Tuesday, September 27, 2016

Update on Kirby's Cancer

Kirby at the clinic
On Thursday the 22nd we took Kirby to see the oncologist, Dr. S. It was our first visit to Veterinary Specialty Services, a clinic filled with board-certified veterinary specialists. So basically every animal that comes in there is in some sort of a crisis situation. I filled out the paperwork, and we had a short wait before the vet could see us. We found Dr. S. to be a no nonsense type of person, but with a wonderful bedside manner. We discussed Kirby's surgery and the pathology reports, and she suggested doing an ultrasound to see if there were any additional tumors in the belly area. If he was loaded with tumors then followup treatments would not make sense. We agreed that was a good starting point.

They took him in the back, shaved his tummy and did the test. It was questionable whether they would have to put him under for the ultrasound, but in the end a muzzle took care of the issue. We met again with Dr. S., who said that the good news was she did not see any new growths. She also did a needle aspiration on a lump on his leg, and that was just one of the many fatty growths he has on his body. Her recommendation was to do chemotherapy, whether through pill form or IV. That would be up to us. She explained that she hates mast cell cancer because it is so unpredictable, and the fact that he had it in a lymph node was very troublesome. We discussed the pros and cons of the pill versus IV therapy, and honestly my biggest concern at the time was that the pills are very dangerous to humans. You have to wear special gloves when you handle them. It makes sense to me to have them administer the IV in a controlled setting where they know what they are doing. The treatment would involve going in once a week for four weeks, and then every other week for four additional treatments. So three months, essentially. The pills, on the other hand, would be administered every other day for three months. Whichever way we go, Kirby's saliva, urine and feces will be toxic to us and other animals, so we'll need to exercise caution with that. His immune system would be compromised either way, and he would not be allowed around any other animals. Not even at the groomers.  After further discussion, we set up the first IV treatment for the next day, Friday the 23rd.

At 4:00 in the morning on Friday, Jim and I were both wide awake and fretting. I could not stop crying, worrying about whether or not we were making the right decision. We finally decided that if we were both concerned, then we should listen to our guts. We are not impulsive people who make major decisions without looking at all the facts and options, and I think that was part of the problem for us both. I called and cancelled the appointment, and asked for Dr. S. to call me. She returned my call a few hours later and answered all of my questions to the best of her ability. Basically, mast cell cancer cannot be cured. It will come back in Kirby, so it's not an "if" but a "when" situation. What you are hoping to accomplish with chemo is to destroy or disrupt the mast cells that have gone rogue in his system. Unfortunately there are no good statistics to help with the decision. It's not like she can say if you give him chemo, he can live for another 2-3 years. Or if he doesn't get chemo he will die in 3 months.  If he was five instead of going on eleven, that would make the decision easier.

We have since talked to a couple of people that worked in clinics that treated dogs with cancer, and they both said most dogs handle the chemo better than a people do. But all I can think is, if he is one that gets really sick, how in the world do I get his toxic waste out of hardwood floors and tile grout? Would he have to be kept in a kennel? Can we even take him on any walks if his waste is hazardous to other animals?

Lots of questions and no easy answers. At the moment, we are doing nothing other than keeping him on the medications he has been on since surgery - Benadryl twice a day, a Pepcid AC cut in half twice a day, and an Apoquel once a day. The mast cells release too many histamines in the body, causing itching and a chance of damage to the stomach lining, so these drugs help to keep that in check. I am taking him tomorrow for his grooming, which we do every two months and he is due for that. And Jim's parents want to see Kirby while he is still feeling good, so the two of them are going to do a road trip soon. Then we'll have to make an executive decision on which was to go. It is hard because Kirby has no say in this whatsoever. What decision would he make???

1 comment:

Mrs. Wryly said...

He would say he does not want to suffer and an aspect of that is he does not want to see you suffer. Either way, he does not fear his fate and he is trusting you to do what is best for him as you do not want him to suffer.

Clear as mud.

I think you did the right thing by cancelling the chemo. How can you snuggle and hug him if he's toxic? He would be confused by the new rules, and that would be a heartbreak in itself.

Cyberhug to you; I'm so sorry this is happening to your sweet little guy.