Arwen Finished Chemo

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Arwen is done with chemo! DONE. No more going to the vet every week!! We are so excited for her. We feel very lucky because she did not have side effects from the chemo, except possibly the very last treatment (she seemed lethargic that afternoon then threw up twice the next day, but then was back to herself).

Throughout the chemo treatments, we were able to keep Arwen’s life very “normal.” Same routine as before, going up to the mountain to play every weekend, walks on weekday afternoons, lots of cuddles at home. We didn’t really travel much because we were worried about going too far from her vet if there was an emergency.  But now we feel like we can breathe a little more and just got back from a snowboarding trip to Washington with her.

FUTURE VETERINARY TREATMENTS

We have decided not to do further treatments for Arwen. There has been a lot of talk about the vaccine trials for osteosarcoma dogs. The listeria vaccine sounds promising, and there is a vet clinic a few hours from us doing this treatment, but as I mentioned in Arwen’s last post, the chemotherapy visits were stressful for Arwen.  Chemotherapy was only 6 treatments (with blood checks in between), and a few more treatments doesn’t seem like a lot, but we promised Arwen we wouldn’t admit her to a vet office anymore.

Arwen’s vet is recommending that for follow-up monitoring, we do chest xrays for Arwen in 4-6 weeks, then every 3 months after that. This is to check to see if the cancer metastasizes to her lungs, which our vet has practically guaranteed us that eventually, it will. We are still undecided on what we will do regarding this follow-up. She won’t have to be admitted for chest xrays so it won’t be so stressful for her, and we also wouldn’t be getting them done at the office she had chemo and her amputation at, so that’s less stressful, too. But if we won’t be doing any further treatments or chemo if the cancer is found in her lungs, is there a point in knowing? We are in 2 different camps, with my husband more not wanting to know, and me wanting to know.  We may compromise and consider chest xrays every 6 months. We’ll have to see.

But we will continue to focus on keeping Arwen as healthy as possible through diet, exercise, and mental health. She will continue getting her immunotherapy supplements from K9 Medicinals, and her daily Phycox glucosamine and fish oil. We may consult a homeopathic vet, but for now we are letting Arwen have a nice break from vet offices (exception: physical therapy).

PHYSICAL THERAPY

Arwen enjoys her physical therapy visits, where she gets lots of treats and we get to stay with her, and we truly feel that these visits have been beneficial to her. She has about one visit a month, but we do exercises with her every day.  Her muscles and core seem stronger since we started doing exercises. But her therapist still wants us to take it easy on long hikes. So we continue to keep walks under a mile for Arwen.

Because Arwen has bowing in her carpal wrist area, her therapist recommends Arwen wear a brace to prevent further bowing in the future. Note: Not all tripawds will need a brace. And a hard brace could hurt a dog if not fitted properly under the supervision of a vet or therapist. Arwen has a soft orange brace, but she recently got a hard black brace that Arwen’s physical therapist special-ordered for her based on her measurements. Both her braces are from Therapaw.

Arwen’s black hard brace is a lot larger than her soft orange one. It looks like a cast to me! I’m still getting used to seeing it on her.

THE FUTURE

We don’t know how long we have with Arwen. The vet told us 9-12 months from diagnosis if we did amputation and chemo, but we sincerely hope we get more than that. However, we have seen heart-breaking stories where the time was much shorter. And we have seen uplifting stories where the time was much longer, even when chemo was not done. We will just continue to live with Arwen knowing that we need to make every single day count. We love her so much, and seeing her happy is our favorite thing in the world.


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Arwen 4 months & 4 days Post Op

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Arwen’s Got 99 Problems But Missing A Leg Ain’t One of Them

Not much news about Arwen is good news! The best news is that Arwen has one more chemotherapy treatment before she is finished. Hurrah! She has been very lucky and has had zero side effects from the chemo, except for a low platelet count every second week after chemo treatment. So she is at risk of her blood not clotting properly, but as long as she doesn’t get in any horrible accidents, the low platelets won’t affect her. The truly worst part about chemotherapy has been having to admit Arwen every 3 weeks. Arwen has never been a fan of the vet, but since her amputation surgery she has become even less of a fan, and understandably so. She starts shaking in the car the second we pull into the parking lot. In the lobby, she tries to hide under the chairs and tables. At the office’s recommendation, I have been giving her trazadone prior to every visit, but it has not made a large difference. Having to leave her while she’s scared at the vet is extremely hard for me, but is the standard process for chemo treatments. I have asked her vet to make an effort to keep Arwen for as short a time as possible. Sometimes I have been able to pick her up after about 3 hours, but the rest of the time Arwen is admitted for 4 hours or more. I have made a request that her last visit not last that long, and my vet is going to make a real effort to make it as quick a visit as possible (without compromising Arwen’s safety, of course). I have yet to discuss what recommended follow up will be for Arwen after chemo. (I actually have not spoken to the veterinarian overseeing Arwen’s care since October. I get emailed visit summaries from him, but every time I have a question or concern, a technician or receptionist relays the answer back to me. Not sure if this is standard for specialty practices.)

Nick and I have already decided that any further treatment that requires Arwen to be admitted for hours at vet offices is not going to be treatment we will pursue.  It is my natural desire to want to pursue every avenue and treatment there is to keep Arwen well and give her as long a life as possible, but I have to check that desire to consider what Arwen would want. I wish she could tell me, but since she can’t, Nick and I have to rely on our parental instincts. And those are telling us that she doesn’t want to be admitted anymore.

I still take Arwen to a physical therapist once a month, and while she is a little wary at those visits, she’s not even half as bad as when she’s at the oncologist’s office. She gets to stay with me the whole time she does her PT, which keeps her confident, and she happily eats lot of treats with them (at her oncologist’s office she rarely accepts any treats). Her therapist ordered her a “hard” brace. They did the measurements and ordering about 3 weeks ago and the brace arrived yesterday. The brace is to help prevent further bowing in Arwen’s remaining front carpal area, and to help avoid the issue of carpal hyperextension.  It is a lot stiffer than Arwen’s orange neoprene “soft” brace. We will slowly start using it every few days to get Arwen used to it.

Overall, we are so proud of how well Arwen is doing. I have started saying “Arwen’s Got 99 Problems But Missing A Leg Ain’t One of Them.” Here is a link to Arwen running with Nick 3 months post-op. The Ruffwear Webmaster harness with a brush guard comes in quite handy for them:

By comparison, here is Arwen just 8 days after amputation surgery:

We walk Arwen a half mile (with no assistance) every day and she gets to go up to the mountains every weekend to play in the snow at our local ski resort. Once chemo is done, we will feel more comfortable traveling with her again.

Kisses and hugs to all Arwen’s fellow tripawds and cancer patients!!

Arwen 84 days Post Op

Haven’t posted in awhile, and that’s good news because Arwen has been doing really great. Her third dose of chemotherapy is tomorrow, and she still has not had any negative side effects from the treatment. No loss of appetite, no GI issues, no lethargy (knock on wood).

We have been keeping her active (but not too active), and we have snow in our area so she is in heaven. (I have had trouble resizing videos to share them on this blog but Arwen does have a public Instagram of arwen_snow_dog if anyone wants to see videos of her). We have a summary from her therapist specifically stating that we aren’t supposed to let Arwen sprint. We have only been letting her run fast when Nick holds her harness and runs with her to take a lot of the work off her legs.  But the other day we violated our “not too active rule” and let her sprint through the snow on her own. She runs so fast you can’t even tell she has 3 legs. But I would have regretted it had she injured herself so we definitely won’t make a habit of it. For now.

The only negatives are that Arwen still has the fatty cyst on her tail that randomly opens every couple weeks and bleeds, but until she is done with chemo her vet doesn’t want to discuss removing it, so we have just learned to deal with it and keep it clean. She also has a recessed vulva apparently, and the vet said a sudden drop in physical activity, like Arwen had with her amputation surgery, can aid in yeast and/or bacterial infections, so we are cleaning her vulva area daily with a cream and wipes.

Unfortunately, Arwen’s physical therapist doesn’t like how much Arwen’s right carpal/wrist area is bowing. We never walk Arwen outside without her brace on (it’s the Therapaw Carpo-Flex Sports Wrap), but the therapist was saying a soft brace like this can help with support before bowing occurs. But because Arwen’s carpal area is bowing more than she originally thought when first seeing her, she thinks we may need to upgrade to a harder brace already. We are waiting to hear back to find out what kind of “hard” brace to get.

We are doing therapy exercises with Arwen daily. Per the therapist’s recommendations, we made a 2 inch high foam platform with a yoga mat taped to it that Arwen stands on with just her front leg on it, then just her back legs on it. She also goes into Sphinx pose while laying down with a straight spine, and we have her practice standing up and laying down with no sit position in between and trying to keep her feet planted. We are also supposed to be having Arwen roll over on both her sides as a good core exercise, but Arwen won’t roll over. She used to do it and knows how, but she hasn’t done it in years and acts like she can’t do it anymore. The closest I can get is having her play dead. We’ll have to keep working on it.

She’s nice and trim now also. At surgery Arwen was almost exactly 100lbs, and last weigh in she was 85.9lbs. She has always been 5 – 10 lbs overweight, but now we are being really good about trying to keep her weight down to keep the pressure off her joints.

The thing I am struggling most with regarding Arwen’s diagnosis is her diet. Trying to choose what is the best “cancer” diet for her has been hard. There is so much information from the Tripawd site (which I appreciate) and other resources and it’s difficult deciding what recommended changes I want to make. I am definitely cutting out refined sugars and most carbs (breads, white rice, white potatoes, etc.), and adding more whole fruits and vegetables to Arwen’s diet. I was unsure what Arwen would and wouldn’t go for with veggies. Usually I have to talk her into trying even a blueberry or piece of banana. But lo and behold, I steamed some spinach leaves and carrots and put them over her kibble and she devoured it! I thought I would have to place them in broth but she was fine. I have also started adding mashed yams and apples over her kibble and she loves that, too. I also want to start reducing her kibble and replacing it with cooked meats. (Some owners go for a raw meat diet. We have a lot of experience with this as we had a cat with severe IBD and he ate raw meat for the last 2 years of his life, but we have currently decided to not do this for Arwen.) This is all a learning process for us and I have some canine recipe books in mind from veterinary nutritionists.  I am sure I will get more comfortable making choices as I go.

Here’s hoping Arwen has a good chemo appointment tomorrow! She is terrified of the vet, so I will spoil her afterwards, though spoiling is just a daily habit in our home with such a sweet pup.

 

55 Days Post Op, 20 Days Into Chemo

No news to report for awhile, and no news is (mostly) good news. Arwen continues to manage on 3 legs well, she has a healthy appetite and she is very happy. We never saw any side effects from her first dose of chemo. Her second dose is scheduled to be administered in 2 days, and her vet said the first dose is usually low as a precaution, so we are nervous about this next dose being higher. Fingers crossed that she continues to have no side effects.

The only bad news is a fatty cyst on Arwen’s tail decided to open up. It is very frustrating to have a dog for 9 years and never have a single wound issue, then as soon as she is diagnosed with osteosarcoma we have to deal with 2 wounds right in a row. Arwen’s vet had warned us that cysts that develop on tails can be a pain in the butt if they open and of course, it has.

Arwen’s first wound on her right side delayed her chemo until it could be stitched and risk of infection was over. The vets have decided that this open wound on her tail will not mess up her chemo schedule for now, as long as we keep on top of it. If it gets infected and/or won’t heal, we may have to lay off chemo for a little bit. But she’s back on antibiotics and we are keeping the wound clean and using a soft cone when we aren’t home to keep Arwen from licking her tail (though I think the antibiotic spray they gave us is acting as a deterrent to licking on its own.)

As annoying as Arwen’s tail wound is for us, she is as happy as ever. We are anxious to keep her life as full as it can be, but are mindful about still limiting her exercise. We are taking her to lots of fun places, but have only allowed her to walk over a mile (1.2 miles) just once. Mostly we do 1/4 mile or 1/2 mile jaunts, then drive her somewhere else new and let her sniff and explore, but not hike. She has a physical therapy appointment next week and we want to be sure she doesn’t overwork her right, front leg.

Her 2 month ampuversary is almost upon us!

 

 

Chemotherapy Day 1

Today was Arwen’s first chemotherapy dose! We have been waiting for this for weeks.  Arwen is 35 days post op, and ideally we wanted to start chemotherapy 2 weeks after her amputation, but had to wait because of the strange wound on her right side. Luckily, that wound has healed great. Keeping T-shirts on Arwen kept her from licking it, and the stitches came out today, as well.

Yesterday, to celebrate her last chemo-free day, we drove Arwen up to the mountain to play in the snow. Arwen has constantly been surprising us with how well she is doing on three legs, and yesterday was no exception. I have been worried about how she would do in the snow. I thought maybe she would slip a lot or lose her balance, but she didn’t at all! She ran around and played and even went through a little deep snow and managed great.

Arwen standing in her first snow since her operation

When I picked up Arwen from her chemo appointment, another couple who just had their golden retriever diagnosed with cancer was marveling at how well Arwen was bouncing around as a tripawd. I’m glad she is showing people how quickly pups can adjust to the change.

So Arwen’s chemotherapy schedule is a planned total of 6 doses spread 3 weeks apart, with blood work being done every week in between (the chemo drug is carboplatin). That means Arwen has to go to the vet every week for the next 18 weeks. Arwen has never been a fan of any vet office, but the place she had her amputation surgery she is especially nervous going to now. I feel so bad for her, so I gave her a little bit of cheeseburger in the vet lobby today (my coworkers got Arwen a McDonald’s gift card so I can spoil her with occasional ice cream cones and plain burgers), and will plan to do it every time to try and give her a positive association with the place.

Arwen also had her first physical therapy visit last week. Arwen’s orthopedic doctor recommended it, and the Tripawds foundation has a great set up for helping people with their first visit. The rehab clinic we visited has balance discs and an underwater treadmill, but Arwen hasn’t tried any of those yet. Instead the physical therapist showed us stretches and joint exercises we can do on Arwen legs and hips, and she went over all of Arwen’s bones and joints to make sure all was in good working order (it is). The therapist recommended we add fish oil to Arwen’s diet (we ordered Nutromax Wellactin fish oil and Arwen LOVES it). She also said a carpal/wrist brace for Arwen’s front leg isn’t a bad idea to give her a little added support. We are planning to order one in the coming week.

We are SLOWLY increasing Arwen’s exercise. My husband and I still haven’t taken her further than a half mile, and are still mostly just taking her on walks every other day. We love her so much! We are really hoping she has no side effects from the chemotherapy and can continue being happy.