. I was doing what I could to make her feel better and eat but she wasn’t enjoying being away from her own bed, yard and routine.

I was lucky to have extra vacation days so I had taken the next week off of work as well. Emmie, Gir and myself had some nice quality time back in Austin and were enjoying the peace and quiet. By the time of Em’s next chemo her bloodwork was back to normal and thanks to beef broth she was eating again.

Dear Cancer,
I am ready and waiting. Get ready for another hit.
Love,
Emmie

PS: you still suck.

Knee surgery Consultation: December 21

Time for a quick break in the cancer posts – suck it cancer!

The week of Christmas I had a consultation with Dr Hulse regarding Emmie’s ACL tear. I had already spoken to my regular vet about the different options but Dr Hulse suggested Extracapsular Stabilization so that’s what we did. To spare you my rookie description, here is a link if you want to read more. With this surgery she was set to have full recovery and while it was expensive it was doable. On a side note, Emmie is available for commercials if anyone would like to hire her. I think it’s only fair that she start pitching in for her own vet bills. Thankfully Dr Hulse and Dr. Hintermeister are in the same office so they were able to easily discuss the timing of Emmie’s surgery to minimize the interruption to her chemo schedule. We were now on the surgery calendar for January 4th. Bring it on 2010. Emmie is tough and can take whatever you throw her way!

Treatment 4: December 16

I failed to mention in my earlier post about how Emmie did with the Lomustine Pills. She was now ready for her second dose and let me start by saying I was not looking forward to it. Both types of chemo seem to make Emmie sleep more than normal. These pills, however, make her not want to get up for food and once she is up she won’t eat. As always we have a CBC one week after chemo to make sure her bloodwork looks good. Each time she has taken these pills she has a significant drop in her white blood cell counts. One of the scary & potentially fatal side effects of these drugs is that it can cause bone marrow suppression which can open the door up for infection. The weekly dose of antibiotics seemed to do the trick and prior to the next treatment her levels were back to normal.

In order to keep Emmie from losing too much more weight we tried a few different things. First I resorted to feeding her out of my hand. This seemed to work but wasn’t sustainable, especially when I had to get to work at a reasonable time. It also didn’t get her to eat the full amount at each feeding time. Anyone that has a beagle knows that they will do almost anything for food. In order to get her more excited about what she was eating, we resorted to giving her a little people food. I promise I didn’t start giving her steak or Christmas Cookies (those were mine). Instead we started adding some beef broth to her dog food and this made her scarf it all up. She still was slow to get to the food bowl but once she was there at least she was eating.

Dear Santa,

I have been a good girl this year. Please make me strong and my chemo effective. I'd like treats and to be let up on the couch.

P.S. I don't think I need to mention that Cancer should be on your naughty list FOREVER.

Love, Emmie

Treatment 3 - December 2

Thanksgiving provided us with a little break in the chemo routine. We took a trip to the Ozarks to spend the holiday with my family. My husband, myself, Emmie & Gir (our Corgi) were able to spend some QT with both Human and Equine members of the family. As always we had a lot to be thankful for and we were excited to spend it with family. I think it was around this time that we were fully hooked on Emmie’s new diet (recommended for dogs with Cancer). She was eating a new dog food – Wellness Brand - Ocean Formula and getting a daily supplement of fish oil. We weren’t sure that the extra money was worth it but Emmie’s Allergies were clearing up and her coat was super shiny. She loved the flavor and we even switched Gir over too. Grain Free was for us!

Once we were back in Austin it was time for the next treatment.

Dear Cancer,

Get ready for round 3. We are well rested and ready to fight. You are going down.

Love,
Emmie, Gir, Kathy and Ron

ACL Tear – Mid November

Emmie has always been a low maintenance dog. She never got sick and preferred the free toys known as “sticks”. Her expenses involved food, Benadryl for allergies, and routine checkups with the vet. In 2009 she started making up for lost time and with it came the medical bills. Enter complexity # 2 - torn ACL. I have no idea how it happened and don’t believe it was related to her cancer treatments. It happened on a normal day. She went about her normal business of sniffing around the back yard, barking at anything that seemed out of place and sleeping the day away. The next thing I knew she wasn’t putting weight on her back leg. Drama! I took her to my normal vet and they confirmed she had a torn ACL. They gave me several options for treatments and after talking to several different people I scheduled a consult with the orthopedic surgeon at the Capital Area Vet Specialists, Dr Hulse. More to come on that later (precursor, thank God for my wonderful vets).

I’m told that a torn ACL isn’t painful for a dog and Emmie proved that theory. She moved around like a champ on three legs. We did have to make one big modification though. She could not jump up on the bed! This was going to be hard for both Emmie & I. Emmie has slept next to me since she was a puppy (she is now 10). My husband wanted to kick her out of the room for a while because she slept directly between the two of us. My philosophy was that she was there first and she did move out of the way when she had to. Not that I don’t love my husband but I was now motivated by her health and I didn’t want her to hurt herself further. We started locking both dogs out of the bedroom and made sure they had beds available on the living room floor. Obviously they preferred the couch and chairs so we blocked their access with strategically placed tennis rackets & folding chairs. Not exactly ideal décor but it works.

Treatment 2 - November 11

Emmie proved to be a real champ after her first treatment. She showed no side effects and her CBC came back perfect. We were off to a great start.

Treatment 2 involved the freaky radio active looking pills. They came in a sealed bag that included 4 pills and gloves. My doctor made sure to tell me to stay far, far away from these pills if there was a chance I was pregnant. I decided just to be safe Ron would be giving Emmie these pills. Since Em will eat anything wrapped in bread we made her a chemo sandwich and waited to see how she would do.

Dear Cancer,

We have a little present for you.

Love,
Emmie, Gir, Kathy & Ron

Treatment 1 - October 28th

I decided early on in Emmie's cancer diagnosis that being positive was the key to making it through this 16 week treatment plan without any extra stress. I took inspiration in my friend Jenny, a cancer surviving human, who personified cancer in order to express her disgust with the disease in a humorous way. I decided to write little notes to Cancer on behalf of Emmie & the rest of the fam to make sure it knew it would not win.

The last week in October kicked off Emmie's fight with Cancer. She needed a little coaxing to leave the waiting room without me but did trot off for her first treatment. Both my husband and I waited an hour while they administered the chemo. I wasn't sure how she would react to the treatment and was dreading the worst. Surprisingly Emmie ran out to greet me, pulling along the Oncology Tech. She had a little pink bandage around her back leg where she got her injection but otherwise looked great.

Results are in: Emmie 1 , Cancer 0

Treatment Plan

As I have stated before, Emmie & I are lucky to live in Austin, TX a really awesome & fun city that thankfully has multiple specialty veterinarians. We were referred to the Capital Area Vet Specialists where we met with Dr. Hintermeister to discuss next steps.

During our first meeting we discussed the data that was available from Emmie’s previous test results and decided to send the results out for a second opinion from a different lab. It took a few weeks to get results back but we finally confirmed that Emmie did have Cancer that had spread to her lymph nodes.

I have to give props to Dr. Hintermeister who helped me from losing it while we were talking through treatment options. He was so positive and made me feel very hopeful that we could treat Emmie. His cancer killing cocktail recipe involved alternating doses of Vinblastine w/ Prednisone and Lomustine. Our routine was as follows:

• Week 1: Vinblastine Injection
• Week 2: CBC to check her white blood cell counts
• Week 3: Lomustine Pills
• Week 4: CBC and then start the routine all over again
  

This would happen for a total of 8 treatments (4 of each) over 16 weeks. Attached are some external links for more information about these drugs: Lomustine and Vinblastine. Prepped with tons of information from the vet & an estimate of the treatment plan we scheduled our appointments and headed home.