Hi Patricia!  Griffin's first chemo day was a long one, too!  He had a rehab appointment as well, but that only added about 45 minutes to a 6 hour visit to the Animal Medical Center.  They conducted an abdominal ultrasound and did regular blood tests, but I'm not sure exactly why it took as long as it did.  You are correct about Doxorubicin having potential cardiac side effects.  Griffin had an echocardiagram performed in February after blood work for a different procedure showed elevated cardiac enzymes.  The oncologist spoke with the vet who conducted the echocardiagram to ensure that Griffin was cleared for that type of chemo drug (he was).  I have become somewhat accustomed to turning Griffin over at the door, but I don't think any of us are happy about not being with our pups during the exams, not meeting the doctors, and not speaking with them face to face.  AMC has been great with communication, as evidenced by the replies I received today to my chemo questions (see below).  I hope this information is helpful to those thinking about/going through chemo.  I'd love any additional notes others may have!  ~ Stacy

Blood Tests - My oncologist does a complete blood count (CBC) test after giving chemo the first time in an effort to anticipate what will happen after each treatment. She looks for drops in white cells mainly but also platelets and red cells. Each type of chemo can have lows at different times. For Carboplatin, the white cells tend to drop at week 1 and/or 2, but the platelets at week 2, 3 and/or even 4, so she recommends a CBC both 1 and 2 weeks after the first dose. For Doxorubicin, the white cell drop is generally at week 1 and platelets don't tend to be affected, so she recommends a CBC 1 week after the first dose.  Provided there are no issues, Griffin will not have blood tests scheduled after subsequent rounds of chemo.  My oncologist said that my regular vet (walking distance from my house) could run the blood tests provided that she was prepared to prescribe medication for bone marrow suppression if needed.  I emailed my regular vet to see if this next CBC (scheduled for May 1st) could be done locally.  Assuming all is fine with that CBC, Griffin will have only one more scheduled a week after his second round of chemo (first round of Doxo), and I'll probably return to AMC for that one.

Scheduling of Chemo Rounds - My oncologist plans to administer alternating rounds of chemo drugs, with a 4-week wait for the next round after Carbo and a 3-week wait after Doxo.  She is recommending 6 total rounds of Carbo and 5 total rounds of Doxo.  There is a limit of how much Doxo a dog can have in his lifetime, but she said that some families continue to administer Carbo every 4 weeks indefinitely provided there are no side effects.

Acupuncture - My oncologist recommends blood tests before acupuncture to ensure that Griffin's platelets are not dropping which could make him at high risk for bleeding during acupuncture sessions.  Because of the extra $250 cost for an exam and CBC which would be required before every session, I will be discontinuing acupuncture.

Cost - I had read somewhere that Doxo costs a lot less than Carbo, but my oncologist said that for a dog Griffin's size, they are about the same.  The cost for just the Carbo ($925), catheter administration ($215), and an injection of anti-nausea meds ($30) was $1,170.  My oncologist is going to provide me an estimate for the remaining 10 rounds of chemo so I can plan accordingly.

Hi Nancy - I can't wait to get Griffin back in the pool this summer.  And while he wouldn't trade me for a pool, he'd certainly love to have both if possible! Stacy

Hi Sally!  Thanks for weighing in here.  I actually started a new topic, "Chemotherapy Protocols" in the Ask a Vet forum to gather more input about the number of chemo rounds, the alternating of drugs, and the length of time between rounds.  Clearly, I don't need to make a decision about how many rounds right now, but if I choose to go beyond 6 rounds, I want to make sure I have budgeted appropriately.  As long as Griffin is tolerating the chemo well, and knowing that there won't be future blood tests between rounds, I'm happy to take it one round at a time.  Another consideration is the Yale vaccine trial that Oakley's human, Paul, mentioned in his initial post.  Griffin would need to complete all chemo and wait 3 weeks before taking the first of 2 doses of the vaccine.  I haven't decided about that course of action either, but I'm trying to gather as much information, based on data or experience, as I can so I can make informed decisions when the time comes.  I'm so thankful for the Tripawds community! ~ Stacy