I took Penelope to the vet school yesterday with her having enlarged lymph nodes. When they called me at noon, they said that her cancer had indeed relapsed again. They have three options. The first one was to increase the dosage of doxorubicin to every two weeks. But the oncologist didn't think that's a very good idea because Penelope had severe diarrhea when given the drug last time. The second option was to try this very effective drug that has few side effects, but the only drawback of the drug is that it costs $400 each dose. The third option was to try this oral drug called CCNU. It's only about $40 per dose, and Penelope would only have to take it once every three or four weeks. The oncologist recommended getting the CCNU now, and if Penelope doesn't respond to the drug, then later we can try the more expensive drug. Some possible side effects of CCNW are lethargy, vomiting, and depression. Also they put her back on prednisone and the anti-ulcer medication. They said that from the blood work, it seems like she might be having stomach ulcers again. We have to come back next week for another blood test to make sure Penelope's body is still okay with CCNW. Otherwise, the oncologist said
Penelope looks pretty good.
Because Penelope was not given doxorubicin anymore, they did not do an echocardiogram on her yesterday, and they did not have to sedate her either. Because
Penelope's annual vaccines were due, they also did titers on her to check if she needs any booster shots, rather just giving her the vaccines. The results of the titers won't come back for another two or three days. Also, I asked the oncologist to check Penelope's teeth. She said they are not bad, but she said it's still a good idea to have them cleaned at least once a year. She suggested that not to do the dental cleaning on a week that Penelope's getting her chemo drugs, but she said otherwise she thinks Penelope's body would be okay with anesthesia. So I asked her if next week would be okay. She suggested that we do it after next week's blood work. If it's still okay, then she'll call our regular vet, and tell him that Penelope's okay for a dental, and she will also tell him that she would give Penelope some antibiotics to take a few days before the dental, and a few days after the dental. She said that the antibiotics are necessary because when they clean the mouth, a lot of bacteria come out, and because Penelope has suppressed immune system, it would be a good idea for her to take the antibiotics as a preventative.
Since we came back from the St Louis trip, Penelope is eating better and having more energy than right before they gave her doxorubicin. Even the oncology team could see the difference. Penelope now follows me around the apartment all the time, even when I'm preparing her food. She still would not eat the dry food by herself, but she likes the canned and homemade food and the treats. Before she would "hide" on the bed when she saw me preparing her food. She's now back on the treadmill, but only 0.5 miles per day, because I know she doesn't really like to do it that much (just trying to pamper her), but she still needs the exercise. We haven't done agility for a while though. Maybe we'll try that again a little later.
Penelope ate one cup of dry food by herself. I think it's because the prednisone increases her appetite.
They found that Penelope's lymph nodes are enlarged and decided to try another drug. We decided on l-asparaginase injection (we had used this drug before at the very first chemo treatment) and oral CCNU combination. The oncologist said that at the beginning of the treatment, they expect 100% remission, but now with three relapses and several drugs later, we are down to only a few more options, and the chance of going back to remission is only 30%. I think she's hinting that be prepared to have Penelope euthanized.
We had to wait a long time at the waiting room today to find out if Penelope�s white blood count is high enough for us to do another treatment. I think if you wait long enough at the waiting room, there is a big chance you'll get to see some �weirdo� pet owners. Today there is this couple in their fifties who came in with a rooster wrapped in a blanket. They said that they have many chickens, but he has become a pet and was never killed for food. He was in for mite infestation and a limp foot. When the vet suggested keeping the rooster there for two hours so they can do an ultrasound on his foot, his mom just got worried and thought that the vet students are going to "practice" on him if they leave him at the vet school cage. But the vet assured her that he will be well taken care of, and she finally said it's alright. Also there was this cream colored Persian cat with the cutest face and big eyes, who came in on a frontpack worn by his/her mom.
At the vet school today, they said that Penelope's lymph nodes are still enlarged, but they said they'll wait until next week to see if we need to switch to another chemo drug.
Also, the oncologist called our regular vet about giving Penelope a teeth cleaning, but he said he thinks it's too risky to do it right now, and he wants to wait until Penelope's back in remission.
Penelope's cancer has been out of remission for the past month, but we've been trying new drugs and different combinations of drugs. When we went to see the oncologist earlier this week, she stated that "With any protocol we try, our chances of getting a response are 20-30% and any response we get is likely to be short-lived."
So I have decided to have Penelope euthanized on May 17, Monday, or sooner if needed. Virginia and Oscar will come that weekend to say their final goodbyes. And I've found a pet crematory in Atlanta that would do exactly what I want with Penelope's remains (same-day viewed cremation).
Penelope's not only my little girl, she's my canine soul mate. Over the years I've learned to trust her instincts. And although she's not the prettiest dog or the smartest dog, she's the most perfect dog for me. To say that she will be sorely missed is a major understatement.
