A Status Report

Yesterday was Tony's first day on the stepped-down dose of Prednisone, and I was so glad, I would have danced if not for the pain.  During the week he was on two doses a day, he ate (and begged) constantly, drank vast quantities of water, and had numerous accidents in the house.  By now, we've cleaned the carpets in almost every room (he wasn't the only dog with a problem), so we've got a jump on the holiday cleaning.  I'm trying to keep a positive attitude, as you can see.  And in that vein, Tony's kidneys have been fully flushed during this time, which is also good.  He hasn't shown any real difficulties with the drug, but having to let him out at all hours is a problem for me.  I don't sleep well at the best of times, and the even-worse sleep I've been getting isn't close to enough.  However, he didn't have any accidents last night, and I have hopes for tonight.

Keeping track of all his meds and doses has taught me something that I'm going to pass on:  as soon as you get a dog, start a log of his/her vet visits, medications, etc.  You could, of course, just look back at the vet bills and prescriptions, but I've found that I want a bit more information, especially information that I don't have to decode.  This blog has actually been very helpful in that regard, since I've tended to post when things change.  I now have a record of what was going on when.

In fact, I think we probably ought to do this for other things, too.  For example, you buy a house, and from that point on, repairs are ongoing.  It's handy to have a way to know when you bought the new water heater, or the last time you had the chimney cleaned (was it last winter, or the year before?).  My memory is pretty crummy about things like that, all the more so lately.

Wanna play a game?

This is just a quick post to let you know about the Nobelprize.org's The Diabetic Dog Game.  It's basically an online pet simulator, with a blood sugar monitoring bar so that you can keep track of the dog's levels.  If you have a child in the house, this would be a good way to help them understand what is going on with your dog.  I have found that it's hard to make people understand that they can't give Tony treats, and kids often think I'm just being mean.  Playing this game would give them an idea of what happens when you give a diabetic dog food he isn't supposed to have.  And, it's pretty darn cute.

A warning:  if you don't take good care of your diabetic dog, the game takes it away from you.

In case you're wondering what the Nobel Prize has to do with dogs, the answer is that the discoverer of insulin won the prize in 1923, and I guess that using a dog was to make it more appealing so kids would want to play (and not even notice that they are learning).  It would also be good for parents to use to impress upon kids that adopting a dog is a very serious responsibility.

Attacking Cancer Nutritionally in a Diabetic Dog

As part of my "shotgun" approach, I sifted through a bunch of material on diet and cancer in dogs.  It appears to be generally agreed that carbohydrates need to be reduced, especially carbs that are from grains and starches (one site says that the ratio should be 95% protein and fat, 5% carbs-- only non-starchy vegetables and fruits).  There also seems to be agreement that Omega 3 fatty acids must be increased, although Omega 6s are controversial, with some saying they feed the cancer (this is said about carbs, too) while others think that they should be at the same level the dog has always had.  Many vets and pet owners recommended yogurt as well (Tony already gets plain nonfat yogurt as his bedtime snack), and others raved (some ranted) about the benefits of a raw foods diet for dogs with cancer. 

Safflower Image via Wikipedia

Several sites talk about a study that was published in the journal Cancer Letter in 1992, where 75% of a small sample group of dogs went into remission of the skin form of lymphoma with only the addition of safflower oil (high in Omega 6s, especially linoleic acid) to their diet.  I particularly like the Pet Web Library website of the Mar Vista Animal Medical Center in Los Angeles  (http://www.marvistavet.com/index.html), as they have set up pages on most of the conditions their clients are likely to ask about.  The lymphoma page was very helpful when it came to nutrition.  They mention that the safflower oil study remains controversial (there is a later study that produced the same results, but again on a very small sample), and they also point out that the brand preferred for this is Hollywood, not Hain. 

Along with all of this new information, I realized that I already knew some things about supplementation and general nutrition for diabetics that I could apply to the problem.  After all, I live with two diabetic humans, and I have a chronic illness (Still's Disease) as well, and all three of us (one of whom is an R.N.) use nutritional supplements for our various health issues.  Thus armed with a bunch of ideas, I started formulating a basic diet plan, intending to revise it as I learn more and as Tony gives me feedback.

First, I ruled out going the raw food route whole-hog, so to speak, but I would not fry or bake any meat or fish, to avoid the Maillard effect.  This is basically browning, the thing that gives meat a lot of its flavor, but it has been implicated as a risk factor for cancer in many studies, so I decided to stick with boiling and steaming, which means that I can use some canned products.  I discovered on a trip to Woodman's, my very favorite supermarket of all time (even though the store is so enormous that I often have to lie down when I get home after a shopping trip), that there are a number of brands of canned salmon that are reasonably priced (certainly less than premium or prescription dog food) and would work well for my purposes.  I would not eat these brands myself (yes, I'm picky-- the salmon just isn't pretty enough for me; there's skin and those little round vertebrae that creep me out), but Tony loves them, and they have a number of benefits for him.  Additionally, I can boost their Omega 3 content with his 3V oil (from Foster and Smith), which he has been spurning lately, and add anything else I need him to eat, because the smell is so strong that it masks the stuff he doesn't like.  Hurray!

I've already mentioned in a previous posting that I have given him either asparagus (canned spears and tips) or broccoli (frozen) at various times; now he is getting both, twice a day, mixed in with the salmon.  To this I am adding a scant teaspoon of Hollywood  safflower oil, a tablespoon of chicken broth heavily seasoned with turmeric, and a sprinkling of cranberry meal (I'm using the capsules I take), plus a crushed multivitamin in the breakfast bowl.  He eats this eagerly.  

There are other supplements that he takes:  brewer's yeast, which he will take as a whole pill, and a milk thistle supplement (Marin is the brand name), which gets crushed up with his medications and is mixed into a teaspoonful of peanut butter (I'm past worrying about his kidney stones-- he needs the medicine to keep him alive now, and he has never refused peanut butter).  The milk thistle and cranberry meal are to support liver and kidney function respectively; this is important, because most dogs with lymphoma die of liver or kidney complications.  However, most of those dogs are being treated with chemotherapy (non-radiation), which Tony will not be.  As an older dog with diabetes, he is just not a good candidate for chemo.

I have also added another pair of supplements for what is called "immunomodulation."  I don't know if this will help, but I can't see how it would hurt.  The products are K9 Immunity and K9 Transfer Factor, and according to the makers, there is usually some improvement at the ten-day mark.  Of course, this is usually given in conjunction with chemotherapy. 

Tony has been on this diet since Wednesday, 10/7, and he started on the K9 supplements a day later.  Just today, 10/17, I noticed an actual improvement in his condition, which may have nothing to do with any of this, but it's the first positive change in weeks.  It has to do with his skin condition, which has been terrible.  He has had lesions popping up, first on his stomach and then all over.  His beautiful fluffy fur coat turned into a series of giant mats, and removing them was like shearing a very small sheep-- it came off in one solid layer.  Underneath that, his skin was almost covered in a white scaly substance that flaked off when you touched it.  Many of the flakes had sharp edges.  This morning, when I picked him up for his insulin shot, his stomach felt soft.  After the shot -- and the obligatory treat, I rolled him onto his back.  There were only a couple of small lesions left, and very little of the scaly stuff remained in that area.  He has only been on Prednisone for two days.  

So far, I think I'm doing the right things, but I know that I could easily be mistaken.  Dr. Kroll sees no problem with these changes as long as they don't affect his blood sugar adversely (they haven't yet).  We'll see how it goes.  

My diabetic dog has cancer

Image via Wikipedia. "Cytology from a needle aspiration biopsy of a lymph node of a dog with lymphoma. The predominant cells are lymphoblasts. Slide was stained with a modified Wright's stain."

I had to use that as the title for this post, just because it's so hard to say. Today, Tony is wide awake, walking around the way he usually does first thing in the morning. We call this "checking the perimeter," since it does look like that's what he's doing. He wants to know where everyone is; once he knows that, he settles down for a little snooze. It all seems totally routine, but with one look at him, anybody could tell that something's wrong. He had his stitches from the biopsy removed on Wednesday and started Prednisone on Thursday (the wait time from the diagnosis was caused by his taking Rimadyl; he needed to be off it for at least a week before they could give him Prednisone, as the two interact badly, apparently). Dr. Kroll warned me that he would be very hungry and thirsty on the Prednisone, and so it has worked out. Yesterday, he emptied his breakfast and dinner bowls on the first try, which he has never done before (he likes to leave a bit for a snack). This isn't a bad thing, since he's been losing weight (now just over 8 lb.). I had even been cutting back his insulin a bit before this as he wasn't eating as much as usual, what with the change in his food (more about this later)

As to what I've been doing since the diagnosis, you can probably guess. After I finished my last post, I began researching lymphoma in dogs, looking not just at peer-reviewed veterinary journal articles, but also at what ordinary people had to say about their experiences. I felt better once I had done this; it got rid of some of the helplessness I had been feeling. And I found some interesting stuff.

The first thing I discovered is that when this happens to your best friend, you want to talk about it. There are a lot of web pages devoted to dogs who have had lymphoma, along with the stories of their treatment. There are also, as you might expect, pages and sites that are trying to sell you something. I tried to weed out as much of this as I could, but a couple were actually useful. One of these is by a guy named Ted Schneck, who is selling a book titled Curing Canine Cancer: Natural Treatments That Work (Secrets of Marty the Wonderdog). No, I did not buy the book; as I've mentioned before, I'm broke. I've already spent over a quarter of my annual income on Tony's care this year, and I can't even afford to consult with a veterinary oncologist. However, Ted seems to want to help: even if you aren't buying the book, he has free tips that he will e-mail. Of course, that gives him more chances to make his sales pitch, but I didn't mind because a couple of the tips were very helpful to me. One of them was to encourage me to take a "shotgun approach," trying anything that might help as long as it doesn't hurt. I was already leaning in that direction, but the validation, even from a layperson, made me feel that I was doing the right thing for Tony. The other thing was even better; it had to do with my behavior around Tony, and I'll explain that in a later post. In fact, I'll talk about all of these issues in individual posts, I think.

I guess I'll give Ted a plug, since he did me a favor. His url is http://www.curing-canine-cancer.com/.

A new direction

I had meant to post last Tuesday, when Tony was supposed to have his biopsy, but it was postponed until last Thursday. I have an 11AM-12:15PM class Tuesday and Thursday, so I popped him into his carseat and drove him up to the vet for his 8AM appointment, then turned around and went home. About 5 minutes after I walked in the door, the phone rang and the caller ID showed it was the vet. Reading that, you probably have the same sense of foreboding that I had then. It wasn't good. While they were doing the pre-anesthesia exam, Dr. Kroll noticed that Tony's muzzle was swollen on one side. He has a mass there and another on the other side of the mouth towards the back. She began listing my options, and I stopped her as soon as she pointed out that he was there and prepped already, so it would be easy to biopsy the masses as well as his skin lesions. "Do it," I said. I didn't want her to tell me how much it would cost right then, figuring that when I went to pick him up was soon enough for that and I didn't want to be tempted to postpone finding out what this fresh catastrophe was going to mean.

I picked him up Thursday night, and he seemed a bit groggy, but otherwise his same old self. Even the techs were saying that if he didn't look the way he did (much of his fur shaved off, his face swollen, etc.), you wouldn't know there was anything wrong with him from his behavior. All weekend long he was fairly peppy and alert, and he still is today. But when I got home after my 8AM class today, I had another call from Dr. Kroll. The news was bad.

The biopsies showed that the masses and the skin lesions had the same cause: lymphoma. She was more upset than I was; I was numb (still am). I told her that I needed some time to take this in and figure out what questions to ask, and she told me to call her anytime, saying, "I'm always here." That actually made me laugh, because she certainly seems to be there all the time, even on days when I know she is scheduled to be off.

I wanted to get this posted as soon as possible for my family members who live all around the country, but I really don't have much more to say now. It looks as though this blog is about to go in a new direction.

The Zemanta feed just popped up the photo below with the caption "Shuttle's exuberance for life, lymphoma and all." I'm going to take this as a good omen.

Image by dglassme via Flickr