I'm posting a quick update just to say that today is Griffin's 6 month ampuversary!  I can't believe the time has flown by so quickly and I know we would not have made it through this journey without the love and support of our Tripawds family!  This has been a good week, with Griffin's appetite steadily improving and his spirits remaining happy!

And he looked quite dapper today with his special Halloween (candy corn) leash! 

Griffin was at AMC on October 7^th for another round of Doxorubicin after a washout period of about 2 weeks since we ended the use of Palladia.  During that time, Griffin’s appetite steadily improved, and while it was not yet back to “normal” (prior to the start of Palladia in mid-August), he was eating a good amount of dry and wet dog food along with home-cooked meals each day and he gained one pound.  After the chemo on Wednesday, we celebrated with McDonald’s cheeseburgers around 2pm which was the last food that Griffin ate until Saturday (yesterday) afternoon.  It is not clear if the chemo was causing nausea since the side effects of Doxorubicin usually appear about 3-5 days afterwards, not immediately, but regardless of the cause, Griffin was definitely not interested in food.  After 48 hours, I contacted his oncologist who prescribed Zofran (brand name version of Ondansetron) which is an anti-nausea medicine and Entyce (brand name version of Capromorelin) which is an appetite stimulant.  Griffin started both meds Friday night, had a diarrhea accident in the house overnight, and was very lethargic on our morning walk on Saturday (to be expected since he hadn’t eaten in 3 days!).  However, by yesterday afternoon, he was interested in food and ate 2 large turkey burgers.  He had another diarrhea accident in the house last night and has not yet been interested in food today.

Needless to say, I am incredibly frustrated, although I try very hard not to show it to Griffin.  I would feed him anything he wants, but that seems to change from day to day, so I have no way of knowing what to offer him on any given day.  While his appetite was improving after we stopped the Palladia, Griffin was still refusing to eat any wet dog food on its own or with dry dog food, and would usually eat one large meal of wet/dry mixed with home-cooked (ground meat with kale and spinach) in the evening as opposed to one smaller meal in the morning and another in the late afternoon.  So, we still have not found a wet dog food that Griffin will reliably eat, although I am grateful that he is not refusing his Taste of the Wild dry food.  I have wasted so much food trying to tempt him and I am never sure if he is truly not feeling well enough to eat or if he is just waiting me out to see what else I might offer him.  He has stopped eating pill pockets or anything that might contain meds, so I have to push pills down his throat, which neither of us enjoy (although to his credit, he doesn’t really fight me or seem to hold a grudge!).

Here’s his current medication and supplement list:

• Zofran – 4mg up to 3 times a day (small pill)
• Entyce – 2.5ml once a day (liquid that seems to taste nasty)
• Ellevet CBD Oil – 0.3ml twice a day (liquid that he seems to tolerate)
• Cobalequin – 1 tablet daily (oh right – forgot to mention that Griffin is B12 deficient, probably due to his prolonged inappetence from the Palladia)

To add insult to injury, the cost of the new meds that I picked up from AMC was $300, but I could have bought them from an online veterinary pharmacy for $75.  I know things in general are more expensive in NYC than elsewhere, but price gouging on meds is infuriating.

Sorry for the long post – I just needed to vent.  As always, any advice about our current situation would be most appreciated.  I know diarrhea is a potential side effect of Entyce, so I’m not sure how worthwhile it is to keep him on it if that continues, but if anyone has specific experience with that medicine, I’d love some input.  Thanks!

If you've made it to the end of this very long post, please enjoy this lovely autumn photo of my handsome boy!

Thanks for the support Rene, Jackie, and Sally!  We are going on over 2 months of the issues with Griffin’s appetite and I don’t feel like I’m any closer to figuring it out than I was at the start, but I’ve tied a knot at the end of my rope and I’m hanging on!

I truly have no idea if it is the Doxorubicin that is making Griffin nauseous.  He never had an adverse reaction to either the Carboplatin (3 rounds) or Doxorubicin (2 rounds) previously, and this side effect occurred the next day rather than during the usual 3-5 day window.  One member of his oncology team remarked that he could be experiencing pancreatitis due to the fatty nature of the McDonald’s cheeseburgers, but he’s never had an adverse reaction to them before (and doesn’t eat them all that often).  The Palladia really did knock him for a loop, and I think he wasn’t fully recovered before the latest round of chemo, so perhaps it hit him harder than usual.

I also really struggle with interpreting when he is truly nauseous and when he simply doesn’t want what I am offering.  In my mind, if he were feeling nauseous, he wouldn’t show any interest in food or check it out by sniffing, but that’s what he does all the time.  When I ask him if he wants a treat, he jumps up and heads to the kitchen, but then will sometimes refuse high value treats, such as a Rocco & Roxie jerky stick.

During his oncology appointment on September 26th, his oncologist remarked that the prolonged inappetence could make him B12 deficient, and since the lab test would take days to return, she proactively gave him a B12 injection.  Turns out he tested very low for B12, so he’s taking a supplement now.  Here’s what I learned about why a dog needs vitamin B12:

Vitamin B12 (also known as cobalamin) is important for many aspects of your dog’s health. It’s crucial for healthy nervous system and brain function, as well as for the formation and growth of blood cells. It’s also involved in intestinal health, so your dog needs B12 to maintain healthy digestion.

After starting the B12 supplement, I noticed that Griffin was drinking a lot more water each day than normal.  He was eliminating it easily, but when I mentioned it at his October 7th oncology appointment, they ran blood work and a urinalysis to rule out issues with his kidneys or a urinary tract infection.  Turns out he is borderline hypercalcemic, which could be caused by his dietary issues or could be another issue entirely, including cancer. 

So, the B12 and hypercalcemia could be caused by his inappetence issues, since he was not eating consistently or nearly enough each day for 6 weeks, which was likely caused by the Palladia, and in turn, his low B12 and hypercalcemia could be making him lose his appetite again now.  Or it could be something else altogether.

And, if this weren’t enough for him to deal with, Griffin has an aural seroma (like a hematoma but containing fluid and not blood) that formed in his left ear flap from his excessive head shaking after swimming for hours each day on our summer vacation in August.  It was drained twice by our local vet when she administered the Yale vaccine, but it returned each time larger than before, so it needs to be dealt with surgically.  I have a consultation this week with the surgeon who amputated Griffin’s leg (whom we adore!), and while he assured me via email that it is a simple procedure, it will require him to be anesthetized.  That procedure is currently scheduled for mid-November (Dr. Spector is actually booked through December, but they made an exception to squeeze in Griffin – I guess he has clout at AMC!).

I’ll end this on a positive note.  Griffin was left alone for a few hours this afternoon and managed to eat a fair amount (turkey burger with some wet and dry dog food), and then polished off a chew treat after I returned home.  Go figure!