Category Archives: good days & bad

Kindness in the Waiting Room

From the Dog Cancer Blog

Kindness in the Waiting Room

kindness-dog-cancerA beautiful thing happened in my waiting room this week.

It’s pretty common for my oncology clients to chat in the waiting area during their pet’s chemotherapy treatment. This is helpful: new clients hear about the experiences of pets already undergoing treatment. They see happy wagging dogs coming back from treatment, and hear firsthand from the pet Guardian that there really are minimal side effects from chemo. The dog is enjoying his daily activities. The dog is doing so well, the Guardian forgets the pet has cancer.

This week Jack and Mickie were being treated on the same day. Jack is a bull dog with a high grade mast cell tumor (MCT) of this back leg that has metastasized to his sublumbar lymph node under his lower back spine. He was in only for his second vinblastine chemo treatment, and so far has had no side effects. Mickie is a kitty with a recently removed high grade injection site sarcoma. Mickie was also in for her second treatment.

(This blog is really dedicated to dogs, because cats are so physiologically different – but this story happens to be about a dog and a cat, and I have to share it with you, so bear with me.)

Mickie the cat came to me a few months back with a large infected and ulcerated tumor on her left flank. It was oozing pus. The tumor was so large, my surgeon and I knew we would not achieve margins with the surgery. There was no way to get a normal rim of tissue around the tumor, which is critical to prevent recurrence. Typically, four weeks of radiation is recommended for these connective tissue cancers after surgery, similar to the soft tissue sarcomas in dogs. But these tumors also have a higher spread rate, and so chemo is also recommended. As you can imagine, it’s very costly to treat these tumors in cats as they often need all three: surgery, radiation and chemo. Not only that, but I also diagnosed a urinary tract infection in Mickie.

Mickie’s mom could not afford all treatment options. She’s an elderly woman on a fixed income. But she explained to me that Mickie means the world: she belonged to her brother who had passed away.  She had to treat Mickie.

So she got the money together and our surgeon removed the tumor, which was good, because I was concerned the infected tumor could start to affect Mickie’s overall health.  No chemo, and no radiation, even though we all knew it was less than ideal to only do surgery. We didn’t get clean margins, as we feared … and these tumors typically recur in six months without clean margins.

Still, Mickie healed well after the surgery. And then, at the suture recheck appointment, Mickie’s mom surprised us by telling us she wanted to give chemotherapy after all. Paying for treatment would be challenging, but she had to do it for her brother. We reviewed the cost and side effects so she could be prepared. She scheduled the next treatment, but had to delay a week when she needed just a little more time to get the money together.

I love when pet moms want to treat cancer, of course, but I worry when to finances are such a burden.

But Mickie’s mother was determined, and this week found her at Mickie’s chemo appointment just as Jack’s mom came in to pick him up after his treatment. And of course, they chatted. I don’t think they were waiting for too long together, but it was enough time for them to get to know each other’s pet’s story.

This is the part that still brings tears to my eyes.

As Jack’s mom went over her bill with my nurse, she quietly asked to see Mickie’s bill, too. In addition to the chemo that day, and the routine complete blood count (CBC) we ran, there were also some charges for extra blood work and urine tests we ran for her early kidney disease. The bill was almost $700.

Jack’s mom paid for it on the spot. She left with Jack and said a warm goodbye to Mickie’s mom, but didn’t mention her kind deed. My nurse had a hard time keeping her emotions to herself, but she respected Jack’s mother’s wish to keep it quiet and tell Mickie’s mother only in private.

So, I had the privilege of telling Mickie’s mom. We both cried. That was a lot of money for her, and an amazing act of generosity.

Jack’s mother didn’t just help Mickie’s mother. She also helped me, by reminding me that in a world filled with random and inexplicable events like planes that disappear, horrific ferry disasters, devastating tornados, high school stabbings, and loved ones with cancer, there are still moments of generosity and hope.

Live Long, Live Well

Dr. Sue

About the Author: Susan Ettinger, DVM, Dip. ACVIM (Oncology)

Susan Ettinger, DVM. Dip. ACVIM (Oncology) is a veterinarian oncologist at VCA Animal Specialty & Emergency Center in New York, and the co-author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity.

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Diarrhea Help

Mosey had diarrhea often during his 9-month battle with cancer and I know it is a common ailment for all dogs. The following article from Healthy Pets provides many helpful tips to prevent, diagnose and treat. Please visit their website for additional resources.

What to Do When Your Dog Gets Diarrhea

by Dr. Becker

I think it’s time for another discussion on how to handle the problem of doggy diarrhea.

If you own a dog, chances are you’ve lived through at least one bout of doggy diarrhea.

It’s not a matter of if it will happen – just when.

When will your dog get diarrhea?

Knowing ahead of time the steps to take when your dog develops diarrhea or loose, watery stools can give you peace of mind when the time comes.

And as we all know, the time will come!

Causes of Diarrhea

There are a lot of reasons dogs develop loose stools. The most common reason is dietary indiscretion, which means your dog ate something she shouldn’t have. This was the cause of all the phone calls and emails to me over the holidays.

During the holidays, when people are cooking and hosting a lot of events that involve food, a really ripe environment is created for the ingestion of new foods dogs have not consumed before.

Sometimes it’s leftovers that cause GI upset. And sometimes, owners don’t even know their dogs have gotten into food.

That was the situation in my home, actually. My dogs were tearing open the garbage bags that we had put outside by the garage. They foraged all afternoon and into the evening on a feast of leftovers and we were clueless until we came upon the mess.

Many dogs spend much of their time sniffing around the house for morsels and tidbits anywhere they can find them, including gas grill grease traps, bathroom garbage cans, bird feeders, bird baths, ornamental ponds, and certainly the garden.

Another cause of diarrhea is a sudden change in a dog’s regular food. Also allergies to certain foods and poor quality dog food in general. I see a lot of kibble-related diarrhea in dogs.

Parasites like giardia can cause intermittent diarrhea. This microscopic parasite causes a wax-and-wane type of diarrhea that just pops up out of the blue. And about the time you think you should call the vet, the stool firms up on its own. You assume all is well – until another bout of diarrhea occurs days or weeks later.

Viral and bacterial infections in the digestive tract can cause diarrhea. So can certain medications such as heartworm preventives.

Even stress can bring about an episode of diarrhea in dogs and puppies. While you may think nothing very eventful is going on in your world, your dog can experience stress over even a slight change in routine. Suddenly you’re looking at a bout of watery doggy poop that seems to have come out of the blue.

Symptoms of Diarrhea (the obvious and not-so-obvious)

The most obvious symptom of diarrhea is when your dog is standing anxiously at the door and needs to get out quickly. Once he’s out he runs urgently to a spot and often passes loose, watery stool.

Or … you’re not around when the urgency hits and you find an accident on the floor when you get home.

A less obvious and often confusing symptom of diarrhea can be when your dog strains to go. It actually looks more like constipation than diarrhea.

Diarrhea upsets the normal rhythm of the muscle contractions in your dog’s intestinal tract. This can give him the sensation that he constantly needs to poop. So even though he’s hunched over and straining, his colon could be empty from repeated bouts of loose stool.

Other symptoms that can go along with diarrhea include fever, lethargy, malaise, loss of appetite, and dehydration.

Most healthy dogs experience an occasional episode of loose stool or diarrhea and it’s done – over with. It resolves all by itself. In this instance the underlying issue is probably something she ate she shouldn’t have, or perhaps stress was the trigger.

But any dog has the potential to become very ill from chronic bouts of diarrhea. Puppies, small dogs, and seniors are at higher risk of dehydration from just one round of explosive diarrhea.

It’s important to make sure that your pet has access to clean drinking water at all times, and encourage your pet to drink if you can.

When to Seek Professional Help

If your dog seems fine after a bout of diarrhea — meaning she’s acting normal, with normal energy – it’s safe to simply keep an eye on her.

But if you notice she’s also sluggish, running a fever or feels warm to the touch, or there’s a change in her behavior, I certainly recommend you contact your vet.

If you see blood in your pet’s stool or she’s weak or shows any other signs of debilitation along with the diarrhea, you should make an appointment with the vet.

If your dog seems fine but is experiencing recurrent bouts of diarrhea, you should make an appointment.

It’s important to bring a sample of your dog’s stool to your appointment, even if it’s watery. Use a plastic baggie and shovel a bit in there to take with you. This will help your vet identify potential underlying causes for the diarrhea.

Home Care for Diarrhea in Healthy Dogs

If your pet is an adult, otherwise healthy, and behaving normally except for the diarrhea, I recommend you withhold food – NOT WATER – for 12 hours.

At the 12-hour mark, offer a bland, fat-free diet. I recommend cooked ground turkey and plain 100 percent pumpkin.

Cook the ground turkey to remove grease and extra fat. And make sure the pumpkin isn’t pie filling, just plain canned or fresh cooked. If you can’t find plain canned pumpkin, substitute cooked sweet potato or even instant mashed potatoes.

This is a different bland diet from the traditional ground beef and rice combination that is often recommended. Even the leanest ground beef contains a lot of fat, and fat can worsen a case of diarrhea.

Rice, even though it’s bland, is very fermentable. Fermenting rice in the colon of a pet with diarrhea tends to increase gassiness. Also, rice tends to just zip right through the GI tract, exiting with the next bout of explosive diarrhea totally undigested.

Because of its large surface area (when compared to kernels of rice), many pets do much better with pureed pumpkin or sweet potato. Even through a bout of diarrhea, it is readily absorbed.

Mix the cooked ground turkey and pumpkin or sweet potato 50-50 in your dog’s bowl. Feed 2 to 3 small meals a day until stools are back to 100 percent, which should happen in about 72 hours.

My favorite all-natural anti-diarrhea remedy is an herb called slippery elm bark. I recommend always having some on hand so when you need it, it’s right there. You don’t have to run to the store.

Slippery elm is safe for puppies, adults, and geriatric dogs and it is completely safe blended with other medications. I recommend about a half teaspoon for each 10 pounds of body weight, mixed into the bland diet twice daily.

I also recommend you add in a good quality pet probiotic once the stool starts to firm.

Feeding a bland diet and supplementing with slippery elm bark is a good plan for about 3 days, at which time your dog’s stool should be back to normal.

If after 3 days the diarrhea hasn’t cleared up, it’s time to check in with your veterinarian.

MoseyLove!

Diane, Mose and Jasper

2.7.15

mosey and me

Chemo Side Effects Help

Mosey and Zola at Substance 3

Mosey has been back on Palladia for a full month. We received really good news yesterday…at our monthly check up with the oncologist we learned that, not only has the tumor not grown, the tumor has shrunk a tiny bit! We compared x-rays from December and then had the radiologist confirm. We are ecstatic as we did not dare to hope that the tumor would cease to grow for a bit…the icing on the cake was the shrinkage. So we are staying with the Palladia as we think this is what is causing the good prognosis. That means we need to deal with the side effects. Mosey suffers from very soft stools a few times a week. We also learned that there are increased levels of protein in his urine which means yet another drug to counter this condition. The following article from The Dog Cancer Blog offers valuable tips and advice for dealing with side effects from Chemotherapy.

Chemo side effects: What should I do?

by DEMIAN DRESSLER, DVM

 

Chemotherapy does have side effects that need to be considered.  About 5% of these will require your pet to be hospitalized, on the average, and there is a 1% chance of fatal reactions overall with chemotherapy.

Although I have not seen any published data, unpublished estimates on overall risks of any side effect are roughly 25-40%.  This means that about one in three dogs will have some kind of adverse effect, but it could be a mild one.

Some of these milder side effects include loss of appetite, vomiting, and diarrhea.  Other adverse reactions include lowering of white cells (leukopenia, which causes immune system suppression), heart damage, lung damage, kidney injury, anemia, blood clotting problems, liver injury, and others.

Of course, this is a summed list for many different drugs.  A given drug will not have all of these.  You should certainly be aware of side effects with all drugs but particularly Doxorubicin (Adriamycin), cyclophoshamide, prednisolone or prednisone, Lomustine, Palladia,  vincristine, L-asparaginase, and more.

You should ask your veterinarian or oncologist about the specific effects of your dog’s treatment, and what to watch for.

For example, keeping track of body weight is quite important during cancer care.  You may need to increase the amount of calories your dog consumes.  When muscle is lost, the amino acids loss in the body hinder the immune system and the lining of the intestine.

Similarly, it is also important to monitor your dog’s rectal temperature.  The reason for this is that a low white blood cell count can often lead to infection in the body.  Most commonly, infection will produce a fever.  Most chemotherapy drugs used in cancer protocols can cause low white blood cell counts.

If your dog is drooling or smacking his or her lips, it could be a sign of nausea or too much acid in the stomach.  Usually this means we need to temporarily rest the stomach, then go on a special diet, offer antacids like cimetidine, give ginger, and consider branched chain amino acid supplements to help restore stomach or intestinal health.

Keeping an eye on the quality of the stool is vital too.  Many chemo drugs will cause diarrhea.  If this occurs, your vet should also temporarily change to a highly digestible food, and consider using something to help with the diarrhea.  Slippery elm, pepto bismol, kaopectate, or other medications and supplements can all help.

The Dog Cancer Survival Guide has more information about what you can do to help with some of the more serious side effects by giving certain supplements.  Please consult with your veterinarian and the Dog Cancer Survival Guide for proper doses for your individual dog.

Best to all,

Dr D

About the Author: Demian Dressler, DVM

Dr. Demian Dressler, DVM is known as the “dog cancer vet” and is author of Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity. Visit his blog and sign up free to get the latest information about canine cancer. Go to http://DogCancerBlog.com.

MoseyLove!

Diane and Mose

2.26.14

mosey and me

How much activity is appropriate for my cancer stricken dog?

I saw this post a few weeks ago and it was perfect timing. Mosey was just recovering from a few really bad days…so bad that we actually had made an appointment to send him over the rainbow bridge. Earlier that week, when he was happy and active, we were at the park playing his favorite game of catch/retrieve with a tennis ball. After the bad days were over, our vet said that perhaps we had overdone the exercise. Imagine my guilt…I thought playing and exercise were good things. The advice and tips below came directly from the Dog Cancer blog:

Enhancing Life Quality for You and Your Dog with Cancer: The Joy of Play

by SUSAN HARPER

play-for-dog-cancerWe love it when our dogs want to play. The repeated nudges and insistent offers of their toys are charming, aren’t they?

Just like us, a dog who doesn’t feel well may go through periods of not wanting to play, or being too tired or not physically capable of regular play. Responding to surgery, chemo or radiation treatments, and just the exhaustion of the emotions and perhaps the tension of vet visits affects them, just as it does us. Even our wonderful senior animals, with or without a cancer diagnosis, may appear to be “past” the playful stage of their lives.

We can get so wrapped up in the drama of their situation that we may over-encourage rest and quiet.

“Don’t use your energy, Ziggy.”

“You’ve got to rest and heal, Oreo.”

It’s so easy to forget how important — and actually healing — play can be for us all.

Using Joy to Heal

In The Dog Cancer Survival Guide Dr. Dressler has included valuable information about dealing with our own emotional state.  Our dogs are so sensitive to our moods, the last thing we want is for them to take on our depression or worry.  We need stress relief and joy; our dogs need stress relief and joy.

Your Dog’s Job Is Joy!

In addition, our dogs want something to do. A job. A purpose. Play fulfills this need beautifully. Here are some suggestions to modify the usual games for our recovering pets, and bring back the joy for us both.

Ball Fetch: My boys and girls spent their youth flying down hills and across fields to get the prized tennis ball.  When my senior could no longer walk I discovered he still loved that ball:  I just had to change the game.

I’d sit in front of his bed and tempt him with the ball.  As the temptation grew he’d follow my magician’s hands. Where’s the ball?  I’d bounce it in front of him, closer, further away, closer again. When he started reaching for it with open jaws and bright eyes I aimed the bounces to land just in front of his nose.  He’d catch it and chew with complete joy, then spit it back at me for another go.

Involving my family in ‘keep away’ teasing added to the fun and within minutes we were laughing and my dog was thoroughly enjoying his ball again. It didn’t matter that he hadn’t chased it.  He’d caught it, and the prize was his!

Puzzle Toys:  The pet industry is full of great choices in puzzle toys these days.  Everything from balls in which you can hide treats like the Ethical Contempo Halo Food and Treat Dispense for Dogs, to Nina Ottoson’s Interactive Dog Toy and the Ethical Pet Seek-a-Treat- Shuffle Bone Dog Puzzle.  You can find these and many variations, and we’ve listed a great selection in the Dog Cancer Shop.

The secret to all of these toys, though, is that you play with your dog.  Our busy lives are such that we’re used to handing over a toy and walking away. How much better is it to play the puzzle with your dog? Add your excitement to hers as she wonders where the treat is?

Find-It Games: ”Find-it” doesn’t have to be a high-speed chase game outside.  Simply playing “which hand” adds a dose of joy to the regular “here’s your treat” action.  Showing the treat, then hiding a few in another room and taking your dog in to look together is easy and fun.  Don’t hesitate to ask for the old bargain, a ‘speak’ for a treat or a ‘paw’ for a treat. They love to be involved.

Tug and Tussle: It doesn’t need to be rough play, but this variation of keep-away gets their juices flowing and tails wagging.

Food Games: My dog loves his food, and we hand-feed because of his throat surgery. A few months ago I found myself in a routine.

1. Make good food.

2. Feed good food to dog.

3. Done.

I was just feeding spoon after spoon like a robot.  It was time for a wake-up call!  No longer did the food simply appear before his mouth. Occasionally I would present it just near enough that he’d reach for it.  Or I’d offer it higher, or lower than before, or circle it round his nose. Where would the food be next?

He became more involved and more interested because I was more involved and interested.  He got back at me, too, when he wouldn’t let go of the spoon. Who says dogs don’t have a sense of humor?

Licking and Chewing: Dogs release tension through their jaw, and we know how much our pets love leisurely licking their paws or a nice treat. Using a Kong, or a kong-like toy is a great way to give them long periods of content.  Fill one with a little bit of healthy peanut butter, honey, or some of your own healthy, pureed food that will stick to the inside.  If your dog cannot hold it for any reason, join in and hold it for him.

You can also make tasty ice-licks. I take the chicken broth from my cooking, fill very small saucers and freeze them.  My dog loves licking the tasty, cold treat.  However, don’t leave them alone with it …  once the ice is gone he may forget that the saucer isn’t edible!  Chicken broth ice cubes are also a great treat, and frozen treats are easy to make and keep.

Laugh:  Finally, I found a wonderful and surprising resource; Laughing Dog.  The website explains how dogs vocalize when they are happy, and gives a brief demo on how to mimic their laugh.  Other resources are available along with the research that went into the development.  I regularly laugh with all my dogs, and you know what? They laugh along with me.

These are just a few suggestions to try. And here’s another: remember to bring variation into the environment too. Move your dog’s bed around with the sunshine, because the vitamin D is so important for them. If your dog is often confined inside, wrap her up and take her out.  Go for short drives. Sit on the floor together while you watch TV. Share a bowl of popcorn. Offer different bedding options. Take a nap on the floor with him.

Don’t just tell him how much you love him, tell him how happy you are that he is your dog.

Now’s the Time:

I’ve spoken to so many people who feel as I do; that this journey has actually brought me closer to my dog in ways I hadn’t considered before.  Enjoy the moments. None of us know what’s ahead, but it’s really not as important as this moment, right now.  So thank you for reading, and I hope this helps.

Now get off your computer and go play with your dog!

Happy tails!

About the Author: Susan Harper

“I’m a member of the Dog Cancer Support Team & a Dog Cancer Survivor! Two of my beloved dogs have had cancer, and with the Dog Cancer Survival Guide, Apocaps, and full spectrum help given with boundless love, Shadow lived 10 times longer than his prognosis, and Keymos triumphed, cancer-free for nearly 4 years, passing over peacefully in our arms at the age of 16. As a Member and Assistant Teacher with the Healing Animals Organization (MHAO) I’m passionate to help dogs and their people get through this journey. Early on I asked the Team how I could help, and here I am.”

Thank you Susan…This really helped.

MoseyLove!

Diane and Mose

2.16.14

mosey and me

“Good Times, Bad Times”

“you know I had my share” Led Zeppelin

maddie, mo and me 11.2.11

 A miracle happened! My husband and I woke up yesterday morning prepared to send Mosey to the angels. He had been listless for the past three days and  yesterday refused food. (If you have ever had a Golden Retreiver you know this is a major warning sign.) We thought it was time…cried all night..and first thing in the morning I phoned our vet to tell her what was going on…get her opinion..and schedule the appointment for last night. The vet was in emergency surgery and I was told she would phone as soon as she could.

Crying, I hugged Mosey, told him I loved him and that I did not want him to suffer. I told him to give me a sign if he was not ready and the sign was to eat something. He had not eaten anything for 36 hours. He spent all morning sighing and/or sleeping and refused food. The vet finally phoned around 1:00 pm. I told her what was going on and she said that she wanted to see him, but that it was probably his time and we agreed to meet at 5:15 pm to send him over the Rainbow Bridge.

I swear to you the second I hung up the phone Mosey stood up…went to his water bowl and drank almost the entire thing. Then he walked over and gave me the Golden Retriever look that says “feed me now!” He ate an entire can of food. (I have been giving him Taste of the Wild along with all the fresh stuff) Prior to this he would turn his head away when I tried to feed him. Later that afternoon he ate some chicken and, while he was not back to normal, was much perkier than before. We went to the vet anyway so she could check him out and he went prancing into her office begging for treats. I swear it was like he heard me making the appointment to end his life and said “Hey Mom..Simmer down, I am not yet ready to go!”

Do you believe in miracles? I do. The vet prescribed prednisone and agreed it was not his time.  She cautioned us that this horrible roller coaster would continue with semi-good days and really bad ones…but said Mosey is a fighter and is not yet ready to say goodbye. Today he is eating, drinking and seems happy. I don’t know how long we will have him but, since I thought I would be without him last night, every future day is a gift.

This roller coaster ride is sad, scary, exhausting, joyful at times, and incredibly stressful. I will take it if it means I will have my sweetpea a bit longer. I have joined a number of support groups for pet cancer on Facebook and many, many people have shared experiences similar to this. With 1 in 3 dogs getting cancer in their lifetime my story, sadly, is not unique. But, hopefully, it will help others going through this for the first time.

MoseyLove!

Diane and Mose

1.25.14

mosey and me

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