Ways to de-stress...

On a Friday night.

Improvement! Day 5

I emailed the clinical trial tech at MU for an update on Linus:

Dear MrsLacubrious,

I was just down in ICU looking at Linus, he seems to be doing much better today. His temp is down to 102.8, he is still ataxic, but not nearly as bad as yesterday. He pulled Lorie around this morning when she took him out for his walk. He did tolerate the rest of his plasma transfusion. I think that the worst is behind us. I will check with Dr. Selting when I see her this morning about repeating a CBC on him today to see if his platelets are rebounding yet.

He is sleeping like a baby now. I’m sure he’s exhausted he had a bad day yesterday.

I’ll keep you posted on how he’s doing.

DT



*******UPDATE FROM LORIE***********

Linus was alert and walking although still somewhat wobbly. He went outside and did his "thing". They gave him his medicine wrapped in some ham which he took but when they offered him dog food he turned away. So they fed him Vienna sausages! He ate those but later on vomited, probably due to the sausages! He's not used to that type of food! Anyhow, they're going to continue giving him fluids and monitor him overnight. The neurologist still see that he has some neurological deficits but he is brighter and more alert than yesterday so we're hopeful he'll continue to improve.

If they release him tomorrow we're considering just going up to Columbia and staying Saturday night and Sunday night so we can cut out some driving and be ready to take him back in on Monday for his clinical trial evaluation. It would be nice to bring him home though if even for a little while...


*******ANOTHER UPDATE FROM LORIE***********

So Linus just went outside again and seemed to enjoy the nice weather for awhile but eventually stopped walking and just stood in one place. They gave him something called Cerenia to help control the nausea. They plan on offering him food again at 5pm. Then they will monitor him this evening and run more blood tests in the morning. I emailed Debbie Tate, the clinical trial coordinator, to let her know that soft foods are what we had Linus on this last month. So now he probably prefers them. The ataxia is still present. Lorie said he walks like he's drunk which fits in nicely with our crowd (LOL). Seriously, we hope that the ataxia will wane as he gets better and is certainly something we can cope with.

Update on Linus's return to ICU

MU called and Linus's fever is down to 104.1 but he had an allergic reaction to the plasma tranfusion. So it was stopped while they treated him with benadryl. He still has no appetite but they're hoping after the itching and facial swelling subside he will feel like eating.

In an earlier call we were told that he is anemic and low on protein. So tranfusions would be needed. A call to NIH was made and the study manager indicated that these low numbers did happen in other animals on the trial and that they had recovered.

The thing to watch for is something called capillary leak.They will recheck his bloodwork in the morning and once his temp has come down to normal they will reevaluate his neurologic response namely the weakness in his legs (ataxia). They plan to do a spinal tap to rule out some things.

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Back at the University :( - Day 4

Linus had to be taken back to MU since the fluids were not helping the fever enough and he started showing signs of ataxia. First in rear limbs then in his front limbs. I had to lift him out of the car at MU but couldn't get him to walk so I carried him into the clinic.

Bad night...

Well Linus spiked a fever of 106.3 so we had to take him for an IV at Sullivan Vet Hospital! I called the emergency service and they paged Dr. Kat Stuart. She met us at the clinic at 1am and was ready with the IV. We first tried it in his already shaved leg up on the table but it got pulled out. So she suggested he may be more comfortable on the floor so we moved down there and I held him on my lap while she shaved his other leg and started the IV. He was very quiet and just laid there.

She pushed the 1st 100 ml in within the hour then dialed it down for the rest of the night. Since we had no way to confine him we opted to leave him at the clinic for the night and check on him in the morning. Dr. Stuart was going to call MU first thing to give them the info on his status.

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Linus is home! Day 3

Linus is home and recovering from his treatment and testing. He slept most of the way home and has been pretty lethargic. I gave him his antibiotics (clindamycin) and pain meds (tramadol) but he hasn't had any appetite this evening although he has been drinking water. We're going to monitor him and hope he perks up in the morning.

This video shows where he had his neck shaved for the jugular cath and also where his front leg was shaved. I took him on a short walk down the block hoping he would perk up a bit and maybe eat some dinner. As you can see he's fairly alert.

Evening update #2

MrLacubrious took this evening's phone call from MU since I was at an appointment. He found out that Linus was treated with NHS-IL12...but we don't know if he is having any response to it yet. They said he was eating fine and doing well. We're supposed to pick him up any time after 10am tomorrow.

Morning Update - Day 2

Jen from MU called this morning to give us our update. She said that Linus was bright and energetic this morning and excited to go outside to do "his business". He's handling the treatment just fine and is not even bothered by the catheter and in fact was up and barking in his cage! I told her that can't be good for ICU but she said that they like to see that energy. Jen wasn't sure which drug he ended up with or when he will have the catheter removed but said she would find out and call us this evening with that information.

Speaking of energy, here's a pic from the time that Linus destroyed "bobo", his stuffed dog toy!

Evening update...

Well we did not get our phone call about Linus so we decided to call the emergency line and see if we could get in touch with someone who would give us an update. We were patched through to the vet tech in charge of the clinical trial. She told us that Linus was just chilling out in the ICU. He had been sedated, cathed, and received his treatment. He didn't seem to mind the blood draws from the catheter but he was not becoming a fan of the rectal temp check! Other than that she said he was being a good patient and we should be proud of him. So good news so far. We should get another update tomorrow then pick him up on Wednesday!

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Morning update...IL-12 Injection Day 1

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Originally uploaded by dehmystic

Jen Wolf called from MU Vet School to let us know that Linus had a good night and was alert and in good spirits this morning. He was walked and went potty normally.

The plan for the day was to sedate him for the jugular catheterization (ewww) and inject the clinical trial meds. She promised to call around 5pm to give us an update on his status. She also confirmed that he will be in ICU until we pick him up on Wednesday.

WE miss him!

Yesterday I took him for a walk with Baby so he would be calmer for the ride. We headed out around 3pm to take him to Columbia and we stopped to buy him a plain hamburger (minus bread), which he LOVED! He even licked the wrapper! Then he settled in for the ride. We got delayed by a motorcycle accident on Hwy 47 just past Marthasville but I made up the time on the Interstate. (I will not tell you how fast I drove!) We ended up 15 minutes late but it was fine. We signed the Hospitalization Agreement and resuscitation authorization. Then they took him away. DH and I got the heck outta there before we put too much thought (tears) into it, headed to Flat Branch for a couple of beers and a snack then out of town and back home to Baby.

dogs0034_NI
Originally uploaded by dehmystic

Girls Night Out

A drink special by Grady, bartender #1.....the Grady-Licious

A drink special by bartender #2.....Brass Balls

Committment...

Having a pet is a long term commitment. At some point you have to deal with the reality that pets don't live forever. However, neither should they be viewed as disposable when a health issue crops up. This is why we are trying to do what we can for Linus and treat his melanoma so he can live his life fully.





As I stated before, we decided to take Linus to the Missouri University Veterinary School in Columbia, Mo. Per their website, the visit was just what we expected. Jen Wolf, Senior Level Student came out to the waiting room to take a history on Linus. Then when they were ready we took Linus to an exam room and Jen checked him out from head to tail. After that, she went to get Dr. Alix Partnow and review the history with her. Dr. Partnow came in and she examined Linus herself, and went through all of our possible options, explaining things as she went and as we asked questions. What they needed to do before anything was to "stage" his tumor, meaning they needed to know if it had spread anywhere else or if he had any other type of masses or health issues. The meant we had to leave Linus there for a few hours while they ran blood tests, aspirated his lymph glands, xrayed and ultrasounded his body (they shaved his belly!) and performed a urinalysis.

We were told to return at 5:15pm to pick him up, however we got a call at 4pm telling us they were done and no other masses or issues had been found! Good news! So we headed back to the hospital to get him and figure out what to do.

Jen Wolf, Dr. Partnow and Dr. Sandra Axiak, the oncologist, all met us in the exam room to discuss the choices for dealing with the tumor. It was news to us that the bulge he still has on his gum line is a tumor. It grew back that fast and I do not think the Vet in Sullivan was aware of this. In fact, I'm sorry we put him through that first surgery because I do not think it did any good other than giving him a tiny bit of relief for only a week.

Basically, the choices now are:

--Do nothing and watch the mass on his gum continue to grow until it affects his eating, metastasizes, and impacts his life.

--Enter him in the Clinical Trial NHS-IL12-IL2 or NHS-IL12 Immunotherapy for canine melanoma.

--Treatment with the human DNA (tyrosine) based melanoma vaccine.

--Surgically remove the tumor and surrounding tissue and bone in hopes of getting all the tumor cells out. Radiate the area for 4 to 6 weeks.

--Debulk and laser the tumor and surrounding tissue and bone. Radiate the area for 4 to 6 weeks.


We decided to try the clinical trial for several reasons;
#1 It's least invasive, although not entirely pleasant for Linus.
#2 The entire cost of that treatment is covered by the study.
#3 We can turn to the other solutions if it doesn't work within 3 weeks.
#4 Linus has a chance to leave a legacy of contributing to science and a cure.
#5 Linus's tumor tissue sample will become part of a tissue bank regardless of success. Canine Comparative Oncology and Genomics Consortium (CCOGC)
#6 We just aren't ready to put him through surgery again so soon.

So here's what is in store for Linus (and us) over the next 5 weeks...

Week#1 - Drop Linus off at the hospital on Sunday, July 26th. On Monday they will shave his neck and insert a "port" for blood draws. He will then be given either NHS-IL12-IL2 or NHS-IL12 and then his temperature and blood will be monitored according to a schedule over the next 2 days while he is in doggy ICU. We will pick him up midday on Wednesday and we will need to take his temperature daily for five days and report it on a special form. We can expect him to be lethargic and not quite himself due to the immune system response.

Week#2 - The following Monday, Linus will need to be brought in for more bloodwork, fine needle aspiration of the lymph glands, and biopsy of the tumor. The tumor size will also be measured to see if there is any response to the immunotherapy.

Week#3 - Repeat of week#2. If there is response we continue. If not we stop the trial and discuss other options for treatment.

Week#4 - Repeat of week#3

Week#5 - Repeat of week#4 and evaluate 28 day regimen.

So, this is the plan for now. I know some people wonder if we are putting him through too much but honestly he still gets excited to get in the car even though his last 3 trips were to be poked and prodded. That tells me he has no lingering effects from his medical treatments.

Last night we came home to find our chain link fence completely installed! We put both dogs out there and even got Linus running around and chasing the tennis ball a little bit. So he's all about living in the moment and we're all about making sure he has as many moments as possible.

Linus in Columbia

Linus is spending his afternoon at the small animal hospital in Columbia getting bloodwork, FNA, xrays and lord knows what else! We're supposed to pick him up at 5:15pm and they will give us the lowdown on treatment options. Most likely he will have surgery again to remove more tumor plus possible jaw bone in an effort to get all the abnormal cells out. The doctors also noted that his lymph gland on that side of his neck is a bit larger than the other side so they'll aspirate to see if there are any melanocytes in there and determine if it is spreading. I really wish I had brought him here first as they seem capable to do a full workup on him.

*****UPDATE*****

Linus has been accepted to the clinical trial of IL12 or IL2! More info to follow.

Melon Martini From Last Night!

Holistic Options

So today Linus had his appointment with Dr. Frick to discuss holistic
options for treating his melanoma. She had two things to consider
neoplasene (bloodroot) and cats claw. BUT she recommended holding off
until after our consult at the University on Tuesday. She thought that
if Linus gets into the study then they would not want him on any other
treatments.

She did identify some pain in his hips and we got some muscloskeletal
complex and an herbal analgesic plus cod liver oil. So we will start
on those and see if that helps his allergenic paw licking and his hip
pain. He does pant a lot and that can be a sign of pain so I'm hoping
to see a reduction in that as well.

Fixin the feedback

So we headed to another Javi show at LaGra. Only this time MrJonez was
armed and ready with WD40. Why, you ask? Because every time we've been
at LaGra the kitchen door squeaks in tone that sounds like feedback!
Ugh so MrJonez brought the juice to fix the problem and ensure a
squeak free evening ..... Awesome!

Vino Rojo

Mmmmm vino crianza tempranillo...

Mad as a ...

This is what was left AFTER the powerwasher guy accidentally hit the nest, got chased by hornets, then came back and doused them in chemical poisons.



This was a nest of Bald Faced Hornets. Which, according to Wikipedia, is not a true hornet but more related to the wasp and yellowjacket family...whatever. We've watched them building the nest for a bit and I was planning to get them one night with chemical warfare while they were sleeping and we had a more time to hide from their wrath. Either way they're in insect heaven now.

This is pretty much what it looked like BEFORE...only on ours the entrance to the nest was at the bottom. Picture: Copyright 2005. Jason Edgecombe

Change of plans...

On the advice of our vet, I called/emailed the Veterinary School in Columbia, Mo. I thought that the least I could do was find out about the clinical trial and see whether it would be an option.

What I found out is if Linus doesn't have a tumor that they can monitor then he probably won't qualify. I did find out that we would have to pay for the initial workup ($300 - $400) but if the dog is accepted in the study then the associated costs are covered which would be wonderful.

We've decided to take Linus up there for a review of his situation and just see what they say. I cancelled our local oncologist appointment for Monday and instead I'll take Linus up to Columbia on Tuesday.

I did call the local oncologist office just to get an idea of the expense...The vaccination is $525 and there would be 4 of them, one every two weeks. This brings the cost to $2,100 not including any workup, xrays, etc....so that is something we will need to think about.

It might just be that we will have to wait for the melanoma to become visible as another tumor before the University will accept him. Though delaying treatment doesn't seem a wise choice either.

On another note I received the copy of Linus's lab work and pathology report. His bloodwork suggests that he may have an iron deficiency. NO ONE even mentioned this at the vets office so I'll bring it up at his holistic vet appointment on Saturday and see what we need to do there. I guess I need to feed him some raw meatballs or something!

Linus Update

They checked him out at the vet today and couldn't see any signs of
infection and said the site is healing fine. They gave us clindamycin
to treat the invisible infection and hopefully improve Mr. Stinky's
breath! OMG the dog breath!

After staying at the vet all day and then getting meds and a two mile
walk ole Linus is beat!

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