Thursday, September 24, 2009

Sometimes wanting validation is too much

First off, I'm sorry for the delay in posting Baxter's results for those of you who have been following me via twitter. My satellite was not connecting, thus, I could not get online. It was probably the best case scenario anyway and allowed me to catch up on some much much needed rest.

It's been a pretty rough week, and it's only Thursday! I took Baxter to U. Tennessee Vet Animal Clinic on Monday morning. There, the vet did a full work-up, including a neurological exam,
bloodwork, a chest x-ray, and an EKG. All of these were WNL (within normal limits) except for one abnormality in his EKG which was inconclusive without a 24 hour Holter monitor. We both agreed that his seizures were probably not related to anything cardiological.

The vet wanted to run an MRI of his brain which unfortunately could not be done that day. I was going to leave Baxter there overnight and drive back, but he got super stressed and began having difficult breathing. He does this at vets' offices, but last time and this time appeared to be worse. The vets at the clinic were really concerned and stuck him in ICU with oxygen and eventually gave a sedative. Poor guy! We both agreed it was best to take Baxter home and drive up the next morning. I had already been there almost 6 hours, then had a 3+ hour drive back, so I was super exhausted already.

The next day, I had to leave at a crack of dawn 5:45 AM to make it there by 9 AM. The vet decided to do an upper respiratory exam first due to his breathing issues. There, they
discovered he had an elongated soft palate, typical of any brachycephalic dog, his was just 2 mm longer. I agreed to add a scan of his airway with the MRI of his brain. That scan showed no mass in his trachea (worried there might have been since they had a difficult time with the Endotracheal tube), just inflammation and edema surrounding his trachea.

The MRI of his brain, however, was a different story. It showed there was indeed a mass there in the left cerebral hemisphere. There are two options of what it is. It is either a
glioma, a brain tumor arising from the brain cells themselves, or it could be edema post seizure. The scan was not definitive of which one, but it points more towards a glioma. There was no change when they added contrast and the mass is unilateral which is uncommon for just edema. The only way to know for sure is to do a brain biopsy. He is scheduled for this next Tuesday.

In the meantime, he has been placed on a short course of
prednisone to reduce swelling and an anti-convulsant, zonisamide. We're only trying the zonisamide for a week. It is rather expensive, so I may have to switch to something else.

So things are still a bit up in the air without the biopsy. I know many people do not go to this length as
MRIs on dogs (same price as humans) are expensive, but for me, I have always been the type to "need to know." Plus, I want to know what I'm dealing with as well as placing the best possible treatment for my dog. I'm sincerely thankful to my parents for helping me out financially, as I would not be able to otherwise.

Since Tuesday, there has been many tears shed, simply because if it is a
glioma, his days will be numbered. Gliomas vary in range from low grade, slow growing to high grade, poorly differentiated malignant tumors. The factors of life span vary greatly from the type of tumor to the location to the treatment used. For some dogs, it's literally days after diagnosis, for others it can be 12 to 20 months. It's very hard to say.

I have decided if it is a
glioma, I'm going to try to enroll him in a new experimental treatment out of U. of Minnesota. It is using surgery, gene therapy, and vaccine therapy. Basically, surgery would remove as much tumor as possible, gene therapy would attract immune cells to destroy tumor cells at the surgical site, and an anti-cancer vaccine from the dog's own cancer cells would be given. So far, this is really promising with 9 or so dogs all having reduced or disappearance of the brain tumors. If he is eligible, then almost all costs would be paid. Not only is this study looking at dogs, but points towards implications for humans with brain cancer as well.

In the end, I know whatever treatment option I choose, is essentially prolonging life, as this can be treated but not cured. If Baxter was in poor health, I doubt I would go to this much length. Other than this, his
mast cell tumor, and an indolent ulcer in his eye seveal years ago, he has been very healthy. Now, I could be completely wrong in that it is a glioma, which in that case points towards "idiopathic seizures." But in any case, I still feel like I should prepare for the worst and do as much information digging as possible.

As for how I am holding up, it is so-so. I'm stressed, upset, and have a lot of stuff on my plate in general. This all just comes at the worst possible time. I know it is important to keep myself healthy, but it is truly very hard. The pattern as of late seems to consist of major slippage for several days, then getting sort of back on track, though not completely, then slipping again. I wish I had better things to say, it's just a difficult time.

Anyhow, I want to write another post on the vet hospital experience as I found it to be difficult, fascinating, and touching all at the same time.


Eating Alone said...

For those of us still in the 90's and not using Twitter, please keep us updated!

I'm sure that it's rough for you right now but just think how much better you function for Baxter if you take care of yourself too.

Gayle said...

So sorry you and Baxter have to go thru this. Sending you and he warm {HUGS}. Clearly, you're doing the best you can for him and YOU.

Carrie Arnold said...

Aria and I send big sloppy kisses and hugs to you and B. He's so lucky to have such a loving mom. I would do the same thing for my cat- she's my kid, best friend, and spouse all rolled into one.

Take care and email me and let me know if I can be of support.

M said...

What an overwhelming experience, emotionally and physically. I was a mess just sitting at the emergency vet for a few hours awaiting reports on an ambiguous diagnosis. I know the sinking, panicky, anxious feeling I have every time our older, male greyhound hints that he might be decompensating ...

I honor you for your commitment to animals, and I really hope for the best possible news. If you *do* end up needing to enroll in the trial in Minnesota, I'm thankful for you that it is there and offers hope and that much-needed option to *do* something. Feeling helpless can be as bad as feeling hopeless.

I hope you can get support for yourself ... take good care and be well!


Sarah said...

I'm so sorry about this You have such a special love for animals. I will pray that you will have some clarity about what to do with Baxter, and I will pray that you are better able to keep yourself on track despite the stress. I know it's hard. Can you rely on some easy to eat/prepare meals during this time? Thanks again for all your help with Java.

Telstaar said...

Oh chicki,

My heart goes out to you, I could not imagine how I would be even functioning if it was one of my girls (cats). I feel for you so much. I do hope it goes really well with the biopsy and worst case scenario is not required. No matter what happens, I am glad that Baxter has you as he would clearly know he is loved and cared for and that means the world to any person (in which I include animals). xoxo

Kerry from Georgia's Legacy said...

I'm so sorry to hear about Baxter's diagnosis. Cancer is so hard, but you will get through this experience. Good luck on your journey together as he fights this terrible disease and if there's ever anything I can do to help, find me a

Tiptoe said...

Thank you all for your support. Baxter and I really appreciate all your thoughts and concerns.

Kerry, it's funny you should comment here, because I was just on your well informative site the other day.

Just a quick update: I have gotten in touch with the vet running the UMN study for gliomas. Since I received her e-mail late this afternoon, it was too late to get in touch with UT vets. She has to see Baxter's MRI to assess whether he is a candidate. So, his biopsy may be postponed. I'm really not sure yet until Monday. This is exciting, but at the same time, it's just a flurry of so many things. And I'm unfortunately, currently on a time constraint as well which makes all this more stressful!

I'll keep you posted on what happens.