I haven't updated you on Sydney lately due to not much change the past 2 weeks. Last week I noticed he was whining a little more at night and drooling a little like he had an upset tummy. A few times I think he's just thrown up but not sure if that's due to something he ate outside (you know, horse apples) or grass causing it. One night last Friday, he actually raced down the stairs to go outside to eat some hay (he always in the past gets an upset tummy for various reasons and goes and eat grass, hay or whatever is around including all the fake spanish moss around all my fake trees in baskets <sigh>). So I have been giving him a little pepto bismol inside hollowed out hot dogs, which seem to help. So this past week has been a little different than past week since he started his chemo of doxorubicin.
Yesterday (10/2/03), I went to K-State for his 3rd round of chemo. As normal, he did great, just lying there for them and not causing any fuss. When I first met with the student vet before he went back, I told her about the little lump under Syd's left rear hock that I had found while massaging his leg after his amputation and that it didn't look like it had grown any, but was concerned about it. She asked if I wanted to get a needle aspirate done and I said yes. So they did that as well as his chemo. I also told her I needed refill on the clinical trial pills (either placebo or piroxicam pills) as I was almost out. I asked the student vet if I could find out what type of pills Syd was actually getting at the end of the study. She said she would check with the oncologist.
We normally have to wait about 4 hours to get everything done (bloodwork, chemo treatment, etc) but yesterday because one of the techs was sick, it slowed things down. I came back in to pick up Syd and he was more excited than normal. They took me to a room so I could ask questions about the clinical trial pills and learned something that I was confused about. The oncolgist, who had gone over the gist of the study with me, told me that obviously she doesn't know what type of pills Syd is getting and probably only their pharmacist knows. She said that they wouldn't be able to tell me that, but maybe the pharmacist could in a sealed envelope. I explained that if Syd was on piroxicam now, that once he got off the study, that I could then continue with it if it was helping. The oncologist informed me that Syd had to stay on the pills until the disease progresses! I told her that I thought that the study was during the time he was getting chemo. (They had informed me that after chemo, Syd would be required to come back at 1, 3, 6, 9 and 12 months to get lung radiographs rechecked as part of the study). I told her I thought the study lasted through his last chemo treatment October 30th, and then nothing else was covered after that and that he was no longer in the study. I read through the study sheet and didn't remember seeing anything about he continued the pills until the disease came back. I told her basically then, that since we don�t know what Syd is getting (piroxicam or placebo), that I will be unable to help him by giving him piroxicam or anything else to help slow the progression. I asked if Syd's cancer progresses, would I then be able to see if he had been given piroxicam or not? She said once any signs of the disease shows up, they will immediately take him off the study and then tell me what he has been getting. Then we can treat from there. She said if in his follow up chest xrays, it shows less than 2 nodes in his lungs, they can be surgerically removed and another form of chemo administered like carboplatin. She did say that's why they are doing a study on piroxicam because all the research she has read, there isn't a good correlation as to whether or not piroxicam definintely has anti-cancer tendancies. So now I feel like I almost have a 50/50 chance of giving Syd a death sentence because I chose to have him be part of this study. I know she told me while on this study, I could not give him any pain meds or other immune building things. But I thought that the study was only during the 2 months he got chemo treatment and after that, I could start giving him whatever I felt was necessary to help slow the disease down. I plan on talking more with them in 2 weeks because it's something I want to make sure I want to continue doing for Syd's best interest. She also said that if I did find out from their pharmacist what it was and then started giving him piroxicam because he was only get a placebo, then that would tell the oncologists pretty much what he was getting if I switched, which would skew the study a little. I understand the significance of the study, but like everything else, it's my dog and I have to decide what is best for me and Syd. There are never any right or wrong decisions, you see. Just ones that you have to be comfortable with living with the rest of your life. No regrets.
My oncologist also said he needed to lose more weight. They said when he walks, most dogs walk on their pads, but because of him only having one front leg, he's starting to walk farther down on his foot by his extra pad because of his weight. I asked her what a balanced diet would be and she said anything that would help his lose weight. I mentioned Hill's N/D and she said that is good for dogs with cancer, but it's very high in fat and she wouldn't recommend him having that since he needs to lose weight, not maintain or gain weight. I also asked her about omega 3 fatty oils and flaxseed oil/cottage cheese and she said as long as the cottage cheese is low or no fat, then it would be okay.
She also said they did a needle aspirate 3 times on the lump in his leg and it was just a fatty lipoma! So that's one less thing I have to worry about. Now I'm just kicking myself for this study confusion. I just feel that I've given Syd a death sentence for not being able to give him everything I'd like to in order to give him the very best in treating this disease. I know that he will probably eventually get it back or there is a strong possibility of that happening no matter what I do, but I'd rather him be one of those dogs that thumb their paws at stats!
When the oncologist went out of the room to get some information, the student vet was still in the room with me. Syd was SO excited (probably because of the longer stay), that he actually jumped up with his front paw on my chest and did it again later when he jumped up with his front paw on the exam table! He hasn't done that since before his surgery! He was just such an excited and good boy!!!! I drove home thinking about the study and how I feel like I've shortchanged Sydney. I just want to do the best for him and thought I had done that with this study. I guess I have a 50/50 chance of him getting piroxicam. My vet asked how he was getting around and I told him and he bet that he was on the real thing or else he might be getting sore, etc since he's not on anything else for pain meds or anti-inflammatory. So maybe he's right. It's just so confusing. <sigh>
|
