We spent two hours with Mag's oncologist this past Tuesday to discuss all that is going on.

First off- Maggie is doing really well right now.  Other than being pretty thin still she is pretty much back to her old self, a far cry from the pug she was a couple of weeks ago.  She is eating on her own most of the time (this week anyway) going to the park, playing, and she is always hungry like any self respecting pug should be.

Here is a synopsis of the past couple of months:

Jan 22, two cutaneous tumors removed under local anesthetic, 1 later confirmed to be a mast cell tumor.  Mag is taking benadryl at this point, standard practice for MCTs, she has been on it many times.

Jan 23, Mag is very restless, can't settle at night.  While trying to calm her she urinates in my lap.  This is the sudden onset of incontinence.

Jan 28, Urinalysis and blood work done to see if a bladder infection is causing incontinence (she was due for blood work- I'm glad we did it!).

Jan 29, the vet calls to say the blood work shows kidney insufficiency.  We start changing her diet a bit and put her on pepcid.

We redo the blood work a couple of times to see if the kidney numbers are stable.  They are pretty much the same each time.

Feb 12th we start doing sub-Q fluids to help flush out the kidneys.  We now do it 3 X a week.

Feb 18th we start incontinence med Proin.  We were trying to hold off adding another drug, but the incontinence was intolerable.  The Proin pretty much solves the problem.

Around Feb 20th Mag becomes really picky about eating.  She has to be coaxed to eat- but will still eat on her own.

By the 25th she is barely eating anything.  After talking to the vet we switch her to Prylosec to see if it helps her stomach.

On the 27th she starts throwing up anything she eats.  (of course it is a Sat after the vet closes).

I get her to the vet on Monday morning March 1st for IV fluids, an anti-nausea shot,  and more blood work.  The vet discovers the melanoma tumor and we do a biopsy.  She is put under for just a few min.  We are sent home with some pain meds.  She is really loopy from the meds and does not sleep.

Back to the vet on tues the 2nd.  We change her pain meds and get another anti-nausea shot.  She does not sleep at all Tuesday night either.

Back to the vet on the 3rd.  By now she has settled since I quit the pain meds.  The biopsy came back positive for malignant melanoma.  We do an ultrasound in the afternoon.  The ultra sound and earlier chest x-rays are clear.

By now she has not really eaten (and kept down) anything for 7 or 8 days.  She is under 16 lbs, she should be about 17.5.

I start liquefying dog food and feeding her with a syringe.  I slowly increase the food given each day.  By the Sunday March 7th I get a full day's worth of food in her.  Monday she eats one meal on her own.  Since then I have got a steady stream of food in her between the syringe feeding and her eating on her own.  She now has not thrown up since last Sunday.

BTW- she LOVES eating out of the syringe.  I guess any pug who is pushed in a stroller would expect to be hand fed .

At the oncologist we talked about the ongoing mast cell cancer issues, the new melanoma diagnosis (tumor in her mouth on her upper pallet), and the kidney issues.  We spent a lot of time on the sequence of events that lead up to the 'crash' and how she has been since. Both the oncologist and my regular vet are a bit puzzled about the crash, especially since she seems to have pulled out of it.  Maybe one or all of the illnesses, maybe the drugs, maybe a stomach virus. We talked about tests and treatments for the melanoma.  All of the tests are invasive or would require anesthetic.  And really all they would MAYBE tell us is if the mast cell or melanoma has meted in the organs or lymph system  A CT scan of her jaw would tell how invasive the melanoma is at this point.  We don't think it is into the bone yet because it would be painful, and Mag is not showing pain symptoms now.

But bottom line is that none of the test results would change the course we are on.  Because of her age (almost 11) what she has already been through, and now the kidney issues I am not going to do any more aggressive treatment or tests.

We did talk about the melanoma vaccine that is now available. It is not really a vaccine but a treatment- don't know why it is called a vaccine.  In dogs that have had tumors surgically removed, and follow up chemo or radiation it had proven to extend life span.  There are almost no side affects reported.  In dogs without tumor removal first there is success in only 20% of cases with shrinking of the tumor.  It is a shot given 3 times, two weeks apart, then again at 6 months.  Then I think annually after that.  It is however very expensive at this point.  $500 per shot, which would be $2000 to get through the first 4 treatments.

I'll stop writing now- we definitely have some challenges going forward from here, but we will deal with them as they come up. Our routine has changed a bit with new meds, sub-Q fluids, and wondering on each meal if she will eat.  But having the syringe back up has taken the stress of her not eating out of the equation.  I know I can get enough food into her one way or the other.

For now I am happy to have the old Maggie back for as long as it lasts.  As always it is about the quality of her life.

Karen