The day began with Kimberly telling me that Millie had blood in her urine again...apparently the UTI was back.
I called and left a message with Dr. Dahlgren, who called me back later. We had discussed when she treated the first UTI that if it didn't go away, then she would switch antibiotics. But it had gone away quite readily and now was back. She wanted to hear how Dr. Fulmer felt that treatment would impact the chemotherapy and since I would be seeing her at 3:15, we left it at that.
They checked Millie's white count, which was good. The Lymph nodes were reduced in size and her overall health was good. An ultrasound of her bladder did show that it was quite inflamed and because of that, they decided to treat her with a different antibiotic and not to try to get a urine sample because it would be unnecessarily painful. Kimberly and I both have commented on both this and the no biopsy...it's wonderful to see the doctors temper their medical choices with such concern for the patient's well-being.
Another great thing: HUMAN DOCTORS TAKE NOTE-(I have in mind those doctors whom I have had trouble getting to look at another doctors test results!) Barely more than an hour and a half passed between the time I spoke with Dr. Dahlgren and our appointment with Dr. Fulmer...yet when we got to there THEY HAD ALREADY SPOKEN and discussed Millie's UTI!
This ended up being a longer visit, only because Dr. Fulmer took a great deal of time to talk with another dog's "mother" who was undergoing chemotherapy and was having some issues. I was perfectly OK with this delay, and Millie came out wagging and happy, almost like she is after Day Care. Today she got Cyclophosphamide and a diuretic to help push it through her system. Ordinarily, this would cause more frequent urination, but between the UTI and the Prednisone, it was unlikely we will notice any difference from her already elevated peeing activity.
Thursday, August 18, 2011
August 10, 2011 The First Chemotherapy Treatment
It was anticlimactic....after all the time we had spent deciding, it went so quickly. I don't think we were there 30 minutes. We signed in, they took her back, checked her white count, and then gave her the Vincristine and we were back home:
I snapped a quick picture of her with her bandage and then it came off. And all was well....we had begun the chemotherapy voyage.
The percentage of dogs who have ill side effects from the Vincristine is less than 2%
Millie was peeing more frequently, mostly because she was still on the Prednisone (we were beginning to taper off the dosage) and was maybe a bit less energetic....but otherwise, she was our Millie!
The percentage of dogs who have ill side effects from the Vincristine is less than 2%
Millie was peeing more frequently, mostly because she was still on the Prednisone (we were beginning to taper off the dosage) and was maybe a bit less energetic....but otherwise, she was our Millie!
August 3-7 Making the choice
(Obviously I started the this blog after the whole process began for us...and I will make the last two "old" entries today...and hopefully stay up to date after that)
So then we had to decide what to do. Before we knew more there was the concern that we would do it for the wrong reasons....that being so desperate to keep Millie around, we would put her through unnecessary pain. Our research and talks with veterinarians had put that to rest. Absent complications, chemotherapy is generally not anywhere near as unpleasant for dogs as it is for humans. And we knew that all we would be doing is buying time. Lymphoma doesn't get "cured"....you simply hold it at bay. Dogs who go into remission and remain cancer-free for 2 years are pretty rare. Anything better is almost unheard of. Realistically, we we contemplating an 18 month extension if everything went perfectly. Millie would still be dying....but then, aren't we all?
She was a very good candidate for chemotherapy: young, in good health, no major organs involved and we had caught it early. As for the money....it would be hard, no doubt. The thing I couldn't get out of my mind was that the amount we were talking about was what we had spent on trips and vacations. We had probably spent more for our trip to China. Millie means much more to us.
Kimberly has said that at this point she was pretty much 49% do chemotherapy and 51% make her comfortable and enjoy the time we have. I spent a lot of time floating back and forth across that line. Kimberly felt we were in tune enough to let me choose...and she felt that I would carry a lot of the extra burden, not just financially, but time-wise as well...I would be taking her for treatments. Ultimately I chose a place...we would do it....one aggressive course and then accept what came.
For those of us who like God and the universe to let us know we're on the right path, after we had chosen, the sign we got came in the form of checks from my parents....which would pay for almost half of the cost.
So I made the appointment....it could have started sooner, but I did not want to leave Millie and have wait for hours in a cage at the VEC, I wanted to take her and have her leave with me as soon as it was done. So August 10th became the date for the first chemotherapy treatment.
So then we had to decide what to do. Before we knew more there was the concern that we would do it for the wrong reasons....that being so desperate to keep Millie around, we would put her through unnecessary pain. Our research and talks with veterinarians had put that to rest. Absent complications, chemotherapy is generally not anywhere near as unpleasant for dogs as it is for humans. And we knew that all we would be doing is buying time. Lymphoma doesn't get "cured"....you simply hold it at bay. Dogs who go into remission and remain cancer-free for 2 years are pretty rare. Anything better is almost unheard of. Realistically, we we contemplating an 18 month extension if everything went perfectly. Millie would still be dying....but then, aren't we all?
She was a very good candidate for chemotherapy: young, in good health, no major organs involved and we had caught it early. As for the money....it would be hard, no doubt. The thing I couldn't get out of my mind was that the amount we were talking about was what we had spent on trips and vacations. We had probably spent more for our trip to China. Millie means much more to us.
Kimberly has said that at this point she was pretty much 49% do chemotherapy and 51% make her comfortable and enjoy the time we have. I spent a lot of time floating back and forth across that line. Kimberly felt we were in tune enough to let me choose...and she felt that I would carry a lot of the extra burden, not just financially, but time-wise as well...I would be taking her for treatments. Ultimately I chose a place...we would do it....one aggressive course and then accept what came.
For those of us who like God and the universe to let us know we're on the right path, after we had chosen, the sign we got came in the form of checks from my parents....which would pay for almost half of the cost.
So I made the appointment....it could have started sooner, but I did not want to leave Millie and have wait for hours in a cage at the VEC, I wanted to take her and have her leave with me as soon as it was done. So August 10th became the date for the first chemotherapy treatment.
Morning of 2nd Chemo appointment
This week Millie went to Barker Field to play with her usual friends that she sees every weekend. Her energy was zapped pretty fast but she seemed good. Later in the week we took her to her usual Doggie Day Care 4 Paws in the Fan. The staff there said she was still Spunky. This morning as I took her for a walk...her UTI has returned. Today will be Millie's 2nd chemo appointment. Millie's Dad will be taking her and addressing the UTI specs today as well.
More on the First Appointment
There was concern on my part on how Chemo would affect Millie. However, the doctor agreed with most of the on-line information that we found......quality of life for dogs undergoing chemo is very good. Generally they do not suffer the same problems as humans. There is no hair loss, nausea is rare. I asked about limiting her physical activity and was told that was not necessary. If she wants to swim or go to the park or whatever....the doctor would not tell us to limit her activity at all. So what we were comparing......an affordable steroid treatment only which she would feel good during until her body no longer responded to the steroids and then there would be a fast decline giving us 3- 4 months OR an expensive aggressive chemotherapy where her quality of life would also be good during treatment, possibly go into remission with a hopeful 18 months.
Wednesday, August 17, 2011
August 2, 2011 Our First oncology appointment
We met Amanda Fulmer, the only board certified veterinary oncologist in Richmond, today. It was both as expected and not. The biggest surprise was also the most disheartening: my expectation was that she would want to do a biopsy...and she didn't.....didn't feel it was necessary. I was thrilled for Millie to not to have to go through the painful procedure....but...for the doctor to think it was unnecessary really hammered it home....she really did have it. Our sweet Millie had Lymphoma.
The options were almost as straightforward as we expected: we either did chemotherapy or we didn't, the only real modification was we could either do a full aggressive course of chemotherapy or a shorter, less aggressive one...this didn't really seem like much of an option to either of us....it was potentially less effective and the only upside was it would cost less.
Which brings us to cost.
The full aggressive course, which I feel that both Kimberly and I knew was the only way to go if we decided to do it, would cost around $5000. The VEC gave us very detailed breakdowns, showing what each treatment would cost as we rotated through Vincristine, Cyclophosphamide, and Doxorubicin in four week intervals with a rest week in between. It worked out to about $1227.00 a month. The individual treatments varied from a low of $242 and a high of $379.
There was also little doubt that Millie's eye issues were Lymphoma related....the glands around her eyes were swelling. This we did not have to make a decision about, at least. Whether we decide to do chemo or not, Prednisone would begin immediately. But this also started the clock....if we didn't start chemo quickly, the steroid had the potential to interfere with treatment later.
Amanda and her assistant were understanding and informative and that played a role in our later choice. But that was the big step ahead....a literal life or death choice.
The options were almost as straightforward as we expected: we either did chemotherapy or we didn't, the only real modification was we could either do a full aggressive course of chemotherapy or a shorter, less aggressive one...this didn't really seem like much of an option to either of us....it was potentially less effective and the only upside was it would cost less.
Which brings us to cost.
The full aggressive course, which I feel that both Kimberly and I knew was the only way to go if we decided to do it, would cost around $5000. The VEC gave us very detailed breakdowns, showing what each treatment would cost as we rotated through Vincristine, Cyclophosphamide, and Doxorubicin in four week intervals with a rest week in between. It worked out to about $1227.00 a month. The individual treatments varied from a low of $242 and a high of $379.
There was also little doubt that Millie's eye issues were Lymphoma related....the glands around her eyes were swelling. This we did not have to make a decision about, at least. Whether we decide to do chemo or not, Prednisone would begin immediately. But this also started the clock....if we didn't start chemo quickly, the steroid had the potential to interfere with treatment later.
Amanda and her assistant were understanding and informative and that played a role in our later choice. But that was the big step ahead....a literal life or death choice.
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