Casey's Tale
Casey gets his first post-amp X-Rays today. We’re hoping for good news, but a little nervous in that 12 days passed between his diagnosis and amputation. With clear X-rays, it will be off to the oncologist for chemo round 4 tomorrow.
Otherwise, he’s doing great, and gets really irritated when we try to coddle him. He says c’mon . . . let me be a dog. Hard to argue with that.
Oh Yeah! Just back from the vet. Lungs are clear!
We’re off to the oncologist today for Casey’s third round of Carboplatin. He is tolerating it well with no significant side effects noted. We did a CBC Friday, two weeks after his second round, and that was normal (I understand Neutrophils bottom out at 13 to 14 days, so that’s why we tested then). Today we will discuss increasing his dosage. After some research, we’ve learned that there is a dosage range calculated as a function of body area as estimated by weight. Casey is a tripawd Golden Retriever at 55 pounds, or 0.85 sq. meters of body area. His first two rounds were at 200 mg/sq. meter. The oncology center where we hope to pursue the osteosarcoma vaccine prefers 300 mg/sq. meter, or 50% more. In that Casey tolerated his first two rounds so well, we hope to increase the dosage and stretch the frequency from every other to every three weeks. That will lead right into the vaccine study in mid to late April.
At diagnosis, almost eight weeks ago now, his vet gave Casey two months on the outside (without amputation). When we stopped in for the blood draw, she watched his roundhouse tail wags and said “I smile every time I think of how well Casey is doing.” So do we.
It’s looking like Casey will be included in the osteosarcoma vaccine extended field trial expected to start in late April. He needs to complete his Carboplatin chemo and be free of lungs mets, so our fingers are crossed that everything continues as it has. Next X-rays are about three weeks out, so . . .
This question is perhaps better posed in the forums, but for those of you who used Carboplatin, what was the dosage per meter squared and frequency, 2 weeks or 3? Casey had his second dose at two weeks, and depending on blood count, will have his third 19 days later. I’m thinking of just moving him to a 3-week schedule after that as it dovetails nicely with the expected vaccination cycle.
Soon after his diagnosis, Casey started shedding. Now, Goldens shed, but this was ridiculous. We were covered in fur. Not clumps, but individual hairs. The vet explained that this was stress shedding due to the combination of his pain and the cancer, and Casey was in distress. It was amazing how his condition had deteriorated in the week from his diagnosis, even with tramadol and Rimadyl. You could see it in his eyes, and the way he would hold his sore foot out to us asking if we could make it better. Little did he know what was coming.
After amputation, there was discomfort from the surgery and the incision, and it was awkward getting around, but Casey was doing okay. He only yelped or whimpered when we picked him up or moved him the wrong way, and that seldom happened. We used the topknot on his T-shirt to support him, and that bore the weight just behind his incision and in front of his plumbing. We’re two days past surgery, and figuring things out. I sat with Casey and explained that we’d made the big hurt go away, and while that hurt was just going to get worse, this new hurt was going to get better.
The next day, we realized Casey had stopped shedding.
Here’s Casey the Pirate, A-Day +2.
Casey was pretty zonked, and made it through that first night without issue. He slept in Jake’s bed, penned into a corner, and I slept next to him on the couch. The vet was right, and Gabapentin is powerful stuff. Now, we had to learn how to deal with a TriPaw. How do we maneuver this (now) 53 pound dog and help him to his feet? I carried him outside and stood him up for the first time with a long pillowcase under his abdomen for support. He was able to urinate and we carried him back in, offered him breakfast which he refused, and elevated a water bowl on a stool. He drank heartily and got his first cupcake with sprinkles. This was a little square of bread with peanut butter, topped with 200 mg Gabapentin, 100 mg tramadol, and 50 mg Rimadyl. He gobbled that down, put a T-shirt on, and it was back to his corner. He didn’t really move all day, but at dinner time, I carried him out with his brothers while Ann put out kibble. Casey came in and ate his normal portion, had a drink, ate another “cupcake”, and went back to bed.
He never demonstrated acute pain, but he did pant at times, telling us he was uncomfortable. Still, he was resting easily with occasional stirring, and as the night progressed, I carried him outside to take care of business, and when we came back and I lied him down, he worked his way up into a sitting position for the first time, and looked out the window. He was in dreamland, in the glow of the Christmas lights, watching the snow flurries through the blinds. He sat there for over an hour, wondering what the heck had happened, and what his new life was going to be like. He’d been a Tri-Paw for just over 24 hours.
