Handsome Hardee

Handsome Hardee
We are a patriotic family!

Face of Courage

Face of Courage
Face of courage

Wednesday, November 17, 2010

Wed., Nov 17, 2010 - Today's results

Today's CT shows that the tumor has grown substantially from 2 weeks ago.  HH is getting chemo now, but Dr V said he does not hold much hope.  

I find no joy today, but it is still all about Hardee.

Monday, November 15, 2010

Mon., Nov. 15, 2010 - Hardee's nose bleed

Well, our Veteran's Day and weekend did not go as planned.  On Thursday, Veteran's Day, we had an agility trial that started in the afternoon.  Jim gave Hardee a bath Thurs. morning, and during the sneezing episode that followed the bath, Hardee really started bleeding and flinging blood everywhere.  We'd think we would have it under control, and it would start again.  His nose bleed continued for 4 days, and sometimes would be dripping continuously.  It is much better today, but it was truly scary to witness, especially after it went on for so long.

By yesterday afternoon, when Hardee's gums started getting pale, I was really worried.  I placed a call to Dr P, but I have not heard back from him yet.  I also called to Dr V (local oncologist that we saw Wed) this morning early, and I just heard back from him tonight.  He agrees that this can be a worrisome sign of what the tumor is doing.  The tumor can be growing, but he also said that it could be that the tumor is dying.  I also told him about his right eye watering again, so I know the tear duct is blocked again by the tumor.  The right eye watering with the nose bleeds tends to lean us towards the tumor growing.

Our options are to CT again since it has been 2 weeks since the last CT to compare the scans for growth, or go ahead and start chemo as our last ditch option and CT again in 6 weeks, after HH has had 2 doses of chemo.  Dr V said he would NOT hold off chemo just because Hardee was anemic from bleeding so much, and that he could give him a blood transfusion before he did chemo, depending on what his blood tests showed.  I think I'll take him in Wed. to start chemo, but I need to talk to Jim about it, and he's not home from work yet.  Keep in mind that chemo doesn't generally work for nasal tumors.

Never......ever......did I want to be writing these words just yet, but I think I'll call The Georgie Project and order a container to have on hand to send Hardee to them when the time comes.  The Georgie Project is a collaboration between owners of PWDs (Portuguese Water Dogs) and the scientists at the University of Utah where they study the genetics of PWDs.  They perform a complete, detailed autopsy and send you the results and the ashes of your beloved dog.  There has been talk on the PWD list lately about this, reminding me that I need to do this.  Though it seems like defeat to me, I know we are on last ditch options, and I need to do this.  I want Hardee's body to go somewhere he can help.  I hope the vets will help me package him for shipping as I don't have any PWD people out here to help me.

It's been a couple hours since I wrote that last paragraph, which was very hard for me to write.  During my break, Jim has come home and we've have time to talk.  I'm going to call Dr V and schedule for another CT.  While the CT is being done, hopefully they'll get the blood work results back, so we'll know whether or not a transfusion is needed.  After we've had time to compare the CT results, I'll decide about the chemo.  If they can do that all in one day, plus administer the chemo if needed, then that's the route we'll take.  Hardee gets so upset when I take him into Dr V's that I don't want to have to do it 2 days in a row, and if we're going to try chemo, it needs to be soon.  I hope our troops can rally to get through this.

Until then, it is still all about joy and all about Hardee.  Please keep him in your thoughts and prayers.

Wednesday, November 10, 2010

Wed., Nov. 10, 2010 - Chemo

Finally, we are home from the oncologist appointment.  We had to wait an hour, and Hardee gets so upset there that we almost left before being seen.  It is so stressful for him.  This place is where Hardee was first diagnosed, had a couple surgeries, spent time in their ICU, etc., and he doesn't like it there.  I felt so badly for him while we waited and he panicked, that I felt physically sick to my stomach.  I wonder how I will take him back there and leave him for chemo treatments.

I sat there getting mad at Jim because he has never had to take Hardee to one appointment, not one CT scan, not one radiation treatment, not one surgery or biopsy....nothing.  It was displaced anger though, when what I was truly upset about was the waiting and what it was doing to Hardee.  It is sad though that Hardee didn't even want to get in the car to go with me today because he knows that I always take him somewhere where people do things to him that hurt and they separate him from his Mom.  It's all so heartbreaking and so hard to do.

Dr. Vaughan thinks we should do chemo now but said we can start it anytime.  He said that he talked to Dr. Proulx about where they were with Hardee's case.  He reminded me that radiation can take awhile to work, and I reminded him that it had been 2.5 months.  He agreed that we were reaching the end of the efficacy phase of the radiation.  I also told him about the biopsy results that showed NO evidence of necrotic tissue, and he agreed that was something to worry about.

Dr V recomended the IV chemo over the pills to try for nasal tumors.  They would use 2 different types of chemo given every 3 weeks, alternating the drugs.  Unlike radiation that can take a long time to work, chemo acts quickly, so we should know whether chemo is actually working fairly quickly.  Hardee would probably lose his hair though.  That concerns me heading into winter.  A friend sent Hardee a very nice jacket that she no longer used, but it is too big for him to wear outside to potty.  He wears it to sleep at night though.

I asked about quality of life for Hardee while on chemo.  As we've all heard, dogs supposedly handle chemo better than humans, but each dog can react differently.  There are limited types of chemo that can possibly work for nasal tumors, but if he doesn't do well on one, we can try another.  Dr V said that Hardee could possibly still run agility while on chemo depending on how his body handled the poison.  We only have outdoor agility trials here in So. Nev., So. Cal., and Arizona, and Hardee can't wear a jacket while running, so I think agility would be out for the winter, as would his other performance sports.

So much to think about and consider.  Jim isn't home from work yet, so we haven't had a chance to discuss this yet.  We are so grateful Jim has a job though. 

Tomorrow starts a 4 day agility trial for us.  If HH feels up to it, we'll try rally and obedience also.  It will be a wonderful 4 days to be able to forget our worries and just have fun with our boy.  We'll worry about decisions later.  As always, it is all about joy and all about Hardee!!  Our fingers and paws are crossed for some more QQs.

Happy Veterans Day, Jim!!

Tuesday, November 9, 2010

Tues., Nov. 9, 2010 - Considering options

My head hurts from trying to weigh the options and make the right decision.  A friend wrote "one thing I know is that there is no wrong answer, no incorrect way to approach something unknown."  While I appreciate those words terribly, I still don't want to make the wrong decision;  the decision that affects Hardee's life, or his quality of life.  Another friend wrote "sometimes we love so much that we lose perspective."  I don't want to lose perspective either, though.  My head is tired from trying to figure it all out.  Thank you, friends, for giving me something to think about.

I did call and schedule an appointment with the medical oncologist in town for tomorrow at noon.  I need to know the chemo options.  Dr. Vaughan did give me some info on chemo when I saw him last back in Aug., right after Hardee was diagnosed when he referred us to Dr P in So Cal.  I read that info again this morning and have some questions.  The kick ass of chemo isn't listed on my info, and I want to find out why it isn't an option.  There is one listed where you have to wear gloves to handle the pill, and clean up any urine and feces as soon as the dog potties, especially when there are other animals around.  That's a little scary that I would be giving that poison to my dog.

Another point to consider is quality of life.  Hardee loves to be out there competing, especially running agility and doing water work.  He wouldn't be able to do that on chemo, so would he be happy laying around the house, too tired to go out, with other side effects of chemo happening, all for the slim possibility of chemo helping him.  It might possibly extend his life a little, but would it be a happy life for Hardee or would it just be selfishness on my part.

Last night I was really leaning towards chemo.  Today, I'm not so sure.  Hopefully tomorrow I'll know more to base an informed decision on.

One thing I am sure of.  It is all about joy and all about Hardee!  And for as long as it is in our power, it always will be.

Monday, November 8, 2010

Mon., Nov. 8, 2010 - Biopsy results

About an hour ago, Dr P called me back with the biopsy results and he's stumped and doesn't know exactly what to make of them.  The biopsy results clearly showed nasal chondrosarcoma cells which is bad news.  More bad news is that the biopsy didn't say anything about any dead or necrotic tissue which Dr P would have expected to see because of the radiation.  The only glimmer of hope is that the biopsy showed no evidence of tumor cells dividing. 

These results might not be reflective of the whole tumor though.  I mentioned in my last post about the fact that because we had done radiation, a part of the tumor can be doing something different than where the biopsy was taken from.  So, we don't know if this is the original tumor that just wasn't killed by the gamma knife radiation, if it is the original tumor that still might die from the radiation and is just taking longer than expected to die, or if this is a new tumor that has grown after the radiation killed the original tumor.  It's all very confusing to me, and also Dr P.

Dr. P prides himself on his gut feelings that he has for his animal patients and what their outcomes might be.  For the first time, Dr P doesn't have a gut feeling on how this will turn out.  This doesn't sit well with me, and I don't know where to go from here.

Our options are limited.  One option is to wait it out and CT again in 2 months to see what the tumor is doing, and if the radiation did any more to kill the tumor.  I don't think I can just wait around for another 2 months to see what the tumor is doing.  That scenario doesn't fit into my being proactive plan.  The other slim possibility is to try chemotherapy.  Chemo doesn't generally work for nasal tumors and is very expensive, not that gamma knife radiation wasn't.  Dr P said he might not try the chemo route until he saw positive proof in 2 months that the radiation hadn't cleared the tumor since in nasal tumors chemo is used as a last resort.

If we did try chemo now and the tumor did shrink when we CT again in 2 months, we would have no way of knowing whether the chemo or radiation killed the tumor.  I needed to know if that aspect played any role in what Dr P was telling me now as far as choices.  I said my dog's life has to come before his research, and he agreed 100%.  I would like to not do anything to screw up this new field of gamma knife radiation research so that what Hardee has been through will benefit others who come after us, but not at the expense of Hardee's life.

We haven't has enough time to digest these latest results yet or sit down and talk about it as a family (Jim is still at work), but I am leaning towards the chemo last ditch option.  I need to try anything and everything to save my boy.  I'll talk to Jim tonight about scheduling an appointment with the local oncologist to see what he has to say.

Even with our news today, it is all about joy and all about Hardee!  Please keep the faith.

Saturday, November 6, 2010

Sat., Nov. 6, 2010 - We are finally home

It's been awhile since I have written, but we are finally home, sweet home.

Last Tuesday, we went for Hardee's first post radiation CT scan, earlier than planned.  Dr. Proulx also did another biopsy of the tumor to see what we are dealing with currently.  As I wrote in my last post, the results should be back this Monday or Tuesday.  The problem with another biopsy is where the samples are taken and whether the results reflect the whole tumor.  What I mean by that is depending on where you take tumor tissue from, because we have done radiation, the tumor can be dead or dying in spots and live and growing in other areas.  We have no way of knowing if the biopsy results are actually reflective of the whole tumor and what it is actually doing. 

Dr Proulx said he will be devastated if the biopsy shows live tumor and doesn't know why the radiation wouldn't work.  He will not be the only one devastated.  The New York facility that also does gamma knife radiation does a setting of 10 for 3 days for their gamma knife treatments.  Dr. Proulx did a 14 setting on Hardee for 3 days.  The New York facility case study showed a nasal tumor growing back in a year, so Dr. P has been increasing his settings trying to get better results.  Of the 2 dogs with nasal tumors that Dr. P did gamma knife on before Hardee, the first one died because the tumor was so far advanced into the brain before they caught it that they didn't think it would work, but the owners wanted to try anyway.  The second dog was done a month and a half before Hardee, so there hadn't been enough time since radiation to be able to do a post radiation scan yet.  Hardee was the third dog, and since Hardee, another dog has been gamma knifed, ironically from Vegas also.  I asked how the second dog was doing and if the radiation had killed the tumor, and another irony, those owners called the day after I called Dr. P saying that I was seeing some worrisome signs, and they were saying the same thing and they come next week for their CT scan.  This is very worrisome news to me.

Hardee did a lot of bleeding after this biopsy also.  He stayed the night at the hospital for bleeding control and was still bleeding when I picked him up the next afternoon.  I took Hardee out to feed him before we started the trip back to my Mom's because for some reason they had not fed him yet, and he started sneezing which blew bright red blood everywhere.  After trying to control the bleeding in the parking lot to no avail, I took him back in where they took him to the back again.  That really upset him and he bled more.  They gave him an injectable sedative, iced his nose again, and told me to come back in an hour.  When I came back in an hour later, they wanted to keep him overnight again but I said no.  They sent him home with oral sedatives to try and keep him down and quiet until the bleeding could stop.  He is also on antibiotics to help with any infection while his immune system is weakened, unlike the last biopsy when he got that horrible infection.

Hardee is still bleeding, but each day we see less blood come out of his nose, especially when he sneezes.  Last night I finally felt comfortable enough to try the trip home from my Mom's house, and we got home late.  Hardee rides in his crate right behind the drivers seat, and I cannot see him if he really starts bleeding again where it doesn't stop.  I can hear him sneezing, then I worry.  I gave HH another sedative right before we left, so hopefully he would sleep during the drive and not be so excited to see his Dad when we got home that the bleeding would start again heavily.  Today is the first day I haven't used the sedatives, and HH seems to be doing fine without them.

The amount of bleeding after this biopsy worries me.  I know that tumors have quite a bit of blood supply, thus the reason they can grow so quickly.  But, it seems to me that if this tumor was dead or dying, it wouldn't have this amount of blood supply.  Dr P says differently, but I still worry.  My Mom says that if I didn't have anything to worry about I couldn't live, so maybe it is just me worrying too much again.  I still dread the biopsy results coming this week but am anxious to know also.  I will worry though how reflective the results are of the tumor as a whole. 

I'm not sure about this whole gamma knife radiation and how well it works.  I am convinced that it was Hardee's best shot at survival though.  We couldn't have put him through traditional radiation and it's horrible effects.  I'm not sure where we go from here.  We'll see what the results show on Monday.  I hope that regardless of Monday's results, Hardee's gamma knife radiation experience will help formulate a better plan for other owners whose dogs have nasal tumors.  I just hope it works for Hardee.

We love HH so much and cannot imagine our lives without him.  We have been blessed by his presence and would do anything in our power for him.  He deserves whatever we can do for him.  He has brought us so much happiness in his five years with us.  I wish that pure love was enough to save our boy because we have that.  Here, it is still all about joy and all about Hardee, and we hope it stays that way for many years to come.  Keep those fingers and paws crossed!!

Tuesday, November 2, 2010

Tues., Nov. 2, 2010 - Hardee is spending the night in ICU

Well, I kind of don't have good news, but I don't have bad news, yet, either....just neutral news.  In other words, we don't know yet.

The CT scan clearly showed a smaller mass.  I'm going to guessimate about 60-75% of what was there previously, so about 25-40% smaller.  I saw the scans and compared them.  What we don't know is if that is the same tumor, if it is dead tumor or dying tumor, or if it is the tumor that has regrown.  Dr. Proulx did biopsies, thus the bleeding, but we won't know the results for a week (next Monday or Tuesday).

Hardee is spending the night here at Calif. Vet. Specialists for bleeding control.  Remember what I went through with him bleeding at home last time?  Well, Dr. Proulx said he probably couldn't sleep well if I took him home tonight because he still is bleeding quite a bit.  They had his poor little nasal passage flushed with cold water, with cold packs on it, to help control the bleeding.  He is also on antibiotics. 

They asked if I wanted to say good night to him, but I declined.  For my sake, I wanted desperately to do that, but for his sake, I didn't.  He would get too excited about seeing me, bleed more, and not understand why I wasn't taking him with me.  I'll have to drive 110 miles back to my Mom's tonight and come back and get him tomorrow.

Rest well, my little bubs.  Mama loves you and misses you terribly.  I'll cry myself back to Grandma's and see you tomorrow.  Until then, I'll try to remember, it is all about joy and all about Hardee.