[PyrNet-L] Lymphoma/Clondike Update

[David P Kintsfather Jr <kintsfat@kutztown.edu>]

Clondike (and family) has gone through some ups and downs since my last
report.  We are on an up phase, so I thought I'd post an update that is
mostly positive.
 
For folks new to this thread, Clondike is a nearly 11 year-old spayed
bitch Pyr who was diagnosed with canine lymphoma (cancer of the lymph
system) at the beginning of the summer.  She has undergone one cycle of
chemotherapy using L-asparaginase, Vincristine, Cytoxan, and Doxorubicin
(one drug per week) and was supposed to repeat this cycle after a one-week
rest.
 
She had a severe reaction to the Cytoxan involving vomiting and diarrhea,
and after she recovered from this, she had a nearly fatal reaction to the
Doxorubicin.
 
We approached the second cycle with GREAT misgivings, as our very "young"
10 year-old was much weakened by 8 days in the hospital on an IV drip.
The first 2 drugs were once again no problem.  The oncologist lowered the
dosage of the Cytoxan and pre-medicated with IV Zofran, one of the latest
in anti-nausea drugs developed for chemo patients.  We tried administering
the Cytoxan IV rather than orally, and we monitored Clondike's white count
closely.
 
Well, she still had the vomiting, and really scared us by 3 seizure-like
episodes while trying to vomit where she would fall on her side and twitch
for about 5 seconds!  The oncologist discontinued Cytoxan after 2 days (it
is supposed to be given on 4 successive days).  By administering Neupogen
to stimulate the bone marrow when Clondike's white count fell to 2800, we
avoided the diarrhea this time.
 
To aid the oncologist in figuring out how to prevent future reactions, our
vet compiled a table of all of Clondike's routine blood counts for her
whole life.  Most of the white counts hovered around 5700, slightly below
the 6000 considered low normal.  I did an informal Internet and phone poll
and found that about half of the Pyrs I could get data on had routine
white counts at or near the 6000 level.  We passed this on to the
oncologist, but she didn't really answer when I asked if it helped.  She
just said Clondike is "sensitive" (as if this is news).

Because of the seizure-like episodes the oncologist wanted another
cardiology exam, and this turned out to be quite a shock.  The
cardiologist said Clondike's heart rate was dangerously low and put her on
TheoDur to raise it.  He also requested a thyroid panel because low
thyroid levels can cause this condition.  He felt that the seizure-like
episodes were related to this problem, possibly aggravated by the Zofran
anti-nausea drug.
 
This week we did a revisit with the cardiologist who got the preliminary
(quickie) thyroid test back.  It showed low thyroid and he feels that this
MAY be the cause of the low heart rate and correcting it may negate the
need for the TheoDur.  Meanwhile, Clondike's heart rate is much improved
on the TheoDur (which she is tolerating just fine), and the cardiologist
is quite pleased with her condition.  (The oncologist wants to wait for
the full thyroid panel to come back from Michigan before beginning
treatment.)

The oncologist had even better news, from our perspective, at today's
appointment.  She said that considering our concerns about Doxorubicin,
and considering that Clondike remains in total remission after 3 full
weeks without chemotherapy, she would recommend trying the monoclonal
antibody therapy without completing the second cycle of chemo.  There is a
risk that we will be wasting money on the antibodies by not giving them
enough of a "head start," but this is a risk we are willing to take--we
lose nothing but money.  Our regular vet has been very hopeful that this
patented monoclonal antibody therapy will provide Clondike with a long
remission, so we start tomorrow.
 
The monoclonal antibodies are not essentially toxic in the way the chemo
agents are, are well tolerated by dogs (well, we've heard that before!),
and have to be administered by slow IV drip over 5 days :(.  So we
re-arrange our schedules for the next 5 days and say lots of prayers.
 
Clondike has regained much of her strength and all of her weight during
the 3 week "rest period" while we have run down the cardiologist and
gotten all the required blood work done.  She was able to attend the
tailgate picnic after the Penn-Dutch Regional, and greatly enjoyed the
attention from the people and 2 of her 3 Pyrenean gentlemen friends
(Nancy Huggard's "Barney Babe" came all the way from Florida to visit Ms.
Clondike).
 
Many thanks for all of the kind thoughts and prayers people here on the
Net have sent to our girl.  They have probably helped her, and they have
been a tremendous comfort and support to Nancy and me as we try to figure
out what is best for Clondike.  Hugs to everybody--fuzzy and not so fuzzy.
 
David (for Nancy and Clondike)


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 David Kintsfather              | PHONE:       (610) 683-4497
 Dept. of Telecommunications    | FAX:         (610) 683-4659
 Kutztown University            | INTERNET:    kintsfat@kutztown.edu
 PO Box 730                     |   "We need not think alike to love alike."
 Kutztown, PA  19530-0730       |                Francis David
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