Monday, January 26, 2009

Ups and Downs and a Difficult Decision

What followed was a week of ups and downs. As you can tell, I kept a journal, so I could go on and on with details, but I won’t. The “ups” were that she would eat a bit, and throughout these days actually began to eat her “kibbles” again after 2 months! Not a lot, but at least she wanted them. That was a huge moment for us! She also took a liking to turkey bacon and bacon treats. Again, not a huge amount, but it roused her appetite. Her digestive system seemed to be getting back to normal, although there was only 1 vomit-free day during that time. We kept her on a regular regimen of Cerenia, Mirtazapine, Reglan, and Pepcid. The “downs” were just trying to get her to eat, only to have her vomit. One thing we had to watch out for was making sure she was not too active after a meal, because so many things could trigger vomiting. It felt like an endless merry-go-round. Still, I cannot adequately convey with words how pleased we were that she was showing signs of wanting to eat again! But when she didn’t want to eat, buddy her little temper would flare! I couldn’t blame her. It was only during this week that I was told about the mini-syringes. They made my life so much easier, as I was able to prepare a very small amount of food with crushed meds. The meds would help to ease her stomach and then she might feel like eating more later on. Had I only known about their benefit 2 months earlier! She would have never missed an antibiotic, steroid, anti-nausea drug, etc.
Discouraged by the chemo reaction, we were at a loss on how to care for her. We felt desperate. This was the first week in 2 months that we did not take her to the vet, although were in consultation. To give you an idea of how much we were at the clinic, I have 15 receipts from the month of February alone! We had a bad weekend, and on Monday, March 10 we were back at the vet’s office. She was dehydrated, so she got Sub-Q fluids and more blood work. {Abnormalities: WBC 32.2 (high), Platelets 761 (high), Neutrophils 27,048 (high)}. She only weighed 11.1 lbs. Sadie’s vet is one of the most caring doctors you could ask for, and I have never seen anyone better at returning phone calls and taking time with a patient. I’m sure it was difficult for her to tell me she’d done all she could do for Sadie, exhausting all her options. The more research I did, the more Sadie’s problems didn’t perfectly align with lymphoma. I still wondered if something additional was going on, although I certainly wasn’t in denial that Sadie had cancer cells. I read everything I could on Sadie’s symptoms. We got back in touch with the vet at the teaching hospital, and she admitted that Sadie’s condition wasn’t typical.
I made a difficult decision that week. Since Sadie’s normal vet was out of options, I couldn’t just quit. I had to do something. My sister-in-law knew another vet who was on the cutting edge of research and whose dog had recently died of t-cell lymphoma. She begged me to take Sadie to her. What if there was something else wrong? I had to know. My inhibitions about seeing a new vet centered around someone new understanding Sadie. Her cases were never simple, nor cut-and-dried. Would a new vet "be there" when Sadie needed them? What if they weren't in the office during an hour of need; were the other vets at the new clinic caring? I knew I had to pack 15 years of history into a few moments, and bonds and understanding don't always happen quickly. Nevertheless, I was desperate. I took Sadie in, armed with all of Sadie’s lab results to this point (she’d had 8 blood tests, 1 X-ray, 1 ultrasound, 2 urinalyses, 2 needle aspirates, and 2 surgeries w/ biopsies since Dec.).
After describing Sadie’s symptoms, the new vet thought Sadie might have mega-esophagus. An initial X-ray showed a slightly enlarged esophagus, so a Barium test was performed, but its results were normal. The enlargement was most likely due to frequent vomiting. The X-ray was encouraging in that Sadie’s organs and lymph nodes looked “beautiful”, which indicated that the lymphoma was not in an advanced stage! The only issue was an enlarged heart, but we were already aware that she had a slight murmur. More blood work was taken. Maybe that would show us something that would help.