Diagnosis and the vet

We saw the radiation oncologist yesterday – (http://www.cityofangelsvets.com/) his offices are nicer than any doctor’s office I’ve ever been in, by far, and the staff / doctors were all incredibly nice. Honey wasn’t afraid of it one bit, which was odd seeing as the last time she went to the vet (Monday the 28th) she was sedated, biopsies were taken, and she had to spend the night. The practice ONLY treats cancer patients, there were a bunch of prednisone-chunky half-haired doggies in the waiting room and they all seemed pretty happy to be there, so we took that as a good sign.

We met with the vet for about 2 hours, and he feels she’s a good candidate for ‘definitive radiation’ which means radiation treatment with the goal of remission or tumor elimination. We’re not sure if her cancer is an oral chondrosarcoma or a nasal chondrosarcoma, which means there’s no way of telling if it started in her mouth or in her nose, but it’s in both now. The survival rates for these types of cancers are comparable – 1-2 years for nasal with treatment, 16-24 months for oral with treatment. We decided to go for it, and she will get 20 doses of radiation – once daily, Monday – Friday for 4 weeks. We hope to start Monday, the 4th, which is the 8th anniversary of the day I adopted her from the humane society in Leon County, but it depends on her ‘plan’ being completed by then. They have a 3 view CT scan of her tumor and will enter it into a program (developed for human treatment) that will determine the best angles for the radiation to be directed, and the position she will need to be in for the treatment. Her first appointment should last an hour or so, where they arrange her position and take a bunch of xrays to make sure the tumor is in the target area, but after that the treatments will take about 15 minutes. They twilight her (thing laughing gas, like the dentist) and put her in the position the plan formulated, and then zap her. It’s just gas, so it’s not total anesthesia and not as dangerous.

The doctor is one of like 16 board certified radiation oncologists in the US, and he is directly responsible for the radiation of every animal. Everyone who deals in any way with the radiation and plan design is board certified, ahs had experience in both human and animal radiation treatment and has over 4 years experience of working with him directly, so we’re confident they know what they’re doing. He aspirated the lymph node nearest the tumor to make sure it hasn’t spread there, and gave her some anti-inflammatories and a sleeping pill (she’s having trouble breathing out of her nose, and for some reason WILL NOT breathe out of her mouth) so the plan was the antinflamatories would make it easier for her to breathe, maybe open up more of an airway, and the sleeping pills would zonk her to the point where she wouldn’t worry about breathing and wouldn’t wake up every minute or so to gasp for air, because her body will naturally open her mouth and take care of it. Too bad that’s not what happened at all – she spent the entire night trying to breathe out of a completely clogged nasal passage, and every 15-20 seconds would gasp for air (really loudly) through her mouth, but still wouldn’t open her mouth to breathe. Cameron and I spent the entire night holding her lips up so she could breathe out of the sides of her mouth and maybe get a little sleep. Result was that we got none and she got a teensy bit of gasping snooze.

I just spoke to the vet and apparently we didn’t give her enough of a does, as we only gave her half a pill, so tonight I’m supposed to give her more and completely wreck her so she’ll sleep. He also said that there is a chance the tumor is growing so fast that it’s occluding her nasal passages, which would be “really really rare” but if that were the case it would affect her chances of a remission. There’s just no good news, is there? Anyway, I’m feeling awful for giving her a dose which made her suffer all night, and freaked her out so much, so tonight ill give her a full pill and “watch her closely for the first hour or so to make sure she’s still breathing” well, you can just rock me to sleep tonight. Thank god tomorrow’s Saturday and it doesn’t matter if I’m a totally and complete zombie. Maybe I can get someone to come over and sit with me and the (hopefully sleeping) Hun tonight while Cameron’s at work, so I don’t lose my shit and freak her out in the process.

Canine Nasal Chondrosarcoma

Honey's biopsy results are back, and it's Nasal Chondrosarcoma. Our appointment with the radiologist is at 3:40 today, and they told us not to give her any food for 8 hours before the appointment, and no water for 2 hours before. I hope this means they're going to start treatment STAT. The weird thing about this is she's not acting at all sick, except that I think the antibiotics (clavamox, causes vomiting and nausea sometimes) is getting to her in the mornings, and the other day coming off the general anesthesia was tough. she’s tired, ill give her that, but last night, I believe 43 hours after her CT scan and two large biopsy samples taken from the roof of her mouth, she was bringing me her ball and catching it in midair.

Apparently Chondrosarcoms has a 10% metastasis rate, and this has not gone to her lymph nodes or her lungs, but the vet did say it was "locally aggressive" I wonder if that means she'll lose her nose? Anyways, I've only had about 25 minutes to do research so I don't have any really good sources yet, but I'm a librarian and believe in the value of facts, so ill ask the oncologist for some info and ill dredge some reliable current stuff up online from somewhere to make available to anyone else who needs info on this.

Honey's sick, I'm an Idiot.

So Honey has had some issues with her nose for a while, since we boarded her when we went to Florida for Christmas. She went through 2 courses of Clavamox and they didn't fix it, so the vet sent us to get a CT scan, which was done Monday, and they discovered a "mass" in her sinuses, which went through her hard palate. Aside from being completely beside myself because my baby is sick, I'm also having trouble handling the fact that I have to wait for a diagnosis, because that not only keeps me from doing research and figuring out what can be done, it also means that all the research I do is really broad and I keep reading these horrible doomsday predictions and the fact that they were written in 2000, and even though logically I know there is newer better information, and treatment of these HAS to have been improved in the last 8 years, I can't stop myself from imagining the worst scenario possible.

she's having trouble breathing through her nose, as the tumor (or 'mass', whatever) is taking up a lot room, and naturally the area is all pissed off and therefore inflamed and there's a secondary infection. So although she can breathe completely fine through her mouth, she won't, and there's a constant noise of her inhaling, sometimes punctuated by gasps when she is really low on air. She can't sleep because every time she begins to drift off, she remembers she can't breathe and jerks her head up and starts over. Thankfully, we have some more antibiotics, and hopefully that will help her clear an air passage. The vet said there is no way she will pass out from lack of oxygen and suffocate, and Cameron keeps assuring me that her body will take over and if she needs to, she WILL, in fact, open her mouth to breathe, but she sounds awful.

Monday she had a CT scan (and the best vet in the world - http://www.asecvets.com/) and had to stay in their ICU overnight, not because she was really in need of it, but she has never been under general anesthesia, and she had a little bleeding from the biopsies they took. Tuesday we picked her up and brought her home and she was pissed off and sick. General didn't make her feel good and she was groggy but couldn't sleep because of the breathing. Awful. Cameron had a workshop at 7:30 and I went home around 5, so she was never alone, but I screwed up royally; I decided to let her dictate what we did all evening, which to me sounds like a nice thing, but I think it freaked her out that I was getting her to decide which way we walked when I opened the door, and where we sat, etc. she has the pack ranks instilled in her so deeply, I think it was like I was asking her to lead, and while she was sick. Terrible idea and it never dawned on me. I also gave her a pain pill, which I guess she had when she was spayed, but not since, and she wigged out – racing around the house and she actually HOWLED, I’ve never heard her do that before. I seriously considered either having a nervous breakdown or taking her to the emergency vet, but she chilled out. I called the vet and they said some dogs just can’t handle opiates and she may be one of them, I swear I almost told her it was probably inherited because I’m the same way. I’m sure they already think I’m insane.

so I’ve been thinking about it, and I need something to do because I don’t care about John and Kate's plus 8, or who got arrested on Hermosa beach, and that kind of low-involvement crap makes me stress out about her more, as I’m basically just staring at the TV waiting for the next 'inhale' noise. Great, now I’m feeling guilty for doing that to her last night. That’s it; I’m printing knitting instructions off the internet and learning lace tonight.

Her appointment with the oncologist / radiologist (one of 16 board certified in the US – in the Hills, of course, - http://www.cityofangelsvets.com/) is Thursday afternoon, and I really have my fingers crossed her biopsies will be back by then because I doubt we can get another appointment before next week and I cannot sit through another weekend like last one, I’ll lose my damn mind.

I would go into the millions of possibilities about her tumor, but there are literally millions. I do know that it’s probably a malignancy, because it went through the bone of her hard palate, and I know that nasal tumors in dogs aren’t uncommon. I swear, if they had told me that years ago I would have added it to the list of stuff I worried about daily and maybe this wouldn’t have snuck up on us. I hope we got in time to do something – it’s apparently not in her lungs and not in her lymph nodes, so maybe there’s still hope.