Cautiously Optimistic

It seems like most of my blog entries are about negative events.  I decided it was time I reflected some of the more positive.

On Feb 9/10, Basty attended for his 6th Chemo session at Canada West.  I typically try to have him at Canada West by 7:30 a.m..  The Cytosar injections need to be spaced 12 hours apart, so he needs to be there early so that I can pick him up around 8:30 p.m..  I prefer to pick him up at the end of the first day and take him home.  The staff at Canada West treat him very well, but he knows bad things happen there, so I rather not have him stressed out by staying over night.

Anyway, when I take him in, I get there early enough to take him for a walk in the area before he has to go in.  On the morning of the 9th, I was very encouraged by his general demeanor.  Over the past few months, Basty has lost that characteristic feature of his constant tail wag… it used to be that his tail just never stopped.  That morning, he seemed to be particularly happy, with his tail back to whipping high swirls.  Not only that, but he was following me as I balanced on curbs (another thing we used to do a lot of… whenever I would see a log or curb or something to balance on, he would jump up right behind me… the two of us balancing along).

I e-mailed with Dr Higgins this past week.  He has been consulting with Dr Fidel at WSU.  They both feel that Basty has progressed to the point where we can discontinue the Cytosar injection treatments, and switch to an oral Chemo protocol using Lomustine.  This is something I can administer myself, so I just need to bring him in for blood tests (need to continue to watch his white blood cell count, and his liver enzymes … CBC / ALT).  I am not sure at this point, how long the new treatment protocol will go on.

We will continue his daily doses of Prednisone, but Dr Higgins indicated that we will start to taper that off as well.  I am happy about taking him off of Prednisone.  If anything, this is the drug that causes him the most discomfort, and, I am sure, is at the root of his attitude changes.

All in all, I am cautiously optimistic about his progress.  I am not expecting full recovery as I am sure there has been some nerve damage that will continue to impact his ability to use his hind legs.  He can’t climb stairs, or sustain a run.  But he can walk well, as he has learned to leverage his hind legs as needed (especially his left hind leg).

One last item… look for Basty in the March 2011 issue of Dogs in Canada.  They did an article on Neurology and used him as a subject.  http://www.dogsincanada.com/

Lomustine resources:
http://www.marvistavet.com/html/body_lomustine.html
http://www.wedgewoodpetrx.com/learning-center/professional-monographs/lomustine-for-veterinary-use.html

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Aaaarrrrggghhhhh …. Not Again….

My poor boy… today, I had to bring Basty in to see his Vet.  We woke up this morning, and Basty was having a bit of difficulty with his airway.  He was not choking, but had occasional ‘gag reflex’ action as if perhaps something got lodged in his throat.  I happened a couple of times before we went to bed, but I didn’t think much of it.  As the morning wore on, he seemed to be getting worse… he seemed to be breathing with some discomfort, and the gagging seemed to be getting worse (started sounding like there was some flem building up).  In addition, he holding his head up as if it was uncomfortable to lay it down.

By 10:30, I decided I needed to take him in to see Dr Andrews (his regular Vet).  A cursory look didn’t reveal anything, so we decided that he should be given a mild sedative and then have his airway scoped.  One of Dr Andrews concerns was that his SM condition may be causing some issues with the functioning of his ‘flap valve’ (SM being a neurological condition where progression can start to affect function controlled by nerves in the neck area).  Of course, we also wanted to make sure there were no foreign objects obstructing his airway.

The scope did not find an obstruction… which was actually disappointing because if that was the problem, the obstruction could be removed and we can move on.  The scope did clearly show some swelling of his tonsils, so there is a bit of infection in the throat.  I suspect this swelling may be leading to some discomfort (a ‘sore throat’).  The odd thing being that given he has been on Prednisone for some time now, one would not expect to see such swelling as Prednisone is an anti-inflammatory.

The other thing the scope showed quite clearly, is that the back of Basty’s soft pallet is somewhat ‘V’ shaped (upside down ‘V’), where normally it should be straight across.  This is what probably causes his snorting episodes (Cavy snort that he has had since he was a pup).

So… unfortunately, although we know his airway is OK, he is still not feeling so good this evening.  The gagging seems to have subsided, but I think the sore throat is bothering him.  So much so, that he didn’t want to eat too much this evening (which is amazing when you recall that Prednisone makes him feel constantly hungry).  Dr Andrews prescribed Amoxicillin, an antibiotic to address his throat infection.

Basty has been through so much in the past six months.  I feel badly for him.

Say hello to 2011

To employ an overused vernacular, time marches on.  I have thought many times about making an update blog entry.  I guess tonight is as good a time as any.

It is the middle of January, Basty is sleeping at my feet, and a cup of Earl Gray is steaming on my desk.  It has been a bit of an odd Winter thus far, but then again, I guess odd is the new norm.  I had been expecting a very cold Winter, with snow that took up semi-permanent residence.  That has not happened.  It has been a sprinkling of some cold, some snow, some rain, clear days, cloudy days, pouring rain, and balmy winds.  Kind of like the ups and downs of life… 😉

Basty has been holding his own… that is the expression I use when people ask me how he is doing .. ‘holding his own’.  I mean, he is not getting better, but he is not getting worse either.  Dr Higgins is pleased with his progress.  I am not sure if he sees something I don’t, or if he is just trying to be encouraging.  But I keep reminding myself that if he keeps holding his own, it is something to feel joy about.  I can hardly expect Basty to ‘get better’.  Even if he goes into full remission, there is damage to his spinal cord that will likely be a barrier to his regaining complete control and strength of his hind legs.

Concern for Basty’s health has been a preoccupation, to say the least.  I know that I really should learn to appreciate every day as it comes.  Basty really is a joy to be around.  He is affectionate, well mannered, and maintains an upbeat attitude of his own.  He lives in the moment, and although he is not aware of his condition or its implications, he doesn’t let his discomforts get him down.  I guess, that is my biggest concern.  His discomfort is minimal at this point.  He went through a lot during the Summer, recovering from his back surgery, but my worry is what he has yet to endure.  I am firm in my resolve to euthanize when the time is right, thus avoiding unnecessary suffering.  Question is, when is enough..?  Not today…

I took a video of him on our walk this morning.  I will post it as soon as I have had the chance to sync it, and make a few edits.

– – – – –

On another note, I have ventured further into the world of the Mac.  I have been considering a replacement for my MacBook for over a year now, and had planned to do so with a MacBook Pro.  But, then I realized that I almost never went mobile with my MacBook… and if I really didn’t need the mobility, why not buy more power with the same dollars?  So, I went with an iMac 27″ i5 Quad Core.  A very impressive machine, to say the least.  I will keep my MacBook for those times when I do want to go mobile, but having the power of the iMac at home really is very pleasing.

In addition to the iMac, I also picked up an Apple TV.  The A-TV is great for streaming various web based media, including vids from my NetFlix account and favorite TED and other Pod casts.  Integration with media residing on my Mac network (iMac, MacBook, TimeCapsule, iPhone, etc) is easy with Back-to-my-Mac, MobileMe, and AirPlay.

Plan is to keep my NetFlix account alive for now, test MobileMe service, and eventually cancel my Cable TV subscription.  I am a bit disappointed with the AirPlay feature as it really only supports YouTube right now, but I am hoping Apple expands it to support any web based video source (Network TV streaming video would be especially nice).

That is it for today.  The sauna should be just the right temperature by now, so I am heading down for a bit of a sweat.

~ Basty ‘n Me

Basty Physio

This Blog entry is out of order.  It is a video that I started to put together in August, before Basty was diagnosed with Spinal Lymphoma.  I decided to finish the video and post it to show appreciation for the folks at Canada West’s Rehabilitation center.  Enjoy…

Some browsers have problems with embedded video from YouTube (FireFox on Mac for example)… I have included the direct YouTube link below in case you experiance a problem…

Life is not fair…

When Jen and Sarah were little, and would whine “that’s not fair..!!”, I would respond “Life is not fair..!!”.  And I guess that kind of sums up this blog entry.

But, I am getting ahead of myself.  It has been almost a month and a half since I made an entry here.  Not sure how worth while it is as I don’t think anyone actually reads this, but if nothing else, it gives me a chance to reflect on what has transpired.

So, where to start…  Basty had been in Rehab; at first all seemed to be going well.  He seemed to be responding well, and was gaining strength in his left hind leg.  Then, towards the end of August, we started to see regression; he was again loosing movement and control in his left leg.  When I brought him in for his Physio session on August 28, the therapists noticed the regression right away.  We decided that Dr Higgins in Neurology needed to have another look at him.

Dr Higgins concurred that there might still be something going on, and was starting to show again.  The only way to know for sure was to do another MRI.  So, Basty was scheduled in, and the MRI was performed on September 11.

During the first MRI that was performed on Basty, they elected not to use a dye; for this one, a dye was used so that soft tissue anomalies would be more visible.  In fact, they first did one without the dye and then administered the dye before they did a second series.  This required Basty to be under anesthetic for an extended period, which affected his recovery from the anesthetic more than usual.  He has never had problems recovering from anesthetic before, but this time he was not himself again until the next day. It took a good nights sleep for him to recover (needless to say, I didn’t sleep much that night).

The results of the MRI were less than encouraging.  And honestly, I really expected the results to show that he was indeed showing progress, and that this little bit of regression in his progress was nothing more than part of the healing process.  That was not to be.  The first of the two scans that were done during this MRI session were generally uninteresting from the perspective that they looked the same as the original MRI that was done back in July.  In the second of the series, which was done with the dye, light patches were showing up in the same area where it was originally thought he had a ruptured disc… the same area where he was operated on.  As Dr Higgins stepped me through, comparing the scans, he explained that there were two likely explanations for the light patches that were showing up in the dye series.

During Basty’s operation in July, just before closing, a gel foam was injected to protect the spinal cord during the healing process.  Over time, this gel foam will disappear as it is absorbed into the body.  The first possibility was that it was this gel foam that was showing up as the light patches in the dye MRI.  I was optomistic.

The second possibility was a little more disconcerting… the light patches could be showing a tumor.  I acknowledged it as a possibility, but honestly, never believed it could be.  Basty was very healthy, after all.  And all of the other tests that were done back in July (blood, urine, Ultrasound, etc) proved it.  Except for the Sryingo and the chronically herniated discs, he was in good shape.

Because a dye was not used in his first MRI series back in July, there was nothing to compare the results to; no way to know for sure if the light patches showing up in this MRI were indeed the gel foam.  The resolution of the MRI was not clear enough to say for sure what we were seeing.

The recommendation was a third MRI series, this time using a human machine.  A human machine has much larger magnets and therefore much better resolution.  Canada West has an agreement with a human MRI clinic, where they are allotted time to use their machine for special cases (usually for larger dogs that wouldn’t fit in Canada West’s smaller machine).  A time slot was reserved for Thursday September 16th.  I had some reservations about doing another MRI, especially as it meant putting Basty under anesthetic again so soon; given his difficulty coming out last time, I was not sure I wanted him to go under again so soon.  And, I guess I also was in a bit of denial… I didn’t want to find out he had cancer.  In the end, I went along with the recommendation… how could I not..!?!

Life certainly is not fair.  Anyone who has even known Bastian, knows that he is a charming, gentle, loving, patient, kind creature.  In his entire life, I have never ever heard him growl… he has never even barked at another living creature.

But evolution has no awareness of the concept of fair.  Survival of the genetic pool is the only ‘rule’.  I have always known that Basty would never survive in the wild.  His kind and gentle nature would be his downfall if he were faced with the need to survive on his own.

And so it is that Bastian has been diagnosed with Spinal Lymphoma.  He has a 9mm tumor in the middle of his spinal cord.  Because of it’s location, the tumor is not operable.  On Friday September 17th, additional tests including a spinal tap, liver biopsy, and lymph node biopsy were performed to determine the type of cancer.  Although no cancerous cells were found in the spinal tap, they did find lymph cells.

Friday/Saturday September 24/25, Basty underwent his first Chemotherapy treatment.  The treatment consisted of four (4) injections of Cytosar (Cytarabine 55.5mg); one every 12 hours.  For the 7 days following, his Prednisone was doubled to 5mg; 1 1/2 pills every 12 hours, and back to 1 1/2 pills every 24 hours after that.  In addition, due to the side effects of the Prednisone, he was also put on Ranitidine 10mg, 1 hour before his Prednisone, to protect his stomach.

He is scheduled for a second round of Chemo on October 20/21.  At the same time, he will undergo followup neurological tests to see how he is progressing.

Physio Therapy

On Wednesday, Basty went for his 2nd follow-up with Dr Higgins.  Prognosis… recovery on track, and progressing better than average.  The only area of concern is some muscle atrophy in his left hind leg.  Starting Basty on a few sessions of physio therapy is probably a good idea.

In addition to his neurology follow up, Basty had an appointment to see the Dr Defalque, Canada West’s Dermatologist.  He had been showing signs of worse than normal irritation in his right ear, so his ears were scoped to make sure there was no infection and that the ear drums were intact.  Except for a bit of wax build up close to the ear drum, the ear appeared relatively normal.  The only thing that was noticed is that his ear canals seemed to be narrower that would be expected.  However, it is hard to say if that is normal for him or if it is narrowing for some reason.  At any rate, Dr Defalque did not believe it was anything to be concerned about.

Today, we arrived at Canada West at 08:00 for his first physio appointment.  The Physio Therapist came out to meet us in the Lobby, then escorted us back to the physio room where she carefully explained what was going to happen.  She did a great job of taking Basty through his workout and explaining why each exercise would benefit him.  A good part of his physio will be my taking him through his exercises two to three times a day.

The big event as far as Basty was concerned, was the submerged tread mill.  Basty was led into a seemingly harmless room with glass windows all around.  Once in, the ramp was lifted and he was sealed in.  Suddenly, water stared to flow in, and it kept getting deeper… what is happening..?!?  Basty had a look of anxiety in his eyes like I have never seen before… he definitely was concerned about being in this ‘room’ (tank) with the water rising.  If you know Basty, you know that he does not like water.  Once the water stopped rising, and the tread mill started to turn, he seemed to be OK.  The water did have to be lowered a bit as his left hind leg was really just floating (no physio benefit to that..!).  Overall, he did well for a dog that dislikes water.  The video below shows him in the tank for the first time.

His last ‘exercise’ was to lay down on bed for a dual treatment of electro magnetic and laser therapy.  This, he didn’t seem to mind.

My only concern with the water tank, is that they use chlorine in the water at a higher concentration than would be used in a pool for humans.  Understandable given the same water is recycled for various dogs using the tank in any given day.  Unfortunately, Basty has very sensitive skin, and is already suffering from a mild seasonal irritation (per Dr Defalque).  He was itching all afternoon, and when we got home I gave him a bath using a special shampoo for sensitive skin.  The bath seemed to help.  I will have to investigate if we can shampoo him right after his water tank treatment to neutralize the chlorine right away.

During his treatment, he had three beautiful women working with him… I should be so lucky..!!  … 😉

After, physio, we went over to see Bella… Basty’s first love and remains one of his many girlfriends…  Bella is one of three names I am careful not to say to Basty unless he is about to see them… when I do say them, he starts to get excited about seeing them (the other two are Ginger and Carley… Ginger is a Ruby Cavalier who’s home Basty often stays at when I travel… Carley is the daughter in Ginger’s family… she is the only other human that Basty associates strongly enough with to recognize her name… there actually is a fourth name, Misty (another Blenheim Cavalier), that seems to be starting to get a reaction out of him).

Basty with Bella, earlier today…

May I be the kind of person Basty thinks I am.