A bit of a rough week at our house.  On Wednesday, we took Holly for her 2nd chemo treatment; she was supposed to alternate carpolatin and doxorubicin for a total of 6 treatments.  This was supposed to be her first doxorubicin treatment, and because of the risk of heart toxicity, they did a cardio exam before starting the treatment...and found an abnormality.  It's a bit fuzzy to me, but the cardiologist felt that there was something off about the way her heart is beating - is seems like it isn't expanding as much as it should or something.  After doing a more intensive cardio workup, the dr still wasn't able to determine the problem (which is sort of good, I guess, since that means there is no huge, obvious problem).  There was one small spot on her chest x-rays, but the consensus seems to be that it is a benign calcification or something similar and not metastasis.

Without a definitive diagnosis, we seem to be left with two possibilities: a blood clot or something called constrictive pericarditis.  The doctors were leaning toward the blood clot, since that could possibly be contributing to the pain she seems to be experiencing (they couldn't find anything with her back, legs, etc. that seemed to be a problem).  However, the blood test that indicates whether or not she has a blood clot came back negative.  Apparently it is not 100% accurate, so we are still hoping for that...we are going to try blood thinners and see what happens.  The pericarditis would be somewhat worse....depending on the underlying cause, I guess....and there isn't a way to determine the cause without pretty invasive tests which we won't put her through.  It is some sort of problem with the pericardium, which surrounds the heart.  Possibilities are everything from an infection (no evidence of that) to some sort of immune system problem (which could be related to the immune system being compromised due to cancer) to the very unlikely possibility that the cancer is in the pericardium (apparently this has never been reported in dogs with OSA). 

I'm really frustrated that we don't really know what is wrong...since this started, the only thing that has made me feel like I have any control is getting as much information as possible about her condition and then learning as much about it through reading etc. that I can....and I just can't do that here.  Has anyone had any experience with pericarditis?  Or other heart problems during treatment?  There isn't a ton of info. on it out there.  Also, of course, pretty concerned...not just thrilled that there is something else serious potentially wrong...plus, the doctor doesn't feel that doxorubicin is worth the risk if there are potential heart problems, so we have had to alter her treatment to 4 rounds of carboplatin....another reason I feel completely powerless...now her treatment plan has been dictated by this stupid problem. 

Ugh! Sorry for the long post...I'm just so frustrated and feeling less optimistic than I had been to this point.  Luckily, Holly isn't aware of the problems...she's pretty tired, but it's impossible to know if that is because of the chemo or the heart thing.  We've also had her back on tramadol some when it seems like she is experiencing the random pain, which pretty much knocks her out.  She's still eating and going to the bathroom etc...so that's good.  It's always something, I guess!