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Hi everyone,
My apologies for not posting an update sooner - it has been a hard couple of days. Dino is doing well, but we are all exhausted and needed some rest.
On Thursday we spent a few hours at the vet hospital. It was a long drive there, and I was by myself so I had to put the cone on Dino to ensure he wouldn't lick his stitches. He couldn't settle and fell over a few times in the car - it was pretty stressful. But when we arrived he was a very good boy and the surgery team very quickly got his stitches out. The surgeon was very happy with his healing.
We also saw the oncologist while we were there. Before Dino's first chemotherapy treatment, they needed to do a heart ultrasound. The first chemo drug, doxorubicin, can affect dogs' hearts, so they wanted to ensure Dino's heart was strong. Dino's heart is beating well and there is no arrhythmia, so the oncologist was comfortable going ahead with the first treatment. But she did find two things of note: the first is that when blood moves out of one of the chambers, instead of it all being pushed up in to the following artery, a little bit of blood actually leaks back into the previous chamber. She said she wasn't too concerned about this, since his heart beat is otherwise strong and regular. The second thing she found could be more concerning, but we'll need a second ultrasound at Dino's next treatment to be sure; there is extra fluid around Dino's heart. She explained that your heart has a sac around it, and there is a very, very small amount of fluid there to allow the heart the expand and contract without, I guess, scraping against the other things in your chest. But Dino has more fluid than there should be there. The doctor said that the sac can only expand so far, and if enough fluid is present, it will start to push back on the heart, and it can't beat as well. She said that while Dino's amount of fluid is more than they expected, it could be normal for him. She would like to re-check this next time we are in. And if the fluid has increased, this could actually be a sign of a secondary heart cancer. We are very hopeful that is is just Dino's normal physiology, but we will find out more in two weeks.
After this consult with the oncologist, they went ahead and gave Dino his first treatment via IV in his remaining rear leg. When he was all done, he was very happy to see me. He looked very tired. Before leaving I met with vet tech Amanda who gave me a booklet of information about what to expect for chemotherapy and side effects. I learned that while the vast majority of dogs do not experience any side effects, there is a small chance we could see nausea, diarrhea, hair loss, or lethargy - the same sorts of side effects you'd expect in humans. The hair loss is more common for dogs with more hair-like coats, like poodles and shih tzus. We're very hopeful that Dino won't experience any of the side effects, and the odds are in his favour. If we see side effects, we can expect to see them 3-5 days after treatment (so maybe starting tomorrow) and they gave me medications to treat nausea and diarrhea.
Since Thursday, Dino has been in good spirits. The drive home on that day was smooth - I knew he was so tired that he would just sleep on the way home, so I didn't bother with his cone. We had to stop twice for him to pee, but he was very good about letting me know he needed a break. The last two days are the first times he has not been on heavy sedatives in over two weeks, so he is definitely more himself. He is peeing very frequently - I think this might be a side effect of the chemo. I will be sure to ask the oncology team.
The treatment plan is 13 weeks, but he only gets six chemo treatments, so we do not have to go to the hospital every week (which is great, it is a 200 km drive each way...). On the off-weeks we will go to our local vet clinic to have bloodwork done. I know they are looking forward to seeing the big guy and his progress. Every time we go to the hospital, the local office calls us when they get his updated charts sent to them. They have been very supportive, and the hospital continues to be very kind and supportive as well. We are very, very grateful to have such good healthcare providers for Dino.
Yesterday Dino rested, and so did we. But today we're going to try to go out for a very short time. Dino loves car rides (when he doesn't have the cone on) and I want him to be able to sniff some good smells, so we might pop over to the local conservation area for a (very) short walk. And of course to get some Old Fashioned Plain TimBits on the way home (Dino's fave - he always expects them at drive thrus).
-Megan, Ben, and Dino
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