This is Marley in January 2017
We almost made it through the CHOP protocol - one round, 4 treatments, and we would have been done. But . . .
On Monday, March 20th, at her regularly scheduled blood work appointment, Dr Shaw found a slightly firm lymph node. Mind you a week ago, it wasn't there.
On Tuesday, March 21st, we learned that Marley now has mast cell cancer in one of her lymph nodes. It coming up through the chemo she is receiving for lymphoma is concerning. The cells were small in nature, very granular, which tells us they are aggressive. All I could hear was chemo resistant. Dr Shaw wants to stage this at her next appointment on Monday. Her blood work looked good but all they do is a Complete Blood Count (CBC). The vet did say she is still in remission for the lymphoma. He would like to do staging at her Monday appointment. Needless to say, this was not a good day emotionally. I had no idea a different cancer could come through during chemo treatments and from what Dr Shaw told me, he's never seen it. So, in hindsight, what will be, will be. :(
On Wednesday, the 22nd, I was concerned about not knowing what to look for and she seemed to not be feeling well so I called SAGE and made an appointment for Friday, the 24th. We were not able to do staging at this appointment. I decided not to continue chemo treatments for the lymphoma or start a new protocol for the mast cell. She is on Benadryl and Prednisolone.
On Tuesday, March 28th, Marley came in from doing her business, whining and unable to sit down. After checking to make sure she completed her duties and from that not to be the reason for her whining, I determined that she must have some pain. Going along her body I discovered her to be tender on her left flank. She has some rather large lipomas in that area but I'm not sure if that is actually where the tenderness is coming from or underneath. I called SAGE and was told since I had previous orders for giving tramadol that I could give her some for pain which I did.
These three photos were taken April 2, 2017
These three photos were taken April 6, 2017
At Marley's appointment on April 7th - her half year birthday which makes her 13.5 - Dr Shaw determined the lymph node was now 2 cm. She has significant odor coming from her mouth so he suspects an infection and prescribed antibiotics. Below is the information from her visit.
Friday, April 07, 2017
Date: Friday, April 07, 2017
Weight: 20.000 kg, 44.00 lb
Homecare: Marley's swelling on her muzzle has progressed. The lymph node under the left side of the jaw has grown as well, indicating progression of Marley's mast cell tumor.
At this point, we are trying to keep her comfortable. Monitor for lethargy, low appetite, changes in
personality, pain, discomfort and call if you notice these signs.
I'm happy to recheck Marley as needed or in 1-2 weeks if you would like to set something up in advance.
Prednisone 20mg tablets #60. Give 1 tablet orally once daily. Do not stop this medication abruptly. May cause increased drinking, urinations, hunger, and panting. Refill #3.
Maropitant citrate (cerenia) 24mg tablets: Give 2 tablets orally once daily for 4 days, then as needed for nausea, vomiting, or decreased appetite.
Metronidazole 500mg tablets: Give 1 tablet orally once daily for 5 days as needed for diarrhea.
RX: Tramadol 50mg tablets. Give 1 tablet orally every 8-12 hours for pain. May cause sedation.
RX: Amoxicillin/clavulanate 625mg tablets. #14. Give 1/2 tablet orally twice daily until gone.
RX: Pepcid (famotidine). Give 10mg orally twice daily. This is an over the counter antacid.
RX: Diphenhydramine 25mg tablets. Give 1-2 tablets orally twice daily. This is an over the counter
anti-histamine to reduce the side effects of mast cell tumors.
Please do not hesitate to call (408) 343-7243 if you have any questions or concerns.
Stephen Shaw, DVM, DACVIM (Oncology)
On April 9th, Marley reacted with nausea an hour after she was given a whole tablet of Tramadol. The Cerenia came in handy and she was able to eat dinner later that night. Any more tramadol will be half a dose.
On April 11, she has discovered that I put her medicine in the peanut butter Pill Pockets and has decided to chew or spit the medicine out completely. Unfortunately, this mean I have to slide it along the back of her tongue until I can find something else that will work. I will be in search of something new to hide her pills in once she discovers I've moved to bread. On this day, she turned her nose up at dinnertime. A few hours later, she ate dinner. I noticed she is having a hard time chewing the kibble. I will need to let it soak until it becomes soft in order for her to eat it. I'm thinking about canned food options.
These two photos were taken on April 10, 2017
Are you able to see her swelling progress from April 2 - 10?