Thanks to everyone who chimed in after my chemo post.  I have read through all of the articles and posts you recommended (and extras that Jerry recommended when we chatted this afternoon) - thank you!  The acupuncture answer is that chemo can lower platelet count and thus reduce clotting ability and thus make bleeding a bigger issue.  I don't think bleeding is usually a concern with acupuncture, but the oncologist was being extra cautious by wanting to run blood tests just in case.  I have cancelled our acupuncture appointments because paying an extra $250 for an office exam and blood test on top of the cost of the acupuncture session was just not worth it.

I was able to schedule an appointment at my regular vet clinic for the blood test for this Friday, which will save me almost $200.  I'm compiling a list of questions to ask my oncologist, so if you can think of others based on what I shared, please let me know! Stacy

Hi Sally!  Those are great questions - thanks for suggesting them!  And, to answer your question, my definition of success rate is pretty simple.  If the doctor is recommending one course of treatment that is different than the norm, the outcomes should be better than the norm's outcomes.  I want to know how much better those outcomes are to know what her definition of success is.  She has already stated that there is no published data, only anecdotal information, so I want to know what that anecdotal info is that makes her confident to suggest this course of treatment that is double the norm in terms of total rounds of chemo.  I'll be sure to keep everyone here posted on her answers!  ~ Stacy

I agree with everything you said, Patricia!  From what I read and has been shared with me, there doesn't seem to be any significant difference between 4 or 6 rounds, and between single agent or alternating drugs, so unless my oncologist has access to more recent data, I'd rather try multiple approaches, including immunotherapy.  The Yale vaccine trial costs $1,000, so that is another consideration that will influence how many rounds of chemo we do.  I just wish, like everyone else here, that I knew definitively what the right course of treatment is for my boy! ~ Stacy

This morning started pretty chilly but by 5pm when we headed out for a second long walk, it was 65º - I guess Spring heard me complaining about not sticking around!  Prior to his surgery, Griffin and I would easily walk a 2-mile route from our house to the furthest point at Dyckman Fields in Upper Manhattan, and back again.  Griffin is not yet up to making the 2-mile trip on his own (he can do about 1.5 miles in the morning, less in the late afternoon), so I loaded him into the wagon this evening, hauled him to the park, and then let him meander for a while.  He almost made it to the point, but did not complain when I gave him a ride for the little bit and most of the way home.  About 2 blocks from home, he stood up in the wagon as I was pulling it - yikes!  I swear he was determined not to let our neighbors see him riding in the wagon - LOL!

I went back to my first post and created a blog entry for each major update since then, along with photos and videos, to keep Griffin's story all in one place - https://griffin.....pawds.com/.  I'm feeling extra-techie today after figuring out how to change the blog theme, header photo, and background color.  Go me!

That's the Hudson River, with New Jersey on the left and the Bronx (Riverdale) on the right.

I've spent the last few days trying to figure out the best course of treatment for Griffin.  The standard approach for canine chemotherapy is 4-6 rounds, usually with Carboplatin.  Griffin's oncologist originally recommended 11 rounds of chemo, alternating Carboplatin with Doxorubicin, based on anecdotal information that more chemo resulted in better outcomes.  However, there is no published data supporting that approach and at a cost of $1,300/round of Doxo and $1,700/round of Carbo, the five extra rounds are an expensive unknown.  Additionally, I want to enroll Griffin in the Yale clinical trial for a canine cancer vaccine, which cannot be administered until 3 weeks after Griffin finishes all rounds of chemo.

So, after much consideration and quite a few email exchanges with his oncologist, I have decided that Griffin will complete 6 rounds of chemo with Carboplatin, provided that he does not experience significant side effects.  Griffin had his first round of Carbo on April 17th, which he tolerated very well as evidenced by his behavior/eating habits and the first of 2 blood tests.  The second CBC (complete blood count) test is tomorrow and will be done by our regular vet to avoid a car trip (our vet is walking distance from our house) and to save money ($70 vs $250 at the Animal Medical Center as they automatically charge for an exam visit, too).  The plan is for him to have 5 additional rounds of Carbo, which are administered every 4 weeks.  That will bring us to the beginning of September, and at the end of that month, Griffin and I will go to the Veterinary Care Center in Norwalk, CT for the first dose of the canine cancer vaccine.  The second dose will be administered 3 weeks after that, with re-checks/blood tests one week and 4 weeks after the second dose.  The vaccine could be mailed to my vet at a cost of $1,000, but by going in person (it's only a 45-minute drive), I'll only have to pay for 2 exam fees - the vaccine and the blood tests are free.  Along the way, Griffin will have chest x-rays every 3-4 months to ensure the cancer does not metastasize to his lungs.  The oncologist and I will decide at the end of the year if it makes sense to restart chemo, which would work well financially since his insurance plan would renew in January, giving us a lot of flexibility for next year.

Griffin and I decided to explore a bit of Inwood Hill Park today.  The park is very hilly, giving Griffin a good workout without us going too far.  In the video below, Griffin is showing off his ability to navigate uneven terrain, but the best part is the very end when he is able to lift his back left leg to pee - we've been working on that for a few weeks now!

Hi Sally!  Relief is exactly how I feel.  I've been agonizing over what to do, both in terms of the best course of treatment and the financial cost.  I know that there is no wrong choice - but I want to give Griffin every chance at the best life, even if the clinical trial or additional rounds of chemo are not yet proven to be effective.  So, I charted a bit of a compromise route, which I hope will give him great quality of life and access to various forms of treatment, while keeping the costs mostly within what insurance will cover for this year.  I've also been trying to lessen the stress on Griffin - bringing him to our local vet walking distance from our house for a 5 minute blood test tomorrow, for example, rather than schlepping down to the Animal Medical Center where I have to turn him over at the door for a longer period of time (the upside also being a cost savings of $180!).  I honestly don't know how I would be able to manage all of this if I were working at school and not at home right now, so thank goodness for a silver lining in this pandemic!  Hugs to you! ~ Stacy