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Griffin's Journey
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New York, NY
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27 April 2020 - 4:33 pm
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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! sp_hearticon2 Stacy

1. What is your success rate with the 11 rounds of chemo versus 6 rounds?
2. What is your success rate with alternating agents versus single agent Carboplatin?
3. What is the rationale for waiting 4 weeks after Carboplatin when the standard seems to be 3 weeks?
4. If I wanted to pursue the Yale vaccine option, and knowing Griffin needs to stop chemo to do so, at what point would you suggest pausing/ending chemo to allow that option?
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27 April 2020 - 4:49 pm
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Very interesting information Stacy! I believe the more we know the best it is, and it makes it easier to take informed decisions. And yes you seem to have very good communication with your oncologist that’s the key. And as you said you can decide things as you go, nothing is set in stones. I have to say that I am very happy with the team taking care of Arktik as well. The rehab specialist contacted me back today to check if I had more questions even if they can’t do rehab session with him, at least I get a follow up.

Like Sally mentioned, I think we are following a more ‘traditional’ approach with 4 rounds of carboplatin. The oncologist suggested between 4-6 but due to budget limit we will probably stick to 4. We don’t have insurance so it does add up very quickly. He mentioned that sometimes 6 seems better but not necessarily and that there were no strong studies proving it.  My take from that would be that if you have the budget and if (important if), the dog is doing well on chemo 6 would not hurt so why not. But in the end 4 might be almost as good. 

On a side note, I’m with you Stacy for the weather! 

The temperature in NYC right now is 46º, feeling more like high 30s, and raining.  Spring has occasionally dipped a toe in NYC, but hasn’t yet committed to staying! icon_rolleyes 

Very similar temperature here…can’t wait for more consistant warmer temp. 😉

Virginia




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27 April 2020 - 4:50 pm
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You are certainly  doing your research and are devoted  to Griftin’s best interest.  Such a loved boy interesting about the acupuncture.

Just curious 

+ How many treatments have you done with just Carboplatin?.

         How many had to be stopped due to side effects of Carboplatin?

+ How many trearments have you done alternating the agents?

          How many treatments had to be stopped due to side effects of the Doxo?

And I’m throwing this last one  just, curious what she would say:

+ If, for financial  reasons, a patient could only do Carboplatin, (five sessions for example), does she still stick by the Carbo/Doxo (adding up to eleven) ?

  1. And for you and the Onco, how would you define “success ” ?

❤❤❤

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

New York, NY
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27 April 2020 - 4:54 pm
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Hi Patricia!  I’m really curious as to what my oncologist says about the 11 total rounds of chemo.  It is just so far out of the normal range that I wonder if she has had personal professional experience that this approach works or if there was something specific about Griffin that made her decide this.  And, the more I think about it, the more I think I want to try the Yale vaccine, which requires Griffin to wait 3 weeks after the final chemo treatment before taking the first of two doses.  Once the vaccine is administered, he can go back to chemo if that is what I think is best.  Besides the financial cost, 10 more rounds of chemo would bring us to the end of December and I don’t want to wait that long if I decide to pursue the vaccine.  As you said, I’m really glad I have great communication with Griffin’s team at AMC and even more glad that I have this Tripawd family to turn to for help!  ~ Stacy

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27 April 2020 - 4:59 pm
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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

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27 April 2020 - 5:25 pm
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I think it is a good question and it’s worth discussing it with your oncologist maybe there is a specific reason. If the vaccine would have been an option here (not available) I would have loved to consider it. So, I think if you can it might be worth taking a closer look at that option. As you said if you have to wait until December it seems you have to wait a long time. 

It is definitely tricky to figure out what is the best route. After the first round of chemo I started to have doubts about it. Not about doing the chemo but more are we on the right chemo protocol should we do a mix of drugs or something else,..etc. I read different studies (avoiding those with a bias) and tried to see if there was an option that was really standing out. From the look of it, there were not significant differences in results for dogs only on carbo or on carbo/doxo. But that being said the studies I found were not the most recent (I think the most recent was 2016) and our oncologists would be the people the most aware of the latest development/studies, etc. So it is definitely important to discuss with them. And I believe some might have personal preferences for a given protocol based on their experience. 

I try to keep in mind that we are doing everything we can to give the best life possible to our dogs. 

New York, NY
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27 April 2020 - 5:34 pm
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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

Virginia




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27 April 2020 - 5:43 pm
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arktik said

……. From the look of it, there were not significant differences in results for dogs only on carbo or on carbo/doxo. But that being said the studies I found were not the most recent (I think the most recent was 2016) and our oncologists would be the people the most aware of the latest development/studies, etc. 

  

Patricia, I think I probably  saw the same study. It was on 400+ dogs with osteo after amputation.   The sirvivial times were not much different…maybe 10-15 days??      But the Carbo (six in this study) had less side effects than the doxo (which can be fairly severe).  

But yes, I’m sure  your Onco is top of things and can best advise you.  

As with ANY chemo, there are NO guarantees  one way or another!  

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

New York, NY
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28 April 2020 - 7:11 pm
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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! smiley_clap

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

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The Rainbow Bridge



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28 April 2020 - 8:44 pm
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Oooh I just love your tours of NYC! That’s a pretty view but it’s Griffin who makes it totally spectacular! What a great photo.

I’m glad you two are making the most of spring weather, looks like a lot of fun.

And yes yay you for playing around with your blog! Great job! I can’t wait to check it out.

It's better to hop on three legs than to limp on four.™
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Virginia




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28 April 2020 - 8:53 pm
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That is a fine set of wheels Mr Griffin has.  He looks quite Regal in his Royal Carriage.👑👑 

 Clearly Griffin doesn’t care how far he walks, he just cares about having this special time with his favorite hooman.  His accomplishments  though, continue to amaze us all.

And Griffin, no worries about being embarrassed about the neighbors seeing you in your Roayl Carriage……they are all soooo jealous!!    

And thanks for sharing the beautiful  nature scenery with us.💕

Hugs

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

P S….Gonna go check out your blog…

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

The Rainbow Bridge



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29 April 2020 - 7:47 am
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Stacy said
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! smiley_clap

I just had a chance to dive in, you did great! I love all the detail and photos. You’re a real techie now! 

Everyone be sure to check out Griffin’s blog:

https://griffin…..pawds.com/

It's better to hop on three legs than to limp on four.™
Latest Tripawds News
Read my story here.

Support the Tripawds Foundation!

New York, NY
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29 April 2020 - 2:08 pm
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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.

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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!

Virginia




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29 April 2020 - 2:20 pm
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OMD!!!  LIFTING HIS LEG!!!  LOOOOOVE THAT!!!  No way Griffin is going to pee like a girl, which is what most front leggers do!!!

He shows so much confidence and sure foottedness as he navigates  the uneven terrain.  Are you sure he’s not part Mountain  Goat?

You have done your research and have come up with a good, well thought out plan.  I know there’s some relief to that .

Onward and upward Griffin!!!   And btw, that color harness is gorgeous  on you!!!!

Hugs

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

New York, NY
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29 April 2020 - 2:45 pm
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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

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