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Chemo update for Bailey
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Shannon
1
17 June 2022 - 3:29 pm
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So Bailey had round 2 of Carboplatin yesterday. Before her appt she was happy, playful, eating well, moving around great, ect. They texted me about 9:00am to say she was very anxious and if she was going to get chemo, they needed to sedate her. 

As a recap, after surgery, we were prescribed Trazadone for the recovery period. She had one dose and got way too over sedated, so we discontinued that. The vet said she must be a bit sensitive to sedatives. 

Her 1st round of chemo, they managed to give without sedation,  but the Oncologist stated going forward, they would need her sedated for chemo. She barks alot and digs up her blankets in the kennel they put her in because she is anxious. So, the Oncologist sent home Acepromazine to give. 

Well, I read up on that medication and was not thrilled with the side effects (low blood pressure, decreased respirations). So, I didn't give it to her before yesterday's appt. Their next suggestion was an injection of Butorphanol, or they would not proceed with chemo. So, I agreed to try it.

They gave her the injection at 9:00am. She calmed down, chemo went well and I went to pick her up at 3:00. Unfortunately, throughout the afternoon and evening, she became more and more lethargic, couldn't hardly stand on her own, couldn't get up into a standing position from laying, urinated on herself, whining, restless, ect.

Now, I know I'm hypersensitive to all things Bailey right now because of all the cancer crap, but I just didn't think this was normal behavior. She did still eat dinner, drink water and poop. So, I figured I would just give her the night to recover and I hoped she would be better today. The other unusual symptom is, she is favoring her left back leg, the leg they administered the chemo in. It looks fine, no redness, warmth or swelling that I can see. But she doesn't want to put full weight on it, and she puts it out to the side in a different way when laying down.

Sorry, lots of information here. Anyhow, I got up for work this morning and she still wasn't great, but nothing life threatening, so my family agreed to keep a close eye on her and I had to go to work. She did eat this morning. Though not as enthusiastically as usual, her gait is really weird and extra hoppy with this leg thing. Still sad/kind of lethargic and some small whines from time to time.

I left a message for the Oncology team and they texted me a few times but were unable to connect by phone due to a shortened schedule for them today. Basically, they said they don't know why she is acting this way. Again reiterating that she must be extra sensitive to sedatives. They had me send pictures of the leg, but they said it looks fine, so they don't know why it is bothering her.

Their suggestions were to keep monitoring her over the weekend and then the bombshell, perhaps stop chemo because she's having a hard time. I'm really frustrated and upset. I don't think it's the chemo that is causing all these issues, I think it's the sedative. Round one of chemo ( no sedation) was a breeze.

I called my regular vet for their opinion, but unfortunately my normal vet is out of the office for a week. I spoke to another vet, and he didn't really have any great ideas either. He said that there really isn't a light, sensitive dog sedative. He suggested I try the Acepromazine next time, but that was after he just got done telling me it's not his favorite sedative for the reasons I listed earlier. I mean, what the heck?

I know from reading here that I need to consider Bailey's needs first and foremost, but I desperately want to continue chemo. I just am not ready to cut that option out yet. She normally doesn't mind vet visits and things, so I believe her anxiety is just related to so much happening in 5 weeks time (diagnosis, amputation, chemo, blood work).

Thanks if you've read this far. I'm just spewing out my heart here because I feel like no one understands. I'm frustrated that my options are sedation with terrible side effects, or stop chemo. I'm literally fighting for my sweet girl's life and I feel all alone. 

Of course, with the leg thing, I'm terrified she blew out her knee trying to get up yesterday, or of course osteosarcoma popping up in another leg. This just all sucks s**t and I'm sick with worry and heartbreak. 

If anyone has any thoughts or experiences with Simi issues, please share if you are willing. Thanks t all of you for being here.

Current medications:

Carpofen every 12 hours (been on this since before surgery)

Gabapentin 100mg x once daily. We have tapered down and are supposed to be done with this on Monday (post op day 35)

Cerenia x once daily for 5 days post chemo to prevent nausea.

Metronidazole every 12 hours for 5 days post chemo to prevent diarrhea. 

Shannon

The Rainbow Bridge


Member Since:
25 April 2007
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17 June 2022 - 5:28 pm
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Shannon,

My heart feels heavy and I feel terrible for you and Bailey. I agree, this is a frustrating situation with lots of conflicting advice and options that pretty much suck. FWIW here are some ideas:

1) yeah her leg might be sore from the chemo. Give that time and see how she feels this weekend. She may have slipped or just overdid things at the vet.

2) if your vet oncologist feels like the only way to give Bailey treatment is by knocking her out, I believe it's time to find a new oncologist. We tried Ace and Traz for our Wyatt Ray and they were horrific. Instead of knocking him out for procedures and after-care he needed at certain times of his life, the drugs made him even wilder because they made him feel so stoned and GSDs hate feeling out of it.

There are better ways to treat animals now, like Fear Free vets. They are an amazing new cadre of vet med pros trained to use science-based, non-pharma techniques to help dogs and cats stay calm during treatments. Dr. Rizzo, a veterinary oncologist, is one who we interviewed for tripawd talk . Listen to the show, she's amazing. We used Fear Free vets during Wyatt's last year of life and oh my dog the difference was night and day.  The Fear Free directory may have some listed near you.

If for some reason you want to stay with your current oncologist no matter what, is there any way that you or someone Bailey trusts can stay with her during and after treatment? I know some oncologists would allow this during pre-covid days.

I need to run to a wedding event now. Will be back tomorrow to check in OK. Stay strong, we get it, totally. You are in good company.

Member Since:
14 May 2022
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17 June 2022 - 6:27 pm
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Thanks Jerry,

I noticed when I posted the above update, that I wasn't logged in. Sorry about that, I was wondering why it was asking for my guest name.

I just don't know what to do. This was the most highly reccomend Oncologist out of the ones in my area. They do not allow any owners inside the building at all. It's all curbside. It's the way they've been able to stay open during Covid.

I am really starting to think Bailey tore her ACL yestrrdwhen she was struggling so much to stand after her sedative. She flinches when I touch the knee area. 

I'm just so beyond words and thoughts and what is right or wrong for her. My family is concerned because I'm not handling this well, but I've become so consumed with this whole thing. 

I just feel like nothing I do is the right call for her. Two days ago, I was starting to try and see the positives when I saw her happy self just doing life. But today....she doesn't even want me to pet or snuggle her. She won't eat anything not even her favorites. How can round one and round  two be so damn different? They only increased the dose slightly. 

Anyhow, I'll just keep hoping that she suddenly turns the corner to feeling better.

Enjoy your wedding event and thanks so much for your kindness!

Shannon

Livermore, CA




Member Since:
18 October 2009
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17 June 2022 - 7:02 pm
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I'm sorry for all this- the cancer journey is hard enough when everything goes right.

I'm with you on the sedatives.  My quad Pug Obie is super sensitive- a dose that is supposed to wear off in 3 or 4 hours will take at least 12 hours if not longer.  I avoid them as much as I can.

One thing that caught my eye- you said they increased the chemo dose a bit- that could certainly account for her not feeling that good today.  The effects can also compound as treatment goes on. That's not the right wording- but what I mean is that even if the dose is the same every time the effects might be worse each time. 

I hope she hasn't really hurt herself.  Remember how easy it is for a new Tripawd to pull something- hopefully she will feel better with some rest.

A couple other thoughts:

Maybe you could wait a couple extra weeks before the next chemo visit and see if she is calmer and more ready for another vet visit.

If the oncologist isn't willing to work with you and Bailey then maybe make a few phone calls and see if another would be a better fit.  My Tripawd is a very anxious dog (car accident) and going into the vet without me is hard on her.  I've worked with my vets so that they don't bring her in until they are ready and then they bring her right back out.  Even then she sleeps for hours when we get home.  I know it doesn't work that way with chemo appointments (my first Tripawd had mast call cancer and did chemo) but seems like a good practice can work to make Bailey as comfortable as possible without meds.

Karen and the Spirit Pug Girls

Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.

1999 to 2010

 

              Maggie's Story                  Amputation and Chemo

Virginia




Member Since:
22 February 2013
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17 June 2022 - 9:53 pm
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You are NOT being overly sensitive, or overreacting  and you have every right to be frustrated!!  You know your Bailey best...you are the one seeing her st home after these treatments,  etc  and it does seem like you are not being heard.  Or at the very least, the Onco doesn't  seem open to figuring out the best way to serve Bailey.

Agree with Karen and Jerry 100% on everything!  

If at all possible, see of you can find another Onco who, at the very least, will allow you to stay with Bailey while getting the chemo.  Also there is no reason why an actual "appointment " can't  be made so that you come in at a certain time,sheets her injection and goes home.  I was very lucky woth mh HappyHannah in that she never had to be dropped off for the day, but had an actual appointment. 

And, FWIW, I also would stay away from the Ace or Traz if at all possible!!!!!  

As Karen said, the "slightly " increased dose can be what's causing  the extra havoc mp on the way she feels, ,her appetite,  etc.

I wouldn't  jump to worse case scenario with her sore leg.  Probably  a combo of the injection, and maybe a  soft tissue sprain are what's  causing the lameness.  Keep going with the Gaba and the antiinflmmatory to help ease the soreness in the leg.

And let me assure you, you are handling  this far vetter than most!!  Yoj are dealing  with a lot eight now and are feeling j certain, confused, scared and definitely  frustrated!!  But you're  still standing!!

We'll be looking for your updates.   Hopefully  if most oft thos is chemo related Bailey shoid be feeling better soon.

Stay connected, okay? You are not alone during all this!

(((((((Hugs))))))

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

PS.  The sedative they gave her this time wonder of it was an injection in the same sore leg?

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!

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14 May 2022
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18 June 2022 - 5:45 am
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Good morning, 

Thanks so very much for the support and suggestions. I truly appreciate each of you!

Bailey still is not great this morning. Still really subdued, kind of sad looking. Still having trouble with her back leg, still a bit unsteady. She ate a little chicken and rice for breakfast and I'm having a hard time getting her meds in which has never been a problem. She still doesn't really want pets or snuggles and she still softly whines from time to time.

To answer the above questions; she did not get the sedative injection into the back leg that's bothering her, it was given into her muscle on the opposite side. Also, the Oncologist is part of a large emergency and specialty clinic. AERC in Oakdale, MN. No owners are allowed in the building period, either for emergency care or specialty visits. Chemo day doesn't have appts. Everyone gets dropped off around 8:00am and picked up between 3:00 and 5:00 depending on when your pet's chemo gets done. There is no guaranteed times. They stated that there is not really any room for flexibility in this schedule, since they see so many chemo patients per day. I did ask the vet I spoke to yesterday from my regular clinic what his thoughts were on switching to a different Oncologist. He said as far as he knows, all the oncology clinics in the area run in similar fashion. He also stated that it could be difficult to find a new Oncologist willing to take over and in a timely enough fashion. Additionally, he reminded me that I would have increased costs due to having to establish new patient relationship, new first exam, new treatment plan, ect if going to a new place. He did encourage me to do whatever I felt was right.

My family says we really should continue chemo and just know that she is going to have difficulty struggling to recover from the sedation. Of course, I want to continue as well, hoping for the most time with her as possible. It just breaks me to see her feeling so icky. I also am sad that she's not one of the lucky dogs that just sails through chemo, no big deal. I just feel like we can't ever catch a break, where something in this journey is just easy and uncomplicated. 

I'm just going to let her continue to rest and lead the day with how she feels. Thanks again everyone. Have a great weekend!

Here is Bailey and my son the day before chemo #2. You can see how bright and happy she was. Today, just a sad, not feeling good, pupper, but still the bestest and bravest girl.

View post on imgur.com

Shannon

Virginia




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22 February 2013
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18 June 2022 - 11:38 am
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This just seems quite perplexing It does seem that chemo nd/or the "sedative injection could "possibly " be the culprite. Doing a web search, it didn't appear the  Butorphanol is generally used as a sedative.  It appears to be used ofmpain.  It can cause  sedation though as a side effect, but that's  jot it's purpose,    Of course, thos is just according  to web search....not a Vet and not giving Vet advice.

HOWEVER ,at the very least try and get copies of Bailey's records to see what the dose amount of the  Butorphanol was, as well as the chemo amount 1st injection and 2nd  injection)    A copy of the blood work too.  Have you actually spoken to the Oncologist who did the injection and did the muscle injection  of  Butorphanol?

Also, wondering if eliminating  the Cerenia and Metronidazole would help in some way?  Of course, only with Vet approval. 

For a dog who doesn't  generally mind Vet visits and who sailed through the first chemo with no sedative.........just leaves a lot of questions.  

One thi g uou can definitely  feel reassured  about, quite often a round of chemomis delayed  simply because the blood work shows WBC off.  So delays to happen sometimes  without interfering  with efficiency  of the chemo.  Also, IF, IF you do need to forgo anymore chemo, always remember  there are never any guarantees  one way or another with or without chemo.  Nefer,

Just really wish you could get another  consult so where, of if just reviewing  records.  Wish I had more answers than questions.

Continue  to try any yummy food (without pills), continue  with rest and , of course, lots of love.

And that is a wonderful  picture.  Both look happy!

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!

The Rainbow Bridge


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25 April 2007
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19 June 2022 - 8:23 pm
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Awww sweet Bailey. What a beautiful photo.

I'm so sorry she isn't feeling better. Here's my take on what you described:

Bailey still is not great this morning. Still really subdued, kind of sad looking. Still having trouble with her back leg, still a bit unsteady. She ate a little chicken and rice for breakfast and I'm having a hard time getting her meds in which has never been a problem. She still doesn't really want pets or snuggles and she still softly whines from time to time.

So, she's unsteady but walking? Is she able to do her business and get up to eat? If so, she could still be recuperating from some kind of muscle strain. If it was more serious like a CCL rupture, she wouldn't be bearing any weight at all on that leg as far as I know. Sally can describe what that's like since she's dealt with it. 

About her meds...how are you giving them to her? By hand? Separately from her main food or in a treat outside of meal time? 

You are doing a great job advocating for her by talking to your vet and looking at other options. It can't hurt to start calling and asking what other clinics' oncology appointments are like. What about the University of MN clinic? They offer oncology services and while they might not allow you in with Bailey, they might be more willing to work around her sensitivities to the treatments. 

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13 May 2022
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23 June 2022 - 9:18 pm
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I can only comment on the sedatives ..

For my dog, butorphanol does take about 2 days to fully leave his system. I think he seems confused but mostly whiney for attention. No negative mentality but is sleepy and wobbly from it. 

I know you're tapering off gabapentin but in some doses it can act as a mild sedative. Same with tramadol. 

I think if trazodone only made Bailey too sedate with no other side effects, you could try it at a lower dose.

I love trazodone over opiods and acepromazine. I hate acepromazine. I actually have a dog that was on Traz. for a few years at a low dose for anxiety but is my go to for sedation purposes. 

It sounds like Bailey knew she was about to get the chemo treatment and wasn't interested. It is actually the Fear Free thing to give medications if you aren't able to provide high value distractions that are effective. 

i.e. we would do peanut butter for nail trims or toys, attention,  etc.. then the next step was drugs if a pet couldn't stay below a certain level of anxiety. 

Adaptil collars and sprays can be helpful as additional calming support. It's a pheromone product that replicates a scent produced by mother dogs after giving birth. 

Apatil spray should be around 4 pumps for a towel (for size to pump reference) and sprayed 30 minutes before you introduce your pet so the alcohol smell has time to dissipate. Also, respray every 2 to 4 hours. The collar is every day for 30 day use. 

Another Fear Free concept is to make frequent trips to the clinic and have the staff give treats, you two just walk around the building. Trips that = carefree. 

Solliquin is a nutraceutical supplement that has had studies to prove efficacy as another addition for overall help similar to Adaptil. It does take about a month to know if it has made any impact. 

The Rainbow Bridge


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25 April 2007
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24 June 2022 - 11:28 am
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cloud23 said
I can only comment on the sedatives ..

WOW! Great information, thank you so much. Let me know if you're ever interested in writing a guest blog post for Tripawds News!

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