Hi Family ...

*tears of hope*...... *tears of joy*

1. We went to the vet to get Elspar today. And I believe that he is already responding to treatment. One node is almost undetectable and the other seems smaller than a peanut. He also feels much better today ... at the vet Emerson wasted no time sneak-wrestling and body-slamming his little brother as he was heading to the back for treatment today. Their antics made the ENTIRE oncology waiting room chuckle. #brothers

2. I talked to the vet about the clinical trial that I found. He told me that it was legit.... run by the BEST doctors and that I would be in excellent hands. We reviewed the clinical trial criteria and Emerson would qualify.... so, i was advised to call the office to talk about eligibility and enrollment.

3. The oncologist (clinical trial) confirmed that Emerson would be eligible. We also discussed the fact that it's a double-blind, placebo-controlled trial where 75%!!!!!! of dogs receive Tanovea and only 25% receive placebo. AND, if he were to receive placebo, they would give me $1,500 to use towards the treatment that I desire. All study costs are covered, including emergency vet visits, check-ups, and a full work up.

You guys .... *tears*

Family, we are soo blessed.

The catch? Well, he won't be eligible to start for at least 2 weeks, because we did chemo today ... and because he's responding. We'll ride the wave until he stops responding. I asked if they have an enrollment cap, and they do not ... and, to date they have a total of 10 dogs enrolled.

Can you believe this ........

(also, thanks soo much for suggesting this Rene. You have no clue how grateful I am)

Sally -  I totally cracked up when I read "now quit body slamming your little brother" ...hahahahahaha!!  They've been rough-housing forever. Literally since day 2. One time Rocky 'caught' a paw or tooth in the eye and I had to rush him to the ER. He was only 8 months old and I was beside myself thinking that he was going to go blind (the eye went completely foggy and white as it healed). Vets assured me that he could see out the eye despite how it looked. I will split them up when they get too rough but watched them do the same WWE style wrestling on camera (when I am away from home). I'm glad that they truly love each other... and aren't *trying* to hurt each other.

... So today was an optional oncology visit day. I scheduled this appointment last week and was going to cancel it. But after 2 sleepless nights this week, I figured that I needed to talk things through with Dr. R.  As I mentioned last week, Emerson is out of all of the 'good' options with the exception of a new drug Tanovea. This drug has shown exceptional promise with ~75% of dogs going into remission  (similar to the very first protocol). This drug is entirely too expensive for me to consider... approximately $800/treatment .. for a total of 5-6 treatments.

However, after hearing that we were out of options last Monday, I actually found a clinical trial, using Tanovea that is actively accepting patients. The big caveat is ... well, I'd have to wean Emerson off of steroids for him to be eligible for the clinical trial. And, the steroids that he's currently taking plays a role in suppressing his immune system and controlling the lymphoma. To add additional risk, the clinical trial is a double-blind placebo-controlled study... where 75% of dogs receive Tanovea and the remaining 25% of dogs receive placebo (ie. saline solution). So, I found myself losing sleep over the prospect of prematurely weaning him off of prednisone and enrolling him ... and in the worst case scenario ... having him receive placebo. As a worst nightmare, I would be cutting his remaining time short by fiddling with the standard protocol/effectively denying him the benefit of treatment. (Does this make sense... not sure if I explained it well ?)

So, I had a pretty frank conversation with Dr. R about this. (let me state this, Dr. R is amazing... I feel soo blessed to have found him!). Sooo... Dr. R and I talked about and he framed the entire situation really well for me: Last week, we gave him a rescue does of Elspar (chemotherapy), which has effectively pushed him into partial remission... all of his lymph nodes, except for 2 are normal sized. And the remaining 2 are much smaller than they were last week. Dr. R. said that Emerson has a relatively low tumor burden at this point, and *This* would be the ideal time to wean him and try for the study. He said that if Emerson ends up with placebo, that his disease is likely to progress within a week or 2 at which point we can exit the study re-initiate prednisone or do another rescue dose of something else. He says that this is the ideal time to try if I'm going to try. 

I took a deep breath and we will start our accelerated prednisone wean tomorrow and he should be able to qualify for the study by april 17th.

I talked to my mom about this. She is the type of person to always play it safe.... she is *not* on board; but, says she'll support any decision I make... I have time to work on her

Tomorrow, I'll make some phone calls to get everything set up ... I feel soo lucky.

clinical trial intake scheduled for April 19.  

Btw, Emerson is 100% himself and feeling well after a pred. dose reduction.

Also, I am profoundly grateful for all of your words and support. It means the world to me.