Catching Up

It's the beginning of 2012 and I am going to make a concerted effort to blog more regularly this year. I figure it's probably a good idea to recap all the craziness 2011 brought us. Probably the most consuming event was our little Bella being diagnosed on 12/17/2010 with Transitional Cell Carcinoma in her bladder.

Here is a condensed version of her treatments and what's happened but I know no matter how hard I try this post will be longer than I intend it to be. So here is goes...

This is a very rare type of cancer for dogs. Less than 2% of dogs get bladder cancer. We have always known Bella was special and things have never gone as planned with her, medically and otherwise. :) After weighing our options we decided that surgery was the best option, followed by chemotherapy and NSAID treatment (Mitoxantrone and Piroxicam). I was really hesitant to give Bella chemo. She was not showing any signs of sickness or distress other than the recurring bladder infection that brought us to the doctor in the first place. I was so worried that chemo would have some really nasty side effects. Turns out that dogs do not have the same side effects as people. Bella would go to the Las Vegas Veterinary Specialty Center (to see her oncologist, Dr. Andrew Vaughan, who is amazing!) and would be there all day. She gets a blood test to make sure everything is ok to give her the intravenous chemo and she gets her treatment. It takes about 20-30 minutes, but she has to be there all day long because we work. I think that is her least favorite part. Afterwards, she comes home, runs around like the little nut she is and it's playtime as usual. Towards the end of her chemo treatments we think she was a little nauseous so we gave her a pill to help that.

Recovering from surgery

                    

Getting back to her old, happy self and in one of her favorite spots :)

Chemo, ultrasounds, blood work, meds, etc continued religiously every three weeks ($$). After her initial surgery, Bella's incision became infected and it was suspected that the cancer may have 'seeded' in the incision (a cell got stuck in there and cancer was growing). I was SO pissed! She did not have cancer there before the surgery and instead of taking it out, they spread it...WHAT?! Needless to say I lost my mind a bit. Turns out she had a MRSA infection. What is that you say, MRSA in dogs? Oh yes, and it's highly contagious to people. So we had been cleaning the incision without gloves for days. Thank goodness neither of us got it. We sterilized the house (thank you, mom) and put her on Doxycycline (yes, the same kind humans get) and it eventually cleared up. She started feeling better and everyone kept telling us they couldn't believe she was sick...apparently no one had told her. :)

Peek-a-BOO!

Enjoying Floyd Lamb Park- June

Can I have a cookie now, please?!

Doing what I do best- play with my toys while in my papa's lap

We continued the IV chemo from the end of December into April. There was such amazing progress, too! After her first chemo treatment her tumor shrank by 3/4 of its size. After six treatments, we stopped the IV chemo and switched her to an oral chemo pill that was given at home once every two days. (Chlorambucil) That turned out to be a mistake because the tumors started growing...and fast. From May through mid-December we restarted Bella on the same IV chemo/NSAID regiment and saw that this second time around the chemo was not having the same effect as the first round. She went for a treatment once a month and it mostly maintained the growth and decreased it slightly ('stable disease'). We have been treating her recurring bladder infections as well. That's part of this ugly cancer. There is so much irritation in her bladder that the bacteria gets caught in all the layers of irritated-ness. The problem we have encountered (starting in November) was that she gets two types of bacteria and both are extremely resistant strains. Her little body is resistant to 7 out of the 10 medications that can treat it. So she is on Doxycycline and Clavamox indefinitely even though we know that they are probably not doing too much to kill the infection.

November and December were hard months. For the first time in nearly a year, we could tell Bella didn't feel well. Isn't that crazy!? She is the toughest little Boo in the world. She was lethargic, didn't want to eat, and started getting us up 2-3 times a night to pee. She sleeps in bed with us, so at least she is asking to go out! When we had our appointment on December 1, 2010 we were told the chemo was no longer working and the tumors had grown about 30%. That coupled with the blood work that showed she had increased kidney values. There are a few things that could cause this but I think it's the pretty much unchecked bladder infection moving into her kidneys.

Before Christmas, she just wanted to be held and snuggled

Sad Boo...this is how she gets 'squish face'

We were given a few options: 1. Stop chemo and make her as comfortable as possible (aka give up...which is what I took that option to be). 2. Switch her to a new NSAID and see if it helps with the inflamation. 3. Start a new chemo drug (there are so many out there) that has less proven results. 4. Start her on daily subcutaneous fluids to help flush her kidneys. (Most of these can be done in combination). You might be wondering how much this has cost us. Well, I can tell you it was a lot more than I thought it would be when we started this journey. This was the first time we could not choose what we felt was the best option (trying a different chemo drug) because we could not afford it. The new chemo drug had to be given every two weeks instead of monthly. There was no way, in addition to continuing the ultra sounds, all her meds, etc that we could choose that option. So, we went with trying a new NSAID (Derramax), starting her on daily fluids (which are supposed to be given at home...we'll get to that disaster) and keeping her on all the other meds.

So, they really thought Bella was going to let us stick a needle attached to a syringe the size of my whole hand in her back every day. That's rich. Have they not met my dog? To us, Bella is the most loving, snuggly Boo in the whole world. In reality, she is a feisty little Biotch who can be really hard to handle. To say she has a personality is an understatement. So, after four or five days of trying, two successes, a visit from my brothers friend who just finished vet school, and losing one of my nails in the process, we decided to call our regular vet, Cheyenne West Animal Hospital to see if they could administer the daily fluids. 

This needle is the length of my hand and the plunger is not out!

One of the casualties of Bella's home fluids

What a blessing that they said yes, and are not charging us for this service. For three weeks we (and I use the term 'we' loosely because my amazing mother took Bella during the week) brought her for daily fluids. At her last appointment on January 9th her kidney values were closer to normal and we are now doing fluids only three times a week. Also, the new NSAID is having better results than expected. I get Bella to my mom's house on Monday and Wednesday before work and she takes her in for fluids. Marco and I take her on Saturdays. I hope it keeps working. She is still considered 'early stage renal failure' but what a difference it's made!

I sure do love my papa...

...and I like to remind him that I'm 'Queen of the Castle'

We could see the difference within the first few days. She was eating again, running, playing, and really back to her normal spunky self. Marco made the comment that Bella is making it really hard for us to say goodbye to her. I agree. When we found out the chemo stopped working, I thought she would only be with us a few more weeks and I wasn't even sure about that. Now, it's six weeks later and (other than the frequent peeing) you can't tell she's sick. She's excited to eat again- probably because when she didn't want her dry food we started giving her whatever she would eat (ex: filet, mashed potatoes, carrots, etc). She is now on Blue Buffalo canned dog food and she LOVES it! We switch up the flavors because there was a time she'd like something but only eat it for two days and then not want it anymore, so we keep the variety up. 

At Christmas, looking pretty even though I don't like wearing this dress!

 

Helping mom with laundry

Our next appointment is on February 13th. She will have an ultrasound and be rechecked. There is something that appears to be outside her bladder wall, and if the cancer has spread to a lymph node that is not good news. So far, other than her bladder and urethra, there have been no signs of metastasis. So, we are keeping all our fingers crossed for her and praying a lot.

My favorite picture of Bella

If you can not tell, we love her so much and I really can not imagine what it will be like without her. I got Bella when I was 19 and a sophomore at UNLV. She is my baby and I am her mama and that's the way it goes. :) So, we will keep fighting for her as long as possible and as long as it's what's best for her.

Thanks for reading!