Friday, July 18, 2008

ginger meets a new set of doggie doctors

The cancer protocol the onco vets put Ginger on a couple of weeks ago just didn’t work, and her lymph nodes again started enlarging, which means the lymphoma is back. There is one more chemo protocol they can try, though the prognosis is not good. We’re starting to accept that we won’t have her around much longer, but are hoping she can be comfortable enough for one more trip to Oscoda in late August and early September.

They needed to start her on the first chemo drug they gave her, an induction drug, Elspar. And continue her on Prednisone. Next week she will get blood tests and get checked over, then we start her on yet another drug, but I don’t remember what it is. It’s a pill rather than an injection.

She seemed to be doing okay after treatment on Wednesday. On Thursday, she ate quite well, some wet dog food, a little bit of steak, a bit of baked potato, some broccoli (which she loves—go figure ... ), plus her dog biscuits and her Greenie. Not much of her dog chow. She sometimes gets diarrhea when she eats beef or pork fat (or just beef or pork), so I didn’t think much about it when she had to go out repeatedly starting around 2 am on Friday morning. I was up monitoring a server upgrade anyway, so it wasn’t like I was going to sleep right away. I put newspapers down before I finally went up to bed just in case it wasn’t over.

Ginger chasing a squirrel, July 2008
come back squirrel, i want to play (click to enlarge)

It wasn’t. Only it was much worse—fierce vomiting was the next event. She snagged the cat tuna and blew it. She drank some water—gone at once. Between the vomiting and the diarrhea, I knew it was bad. I called the onco vet, who prescribed some pills to give her, one for each problem. Pills. For a dog that couldn’t even keep water down. A trip to the vet to pick up the scripts and $40 later, I gave her the meds. Barf in 60 seconds. No pills in evidence, but oh she looked so so sick and in pain. The onco vet said to call her regular vet, Dr. Meredith Re at Strawberry Hill Animal Hospital (we’re crazy about Dr. Re, and the creatures love her too, even though she sticks them with needles and shoves thermometers up their butts).

Dr. Re had us bring her in, and it was very difficult because Ginger just did not want to walk anywhere. She got up into the car, but did not want to get out of the car. Stanley had to half pick her up and half shove her out—we didn’t want to yank her by the collar because of her swollen lymph glands. Then, when we finally got her in to the exam room, Ginger shoved her head between the table and the wall and tried to make herself as small as possible.

Bottom line was Ginger needed IV liquids and pretty close supervision overnight at least, since she was dehydrated because of all the liquid she lost—she lost three pounds in two days and only some of it was the lymph fluid going down (they have gotten smaller, but they’re still very much noticeable). Dr. Re’s hospital doesn’t provide ICU-type care and is not staffed during the wee hours, so she recommended we take her to the VCA Veterinary & Emergency Center—the animal ER here in Norwalk. Off we went. Dr. Re was worried that it might be pancreatitis induced by the chemo. We thought, before we saw Dr. Re, that it was all the stuff she ate, or maybe the potato skin poisoned her (they can if they’re green).

Ginger was first “triaged” by an intern? Or orderly? I’m not quite sure who the guy was. We told him that Dr. Re had already called and faxed over her records, seemed rather pointless and a silly procedure—we wanted her taken care of as soon as possible. He left, and soon the vet, Dr. Vaishali Kamath, came in to take a look. I got a good feeling from Dr. Kamath—I felt like I could trust her to take good care of Ginger. The only times Ginger hasn’t been with me are the few days I was in hospital and when we went to Washington DC on our honeymoon, so it was really difficult to leave her there. The vet got her settled in for diagnosis and treatment, and came back to go over the estimate. After leaving $1,500+ to pay for everything (75% of the high-end estimate), we went home to a very quiet house. I asked Stanley if we were crazy for paying so much for a dog who is terminal, and he said, “probably.” I asked if it bothered him and he said, “no.”

Dr. Kamath said, around 11:30 when I finally reached her to get an update (lot of dogs into the ER tonight, but only one from heatstroke), that Ginger was perking up quite a bit, that her blood pressure was back up to closer to where it should be and her blood work was fine except for some abnormalities which the hospital oncologist said was due to her chemo. Lots of IV fluids, IV steroid injection. Her vomiting was stopped, though the diarrhea continues. She is wagging her tail and had just gone out for a walk. We will probably be able to bring her home Saturday—we will hear from the hospital and Dr. Re Saturday morning. Oh, and the vomiting and diarrhea are the result of her chemo and not us letting her eat beef or potato skins. Just a lot of different poisons in her, a lot for her system to handle.

So it seems like she is not ready to go just yet. We’re not ready to let her go yet, either—as long as she is comfortable and seems happy and not in any pain, we’ll hang on to her. The onco vet told us we will know when it’s time to let her die. She’s not under my chair as I write this and the void is huge—I can’t wait to bring her home.

posted by lee on 07/18/08 at 11:14 PM

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