Ch-ch-changes in Lilly Town

Oh, boy. We have news to share — some good, some (potentially) not so good. DIY chemo, 3 weeks off the immune mediator, this week’s blood and urine tests, and more!

DIY Chemo

For a variety of reasons, including the accidental chemo overdose in June 2013, I now have permission to give Lilly’s cytarabine (chemo) injections myself at home. We’re still working out the logistics and legalities, but I next week I will learn how to administer sub-Q injections and to pick up supplies. We will practice with saline.

• This will NOT save me money. It’ll still cost about $226 every 3 weeks.
• However, it will save me the logistical finagling, gas, and time of driving Lilly to 4 appointments in 2 days every three weeks. That’s a MAJOR bonus — especially during winter when the canyon / mountain roads are icy.

3 Weeks Off Cyclosporine

While there may be other changes now that Lilly has been off the immune-mediator drug called cyclosporine for nearly 3 weeks:

• Neurologically speaking she remains stable.

Monday’s Diagnostic Tests

After a month on daily benazepril and a lower-protein diet, time came to recheck Lilly’s protein loss (through urine tests) and kidney function (through blood tests). We also ran a full blood chemistry panel and CBC (complete blood count).

Lilly enjoyed a complete physical exam and lots of smooching before her tests.

Protein Loss Lower / Kidney Values Normal

• Lilly’s protein loss, which has seen a high of 4, has dropped to a 2. ZERO is normal, but 2 is better than 4.
• Lilly’s BUN and creatinine levels remain normal (indicators of kidney function).

Another Bladder Infection

Alas, they found white blood cells and bacteria in Lilly’s urine, so we started 2 weeks of antibiotics today. We will likely begin something called Pulse Therapy, where Lilly takes antibiotics regularly in a certain pattern.

• Recurring bladder infections are likely a side-effect of long-term steroid use. Lilly continues to take 1 mg of dexamethasone daily.

Liver Values Rising

I didn’t ask for the raw numbers, but Lilly’s liver values have increased, despite the addition of denamarin (a liver supporting supplement with both milk thistle and sam-E).

• Rising liver values likely mean all the treatment meds are taking a toll.

Strange Red Blood Cells

Lilly’s CBC also shows both nucleated red blood cells (essentially immature red cells) and band neutrophils (a change in nuclei shape).

• Nucleated red blood cells may indicate bone marrow issues as a side-effect of the cytarabine / chemo.
• Band neutrophils may indicate systemic inflammation and, in some cases, a kind of toxicity.

***

I talked to our main veterinarian about all this today. I’ve not yet talked to our veterinary neurologist. Essentially, this is part of accepting that it will ALWAYS be something. Always.

We’ll simply keep swatting at what comes, as long as we can.

This week, other than some super-soaker nights and diapers, Lilly seems to feel pretty good. She even seems a tad bit steadier / less droopy in the rear now that her cytarabine injections from last week have hit their peak.

Don’t assume there wasn’t boo-hooing about some of this news. There was — nearly leading to some barfing too. So, I went for a long walk (alone) to shake off the dread.

I take solo walks or hikes nearly every day, as part of reclaiming the time I used to give to my mom.  It’s sad to go without Lilly — who isn’t strong enough to walk any distance — but it helps me to get outside in the expanse of the mountains.

Our border collie novelist friends Leland and Angelo Dirks shared an inspirational story recently that explains why getting outside may help. (We’ve reviewed some of their books in the past — Angelo’s Journey and Jimmy Mender and His Miracle Dog.)

Anyway …

It’s a Hindu proverb that tells us to be a lake — not a cup — when feeling life’s pain. 

It’s a similar idea to the Buddhist meditation practice that I’ve mentioned before called tong-len — where you raise your suffering to the universal.

Less lonely that way, even when I’m alone.