27 February Razzle's Big Secret

Okay, I think I’ve figured it out. Razzle’s Big Secret. The thing that made him whiny and needy, now is making him anorexic and picky. It’s gotten so bad even Gordon Ramsey would say he’d gone over the top with his food demands. But you see, it’s all clear when you think about it. There’s a simple explanation for everything. As soon as you grasp this single fact, everything falls into place.

Razzle’s pregnant. Now, before your go running off to hide under facts like “he’s a boy” and other such nonsense, I can prove it. Of course, I haven’t slept in a few days and it’s possible my judgment’s a little shaky, but all that aside, I can back this up.

Coming back from Chemo on Tuesday last, I expected his appetite to be down. We were given an anti-nausea medication and an antibiotic (his white count is still about a third what it should be). I was told that they agreed his tummy was upset as he’d been eating grass, so I was to switch from Pepcid to Prilosec. What the heck, I’m of the “if Benadryl can’t cure you, you’re dead” school of medicine so, what do I know from antacids?

Anyway, I figured he’d be like he was the first few days last time (and he’d had surgery then, remember?). He didn’t want to eat much more than a few spoonfuls of peanut butter and lap at coconut water (an electrolyte Godsend by the way, it’s sweet and when we won’t touch anything else, he’ll lap down the coconut water). He worked his way up slowly and there was always peanut butter to stop gap us.

Well, the rules have changed. Even with anti-nausea medication AND Prilosec AND Pepcid AND feeding him in bed, the anorexia came out for a full blown brass and drum parade. Now, he wouldn’t touch anything and by Wednesday, peanut butter was off the menu. (What am I going to do with a CASE of organic peanut butter?)

His newest trick, when he doesn’t want to eat something, is to spit it out, then go to stand by the door as if to say, “if you make me eat this, I’m leaving”. Usually, in the past, if I could get a little taste of a food onto his tongue, he would then eat; it’s clear his sense of smell has been knocked into another ball park. But that's not working anymore.

So, I dithered, and went through FOUR kinds of dry dog food, peanut butter, cottage cheese, an omelet, a poached egg, toast, rice, poached chicken … well, the cupboard. Wouldn’t touch a thing and by Thursday he was living at the front door and most of his nutrition was by taking one bite of about twenty things. To top it all off, he’d stand in front of the kitchen entry, acting hungry, sitting down, waiting, as if to say, “I’ve ordered from the menu, and I have to keep sending the plate back because it’s not right – ‘you have to get real!’” So, I’m racking my brains and the cupboard feeling like I’m caught in some bizarre Canine Kitchen Nightmare.

Then, in the back of the cupboard on Friday I saw it. “Canned Pumpkin”. Now, we’d tried pumpkin in the past, before the Osteo and he wasn’t a fan; I mean, he ate it, but he’d eat anything and he’d leave bits of it in the bowl and look up at me with that “you can do better, Mom”, look.

But he ate the pumpkin. Spoon after spoon of it. It was very fragrant and that made me think. I went back to the cupboard and had a good long stare-and-think. I’d been giving him things for an upset tummy, but if what is wrong is his ability to recognize food by scent, I needed a food with a scent so powerful it would overwhelm his newly oh-so-picky nose (Mo has NOTHING on Razzle these days) and not be rejected as inedible, or tasting like metal.

And right there, on the stuff-I-never-use part of the shelf, were sardines.

Yep, sardines. Well, I used to love them, but since going Vegan, haven’t touched them. So out with the King Oscar and –

This is when I figured it out. He’s pregnant. Because only irrational hormonal cravings could possibly make you want to eat (or even look at) canned pumpkin and sardines. Or sardines, cottage cheese and pumpkin. They all have to be separate in the bowl, but while I’m feeding him (all right, while I’m hand feeding him) there has to be a variety and that’s the one that works. For now. For this minute. For this weekend.

Since I’m reliably informed he’s not pregnant, I have the dog with the strangest eating habits and shiniest coat in four counties.

I can’t wait until he’s past the lowered neutrophil phase and we can go back to Darwin’s – that at least I know he’ll eat, even when he’s not feeling well.

So, we do this at least two more times and if his system can manage it, four. They had decided to move his chemo from every three weeks to every four, hoping his white count would bounce back so they can continue the treatment.

But I’m running to the loo with a lurching stomach after every meal (which he has one about five times a day since he’ll only eat a little at a time). Something has to give here, and I’m fairly sure it’s going to be my stomach!

As long as he’s eating something, anything, pregnant or not, we win! And as you can see, our other victory this week was a full-blown, all by ourself, roach.

Ah, relaxed at last.

HURRAH!!

8 February 2011 -- Wow! Two Lunches !!

We had our blood and urine tests yesterday, still awaiting results from oncology as to how we're doing.

However, we talked to Dr. Tripp about pain control and she agreed he needed something more (without saying Greyhounds are wimps about pain ... she said Greyhounds are wimps about pain .. and I'm not saying a thing). We added Gabepentin (Neurontin) and it's had a big impact. We slept through the night and after a kind of so-so attitude at breakfast, all of the sudden, he was in line for lunch and then in line for lunch again. Whoopee!! (Hey, it's the small victories that make my day; you should have heard me after adding coconut to his food turned him from toothpaste to bouncy poo in less than a day ... egad, 'bouncy poo' ... I'm actually waxing on and on about poo!!)

All in all, he seems much happier and calmer with the addition of this drug. We're keeping an eye on the Fentanyl patch as it will 'wear out' in the next day or so. He's still taking about 150mg Tramadol, so we haven't crossed the Rubicon quite yet. I'm planning on replacing the Fentanyl patch when it stops working. The problem is, due to differing metabolism in dogs, they don't know when that will be. It could be three days, it could be five days ... it could be they don't want to share that information as a panicked owner with a dog in pain in the middle of the night puts $300 in the till (tsk, tsk, that was a nasty, cynical shot).

We have an appointment Friday to take out the stitches. The wound is closing beautifully and as of this AM (8 days post-operative) his bruises are all but gone. He did have some negative skin reactions to everywhere the tape has been, but I've been staying after all those areas with baby wipes.

He has scraped himself a few times going up the stairs (we have a ramp to go down, but he REFUSES to go up it!) and he's almost fallen a couple times, the trick is trying to get him not to try too much, too fast.

Along those lines ... our BIG accomplishment yesterday was lifting our leg to pee -- it may have been a little shaky, it may not have been the most graceful thing I've ever seen, but he managed it -- out there on two pins, just like Mommy !

6 February 2011 -- Back to Zen Dog

He's much better this AM after a rocky 48 hours or so. The new Fentanyl patch has kicked in and he's much more comfortable. The problem is that his appetite is fairly depressed. He did eat a can of chicken this morning, and some freeze dried lamb treats, but he's really not interested in eating. HOWEVER, good pain control is what we wanted and having achieved that we're HAPPY campers!!

Also gave him a Pepcid which may have helped settle him as well as he's prone to upset tummy anyway. Our pee and poo are a little down as well, but hey, nothing in the front means far less out the back (that's all technical talk by the way, send the kiddies to their rooms!).

He's still eating the K9 Immunity, seems to like a the taste a lot. He's figured out that peanut butter may hide "mysterious nasty tasting little white things" so we've had to resort to pill pockets to get our pills down. We have an appointment with the oncologist tomorrow so hopefully we'll find out exactly where we are. To have an amputation and chemo the same week -- amazing he's made it with so few problems. We slept about five hours last night, which is a record for the last two weeks. And a mommy with more sleep is a lot more patient!

4 February 2011 -- Primum non nocere

I hope this picture doesn’t freak any of you out, but I can’t get over how beautifully he is healing – he’s going to have an “S” shaped scar, for “Superdog”, I am quite certain. His healing has been amazing in terms of the surgical site.

There have been a few other potholes in the road, however.

First and more importantly, Razzle is doing very well. That isn’t do say we haven’t had a few problems the last 36 hours. As the Fentanyl patch wore off? Down? Razzle became more restless, unable to be comfortable. I called last night (Thursday) and asked if we could increase his dose of Tramadol, as I felt he was having trouble managing his pain. We gave him an additional 25mg (he’s taking 100mg as the baseline dose) and that seemed to help and he slept mostly through the night with only a couple interruptions. But he was still clearly unhappy this morning and his temperature was fluctuating wildly. So, we flew off to see his surgeon, who looked him over and decided the drain to the amputation site and the rest of the patches and covers and bandages could come out and off. He was instantly relieved to have all that out and off and gone. A happy naked dog left the clinic.

He was fairly stable during the day, but clearly still not comfortable all the time. We’ve been eating well (cooking his Darwin’s with a couple eggs and some spinach or broccoli seems to be going happily gobbled down with peanut butter globs concealing drugs) and having really spectacular pees and poos (even bouncy poo thanks to adding coconut to every meal).

This evening, though while monitoring his temperature, it was up over 102.8, so we flew back to the vet. His muscles were tense, he was panting more and more heavily and he was in a lot of distress. Leaping to the most disastrous conclusion because that’s always such a productive habit (NOT), I was sure he was developing an infection from the Cisplantin therapy. Well, that what happens when you practice medicine without a license, you don’t have a clue what you’re talking about. Very nice vet, Alison R. at Animal Medical Center was quick to see he was in pain and our problem was the loss of the Fentanyl patch and he needed DRUGS! She gave him a shot, added codeine to his protocol and replaced his patch (HURRAH said Razzle). That was about an hour ago and he is sprawled on his bed zonked out of his mind and in dreamy happy vapor trail druggy land.

So, I learned a lot today. Hopefully, we can manage his pain more effectively going forward and I am going to be more proactive with ensuring his pain is managed before we worry about anything else.

Razzle has had lots of wonderful visitors the last few days, but has he goes into his “possible infection” phase from day 5 to day 10 of his chemotherapy, so the visitors will be cut down and we’ll try to keep his as quiet and germ free as we can.

I was thinking about pain tonight. Neither the ancient nor modern versions of the Hippocratic oath promises to “do no harm”. That's not surprising really. It is a standard that is impossible. For one thing, it could freeze a physician into not acting at all, as any action might cause possible harm and therefore to act could be to harm. Yet neither does either version of the Oath provide a requirement for the practitioner to “alleviate pain”. Yet, this is why the vast majority of us seek medical care of any kind. There are many admonitions in both versions of the oath, but they still fall short of the mark of what I think we expect or want from healing. The physicians best effort, to end suffering where they find it, to educate and to put the wants of the patient on an equal footing with the needs of the patient, might be a rational start.

While I may find how Razzle has faced his pain courageous, even inspiring, it is, at the core of it an experience neither he, nor any creature with access to modern medical care should ever have to endure. To be ill is stressful and frightening enough, pain is an additional torture that should never be added to it. He was not in acute distress and we were quickly able to resolve the dosage problems we had fallen into; but we all failed him in not being more constantly alert to this most paramount of needs – has his pain been alleviated?

Something well worth remembering, especially when we are talking about the inflicting of non-physical pain. There is neither a rational reason, nor, in the end, any excuse for inflicting pain of any kind, be it emotional, spiritual or physical. Those who find such actions entertaining, or amusing, or a part of their character for any reason should realize there is enough pain in the world without conjuring more; create and let loose that monster and it will destroy you.

2 February 2011 -- Home at Last

Home at 7:00 PM last nite and happy as a clam so far and very tired. New twin beds on the floors and people to fuss over him is making him very happy. He hasn't eaten anything and only taken a few sips of coconut water, but we have made it outside twice for big wees and the second time he made it DOWN and OUTSIDE the front steps (shallow, but amazing!) His ability to adapt to three legs is astonishing not only me, but the surgeon, too. He came by as Razzle was being discharged and just couldn't get over how well he was doing.

And I always thought he was sweet but a little slow in the smarts area, unless he was stealing food! He is showing an astonishing depth of bravery and intelligence while still radiating the warmth for which he makes friends wherever he goes. Goes to show you; you think you KNOW animals -- or people, and you just don't!! (Ain't that what makes them so grand? THEM and US! Because after all everyone has done for us this week -- trust me, like Dr. Who says, people are just incredible too.)

Pretty soon he will be able to follow the band who made him their namesake today (pretty cool, huh? He's still astonished, Casen! and I am too!) in person!

It turned out to be a beautiful day after all; back to sleep with my baby ...

24 January 2011 My sweet darling Greyhound ...

Some of you are old friends of Razzle’s and some of you have only met him a few times. I wanted you to know what is going on, as all of you know and love him. Yesterday, Razzle was diagnosed with osteosarcoma in his right foreleg. The bone is deeply involved.

The good news is his blood work returned today and he is otherwise in good shape, with none of the markers to indicate it has spread throughout his system, yet. We will be imaging the other three legs tomorrow, to see if he has developed lesions in any of the other three legs. His chest images were clear.

The medical among you know that the reason for this is that the only treatment for this disease is to amputate the leg at the shoulder and a course of chemotherapy. If the cancer is appearing in other limbs, the surgical option will not be followed, and he will not be with us very long at all, probably a few weeks at most.

The surgery is not to stem the course of the disease (this is not possible) but to alleviate pain and prevent the inevitable serious breaks that will occur in the weakened bone. While there is always hope, and I’ll do everything possible to try and effect a remission, the course of this cancer is always fatal; the survival times range from a minimum of 3-4 months, with amputation and chemotherapy up to a maximum of about 11 months.

I will be taking him to Moclips this weekend so he can enjoy one final, four-legged romp before he faces surgery, probably sometime next week.

I know you all wish him well and will keep you updated. He loves all of you, and I know you will send him good wishes and your best thoughts. If anyone wants to stop by for a hug and pet and a kiss, he’d love to see you