Week #11 Checkup

No chemo this week!! Jenna went in today for a checkup, and all is well. Blood work normal, lymph nodes not enlarged, appetite very much intact. Vet ecstatic. Lymphoma, you should just give up now. You are no match for the Big Bad Bear. Can I get a whoop whoop?

And here is the long awaited Santa picture:

Album: Jenna and the Great Outdoors

Jenna hiking in Waterton Lakes National Park, Alberta ...

... in Mount Robson Provincial Park, British Columbia

... at the Columbia Icefield, Jasper National Park, Alberta

... and in the Alberta badlands, Dinosaur Provincial Park

Visiting the dinosaur museum - they wouldn't let her in, though. She's too poorly behaved (and mutty) to pass as a guide dog. ;)

Having a field day on a backpacking trip in Cypress Hills Provincial Park, Alberta. There are no bears in that part of the province, so I let her off leash during the day. She thought she'd died and gone to heaven.

A routine walk at our favourite off-leash park.

Prissy-dipping in the river at the dog park. A Labrador she is not.

Chemo Week #10

Well, yesterday was week 10 - doxorubicin. This drug makes me a bit nervous because it can cause heart problems. Also, if it accidentally gets into her skin or muscle tissue (as opposed to into the blood vessels, where it's supposed to go), it causes tissue death. As usual, though, Jenna had no problems.

In fact, the clinic was doing pet pictures with Santa in support of our vet's Rwanda charity, and the vet insisted that Jenna stay after her treatment to have her picture taken. I wish to stress that we are not normally the sort of people who pretend our dog is a child or that she enjoys the same things that children do. (I once saw a young woman pushing a Shih-Tzu, which was wearing a fussy little dress, in a stroller. I was vaguely disturbed by this.) But anyway, when the vet who is giving you huge dicounts on your chemo wants you to stay for Santa pictures, you stay for Santa pictures. Therefore, I will soon be posting a ridiculous picture of my dog wearing reindeer antlers and sitting beside Santa. I don't think Jenna minded anyway - as long as she gets a cookie, she doesn't care what you do to her.

Remembering Harlem

Although this blog is Jenna's, I want to write a post about my Labrador, Harlem, because I've been thinking about him a lot lately. I got Har when I was 16 years old. We grew up together. I took him with me when I went to university and moved out on my own, so we were together for his whole life.

Harlem was one of those dogs who you find once in a lifetime. He was a sweetheart and a gentleman, but he seemed to know when to pretend he wasn't. He was a tall, rangy, solid black, 95-pound gigantor of a dog, and he had an enormous, booming bark that he only rarely employed.

My big dog was well behaved, well adjusted, sweet, cuddly, intelligent, and eager to please. He loved cats. He loved to swim. He loved the sunshine. He brought a lot of sunshine to my life, especially in the darkest times. He was a leaner and a hugger and a magnificent bed-hog. I loved him like a son.

He died of cancer on February 4th, 2008, just 2 months before his 10th birthday. He had histiocytic sarcoma - a rare type of cancer. It spread through his body with incredible speed. It was less than a month from diagnosis to the end of his life. I didn't do chemo for him. The vets did not have very positive things to say about the treatability of this type of cancer. Reported survival times, even with chemo, were still poor. At the time, I decided that putting him through chemo wasn't worth the suffering it would cause him for the off chance that it might buy him a month or two. But now that I see how great Jenna's doing, how the chemo has basically given her back her health, I wonder if I made the right decision with Harlem. Even if it didn't buy him much time, what if chemo would've made him feel better, as it has for Jenna? Back then, I envisioned vomiting, lethargy, and anorexia. I didn't know it could be like this.

These are self-torturing thoughts, of course, and they won't do me any good. And I feel guilty about being sad about this when Jenna is doing so wonderfully. But I can't make these thoughts vanish, and in quiet moments, they sneak up on me even though I am trying to ignore them.

Chemo Week # 9

Yesterday morning I dropped Jenna off at the vet for chemo. While the receptionist dutifully asked me questions like "has she had any diarrhea or vomiting?", "is she eating well?", and "how is her energy level?", Jenna alternated between attempting to launch herself at an animal health technician of whom she is particularly fond, jumping up to stand at the counter so she could lick the receptionist, and making sorties towards the cookie jar. I was unable to sign the treatment authorization form until someone came out to take her from me. When we got her home at the end of the day, she went straight for her bowl, as usual. She's doing so well that most of the time, I forget she even has cancer.

Facts About Jenna

We almost never call Jenna by her real name. We call her the Bear. And sometimes the Bad Dog. I'm pretty sure we started calling her this because we hated her name. We adopted her from the Humane Society on October 28th, 2003. She was already 3 years old at that point and had lived in 3 homes (all of which returned her to the shelter within a year). The only thing she seemed to know was her name, so we decided not to change it.

So why, you ask, did 3 separate people bail on this beautiful dog with the Cleopatra eyes? We can't figure it out either. She's great with kids. She's as housetrained as it gets. She's bizarrely trusting, considering the life she's had: she will lie there, semiconscious, and permit us (and total strangers) to clip her nails, remove slivers from her pads, sticks from between her teeth, and even porcupine quills from the roof of her mouth. Vets invariably declare her a gem among dogs.

Yes, we have to put the garbage on top of the cupboard. All shoes go up on a high shelf by the door. Dirty dishes left in the sink remain there at their peril. We have to restock wooden spoons every other month. None of the Tupperware has a surviving lid. Sometimes we find cutlery in the couch. All that's left of my husband's leather belt is the buckle. Oh, and if you leave dog cookies in a coat pocket, the coat will be dragged off its hanger and the pocket will be surgically removed. I guess those might be reasons why someone would take her back to the shelter. Luckily for us, we don't own anything of value, so mostly her escapades aren't much more than a minor inconvenience. Except that one time that she pried open a kitchen drawer and ate a kilo of raisins, and we had to go to the emergency clinic to have her stomach emptied before she had kidney failure. That sucked.

The Chemo Regimen

The chemo protocol that Jenna is on is a slightly altered version of something called the University of Wisconsin-Madison canine lymphoma protocol. It is what's known as a "multi-agent" chemotherapy protocol - that is, several different drugs are used in a course of treatment. This is Jenna's chemo regimen:

Week 1: vincristine (brand name Oncovin) given once IV at the clinic, prednisone (pills) given daily at home
Week 2: asparaginase (brand name Elspar) given as a single subQ injection at the clinic, prednisone given daily at home
Week 3: cyclophosphamide (brand name Cytoxan) pills given for 4 days at home, prednisone daily at home
Week 4: vincristine IV at clinic, prednisone daily at home
Week 5: doxorubicin (brand name Adriamycin) given IV for a full day at clinic
Week 6: no chemo - blood work and recheck only (yay! This is a cheap week!)
Week 7: vincristine once IV at clinic
Week 8: cyclophosphamide pills for 4 days
Week 9: vincristine IV at clinic
Week 10: doxorubicin IV at clinic

If in complete remission at this point, treatments continue every other week:

Week 12: vincristine
Week 14: cyclophosphamide
Week 16: vincristine
Week 18: doxorubicin
Week 20: vincristine
Week 22: cyclophosphamide
Week 24: vincristine
Week 26: doxorubicin

If in complete remission at this point, all therapy stops and monthly rechecks are done. (Keep your fingers crossed!)

It sounds intense, but it isn't so bad. We only go to the clinic once a week. For the vincristine, asparaginase, and doxorubicin, we drop her off in the morning and pick her up at end of the day. Our vet likes to keep her there for the day so that she can monitor her for several hours after treatment, to make sure that Jenna isn't going to have any serious reactions. For the Cytoxan, we just take her in for a checkup and blood work, and then we take her home and give her the chemo at home. Our vet does an exam, including blood work, every week. Jenna also gets Sulcrate pills every day, to protect her stomach from the potential side effects of chemo. Right now, we're starting week 9. So far, so good!

Introduction

I decided to write this blog for me, for all of those who are rooting for Jenna, and, hopefully, to help other people and their dogs who are faced with the same questions, worries, and decisions that we find ourselves facing.

In September, we found out that our 8-year-old Humane Society mutt, Jenna, had lymphoma. We had been noticing for several days that she seemed a little lethargic and strangely "off" to us. Then one evening, our dog, who is normally an eater of all things, edible or non, turned her nose up at her dinner. We went straight to the vet, where an enlarged lymph node was discovered in her chest. They took a needle aspirate of the node, and the results from the lab came back with the diagnosis: lymphoma.

The good news, we were told, is that lymphoma tends to be one of the more treatable cancers, and survival times with chemotherapy can extend to over a year. (Survival time for untreated lymphoma patients, by the way, is about 1 month.) We had lost our other dog from a rare, terribly aggressive type of cancer just 7 months before Jenna's diagnosis, and we were not prepared to go through that again so soon. We decided to try the chemo.

There was a catch, though. About a year ago, Jenna had a near-death experience with a condition called Evans Syndrome. It's basically an autoimmune disorder in which the immune system attacks red blood cells and platelets. It makes the animal life-threateningly anemic and prone to unstoppable bleeding. Jenna lived through this ordeal and made a full recovery, but she is always considered to have the condition, and it is always possible that it could return at any time. The oncologist that advised our veterinarian about chemotherapy said that Jenna was not likely to have the same survival time as a non-Evans dog, but that there was no way to be certain of what kind of timeframe we might expect. She also stated that Jenna may have complications from the chemo because of her previous blood disorder.

However, the thing about Jenna is, she's a tank. We know from the Evans episode that she can tolerate massive doses of some pretty unpleasant drugs without even slowing down. She has a cast-iron gut, which we know from her years of habitual garbage looting, random sidewalk litter swallowing, kitchen pillaging, and shoe/belt/coat eating. So despite the uncertainties,we decided to try the chemo anyway.

After the first treatment, her lymph nodes, which by then ranged from golf-ball-sized to billiard-ball-sized, decreased by about half. As of today, we're 8 weeks into the chemo, and she's plowing through it. Her appetite is as excessive as usual, and she's happier and more energetic than she was before we even started the chemo. The vet has been crowing for weeks that she can no longer even detect the lymph nodes. We don't want to jinx ourselves by saying the "R" word yet, but after 2 more weeks, if she continues to do this well, we can openly declare that she is reaching that ultimate goal: Remission.

This has been a long post. I promise, the rest won't be! Future posts will cover things like drugs, costs, and, of course, regular updates on Jenna's condition, because I know those were things that I was looking for when I found out Jenna had lymphoma. I hope this blog will help other dog owners to feel more hopeful about treating lymphoma, and I hope it will dispel some common fears about chemo. Most of all, I hope that I will continue to be able to blog about Jenna, because it means that she will still be here.