Rocco's Last Chemo

I took Rocco to his last scheduled Chemo session yesterday. He is supposed to come in monthly for check ups to see when the cancer comes back. At that point will have to decide what to do. The Vet at VMS in Campbell says the lymphoma comes back 10-12 months after diagnosis. This would be mid-January to mid-March (3-5 months). I'm a little depressed about this as I had originally thought it was 6-12 months after treatment was finished. Seeing Rocco so healthy now it's hard to believe he has it and I had gotten used to the idea of the cancer being gone. I pushed the reality aside and it came back to me last night and I was very upset. When it comes back you can do Chemo again but there are problems. The drugs have to be stronger for the second time. This is a problem because Rocco had to delay maybe 5 or 6 of his treatments because of low white blood cell counts. For the other ones he was always at the minimum white blood cell count to receive treatment. I don't know if he could handle a stronger regimen of drugs. Also, even with the stronger regimen of drugs the 2nd round of Chemo usually sees the cancer coming back in half the time (on average) of the 1st round. The Chemo was tough the first two-three weeks for Rocco but it was worth it. He really has been living his life pretty normal since then (aside from constant visits to the vet for treatment). When we first diagnosed Rocco it was with our vet in Atlanta and the North Dekalb Veterinary Clinic. Our vet offered to do treatment on this type of cancer (because it was common and he was following a well regarded protocol). This meant our Chemo treatments were $80-$150 each time. Once we left Atlanta for New Jersey and then California we couldn't find a regular Vet to do this and we had to go to specialists. This meant the Chemo treatments were $270-$540 each time. We could afford it and it was a no brainer really. I'm sure there are people though who have to decide between this and rent or a mortgage and can't afford to do it. It bothers me that my Vet in Atlanta could administer the same drugs as the specialists at 1/3 the price. How many people passed over treating their dogs because of the rates of the specialists? I guess I'm getting off the point but when Rocco was first diagnosed I joined a Yahoo group for people who's dogs had cancer. A lot of them couldn't pay for Chemo and resorted to using prednisone to prolong there dogs for a few weeks. Some tried holistic remedies just because they wanted to help there dogs but couldn't afford the most effective treatment. Anyway, back to Rocco. I'm going to buy a Flip video recorder because I don't have much video of him (especially playing with his sister). Hopefully it will be a while before I post on this blog. The next time will be when Rocco is diagnosed with having the cancer return. Best wishes to all......

Kevin

Still going strong

Rocco's last 2 treatments have gone fine, although he was sent home both times with some antibiotics because his count was a little low. We are coming into the home stretch now with only 4 more treatments to go. Meanwhile Rocco has been enjoying being back in CA and getting back into the swing of things at Sunday training class. There's not much else to report, but that's a good thing!

Can you believe - another vet!

Yes, this is vet #4. Since we moved a bit farther north, it made more sense for us to go to an oncologist closer by. Luckily there was no hassle because Veterinary Medical Specialists has locations all over the Bay Area. So this past Tuesday, Rocco had a treatment of cyclophosphamide and so far he is doing great. No intestinal problems that can sometime be a side effect. He is still in complete remission (meaning there are no signs of the cancer in his body) so he is still responding very well to treatment. As of now, the protocol has him getting treatments every other week as opposed to every week so that's easier on all of us. We've got about 11 weeks to go with this protocol, and from there we will have to play a waiting game and hope that his remission is a long one. Some people have asked us if Rocco will make a full recovery, but unfortunately the lymphoma will always return - it's just a matter of when. On average, canine lymphoma patients who receive chemo have 10-12 months from the date of diagnosis. Dogs without treatment typically have only a few weeks. So for now we can be happy that Rocco is living a full life and loving every minute of it.

CA Chemo

Today Rocco had his first chemo treatment in California at Veterinary Medical Specialists in Campbell. It all went very well. Everybody just loved him there as usual. Of course, now that it looks like we'll be staying in San Carlos for a couple months, we have to figure out if it makes sense to go to their San Mateo location. But I really don't want to switch doctors once again. Ironically, the oncologist Rocco saw today did his internship at the hospital we went to in New Jersey.

Rocco's final treatment in NJ went just fine, and he and Havana were wonderful through our 4 day trip out to CA. Rocco was so excited to see his uncle Tony, and Havana to meet him for the first time. I think they were happy to be out of the car finally. And we had a wonderful welcome back at Sunday training class. Rocco was just beside himself saying hi to the old gang.

Low WBC Count - Chemo postponed

Rocco's last Chemo before we left NJ for California was supposed to be Tuesday. His WBC was 2100 which is too low. Alicia brought him back today at it was even lower 1600. The vet had said that last weeks Chemo was pretty strong and it's not uncommon to skip the next week. I don't think she would have had us come in Friday if she thought the count would be lower though. She said not to be concerned yet and that if it is still low or lower on Monday then to worry. Rocco also threw up something strange today, it looked like a rope toy however we only have one rope toy and I'm looking at it right now. The vets let him play with stuff toys and Alicia told them to watch him if they do because he will swallow plush toys and such. Alicia asked today if they were missing any toys and they said no. Strange. We were going to start the drive to Ca. Monday but will postpone it for Rocco's treatment. I'm not sure if we'll leave the next day or wait a couple days. I'm a little worried to be traveling with him if he is going to be sick from the Chemo. We'll see I guess.

Another good week

We completed week 7 of the protocol with another successful chemo session today. I'm happy to see that Rocco seems to bouncing back much better from each successive treatment. The next 2 weeks will be at the specialist here in NJ, then another rest week which will coincide with our drive out to CA. The vet and staff love him there; they said they don't want him to go! We brought Rocco's book today and it was a big hit as usual. 

We had a nice sunny day today and Rocco & Havana spent a lot of time laying outside and enjoying the fresh air. It's funny to watch them bake in the sun until they can't take it and then plop down panting in a shady spot. Of course, once they cool off, it's back to the sun again. Quality of life during the treatment is a top priority to us, so it really means a lot to see Rocco so contented here.

Rocco's Chemo goes to NJ

We moved out of our rented house in Atlanta last Sunday and are up in New Jersey for a month. We found an oncologist who will keep Rocco's protocol up. They are about 1 hours drive from LBI, where we are staying. He went Tuesday, unlike our vet they don't hold him after he receives his Chemo. The oncologist said it's not necessary to do that anymore as the drugs in use now usually don't have severe reactions. She gave us some anti-diarrhea and anti-nausea medicine to counteract side effects of this round of Chemo. The oncologist charges WAY more than the vet and now I see why the vet recommended us using him for the basic protocol. I gave Rocco one pill yesterday for loose stool and that's been it. Him and his sister are definitely happy to be up in New Jersey and enjoy walking around the streets and playing in the back yard. Their paws are a little sore for running around on the concrete in the back but that is the price to pay for fun!! Rocco is doing well.

Today's Chemo Treament

Rocco had a 5000 count for his white blood cells which meant Chemo was a go today. This was his best count in over 3 weeks although he skipped last week just so he could recover. Today was his last dose of the powerful prednisone steriod, he was been weaned off it for now. Next week is actually a scheduled break in Rocco's treatment. My only concern is the vet said the Chemo treatment from today can cause GI Tract problems. I'm worried that this will happen because Rocco had severe GI problems from the first round of Chemo. This is Rocco's first time taking this particular drug though and hopefully things won't be as bad as the first time. I brought his nylabone with him to the vet so he could chew it while there. He had to spend 9am-2pm so I hoped that would kill some time/stress for him. They said he chewed it a lot, I wish I had brought it on previous visits. For the future I will. Oh, and Rocco is 58lbs and almost back to his normal weight. This is good news although the muscle/fat ratio is different and hopefully we can get him back in tip/top shape when this is all said and done! Here's hoping to no GI problems for the week!

Rocco's Chemo is bumped

I guess I jinxed Rocco with my last post but we took him in today and the vet wouldn't do Chemo. He said Rocco's white blood cell count was too low and we'll have to wait a week. This is the second time he had to miss a week. He also was borderline last week but they decided to do it anyway. The vet says the good news is the Chemo is obviously working on his system. The bad news is the Chemo is working on his system and killing the good cells not just the cancer ones. He is up to 57lbs though, 2-3 more to go. The vet gave him some anitbiotics because he is concerned with the low white blood cell count of him catching something. Hopefully next week.

Better Days for Rocco

Only good news to report since Rocco's last treatment. His prednisone dosage went to one pill every other day and he seems to have responded well to the last drug treatment. He is yawning more like he used to and we are having some serious games of tug and he even started pestering his sister again! That is really good to see. I know the vet said the first couple of weeks were going to be hardest on Rocco and seeing him go through what he did really bummed me out. Now I can see it was worth it. Maybe I'm getting ahead of myself because the chemo is different drugs on different weeks and he may still have bad reactions to certain ones but it's nice to see my boy acting like his old self. I'm eager to have him weighed tomorrow for his next treatment. He is still underweight but has put on maybe 2 lbs from just eyeing him.

Yawning again

Well, Rocco had his chemo on Tues, and so far this is his best week yet. He hasn't had any adverse side effects like the vomiting or diarrhea. One thing we've noticed is that he's been yawning a lot more. This is something he did almost all the time pre-treatment, and it had noticeably dropped off once he started chemo. It just shows that he is feeling better and is more relaxed. He no longer has the quick breathing patterns at night, so we can also sleep a lot easier knowing he's comfortable. We are keeping our fingers crossed that he has also started to put on some more weight. We'll see Tuesday when he goes in for the next treatment. 

We are also trying to plan out how we will handle our trip up to New Jersey. I'm done with school next week, and then we'll be moving out of our house in early to mid May depending on Rocco's treatment schedule to head up to the Reilly beach house in Long Beach Island. Rocco and Havana have been there before and should enjoy it. We will have to find a new vet or oncologist to do the chemo for Rocco up there. So that is the next big adventure for us.

Vet Visit 4/14/09

Rocco was due for Chemo today. His white blood cell count was "borderline" according to the vet and he wanted to due a full physical before proceeding. Unfortunately he had to do surgery on a cat for a while so Rocco didn't get his physical until 2pm and was cleared for Chemo then. After a 2 hour hold we could pick him up and did so. He is still on the antibiotic and we have the medicine for his GI tract if he has issues again. Unfortunately he is still 53.5lbs and we couldn't get any weight on him. With his throwing up and diarrhea we had to hold off on the extra feeds/fatty foods and so he is still underweight. His prednisone goes down to one pill every other day now. So tomorrow is his first day without it. He has to be weaned off it because he is dependent on it from the high/frequent use of it with chemo. I'm hoping this is the turning point for him. We actually brought and left Rocco's book in the lobby of the vets office so people can see his story and hopefully be inspired to adopt shelter dogs and maybe even bully breeds that are frequently discriminated against.

Rocco's up and down days

Well, Rocco threw up on Friday as well. Then starting in the afternoon he had diarrhea, he also had it 12am 3am 6am 9am and onward like clockwork. We called the vet and they wanted to bring him in to check his white blood cell count. They said if it's low they would give him some antibiotics. I told them just to call in the prescriptions to Kroger. I'm not bringing him down. His white blood cell was low Tuesday and now he is vomiting/diarrhea so why waste the time and money on the test? What are the negatives of giving him antibiotic? His long term resistance is not important because he is terminally ill. Anyway, just a little frustration. We got the prescriptions at Kroger (also a drug for his GI tract). He still had diarrhea the rest of the day but was at least solid this morning if soft. This is a fun blog, lots of poop and vomit in it. Anyway, with the medicine he seems to be feeling better and chewing bone, playing a bit and enjoyed is walk this morning. We'll see if he can do the Chemo on Tuesday.

Back to the vet

This morning Rocco threw up three times after his breakfast. Kevin called the vet, but unfortunately our chemo vet is not in on Thursdays. However, they told us to come on in because although some vomiting is common with the chemo, it can get worse very quickly. I took him in at 2:30 and they gave him something to settle his stomach as well as some subcutaneous fluids. 

The worst part is that Rocco can't get his regular dinner tonight. We have to give him just a 1/4 cup at 7 and see how he does. But he's been so hungry, and he is underweight. He's not going to like this one bit. The vet also told me to give him some Pepcid to keep his stomach settled. We just have to keep an eye on him and hope he doesn't do anymore vomiting. Worst case scenario, we'll have to take him to the emergency vet tonight. But he seems fine otherwise, so we're hoping it was an isolated incident. We'll just check back in with the vet tomorrow.

Rocco's Diet

I have been meaning to write a post about Rocco's new diet. One of the first things I found out probably in the few hours after learning of Rocco's diagnosis was that cancer likes carbs, and most cancer patients are recommended to go on a high-protein, low-carb diet. So we switched Rocco's food to Wellness CORE grain-free chicken and turkey. Prior to that, he was eating the Wellness Super 5 Mix, Lamb formula. We also added boiled chicken to his diet as well as salmon oil pills. 

Unfortunately, as Kevin mentioned, Rocco has been steadily losing weight even though we have been feeding him more food, so we are considering adding some high-fat puppy food into his diet. It's important that he keeps his weight up through this process. 

Rocco's 2nd Chemo Appt.

Rocco was able to do his 2nd Chemo yesterday. That is the good news. The couple of issues he has now is his weight is down to 53lbs. We are giving him extra feeds and the vet said sometimes cancer just does that. We are working out a way to get him more calories without carbohydrates added to get his weight up. He has a voracious appetite. I started with some drumsticks I slow cooked yesterday and then pulled the meat off the bone and cut it up with scissors. So hopefully this dark meat/skin will give him some extra calories as opposed to the skinless chicken breast I was giving him. Also, his white blood cell count was only 4,000. I was good enough to do Chemo but the vet is a little concerned about that as his normal level is 10,000 and he thought it would be close to that for Chemo. (Last time he couldn't do the Chemo because it was 1500). For this I bought Vetri-DMG upon recommendation from my Mom. It's a supplement for animals that is supposed to boost the immune system. Figure it is worth a shot, he started taking it last night. He is also taking a diuretic because the 2nd round of Chemo requires lots of drinking and peeing to flush the system. Anyway, he didn't play this morning but he had played for the previous week. I think he'll recover from this treatment quicker than the last.

Sunday, the 5th

Well, Rocco has been playing since Friday. Tug at least, he doesn't wrestle with his sister but that may be because that type of movement is uncomfortable to him. The tug is pretty straight foward and back/forth. That first Chemo treatment is wearing off him and he's getting stronger, at least strong enough so that they can give him the next round of drugs on Tuesday. He is still on the prednisone but all his antibiotics are finished for now, he may get more Tuesday. He looks a little underweight. I'm trying to give him extra feeds and treats to get it up. We'll see how much he weighs at the vet visit. He is yawing more too!! Although I figure some of this progress to regress when he goes back for Chemo but I hope the side effects aren't as severe as this first week was. Will update again after his vet visit.

Wednesday update

Well, unfortunately Rocco hasn't showed interest in playing yesterday or today despite skipping this weeks Chemo. He did seem more lively in the morning though. He is still as usual up for his training and dog walks and some good bone chewing. I think maybe the movement of play makes him naseous. His stool is looking better. We'll see if he improves the next couple of days.

Rocco's 2nd Chemo post poned

I brought Rocco in today for his 2nd round of Chemo. They drew blood first to check his white blood cell count and unfortunately it is 1500 which is too low for the Chemo. They require 2000 minimum and Rocco last check up in March showed his normal level at 10000. The vet said this is common and the second treatment sometimes has to get postponed because the first treatment is so strong. He figured by next Tuesday Rocco's count should be almost normal and he can do the Chemo then. The vet also said that Rocco's lack of wanting to play has to do with the effects of the drugs. The Chemo kills of millions of cancer cells and they have to be metabolized back into the body after they die. Poor Rocco, he is trying to hang in there the best he can. He still loves going to the vet, and he still has a good appetite and still likes to chew bone. The vet said the first couple weeks are usually the worst. I hope so for Rocco's sake, he is a strong and stoic dog and I know he is really bothered by the Chemo just from the subtle signs he gives; not wanting to play, laying in the hall by himself (which he never EVER does) and getting out of bed at night which he never does as well. I ordered some homeopathic medicine called Vetri-DMG which is supposed to boost immune system response. Worst case I'm out 20$ if it doesn't work but I think it's worth a try.

Monday, March 30th

Lets see. We haven't mentioned yet but Rocco's weight at the start of prednisone treatment was 59.1 lbs. We brought him in last Tuesday for his first Chemo and he was 55 lbs. That is 4lbs lost in 6 days!! We had increased his food and by Friday, 3 days later he was up to 57lbs so I was happy about that. Rocco played yesterday but did not want to play today. He goes in for another Chemo treatment tomorrow as long as his white blood cell level is up to par. He isn't yawning much (One of the chemo drugs has jaw pain as a side effect). He is chewing a good amount of bone though. Maybe it just hurts to extend his jaw all the way? Anyway, his stool had some blood this morning but not this afternoon so we'll just keep taking it one day at a time.

Vet Visit

Alicia pretty much covered everything. Rocco wasn't taking to the chemo well and the diarhhea and blood stool was a direct result of it. It was painful for me to watch him get swabbed for the stool sample because Rocco is very stoic and look on his eyes and his yelping was a true sign of the pain he was in. The vet said this side effects were possible because the chemo attacks fast growing cells. Cancer cells are fast growing but so are the cells in the G.I. Tract. The medicine he was prescribed seemed to work quickly and Rocco wanted to play of all things a couple hours later! He hasn't wanted to play tug in about 5 days so that brought a great smile to my face. This morning he didn't want to play so I was a little disappointed but his stool is better and he was grinding a lot of bone. The prednisone being cut down helped him sleep better and he didn't need to get up to pee for the first time since he began taking it. I can't wait for it to be phased out completely in 3.5 weeks or so.

Return to play!

Rocco had a rough morning. After calling the vet about his bloody stool and shallow breathing, we took him in. As usual, he was excited to see everyone and kept trying to lick the vet tech's face while she was holding him for the doctor. They had to take a stool sample by using a long swab and oh boy did Rocco hate that. He let out a few yelps and there was quite a bit of blood on the swab. The doctor ran some tests and said that there were no parasites, but some extra bacteria. Lungs and heart sounded good.

 

For the diarrhea, Rocco got an antiobiotic and a GI protectant. Also, he'll be getting some high-fiber soft dog food. The doctor thinks this is most likely caused by the prednisone, so we are going down to one pill a day over the weekend. As for the breathing issues, this is apparently caused by prednisone as well and should go away as the dosage is lowered.

But the great news is that Rocco wanted to play tug today! This is something he hasn't done since Sunday. Around 5 o'clock, he went over to his 'toy box' and looked up at it, which is his signal that he wants to play with his rope toy. We tugged for 10 minutes or so, but it was just so joyful to see him have the desire to play. We figure that he's probably been having an upset stomach for some time, and the medicine is helping already.

Thursday 3/26

Rocco seemed in a little better spirits this morning. He was chewing some bone and played briefly. He is having some issues with the chemo. His stool has been loose which the vet says is expected but today he had diarhea and Alicia said later she saw some blood in his stool. We'll be calling the vet in the morning. The other issue I think that is a problem is his rib cage seems to be puffed out. I don't know if this is from the changing of his food/diet. He is more gaseous and I wonder if that is all gas. I'll ask the vet what he thinks. I really don't like what the prednisone and the chemo have done to him. He is definitely not comfortable but he is hanging in there. He enjoys going on his walks and has a voracious appetite still. He still does his training and chews some bone. The vet said all his symptoms will go away once the prednisone/chemo is phased out. So I guess having him go through a rough few weeks will be worth it if he can get a year of being his healthy, happy usual self. His sister Havana doesn't know why Rocco doesn't want to play anymore. Well, that's all for now.....

First Chemo Treatment

Rocco had his first chemo treatment yesterday. Kevin took him in the morning and picked him up in the afternoon. Our vet is using the University of Wisconsin-Madison protocol which will last 25 weeks, with about 18-19 of those weeks requiring drug treatment. The other weeks are breaks. For the week prior to his first treatment, Rocco started on Prednasone which drastically reduced the size of the lymphnodes. From Wed to Mon, he was on 50mg a day. As the vet told us, this made him extremely thirsty, so he's been having to go out to pee more. The Prednasone seemed to make him less playful, but up until Mon, he was at least wanting to tug some in the evening. Mon was probably his worst day, as he moped around and seemed to want to be alone. We also noticed that he has not been yawning very much, something which he used to do all the time. 

When he went in Tues for the treatment, he had lost 4 lbs since the past week. We're not sure exactly why this is, but we have him on extra feeds now. The Tues treatment was Vincristine which disrupts cancer growth by affecting cellular reproduction and Elspar (L-asparaginase), which is used to get a quicker remission. The Elspar is apparently the strongest drug in the protocol and is only given during the first session. The doctor said the first week is usually the worst.  As of Tues, the Prednasone dose  is down to 35mg and will continue to taper off for the next few weeks. So far, we have not noticed any of the serious side effects of the drugs, although Rocco's stool is looser. The main concern is allergic reaction to the Elspar which luckily did not occur. 

Rocco's mood is not great; he doesn't want to do any playing, but he has been chewing a little more bone today which is good. And he still perks up for walks. As always, he was super excited to see everyone at the vet on Tues, but at home he is quite subdued. We are just monitoring him one day at a time and hoping to see progress. 

Getting the news

Last week we learned that our 4 year-old pit bull, Rocco, has lymphoma. We were absolutely devastated. Rocco is such a sweet, fun-loving boy that losing him was too much to take. Lymphoma is an extremely aggressive systemic cancer, and we were told that without treatment, he may only have a few weeks to live. The thought was absolutely incomprehensible, especially when Rocco was outwardly the picture of good health. The vet explained that chemotherapy treatment could give us another 6-12 months of good quality life with Rocco. We learned online that some dogs even make it 2 or 3 years in remission. Most dogs respond well to chemo with little side effects. That was extremely important to us since we did not want to put Rocco through misery just to keep him with us. We are keeping this blog for a few reasons - 1) to keep all of Rocco's family, friends, and fans updated on his progress, 2) to keep track of his responses to the various drugs in the treatment, and 3) to be a resource to others who may be going through a similar situation.