Beach weekend

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We decided to take Mr. Grover to the Pacific Ocean this weekend. It was a rare weekend that both my husband and I had off and the only weekend that we thought would be decently warm to go to the WA coast.

It was about an 8 hour trip, but the scenery was gorgeous and Grover is a great car traveler. We arrived after sunset on Friday to an absolutely lovely AirBNB right on the beach at Willapa Bay. The next morning was PERFECT. The sun was shinning, the tide was going out and we had the entire beach for ourselves. Grover has been known to get timid around big waves but with the bay and the tide going out – it couldn’t have been more perfect for him.

That night, I just had a feeling. Something wasn’t quite right. We should have been in the free and clear chemo wise – he had a normal CBC at day 9 and 2 days prior on day 14 his neutrophils were just barely under the normal range and that should have been his nadir, or lowest point. I took his temperature three times … high normal. But normal. He ate dinner and we went to bed.

The following morning Grover didn’t want breakfast which is unlike him. We took his temperature and it was 104F … yikes!!! Luckily, as we were leaving and literally pulling out of the driveway back home I ran back into the house and grabbed his antibiotics from the first time he had chemo and ended up with a dangerously low white cell count. We gave the antibiotics and started the long, long drive back home. We briefly considered trying to find an ER clinic closer but decided to make a run for it and get back to our people.

Upon arriving home Grover was still febrile with a temperature of 104F. We went into the ER. They quickly evaluated him – still febrile, but normal blood pressure and not significantly dehydrated. A few minutes later the student came out and said “His CBC was so low that they are manually rechecking it – hang tight.”  I could tell that there were a lot of very sick dogs in the ICU and ER that night – I have no doubt more sick than Grover – and she did a great job keeping us updated to ease this worried owners mind.

The doctor and student came back out and told us that the original CBC was correct. A normal dog should have >5,000 white blood cells and >2,800 neutrophils. Grover had 800 white blood cells and 300 neutrophils – meaning that he didn’t have enough white blood cells to fight whatever was causing his fever and was at risk for sepsis or potentially was septic. They contacted the oncologist who agreed that since he was stable (didn’t have a low blood pressure, not dehydrated), we lived close and would be attentive we needed to get out of the ICU/ER ASAP because he was at risk of picking up a hospital acquired infection that his immune system was in no place to fight. Luckily later that night his fever broke and he has continued to do great.

I felt so guilty Monday. A fun weekend could have killed him. But our very kind oncologist assured us that although that was true, she would have done the same thing if he was her dog and that it’s important for him to have fun too. This will probably push back our 4th dose of chemotherapy because his bone marrow will need more time to make more white blood cells which is disappointing … but right now I am just thankful he is alive and well.

This weekend drove home to me to never take a single day for granted and always have a plan. If we had needed to wait to start the antibiotics until we got home the ending could have been much different. I am so thankful to our veterinary team for taking care of Grover … and me.


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Decisions

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First — all the good news. Grover handled both days of radiation and his #3 dose of carboplatin like a day at the park. The oncologist increased his dose of carboplatin because his CBC never faltered after we lowered the second dose.  I am sure that I am 100% biased but when I came home from a long-weekend business trip I couldn’t feel the rib tumor anymore. I know it’s not gone, but maybe the radiation shrunk it some. Despite increasing his carboplatin dose his neutrophils still didn’t drop. So, we got to enjoy another weekend and took a trail that we hadn’t taken since amputation.

I will admit that learning Grover had a rib metastasis has challenged my “be more dog” mentality as I struggle to sort through clinical trial options. Do potential benefits outweigh potential risks? What does this new lesion mean for us in terms of expectations? I am looking forward to sitting down with our wonderful oncologist this week. She does a good job at kindly and compassionately bringing us back to reality and helping make sense of our options.

In the mean time we will enjoy hikes by day and couch snuggles by night.

Cherish today, for who knows what tomorrow may bring

In summary, we are disappointed after our met check but trying to focus on the positives. On thoracic radiographs today Grover did not have evidence of lung tumors/metastases but he did have a lytic mass on a rib that is consistent with another osteosarcoma.

Putting a positive spin on it, the oncologist told me that in retrospect the radiologists can find the lesion on his radiographs and CT before surgery (it has grown since and is much more obvious) and so technically this means that he does not have any new lesions which is good news. I am honestly glad that they did not identify this as a tumor before surgery because it may have been the straw that steered us away from amputation and no matter what, I am SO glad that we did the amputation because it has bought him truly  happy weeks. I do not know what this means for us long-term. Today he started radiation for the rib to try and slow the growth and we are forging forward with chemotherapy because he did not have lung tumors, so maybe the chemo is doing its job there. She would not have expected the chemotherapy to do much for the tumor in the rib.

Yesterday, in timely fashion, Grover reminded me that we should not waste today borrowing troubles from the future. He insisted on going potty outside, at the exact time of this beautiful sunset and threw himself on the grass. I stopped to sit with him and we watched the sun setting over the hills. I was reminded that regardless of what the radiographs say, tomorrow is never a guarantee. All we can really count on is the moment that we are in so we better enjoy it. #bemoredog

Then an off leash dog came whizzing by, startled us both, and I had to take off running after the three legged dog who it turns out could get up quicker than me. 🙂

We all (owners, veterinarians, etc.) do the best that we can do, with the resources and knowledge that we have, in the moment we are in … and that’s all we can ever ask of ourselves or others.

Making lemonade

As summer comes to an end and fall rapidly descends upon us, I was grateful for the opportunity to take advantage of the beautiful weather.

Friday was 14 days after our second dose of chemotherapy (carboplatin). Based on the very low number of neutrophils and the extended time to return to normal our oncologist lowered the dose this time around. Kill the cancer, not the dog. We never saw a significant drop in his neutrophils this time around — the good news is it meant that we had this long weekend to enjoy out and about rather than staying “quarantined”. The “bad” news is that if the carboplatin didn’t affect his bone marrow, it may not have had as significant of an impact on the cancer. In an effort to “be more dog” we are focusing on the good — we had a chance to share these beautiful moments and make these wonderful memories.

We also appreciated our Ruffwear gear SO MUCH this weekend. As an owner of a large breed dog I am used to Larges or XLs still being much too small. Not with Ruffwear! Their harnesses fit well AND are functional. The harness really came in handy this weekend to help give G a “boost” up banks and ledges.