August 1 marked one year since we have been dealing with Puddin's diagnosis of immune-mediated thrombycytopenia (IMT). The first 6 months were a roller coaster of ups and downs for sure! I was neglectful in recording so much of it on the blog, but let's just say that I am so glad to be past that point. We still have to go to the vet every 4-6 weeks so they can do a platelet count. So much was riding on those results and our vet wanted them to be completely accurate so they are sent out each month to ensure an actual person reviews the platelets under a microscope rather than just relying on the in-house machine for the results. The last 6 months we have seen much more stable numbers and have been able to consistently lower Puddin's meds. Yay! As her body continues to produce platelets on its own now, we have continued to slowly reduce some of the heavy doses of drugs that she was on and thankfully have not seen any negative impacts in recent months. She is currently on 50mg cyclosporine (Atopica) twice a day (down from 100mg twice a day) and 5mg prednisone once a day (at one point she was taking 40mg per day), as well as an over the counter med for stomach upset twice a day. Fortunately, she gobbles up the pills as long as they are wrapped in something tasty like chicken, cheese, hot dog, or liverwurst. She knows the routine and comes running as soon as she hears the pill bottles! She just got another great report this week and on Sept 1, we will try to decrease the Atopica to once daily and keep our fingers crossed! Okay, so that's the first good news!
Now the bad news part as I switch gears to Buford. During one of Puddin's regular blood checks, we also scheduled Buford for a routine vaccination. While there, we inquired about Buford's progressive weight loss and that's the point when everything changed! Tracy and I had both noticed that over time Buford kept getting skinnier and skinnier. I had even asked the president of our adoption group if she had any recommendations for getting some weight on him because it was starting to look like we didn't take care of him :( In my naivety, my mind had just chalked it up old age. After all, his eating habits hadn't changed a bit, he still had the same happy/goofy/lovable personality which hadn't changed, and he would soon be 12. Obviously, we still thought it was wise to confirm with our vet.
Before I go any further, I want to note that while I used to do some fairly extensive travel with my job, that has dropped significantly for various reasons - mostly different responsibilities now and declining travel budgets and more video teleconferences instead. Anyway, in the last year I have traveled three times for work - all trips to California. The first trip was in August 2014, just a few days after we took Puddin to the ER vet and she was initially diagnosed with IMT. It was tough because while she was stable when I left, it was all so new at the time and we didn't know what to expect. The second trip (in November 2014) was when Puddin took a sudden dramatic (near fatal) decline and had to be hospitalized at Veterinary Referral and Critical Care (VRCC) for almost a week. The third trip (in May 2015) Buford got his own turn at VRCC when he underwent surgery to remove a mass on his liver which we later found out was cancer. It's safe to say that I'm a little nervous about traveling to California for work again which I may have to do one more time this year! I truly can't thank my husband enough for loving the dogs as much as I do and doing everything he's done to take such great care of them in some very difficult times all on his own!
Back to Buford's bloodwork... Everything came back normal except for all of the liver values which were off the charts! I don't have the report in front of me right now, but the one that sticks out should have been around 180 and his value was over 3000! Every liver value was severely elevated like that! At that point, it was a very serious situation and we were again referred to VRCC for further evaluation. There were no openings until the following week, but after speaking with our vet they agreed to fit him in on the schedule the next day.
An ultrasound revealed a large mass (about the size of an orange) on his liver. Due to its size and location, there was too much risk in trying to biopsy part of it so at the time we had no clue whether it was benign or malignant. There was actually a very sizable risk that it could burst at any time. Our only options were do nothing, hope for the best, and enjoy him while we could or opt for surgery (and still hope for the best and enjoy him as long as possible). Through lots of discussion over the phone, talking to each other and the surgeon, and weighing our options Tracy and I agreed that we weren't ready to let go and we wanted to at least give him a fighting chance. This all took place on a Friday and he was put on the OR schedule for Monday, May 18. I envied Tracy for having that weekend to spend with him and the thoughts of something happening to my buddy without me getting to say goodbye were pretty darn hard to bear. I worried about his age and the fact that he gets so incredibly nervous at the vet's office alone (or any unfamiliar place) and I didn't know if his heart could handle the stress of it all. All indications were that he was a healthy dog and there were no other troublesome spots found on the ultrasound or chest x-ray.
Thank goodness, he came through the surgery fine. The tumor was removed and sent off for biopsy. The results confirmed that it was a carcinoma, but showed that the margins were clean so hopefully they got it all. The report also noted that it was a slow growing cancer so the hope is that old age will be a limiting factor before the cancer returns or progresses to a point that something would need to be done. For now, we are counting our lucky stars that we still get to share our lives with him!
I was on travel for 3 weeks - came home for 2 days and had to go back for another week! I probably should have just stayed out there when I found out my travel got extended, but I wanted to see my boy! Since I wasn't around I only have a few photos that Tracy sent me from his phone: a before and after surgery shot and my favorite - the one he took right after he picked Buford up to bring him home, this was before they even left the parking lot and seeing that happy face did my heart good!
On the upside, even though I missed him terribly, it was probably best for Buford that he was able to begin recovery quietly at home without the sometimes chaotic nature of little ones playing and running around the house since the kids were with me in CA. It wasn't all good times after that though. Buford was in severe pain, on heavy doses of pain meds, and also sent home with an antibiotic for a bladder infection that he got in the hospital. He had to be leash walked for the next 3 weeks since we had to limit his exercise and he was also not allowed to climb stairs until he healed. Tracy moved a mattress into the family room so he could sleep downstairs more comfortably since Buford couldn't climb stairs. What no one realized is just how little sleep we would get in those first few weeks! Buford's appetite quickly returned - thanks to cooking tons of fresh chicken, rice, and broth every few days I'm sure! Tracy began feeding him smaller meals 3-4 times a day so his stomach could gradually catch up (not surprisingly, he hate nothing while in the hospital). Tracy also noticed a dramatic increase in his thirst level so you know what that translates to! Buford couldn't hold his pee more than a few hours and Tracy had to take him outside every 2-3 hours round the clock - even throughout the night! Even with Tracy diligently leash walking him every few hours, there were still plenty of accidents in the house. This went on for weeks and I wondered if this was going to be the new normal for us. Prior to surgery, he never had problems holding his pee. When we first expressed concern, the surgeon recommended that we give it a few more days because the thirst may have been a reaction to stress, pain, or the meds. We waited it out for a while longer, but then took him back in for another test to see if his body could properly concentrate urine. That's when we found out he still had an infection that the first round of antibiotics didn't clear up. This time they put him on a different, stronger prescription and I'm happy to report that it worked! Once we got rid of the infection, he's had no problems and we can all rest easy. About 6 weeks after surgery, one night he just decided on his own that it was time to go back to the bedroom. We were surprised and elated :-) He climbed the stairs on his own that night and has every night since! It still takes him a while to get going, it's like he has to build himself up to it...he tries that first step at least half a dozen times before he will actually get the momentum and keep going. He has been doing that for a while though (long before surgery) and it is sometimes hard to watch as he ages. I joke (okay only half joke) with my husband that I want to install an elevator in our house just for him!
(photos taken 3 days apart, but show a big difference in healing progress already)
The Tempurpedic mattress in the family room has been a big hit! The dogs think it's just another big bed for them, my kids think it's just for them to jump on and use as part of an obstacle course, and it has become my husband's preferred spot for watching TV at nights. At this point, I think it's probably going to be there until we do some clean-up and rearranging for Christmas decorations and my daughter's birthday party in December! Throughout his recovery, the girls were extra careful with him while making sure that he was loved and got plenty of treats too!
And for the final bit of good news, Buford has completely healed, all of his hair has grown back nicely (you can't even tell he ever had surgery), he has gained weight back, looks healthy once again, and has no restrictions on anything! I took this video of him on June 28 - granted this is about the most we ever see him run at one time, but he's still pretty quick for an old guy that turned 12 the week before and had major surgery the month before!
3 comments:
Oh wow!. Usually, I skim long posts, but I read every word. I love seeing Pudidn' and Buford, and am so glad that Buford is back to his old self, and Pudding' is on her way.
I have been wondering about your beautiful fur babies. When I read your post, I thought to my myself how lucky they are to have such a wonderful family to take care of them during trying times. So glad to hear that they are both doing well. May you have several more years together! Love the black and white picture of your daughter with her best friend!
So glad Buford is doing well now. I feel your pain with the ups and downs. it is so hard. I'm glad Puddin' is doing better and on lowered doses of all her meds. (sorry about the allergy diagnosis though!!!!)
Hugs to you and your family!
Post a Comment