Making Argus Feel Better

 Posted by
Jun 262013
 

A little over two months ago, we wrote a post about our ‘big guy’, Argus.  In that post, we mentioned how Argus is getting up in years and moving a little slower than he used to.  Argus’ heart and mind are the same as they have always been.  He is loyal, loving, courageous and sweet as ever.  The problem is his body, though built like a rock, is not quite as durable as his strong yet sweet and devoted character.  Most likely the inescapable conclusion of a life lived all-out, but also a sentence handed to him by his parents and less than perfect genetics.

We first noticed that Argus was showing signs of discomfort a little while after his tenth birthday.  At the time, we thought his energy was diminishing due simply to the fact that he was getting old.  As time went by, we started picking up on little cues that pointed to pain.  He walked and ran just fine, but seemed to struggle to stand after lying in one position for a period of time.  Argus was always more than happy to go for a walk or play at the park, but he didn’t seem to want to stand still for more than a few minutes at a time.  He began to take stairs more slowly than usual, and began to adopt a two-leg hop when climbing the three stairs to get into our house, rather than the typical left right, left right steps he had always used in times past.  As time went one, new symptoms developed, and the ones mentioned above worsened.

With most of our attention focused on Sasha with her cancer, our other dogs, sadly, were probably neglected some attention.  We didn’t take them out to play, walk or hike as often as we had done before our home was visited by those rogue, mutated cells in Sasha’s body.  And we may have been a little less mindful of any discomforts that our other dogs were feeling.  We were late to do something about the pain that Argus was feeling in his joints, but not TOO late.

While researching canine arthritis and learning the different options that were available, we came across the beautiful story of Schoep and his owner.  Schoep was completely debilitated by his arthritis, and his only relief seemed to come from floating on his master’s chest in the waters of Lake Superior.  A photographer and friend captured the beautiful display of love and commitment between Shoep and his owner in the lake, and posted the photograph on his Facebook account.  The response was overwhelming, and soon, people began to donate money so that Shoep could receive laser treatments to help ease his aching body.  The results were amazing!  Before the laser treatments, Schoep was unable to stand or walk on his own.  After just a few sessions, Schoep was back to taking walks with his owner, and seemed to be happy and enjoying life again.  We were very excited about exploring laser treatment options for Argus.

We found a few clinics near our home that offered the treatment, and we called around to compare cost and convenience.  Once we decided on a clinic to go to, we set up an appointment right away.

Argus just finished his sixth treatment on Monday, June 24.  He seems to be getting around better, and he doesn’t limp as much after physical exertion or long periods of inactivity.  Also, we’ll occasionally glance out a window and see Argus running in the yard.  He doesn’t go very far, and he often doesn’t seem to have a goal to achieve or a destination to reach, but he’s running!  We are so happy to see our ‘Big Guy’ feeling better and getting around more easily.

We used to joke about how our dogs would be as they got older.  In some cases, our imagination was quite accurate; failing eye sight, loss of hearing, and even dementia (all Argus <smiley face>), but there have been other changes in our dogs that we did not anticipate.  We never imagined that the once unstoppable force that feared nothing, loved everything and brought so much joy to our home could ever be slowed down.  The unfortunate truth is, Argus is uncomfortable everyday due to arthritis, and the disease has taken its toll on his usual active and energetic character.  We want to do whatever we can to sooth the aches in our old man’s body, and help him be as happy as he can be.  I think we are on the right track with laser therapy.

FYI: Schoep turned 20 on June 15, 20130!

Sasha Goes Back to UPenn

 Posted by
Jun 112013
 

Liliana and I left Raleigh at around 10 PM on Thursday (May 24) and drove through the night with Sasha, Argus and Shelby to my parent’s home in Parkesburg, PA.  We were able to get in a couple hours of sleep before getting Sasha back in the Jeep, and heading to Philly to meet Dr. Mason at UPenn.  Traffic on the Schuylkill expressway was a bear, and it caused us to arrive at the hospital late.

After having the friendly people at the reception desk notify Dr. Mason of our arrival, Liliana, Sasha and I made our way to the seating area to wait for Sasha’s favorite doctor and friend.  It had been four months since our last time at UPenn, and I wondered how Sasha would be.  I wondered if she would be nervous and tremble with fear, as she does when visiting other veterinary hospitals.  I wondered how she would react to seeing Dr. Mason after so much time.  And I wondered if she would give a struggle to leave us behind when it came time for her to go off with the doctor.  I always worry that things will have changed since her last visit to PA, and Sasha might react in the same way that she does at other places.  Well, things have not changed!  Sasha was not trembling in the waiting area of UPenn, and she was ecstatic to see her special friend, Dr. Mason!  We have cellphone video to prove it!

True friends!

Sasha’s return visit to UPenn is not part of the standard protocol for the Mason Bone Cancer Study.  Some evidence exists that suggests administering the genetically modified Listeria vaccine a couple days after palliative radiation may enhance the effects of the vaccine and cause strong anti-tumor activity from Sasha’s immune system.  Dr. Mason made us aware of this finding, and we all decided to give it a go with Sasha.

Sasha was the very first dog to receive the vaccine when the trial started, and she was given the lowest dose.  This time, Dr. Mason administered the highest dose to Sasha.  We weren’t 100% sure what to expect, but we assumed Sasha would react similarly to how she did last year.  IV fluids would be administered to keep her temperature down, and anti-emetics would help reduce nausea.  If the higher dose proved to be too much for Sasha, Dr. Mason would be able to keep things under control with antibiotics, but of course, that would defeat the purpose of what we were trying to achieve. 

Prior to receiving the vaccine, Sasha had blood drawn for a complete blood count, blood chemistry, and a coagulation panel.  The blood work showed that Sasha was very mildly anemic and her lymphocyte count was slightly lower than normal.  All other blood parameters were within normal limits.  Sasha also underwent a cardiac evaluation to ensure that her heart was healthy enough to proceed with the vaccination.  An electrocardiogram was performed to monitor Sasha’s heart for arrhythmias and a complete echocardiogram was performed to evaluate her heart’s ability to contract. The ECG showed that Sasha has a mild degeneration of her mitral, aortic and pulmonary valves.  These findings are associated with aging, and have nothing to do with the cancer, and they existed since the last time Sasha was at UPenn; there have been no appreciable changes since her last visit.  Dr. Mason explained that Sasha’s left ventricle was very mildly enlarged compared to her last evaluation but there was no associated changes that would suggest she has cardiac disease secondary to vaccination. None of the issues found with Sasha’s heart were considered significant enough to prevent her from being vaccinated. 

Thoracic radiographs were taken, and there was no evidence of metastasis to Sasha’s lungs.  A single radiograph was also taken of Sasha’s left femur and pelvis.  While the metastatic bone lesions at both sites were clear to see, there was no evidence that the disease had progressed since Sasha’s last radiographs that were taken by Dr. Neuenschwander at The Brentwood Animal Hospital. 

Dr. Mason gave Sasha an anti-emetic to prevent nausea, and then administered the vaccine at a little past 1:00PM on Friday.  Within a couple hours, Sasha had developed a fever.  Her temperature continued to rise until it peaked at 104.1 six hours post injection. Sasha vomited twice in quick succession while her temperature was at its highest.  Dr. Mason administered fluids via IV, and Sasha’s temperature began to fall.  It was back to within normal limits several hours later.  She also gave Sasha another anti-emetic for her upset stomach, and turned on a fan to help her be more comfortable.  Dr. Mason said that no other adverse events were noted during or after the infusion period, except that Sasha seemed lethargic and a little depressed. 

For the two days after Sasha received the vaccination, Dr. Mason wrote on Sasha’s discharge papers,

“On May 25th, Sasha seemed a little brighter. She ate canned dog food readily twice in the morning.  Repeat blood work was drawn to determine whether vaccination had caused any changes in her red and white blood cell count or changes in her blood biochemistry. The blood work showed that Sasha’s anemia was now more pronounced (PCR 25%) and she was moderately thrombocytopenic (low platelets). Her white blood cell count was unchanged. Her blood chemistry was normal. Sasha showed no clinical signs associated with these blood changes.”

We went back on Sunday for more blood work.  Dr. Mason wrote:

“On May 26th repeat blood work showed that Sasha’s red blood cell count was recovering (PCV 33%) and that her platelets were also coming back up to normal – although still below the normal range (87,000).  These changes were seen last time Sasha received her vaccines although this time, with the higher dose of vaccine, they were more marked. Repeat evaluation of Sasha’s blood chemistry on May 26th showed that Sasha’s liver enzymes were all within normal limits.”

We said our goodbyes to Dr. Mason and took a few photos of Sasha with her good friend.  The trip to PA from NC wasn’t an easy one for us, but we were happy to make it so that Sasha could receive the vaccine again.  We were also excited to see Dr. Mason again, and we know that Sasha was super happy about that, too.  Honestly, bringing Sasha to see Dr. Mason, treatment or no treatment, was worth the trip and any issues and minor hardships that it might cause.  I’m sure Sasha agrees, but she could probably do without all the poking and prodding!

Sasha with Dr. Mason, her favorite vet.

Sasha with Dr. Mason, her favorite vet.

A big thank you to Dr. Mason and to everyone else who helps care for Sasha during her stays at UPenn!  We will continue to take Sasha swimming, and exploring new places.  Check back for updates on Sasha’s progress and to see more photos of her enjoying life!

It’s About Time

 Posted by
Jun 012013
 

Hi everybody!  It’s been quite a while since my last post.  I guess I’ve gone so long without writing because I started a new job, we have two long-term, live-in guests at our house, and life just gets in the way.  Honestly, though, probably the biggest reason that I have not written is out of pure laziness.  Writing doesn’t seem like it should be all that energy intensive, but my energy level has been lower than normal.  My brain is sleepy, and it just can’t seem to recuperate.  Oh well, sorry brain, you are going to have to work now.

A few days ago, I realized that Lili’s Notes (I) had been neglecting someone very important.  This person means a lot to our whole family, and has been a part of our lives for practivally eight years.  He has laughed and joked with us, and shared our pain and sorrow, too.  He has mended our broken bodies, and chased away our pains.  We count on him to fix the problems that we cannot, ourselves, fix, and he always looks out for my family’s best interests.  His name is Steve Neuenschwander, but we call him Doctor N.  He is the owner of the Brentwood Animal Hospital, and veterinarian to my five beloved dogs.

In case we haven’t made our feelings completely clear to all of you in the past, Liliana and I love our dogs!  They are a major part of our life, and have been for more than 12 years.  We try to give them good lives, lots of love and the best care possible.  I would jump in a raging river for our dogs, and Liliana has run out in traffic to protect one of our babies.  Y’all had better believe we wouldn’t trust our dogs’ medical care (their lives, really) to just anyone!

Now, I have not attended vet school, so I am not capable of testing Dr. N’s knowledge of veterinary medicine.  I have to assume that his knowledge is sufficient and his experience ample.  There are other personal attributes, though, that I feel fully qualified to assess.

Dr. N Cares.  He is a kind and compassionate man.  This has become unmistakably evident to me for the almost eight years that we have been taking our dogs to Brentwood Animal Hospital.  Dr. N has a nuanced character that some people may not be able to immediately decipher, but I clearly hear and see the different emotions on his face and in his voice.  He is usually happy and in good spirits, but on a rare occasion, I see another side of him.  Sometimes Dr. N is more quiet than usual.  Sometimes he says hello when he walks in the room, and then gets down to business without much in the way of superfluous chit chat.  It is on these rare occasions that I know Dr. N had to, or will have to deliver difficult news to one of his clients.  Dr. N had to deliver such news to Liliana and I twice.  The first time was on March 6, 2012, when he had to tell us that our Sasha had Osteosarcoma.  The second time was on February 26, 2013, when Dr. N informed us that Sasha’s cancer had come back.  He hated having to tell us the bad news both times.  Both times, he said he was sorry and that he wished his diagnosis was wrong.  There is a sincerity in Dr. N’s face and in his tone, and I know that delivering bad news to pet owners affects him deeply.

Dr. N is honest, and humble.  He is an intelligent man with considerable education, but he will never put his pride before the best interests of his clients and the animals with whose care he has been entrusted.  Dr. N has a good working relationship with veterinary specialists who he defers to if he believes any advantage can be offered by allowing these other great doctors to do what they are best at.  I cannot tell you how much I appreciate that.

This post would seem incomplete without mentioning some of the staff at Brentwood Animal Hospital.  Shelly has been a fixture at the office since we first started taking our dogs there.  She is a smiling face, a cheerful voice, and a pleasure to see every time we walk through the front door.  Shelly genuinely cares for every dog, cat, bird and other animal that crosses her path.  She know all the human parents of her furry friends, too, and one gets the feeling that she cares about them as well.  Christina has also been at Brentwood Animal Hospital for as long as we’ve been going there.  She is a vet tech, a whiz at drawing blood, and a friend.  Christina is a natural with animals and all of our dogs love her.  She is proud of the vegetable garden that her and Dr. N built in the back of the hospital, and she enjoys showing it off to us when we go.  Dr. N has a great team with these two wonderful people.  I know for a fact that each one feels  very fortunate to be in the company of the others.

Liliana and I have talked about moving away from Raleigh.  We would like to live in a cooler climate and have more land.  We joke, though, that we would not consider moving as long as Dr. N is still practicing.  To be honest, I’m not sure how much of a joke that is.  When you care as much about your pets as we do, it’s hard to imagine moving away from a place like The Brentwood Animal Hospital.

Check back soon: New updates on Sasha and her battle against osteosarcoma (she goes back to UPenn!!).  Argus gets treatment for his arthritis, and more about the rest of the pack.