Update:

The poor pup had an accident in the lobby, waiting to see his onco.  He's not done that since he was a puppy!  I blotted it up with some paper towel, and there was blood.  And a clot.  Ugh oh.  We saw a new onco (to us) and she felt him all over, took his temp, and reviewed his bloodwork.  First off, all lymph nodes and organs feel fine.  Strong heart beat and good sounding lungs!  Normal temp!  His kidney and especially liver values are superb, "especially for a dog his age"! Excuse me?  Being almost 9 years of age qualifies for that?  Pa'shaw!  She's as comfortable as possible without a crystal ball, that leaving for vacation will be OK.  I like her comfort, but we all agree that things can happen.  Ugh.  Spare me.

It's been 48 hours since his last cyclophsophamide and 48 hours of doubling his rimadyl and MSM.  But, he had an accident.  So, they took more urine from him and will culture it.  The poor guy - they got urine using a catheter.  Ummm, that whole system is inflamed and they had to use that...I understand...but OUCH!  He's a trooper!  We'll wait 2-3 days to get the culture back and hear about antibiotic options, if needed.  His urine was a little cloudy, I guess, which may now indicate bacterial growth.

Leukeran: for a dog Jackson's size (60lbs), he could get 2-4mg per day.  Because we're going away, she's more comfortable starting at 2mg and if well tolerated, go up to 4mg/day.  It was interesting hearing about leukeran - there are SO few side effects, if any that she's ever seen.  I kinda wish we had this talk 5 months ago, as I might have chosen leukeran.  She called Diamondback Drugs to get their quote and for 45 pills of 2mg strength it'd be about $85.  For 45 pills of cyclophosphamide, 10mg strength, it was ~$50.  So leukeran is more pricey.

Leukeran has WAY fewer side effects, is more expensive, but is studied less often.  I don't get the sense it's any less effective.

If you know me, you'll know that I'll be hunting around other pharmacies looking for a better price.  Diamondback was really competitive before, so I actually suspect $85 for 45 pills is going to be a good rate.  It's gonna add up....

Extra green veggies for Jackson over these next few days.  I feel sorry for his pee-problems.  Fortunately, they don't seem to bother him when he's not trying to pee.  He's comfy inside and still wants all the food I can provide and still wants to play with all his toys.

One day at a time.  His pee-problems will improve!

~ Katy & Jackson

Hmmm.  I don't think that's right, Michelle.  It's entirely possible to have blood in the urine with and without bacteria.  How the bacteria get there, is a question.  However, we know we've got and dogs have hundreds if not thousands of kinds of bacteria inside us.  All it takes is for some to go where they shouldn't or for some to grow out of control.  Bacteria love inflammation!  In Jackson's case (and maybe Sassy's), the cyclo initially caused inflammation.  That most definitely lead to blood in their urine.  Then bacteria grow, and well, that leads to a bacterial infection.  Using antibiotics on just inflammation, won't do anything - that is, if the inflammation isn't caused by the over growth and resulting irritation (read: inflammation).  Blood in the urine without bacteria is probably pretty rare b/c at that point, bacteria are loving up the inflammation!  An overgrowth of bacteria and/or the wrong kinds of bacteria are irritating all by themselves.  I'm more likely to think Sassy's UTI was caused by cyclo.  It's a common side effect.  Just because antibiotics take away the UTI doesn't mean the UTI wasn't caused by the cyclo.  Make sense?

All of this to say...I should have insisted on a culture earlier in the week, so we could be on something by now!  Although, I guess the sample they took earlier this week didn't capture any bacteria (but I'm almost positive it was there!).  The point it moot.

~ Katy

Hey Sally (Salt ): Thanks for the well wishes and compliments!  20mg of cytoxan sounds perfect.  She's twice Jackson's weight and he was getting 10mg.

Michelle: I forgot to comment on your first post.  Ooops.  It's not that leukeran is stronger than cytoxan; leukeran has a different mode of action.  I don't know what it is, but it still attacks cancer, just differently.  I understand that the dose for leukeran WILL be less than cyclo (=cytoxan), but even at the lower dose, it's pricier.  If you want to start calling places for Sassy for leukeran, I'd start asking at the 4mg dose, but with the possibility of going up to 8mg (Sally, I know you're reading this too, so these doses of leukeran would be the same for Hannah.  Both Hannah and Sassy are twice Jackson's weight).

I was at Walmart this afternoon and asked the pharmacist there about leukeran.  This store doesn't carry the generic (=chlorambucil), so the price was for leukeran (keep that in mind when you call around!).  Walmart would sell me 45 pills of the 2mg strength for.....$684!  Holy cow!

~ Katy