Lymphoma treatment setback (long)

[Albie]

Jack had his fourth treatment of doxorubicin on Monday for lymphoma. His oncologist was very pleased with his condition since he continues to be in remission, but decided to give him a reduced dose of doxorubicin in an attempt to reduce some of the side effects he experiences after treatment. Usually beginning about two days post-treatment, he starts with bloody diarrhea and nausea and we have a difficult time getting things under control, even with medications given before his symptoms appear. Things seemed to be better until Thursday (day three post-treatment). He ate his dinner but promptly vomited it back up. He wasn't drinking much water either. Friday morning we woke up and while I was in the other room, I heard a loud thump. I went into our living room and found that Jack had collapsed. I left a message at the oncologist and called my regular vet, who thankfully has great office hours and was there at 7:30 am. I took him in and unfortunately he had a pretty severe heart arrhythmia, low blood pressure and was dehydrated. She worked on him for most of the day, giving him fluids and getting his blood pressure up, and got us in to see a cardiologist late yesterday afternoon. Jack had an echocardiogram, and it was learned he developed a multifocal ventricular arrhythmia caused by doxorubicin cardiotoxicity. The cardiologist was very positive after the exam noting that Jack's heart had normal dimensions. But, he has low normal left ventricular contractility, which is where his problems are coming from. He explained that the doxorubicin has caused scarring in his heart so that the electrical impulses being sent through his heart aren't being received properly by the left ventricle and it is causing the irregular heart beats. There isn't anything we can do for the damage to his heart, but he put him on Sota to control the arrhythmia. He feels once the arrhythmia is under control (which should happen very quickly), that Jack should be fine. He recommends that Jack does not have another doxorubicin treatment, but since he only has one left, I can't imagine his oncologist would want to continue with this drug. I haven't heard from his oncologist yet, but since we finished up at the cardiologist late on Friday, I expect she'll get in touch with me on Monday. Jack seems to be good today. He ate a bowl of boiled chicken and rice, and is sleeping on the sofa. I don't think he even realizes the scare he put us though yesterday!

 

[packblt]

Glad to hear Jack is feeling better today! Hope you are feeling better too – scares stay with us a lot longer and really take their toll. Sending <<<<healing vibes>>> your way for everyone.

 

[shindig]

Ah, poor Jack, glad he's feeling better now. Bandit also had a bad reaction to his last dose of doxorubicin, the fourth I think. He was fine until day 3 post treatment. He started throwing up yellow bile, drooling uncontrollably and wouldn't eat anything. I couldn't even keep Cerenia down him because he would vomit. My vet came by my house day 4 and gave him a Cerenia shot. It didn't help and he looked just miserable. I took him to the vet on day 6 and he had elevated enzymes in his kidneys and was put on fluids and anti-biotics. He stayed 2 full days at the vet and came home happy and hungry as ever

He in now on Elspar but I'm beginning to think the cancer is going to get the best of him soon. His LNs on his neck are swollen again (not huge but pallable), so he is currently out of remission again. My oncologist is sort of at a loss at to what to try next. It just sucks because I have tried everything I can think of from a grain-free, high protein diet to supplements of all sorts (IP6-Inostol, Shark Cartilage, Fish Oil, K9 Immunity Plus, Vitamin E, Milk Thistle, ect). I also home cook for him and mix in with his kibble.

Kevin

 

[Albie]

Kevin - I'm so sorry to hear about Bandit. You have done so much for him and have provided him with the best opportunity to beat this nasty disease, and I'm so sad to learn that it's starting to get the best of him. All you can do is keep on going until there's nothing left to do... We will keep our paws and fingers crossed that there's still more fight left in all of you!

Jack seems to have been a bit worn out these past two days. I'm not sure if it's post-treatment lethargy or if it's from his ordeal on Friday. We are supposed to keep him quiet this weekend and give the heart medication a chance to do it's job, so it's good all he wants to do is rest. He did get a burst of energy yesterday evening and was whining at the door to go on a walk. I thought maybe I could take him on a short walk down the block without him getting excited, but he refused to walk the way I wanted him to. Instead, he wanted to go up the block to a busier street, which I knew was a bad idea but gave it a shot. As soon as we turned the corner to the busy street, Jack saw a dog and started to bark. That put a quick stop to our adventure until he is seen by the vet tomorrow for his ECG and evaluation to see if the heart med is working. I've had two boxers with heart problems, so to have Jack develop a heart condition is so disappointing. I'm just hoping it doesn't adversely affect how we go forward with his cancer treatments.

 

[rbrianboyd]

Jack and Bandit - Bailey and I know what you are going through and just wanted to remind you to hang in there.

Bailey has been taking Sota for two years prior to being diagnosed with t-cell lymphoma for her arrhythmic cardiomyopathy. Although she hasn't had a episode in two years, she collapsed a week or two ago shortly after having her third dose of doxorubicin. It was minor (relatively speaking from other episodes she had when 1st diagnosed) and, thank god, none since that time. My cardiologist warned in advance the damage the drug could do to the heart but told me that it should have no effect on her arrhythmia. Now after reading your post Albie, I think they told me wrong. We are due back this weekend so I will definitely be speaking with them about what your cardiologist said.

There is a helpful video on dog CPR, just in case you have another episode. Very helpful to get blood to their brain during an arrhythmic episode if there heart isn't doing it on its own. Google dog trainer saves dog with cpr or see link below:

Dog Trainer Saves Dog with CPR - YouTube

Finally, thanks to all for posting here. The info is very helpful and it gives me some sense of relief to know that others are going through the same thing.

Best,

Brian

 

[shindig]

That's a great video Brian....thanks. I'm hoping Bailey gets to feeling like herself again soon. I made a poor decision, or at least I think I did, by taking Bandit to the lake on Sunday. I want him to have a normal dog life, even though he is very sick from cancer. He ran around like his younger self and swam in the lake with the other dogs. I think he drank too much of the lake water and is now vomiting all over the house. I can't even get a Cerenia down him without him throwing up...not a good start to a Monday morning. I'm home with him, and working a little from my house. I sent a txt to his vet to see if I should bring him in for a Cerenia shot. I'm just mad at myself now because I might have jeopardized his treatment.

Kevin

 

[rbrianboyd]

Kevin, in my opinion, you are being too hard on yourself. I think its great that he ran around like a spring chicken and had a blast. I like to let bailey live her normal dog life too. Plus, I don't think lake water would jeopardize his treatment. Tomorrow is another day. Hope bandit feels better then.

Brian

 

[Albie]

What a difference a day makes! Jack seems to have turned a corner and is having a good day. He loves to chew, and has a big bully stick that he's gnawing on and tossing around right now. It makes my heart happy to see him this way!

Thanks for the video Brian. I hope I never have to do CPR, but it's good information to have! It seems Sota is a pretty common drug used to treat heart arrhythmia. The cardiologist said we should see results pretty quickly. So far, so good. No further episodes! The cardiologist was pretty adamant about not using doxorubicin again, so I would be very cautious about using it since Bailey had an episode of collapse after treatment. I spoke with Jack's oncologist today, and she agreed that we would not use doxorubicin again. We now have to figure out where to go from here. Since Jack is in remission, she said she is hesitant to use another drug at this time because if she uses it now, it means she can't use it later if/when Jack comes out of remission. We have to decide if we want to use a wait and see approach and hopefully get a nice long remission without the last treatment, or perhaps use a sister drug of doxorubicin that doesn't have the potential side effects and do another treatment or two. I'm torn as to how to proceed. She's going to call me next week to see how Jack is doing, and we'll try to formulate a plan at that time. Right now, she believes the heart arrhythmia is a more immediate concern than the cancer.

Kevin, it's so great that Bandit had a fun day at the lake! Quality of life is the most important thing right now, and if he enjoyed it, then it was worth it. Look at it as a lake hangover! I hope by now, you've been able to get his stomach settled and things are peaceful once again.

 

[shindig]

Well I'm happy to report Bandit (bandino ) is feeling much better today and hasn't thrown up since yesterday morning. I took him to the vet at noon yesterday and he got a Cerenia shot. I fed him small portions that evening of a bland diet and he was starving this morning . I went home over lunch to check on him and give him a Cerenia by mouth and he was wiggling his butt all over .

Thanks all, sorry, sometimes I have a tendency to overreact to things. I think I get overly worried about him at times. I'm glad it was just a little "lake hangover".

Healing vibes to Jack and Bailey.

Kevin

 

[Albie]

I spoke with the oncologist today and she has definitely decided not to continue chemotherapy at this time. She thinks that there should be no statistical difference in remission time between the four treatments of doxorubicin that Jack received and the full five treatments he was supposed to receive. I'm concerned that we aren't doing anything further at this time, but his oncologist seems pretty convinced that his body needs a break. We will go in for an appointment in a month so she can see how he's doing. He seems great right now, so I'm going to try not to worry and enjoy my time with him!