Prayers needed for Zeke. Potential not good news today.

Within the last week, I noticed Zeke had some what I believed to be enlarged lymph nodes.
I took him to the vet today and as soon as she felt him up she said, "oh crap".
She did a fine needle aspirate on 5 nodes.
She said when a dog has swollen nodes and no other symptoms, it points to lymphoma.

So we sent the samples out and might have some news tomorrow.
If the results say "reactive", that would be good as it points to an infection. We'd put him on antibiotics and move on.
If they don't say that, that's when we'll know it's lymphoma.
If it is, then we'll have to biopsy a node, do blood work, take x-rays, etc in order to type and stage it.
I know it hasn't been confirmed, but my gut is telling me he has it.

To look at him, you'd never know anything is wrong. His weight is good & steady. He eats like horse; always begging for food. He bounces off the wall when people come and go.

My head is swimming right now.
I can't believe this is happening to him. He's the baby. It's not supposed to go this way.
And I want to know why. I know they don't specifically know what causes it, but I still want to know why and how.

So if you could please spare some prayers, well wishes, whatever; we'd really appreciate it right about now.
Respond to this topic here on forum.oes.org  
I'm so sorry you're going through this. I'll say a prayer for Zeke and you Mark.
He's a little quieter today.
Ate his breakfast a smidge slower than normal.
Every time he barks or even attempts to barks, he hacks and gags. Not sure what that means. I'll let his vet know when they open.
Oh no, how awful for you. Sending the biggest hugs can get down "the line". xx :ghug: :crossed: :wag: :tea:
Just got the bad news.
Confirmed lymphoma.

Next step is for the lab to determine if it's B-cell or T-cell. They're both bad but B-cell is a little less worse.
That'll take 7-10 business days.
He'll also have to have x-rays, blood work, and urinalysis.
Once all the results are in from the diagnostic work, then we'll be able to determine treatment options.

He's at the vet now getting x-rays (chest & abdomen), blood work, and urinalysis.

Can't even think clearly right now. Can't believe this is happening. Wasn't supposed to go down this way.
Oh crap :cry:
Oh no! Mark I am so sorry. Please don't get too far into the what-ifs
until you know more. Sometimes it isn't a worst case thing and there can be recovery. I am thinking of you, as we all are. Good luck and I hope you get
a little better news in the days to come.

Shellie
So he had his tests today.
His vet said she saw some enlarged lymph nodes along his sternum in the chest x-ray. Nothing jumped out at her in the abdominal series.
Overall, she said they were mostly unremarkable.
So that's some better news in all this.

We won't have the lymphoma PCR test results for 7 to 10 business days. This test determines type (B-cell or T-cell). B-cell is less bad.

The blood and urinalysis tests will be back on Saturday morning.
These will show any involvement of kidneys and liver and how much. And of course white blood cell count.

All of the data from the tests will determine the course of treatment.

One thing I learned is that it's not Stage 1. Only one node would have to be involved for a Stage 1 rating. He has multiple nodes involved.
And it's PROBABLY not Stage 4 because the films are mostly unremarkable.

So now it's a waiting game. The hardest part.
Mark, I am so sorry to hear about Zeke.

:ghug: :ghug: :ghug:
I'm so sorry to hear about Zeke. I'm keeping positive thoughts that treatment will work. I BELIEVE VERY STRONGLY IN PRAYERS!!! :hearts: :hearts: :hearts: That's why I'm saying for you both. :hearts: :hearts: :ghug: :ghug:
Just got the blood & urinalysis reports back.

They show elevated liver levels and elevated SDMA levels. The elevated SDMA levels can be an indicator of early kidney involvement. The elevated liver levels can be an indicator of liver involvement.
The next step is an abdominal ultrasound.
The worry is, if there is any liver & kidney involvement, and he can't metabolize any of the treatments, we'd be out of options. You need to be able to metabolize the medicines in order for them to be effective.

Still waiting for that PCR test. Apparently this test holds a lot of info. His vet said she'll call the lab first thing on Monday to see about an ETA.

My vet may just refer us to the oncology department at our large animal hospital.


In the meantime, he was slow eating this morning. Slow to start, slow to finish, stopped a few times during. I had to put some wet food on his food to get him to finish. I'll probably pick up some appetite stimulant for him.

But there's nothing else I can do this weekend. This is killing me. I want to help him and help him NOW.
I am so sorry for both of you, hope you get some good news with the test results and have some hope.
Try and keep strong. The waiting is always bad whatever it is you have to wait for. xx

:wag: :tea: :ghug:
Getting ahead of myself, I know, but it looks like there is some real work being done on immunotherapy treatments for dogs with lymphoma.
But we don't even know what kind of lymphoma he has yet, so.....

http://www.vet.upenn.edu/research/cente ... e-lymphoma
I have fingers crossed for tomorrow
Zeke threw up a little yesterday evening and a lot a little while ago.
The vet has prescribed Serenia, an antiemetic.
He seems happy otherwise.

No news from the lab regarding the PCR test.

I called our local veterinary oncology department but they're only in on Tuesday and Thursday.

sigh. The stress is high.
Hang on in there. We are all thinking of you I am sure. xx
The vomiting could be from the antibiotic Baytril his vet put him on for the hacking & gagging.
I'll check with his vet tomorrow.
Just talked with my vet. More than likely, she was going to refer me to the local oncologist.
So I asked them to just go ahead and make the referral and send all his records to the oncologist.
Looks like the oncologist will see him on Tuesday and we'll do the ultrasound then so he can personally see it.
Zeke is on my prayer list.
PCR test says it's B-cell type.
Supposed to be slightly better than T-cell type but I can't tell you why and what it means for him and his future.
Will probably have more info tomorrow after oncologist appt.

In the meantime, his demeanor is up & down.
Sometimes he's quiet, other times he's himself.
His appetite is good one day and weak the next.
He ate his dinner well this evening and promptly threw it all back up.

And something strange; his ice blue right eye has turned gold. The iris, mind you, and not the sclera. No idea what that means. Not even sure if it's something that happened recently. Will ask about it tomorrow.
:cry:
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So not too good news today.
He has a bigger belly.
During the ultrasound, they noticed an enlarged liver and fluid in his belly. It appeared as there are tumors in the liver. His liver levels are up.
And they're draining his belly to check for cancer cells; this will give a good indication if it has metastasized.
He doesn't like to stage these things but when pressed, he put him at definitely Stage IVb, could even make a case for Stage Vb (the b means the dog is exhibiting signs of sickness).

So they gave me 2 choices:
1) palliative care: steroids, pain killers, anti-nausea meds, anti-vomiting meds, anti-diarrhea meds, appetite stimulants. Expected life = 1-3 months.
2) chemo: probably get all the same meds as above in addition to the chemo drugs. Expected life = 6-12 months (maybe even longer).

I asked a whole bunch of probability questions.

He's concerned with the condition of the liver. It could prevent the successful treatment of Zeke because his body would not be able to process the chemo drugs which means he would get no benefit from them.

I made the decision to try the chemo. It sounds like we'll know in a short amount of time if we're making any headway against the cancer.
I told the doc that if it looks like it isn't working, then I won't want to continue with that pathway, which would mean shifting him to palliative care.
Chemo is about a 6 month ordeal. Once a week for a few weeks, then every other week, then every 3rd week, and so on.

The doc said he has a 60% chance of getting into remission. That's lower than normal because of his liver involvement.

So I hope I'm making the right decision here. I feel like if there is any chance that he could get into remission, then I need to give him that chance. Does that make sense?

What are your thoughts?
I have heard that chemo doesn't debilitate dogs the way it does humans because it is more like palliative care itself, it's not trying to eradicate the disease. I hope it goes well for you and Zeke.
Ron wrote:
I have heard that chemo doesn't debilitate dogs the way it does humans because it is more like palliative care itself, it's not trying to eradicate the disease. I hope it goes well for you and Zeke.


I've also heard that dogs respond better to it than humans.

All we can do now is pray that it works, that the remission is durable, and that he's not suffering.
If I think for one minute he's suffering, I will stop the chemo and go into palliative care.
My first thought were enough is enough but then when actually thought about what would I do and I have agree is I could afford all the treatment I would go on the same path as you and the above 2 have agreed with- If not working then at least you know you have tried your best for your best friend or otherwise you/I would start thinking-"what would have happened if I had tried chemo"- nasty effects in humans but worth it if helps in the end- my mum had 5 years more- so go for it and fingers etc crossed. Big hugs. xx xx
:wag: :tea: :ghug:
Mark~~I am so very sorry about sweet Zeke...and you...When Heart was diagnosed with Lymphoma, we weighed all the options and decided not to take the chemo path...Right or wrong~~that is what my gut told me to do. Your gut is telling you to take the chemo path. You have to do what your heart tells you to do. Do not rethink~~do not regret~~you are doing what is best for your precious pup. Zeke knows that..just like Heart knew we just wanted her to be for as long as she could.

Thoughts, prayers. white light...and much support for you in this difficult time.


:ghug:
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Sending prayers to you and Zeke.
Update:
Zeke went for his week 2 check-up and treatment.
Doc says his liver is smaller, there's no fluid on his belly, his nodes are a bit smaller, and his kidney & liver levels are down (still high but lower than the last few weeks).
The fluid they pulled off his belly last week was lymphoma but the doc says that's actually better than the alternative. The alternative would have been liver effusion, which would have meant cirrhosis, which would have been really problematic.

He's on the CHOP treatment protocol.

He seems to be handling the treatment well. He did throw up this morning but we think that was from the disease and not the treatment. We went a week and 2 days instead of 1 week.

He HAS lost almost 7 lbs in the week and 2 days since his last treatment. I didn't see that until I got home. I'll call them tomorrow and ask if that's a concern.

Need to hold off on vaccines for now so as not to overwhelm his immune system. Rabies, though will have to be given. He's due in June. Might be able to push it out a month.
Sounds like a little progress... hang in there, both of you!
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So glad to hear that Zeke is hanging in there.

:ghug: :ghug: :ghug:

Laurie
***** UPDATE *****

Just back from the oncologist. Numbers are essentially unchanged.
Doc says he's a pretty sick guy.
Believes liver is diseased but not 100% without biopsies and he doesn't really want to do that because it's invasive and takes a long time.
No chemo today. Doc said he couldn't handle it.
He wanted to book him into the hospital today. Alternatively, we could send him home with some meds. If he doesn't start eating, or vomits, or the diarrhea continues, we could then book him in.
I chose to take him home with the meds to at least try that.
They sent me home with: Cerenia, mirtazipine, Denmarin, and metronidizole.
Hoping I can get the meds and some food into him without a negative reaction.
Really don't want to admit him into the hospital. VERY expensive. Best case; 2 days and $1,700. Worst case; 3 days and $3,100.
Is this a wise move? The pro could be that I spend that money, we get him over the hump and he continues on his chemo plan.
The con is, I spend that money and it doesn't help and I have to make a difficult decision.
If I don't do it, I'll forever feel guilty for not trying.
If I do it, and it doesn't change anything, I'll feel guilty for putting him thru all that and like a fool for spending all that money.
Might there be other options?

Need some guidance.
I was able to get his Denmarin and metronidizole in him last night.

And this morning I was able to get his appetite stimulant, metronidizole, and prednisone in him.
He then he started barking at me for food.
He only ate about a 1/2 cup but that was better than yesterday where he ate nothing.
I'll try some more in an hour or two.
Smaller, more frequent meals will probably be better for him anyways.

One day at a time. My new mantra.
Glad to hear that you got the meds into him. (Oscar always had a better appetite when he took his pred and metronidazole.)

Does Zeke like canned food? Is there a canned version of Zeke's food? The reason I ask is because Oscar did so much better when we switched him to a canned food. It smelled better (to him!) so it was more tempting to him than kibble. It was also much easier on his digestive system as canned food is sort of "pre-digested". It really helped with the diarrhea.

It's so difficult to figure this stuff out when the medical complications pile up. I am hoping that Zeke continues to eat, as that will help with anything else.

Thinking good thoughts for your buddy......

Laurie
We found the same with the canned food with Fred (previous sheepie), smelt bad to me but he loved it- I always think if food/water goes in and stays in it is a very good "positive". Big hugs. xxxx
***** ZEKE UPDATE ******
We just got back from the doc. No chemo today.
They did another ultrasound and poked his belly to get a sample from his liver.
Dad says we won't know the results of that until next week.
The doc said the size was good, but there was a lot of "echo reflectivity" and the liver looked bright with some blotchy areas.
They sampled the blotchy areas to see what those are. Could be the lymphoma, could be an infection, could be a disease like cirrhosis, or could even be necrotic tissue. Won't know until the results come back.
But some of his liver liver levels are down (like the bilirubin). Doc says he's no longer jaundiced. The other values remain high, but stable. So we're all taking that as a good thing. Stable is better than getting worse. And he gained another kg since last week, too.
Doc seemed more relaxed and comfortable today. He said that maybe he's just being stubborn. :)
So no chemo this week. We'll let the results of the biopsy guide us on next week's treatment.
He's feeling good, though. Bright, bouncy, eating, drinking.
Onward and upward.
Oh I really hope this is a trend upward! I saw a video on
FB - or am I mistaken? - and he looked quite bouncy. Maybe
it was a good day, but that is wonderful to see amid all the
health issues.
Good luck Zeke! Keep up the momentum.


Shellie
Shellie wrote:
Oh I really hope this is a trend upward! I saw a video on
FB - or am I mistaken? - and he looked quite bouncy. Maybe
it was a good day, but that is wonderful to see amid all the
health issues.
Good luck Zeke! Keep up the momentum.


Shellie


Yeah, Zeke posted a video on FB of himself all bouncy. :)

He's been like that for the past 2 weeks.
So glad to hear that Zeke is stable (and bouncy)!

Laurie
Zeke had another oncologist visit yesterday.
Liver levels are still high. The results of the needle biopsy say lymphoma.
The vincristine, cytoxan, and aspariginase are not working to eliminate the lymphoma from his liver. He needs to step up to the stronger chemo agents. The problem with that is, the stronger agents are more toxic to the liver. They WILL kill good liver cells. The question becomes, can he tolerate losing good liver cells when his liver is already compromised? Doc says there is a chance that these more potent agents could put him into liver failure. And it wouldn't be something we would know right away. He would have to go thru several treatments and then we'd have to ultrasound again and poke his liver again to find out if it's helping or hurting. If it's hurting, the damage will have been done with no going back.
The doc says there's a 25-50% chance the stronger stuff will work. I countered with, "that means it has a 50-75% chance that it won't work". He said "yeah".
He also believes that even if we got him into remission, it wouldn't be durable and he would probably fall right back out.
I asked what would he do if it was his dog. He struggled a bit but finally said that he probably would not treat. The risk of damage to the liver is too big. And that any gains that were possible would come with a cost. He would probably feel pretty crummy while undergoing it. He said, "wouldn't it be better to give four OK months instead of 6 yucky months?" (the number of months he used was just for example).
So I left there without making any decision. He did not have any chemo. I want to think more about it. I'd also like to research any alternatives. We talked a bit about the holistic/eastern medicine thing. He knows some people go that route but cannot vouch for it as it was never studied in an in-depth manner. And besides, any thing I put into his body has to pass thru the liver. If the liver isn't functioning properly, it may not do anything or it could even hurt him further.
So I have some research and thinking to do.
In the meantime, he continues to appear to be doing great. Bright and bouncy, eating and drinking well, pooping & peeing well. Just a happy guy.

I would love to get other people's thoughts on the situation.
It is just so hard to decide what to do for the best. We do have to remember that the dog must come first and be living a "for filling" life(don't know how to spell that!). Treatments can and do help but do they make the dog/person carry on with a life of suffering and not being able to live as they want to. As you say he is enjoying life so you want to help him continue to do so. There must come a time when you say " enough is enough" hard and horrible as it sounds. When Fred was so poorly the vet was so good and we ended up just letting him enjoy life for as long as he was able with no more "messing around". Sorry to not be more positive but how long can you carry on with the treatments? What you want to do if it was it was you instead of your Zeke? xx


:ghug: :tea: xxxx
Hi Allyson,
I would like to continue SOME kind of treatment, but ONLY if Zeke is happy and comfortable.
I obviously don't want him to suffer at all.
But if there was some kind of treatment that would at least keep the cancer in check AND he could be happy and comfortable, I feel like I owe it to him to search that out and at least try. I know that's probably a pipe dream, though.
HI Mark- I wasn't meaning to be ,can't think how to put it, horrible? saying what I did-I expect lot of folk would be thinking the same but I do totally agree with you on the idea of finding a treatment like you are saying. Our dogs are so faithful to us so we do have to do all in our power to help when needed. Very good luck on your search. xxxx
Sprox's mum wrote:
HI Mark- I wasn't meaning to be ,can't think how to put it, horrible? saying what I did-I expect lot of folk would be thinking the same but I do totally agree with you on the idea of finding a treatment like you are saying. Our dogs are so faithful to us so we do have to do all in our power to help when needed. Very good luck on your search. xxxx


No worries Allyson.
You were not being "horrible".

If I can't find a treatment that won't make him feel crummy, then I'm prepared to just accept what is. As hard as that'll be.
I think that you are doing a wonderful job being Zeke's advocate. Keep asking questions, get second opinions if need be-we have learned the hard way that it is not a bad thing to get a second opinion or to be referred to a specialist. And above all, listen to your gut and listen to Zeke. I think that you have the right head/heart balance working for you. Virginia sends you cuddles. :ghug:
You are the best person in the entire world to be making these decisions, with all the support we can muster here and on fb of course.

:ghug:
Another oncologist meeting today.
No chemo given.
Doc thinks he's becoming more jaundiced again. A few nodes are up again.
I asked if we could keep giving him the mild stuff but he said there would be absolutely no benefit to that; it wouldn't do anything.
I asked about immunotherapy but he believes that it wouldn't be viable for him. It's typically given in conjunction with chemo and used as a clean-up agent; to get the remaining cancer the chemo didn't.
He had no opinion on holistic other to say that he sees dogs where the owner tries holistic and they are very sick. He says he can't recall an instance where the owner treated chemo and holistic at the same time. He questions the claims of holistic methods.
His only hope would be the stronger chemo, but the question remains; can his liver handle it? It's a total crap shoot. He said “you have to break some eggs”. And we wouldn't know until after several treatments. And by then, any damage to his liver could be done. And it wouldn't be reversible.
Then there's also the question of him tolerating the stronger chemo. He may not even be able to.
He was knocked on his butt by one of the milder agents. What will the stronger do?
So I'm left between a rock and a hard place. Do I treat him and potentially ruin his quality of life with potentially no gain, or do I let nature take it's course? There is a chance that the treatment could work (25-50% chance), but that means there is a 50-75% chance that it won't.
When asked what he would do, the doc said palliative.
If I treat palliative, the doc says he might only have 1-2 months.
I'm conflicted. I want to help him, but I don't want him to suffer.
This sucks. It really f'ing sucks!!
It does f'ing sucks! I remember 3 of my dogs with lymphoma. The first faded quickly. His best buddy we treated with chemo but as soon as we stopped it came roaring back. At the time there wasn't as much help as there is today. The last dog, Olivia, we did palliative from the start and had her for 7 more months. When Harry came down with a mass in his chest, the oncologist said surgery would be very dangerous, a whole lot of delicate things there. He gave Harry 7 months max............he lasted three years. We have to pick our battles carefully with at least reasonable hope for better life. At some point you know you will lose and you accept it as they aren't designed to live 15 years or more. You are really in a s**t hole with two sick dogs. I can understand your fear and frustration. At some point though you run out of options........money.....or the treatment does as much damage as the disease. Then while they are happy you make their days wonderful and as they fail you stay upbeat and cry away from them. They will keep pushing themselves to "please us" but I wonder if they'd really rather say good bye. Only a couple have gotten to the point where I kick myself I kept them around too long. It is absolutely the worst thing about owning a pet. I've had three go suddenly but naturally.........what a blessing, though initially a shock.
Hello Mark, that was very well put Sheepiboss, what I was trying to say a while ago. I think you have come to that stage Mark where you just do palliative and try your damdest to enjoy every moment with your bestest friends. Sorry but he must be so tired of treatments and just wants to cuddle up to daddy, safe and sound and what happens happens. I know I sound hard maybe but there is only so much that can be done and you have done so very well for him with the info you have found out and treatments he has had. . So very sorry though.xxxx


:wag: :tea: :ghug: xx xx
I'm trying to find a holistic/homeopathic vet in my area.
Hope you find one. I go to a great lady for reflexology, she also does flower remedies that I find work very well for me. I asked her and she said would be safe to use on a dog-put in drinking water or straight on to the tongue for relief. You could try looking for a similar person. xx
Zeke saw his oncologist last Thursday.
A few of his nodes are up a little bit and his liver is a bit firmer.
But outwardly he looks like a healthy dog.
The oncologist said Zeke is surprising him. He said these things typically turn on a dime.

I made the hard decision to not pursue the stronger chemo. I just don't want to hurt him.
The oncologist said that was a wise choice.

So now he'll see a holistic vet. The nice thing is she is part of the same hospital, so her and the oncologist can collaborate on his care.
My hope is this approach will keep the lymphoma in check for a while longer so he can enjoy more good days.

Everyone talks about turmeric and how great it is for fighting cancer. The holistic vet said Advanced Dasuquin has turmeric and another compound in it known for their therapeutic anti-inflammatory properties. Typically it's used for joint health. I had some at home and she and the oncologist said start him on it, so I did.

But he's still bright & bouncy, eating extremely well, drinking, peeing & pooping OK.
I had to move his food bag because he figured out how to get in it and feed himself. :lol:
He's NEVER done that before in his life.
Oh bless him. He is going to make sure he is as cheeky as can be to "keep you on your toes"- look at me dad, aren't I clever? Enjoy your wonderful dog, sounds like he is enjoying life at the moment. xx

:wag: :tea: :banana:
I'm so happy this is happy times for him! Enjoy
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