Eider’s Cancer Journey-Timeline

Hello everyone.  As you may have discovered in the forums, our sweet little Eider passed away on 12/22/2019.  If you would like to read that post, please click here.  As you can see there, I promised him that I would share his story, so that people would have a great example of what is possible, even within the confines of this disease.  I have a great deal of detail to share with you about his journey.  However, I thought it might be useful to start back with a timeline.  So, this post is simply about the important benchmarks of the past 3 years, 8 months, 24 days.  This is the storyline of a little black labrador with 3 legs and a giant spirit.  Please feel free to ask questions anytime.

*OON = “On or near”.  I will use this, when I am unsure of the exact date.

  • OON* March 22, 2016: We felt that Eider was having difficulty pooping and happened to be walking him when he made an attempt.  He was able to defecate, but it came out as a relatively flat ribbon vs the normal cylindrical shape we are all used to.  I have a background in veterinary care, so my first thought was that he had an impacted anal gland, or an anal sac tumor at the very worst.
  • OON March 23, 2016: I took the day off from work to take him to our local veterinary clinic.  When Dr. Symms did the rectal exam, he said he knew something strange was going on.  He sent Eider for an X-ray and when he came back to the room, he put his hand on my shoulder and said “Not good”.  He waved me back to see the image on the screen.  On the inside of his pelvis, there appeared to be a softball sized growth, with lots of texture, as if it were “cracked”.  I was in shock.  Dr. Symms said “I am calling Auburn University right now.”  He did and we had our appointment set for next week.  Let me add here that many vets would have handled this differently.  I am so grateful that Dr. Symms had at least, a modicum of faith.  We owe Dr. Symms SO MUCH.
  • March 28th, 2016: Our 11th wedding anniversary, by the way.  We sat in the waiting room at the Auburn University Veterinary Teaching Hospital for several hours, while diagnostics were performed.  Dr. LaRue (now in Texas) was the Oncology resident at the time.  Dr. Matz (still at AU) was the surgical oncologist.  They, along with students, called us into a room to discuss the situation.  I am a bit of a health junkie (read: hypochondriac and serial “google-er”), so I already knew the plan.  I asked with one word, “hemipelvectomy?”.  Dr. Matz seemed a little startled and my husband was a little embarrassed.  The vets said “yes” and that they were quite certain it was bone cancer, but were not able to confirm until a biopsy.  They informed us of the very great risks and said they would perform the procedure the next day.  I already knew about the hemipelvectomy from this very site you are on.  So, I understood that this was a very serious surgery.
  • March 29th, 2016: Eider went into surgery in the early afternoon.  Dr. Matz had told us that he expected it to take 3-4 hours.  Our pup ended up being on the table for just under 7 hours!  We were both temps at our respective jobs, so we had to be at our offices that day.  I was useless.  We finally got a call that night.  My husband answered and I heard him say “Oh, good!”.  I collapsed in tears of gratitude.  Our little guy had survived the procedure.  Dr. Matz and the other surgeon were completely exhausted, so we let them go, knowing we could get the details later.
  • March 30th-April 1st, 2016: The hospital provided daily updates on his progress.  He stood up on his own on day 1!  He also ate his supper.  Those are both good signs.  He is also a labrador and they rarely skip a meal, lol.
  • April 2nd, 2016: The hospital was kind enough to let us pick him up on a Saturday so that we wouldn’t miss more work.  He came out to greet us and it was really surreal to see him on three legs.  I can’t lie… I was really shocked.  A hemipelvectomy results in a pretty dramatic change of shape.  his rear end was VERY narrow.  He had been shaved, so this was accentuated.  However, he was wagging and his spirits were up.  We caught up with the vets about the details of the procedure.  As it turns out, his urethra (the tube that take pee from bladder to the outside world) was attached to the tumor.  Dr. M described having to peel the tissues apart.  This will come back to haunt us later, so that is why I am adding this detail here.  He also felt confident that it was bone cancer, but that he had clean margins.  We left for the 2.5 hour drive home and I had asked when he should have his pain meds again.  The intern said “when you get home is fine”.  So, I assumed they had already given him some that morning.  This was a misunderstanding and resulted in Eider screeching in pain and jumping around in  our car, with about 45 minutes until we reached home.  I was very upset!  I am sharing this, not as a critique, but as a reminder to be SURE that you understand your pet’s medication schedule when you pick them up.  You can shift it to suit your personal schedule once you are home, but you MUST know where they stand when you pick them up from the procedure.  Trust me, you do not want to experience a screaming dog and have no option but to keep going.
  • April 3rd-OON April 5th, 2016:  We had learned, prior to bringing Eider home, that we needed rugs and to minimize access to the home.  So, we were able to use a baby gate to block off the bedrooms.  We moved our mattress to the livingroom and put it on the floor, so that we could all be together.  We had a HUGE crate from my Great Dane mix that we set up for him.  We were armed with great meds (Trazedone, Gabapentin, etc) for pain management and we made a huge effort to keep him calm and resting.  He was in good spirits, but OON April 5th, 2016, we encountered a problem.  He began to stay outside and looked as if he was urinating but nothing was coming out.  Not good.  We would have to beg him to come back inside and basically drag him in, using the handle of his Webmaster harness.  We let him out to pee and he would definitely have a stream of urine, but after it stopped, he stayed in the same position.  It’s like he couldn’t tell he was done.  I believe that the night of 4/5/16 was the night my husband and I took shifts sitting on the back porch because our baby would NOT stop trying to pee.  It was terrifying and exhausting.
  • Diagnosis: Chondroblastic Osteosarcoma.
  • OON April 6th:  I took another day off (still a temp, thank God my employer was so kind) and rushed him back down to Auburn.  They kept him for several days and did observe this strange situation but could only guess that there was nerve damage/regeneration from the surgery.  Remember, he had to peel the ureter/urethra from the tumor itself.
  • April 9th, 2016: We picked Eider up from AU and they sent us home with a drug called Prazosin to help with the strange urinary situation.  On a funny note, they sent Eider home wearing TWO cones of shame.  He was such a rebel that they had to use two different cones to keep him from messing with his sutures.  Silly goose!
  • April 11th, we started pulling back on the pain meds, but he stayed on the prazosin.
  • April 14th:  Eider began his first chemotherapy.  Carboplatin.  They gave cerenia via his IV, and sent us home with tablet form.  PLEASE NOTE: Cerenia is a very mild, but effective drug for nausea.  If your dog gets chemo, please get cerenia tablets and give one at the 24 hour mark after chemo.  We learned this the hard way… the morning after his first chemo, we stepped out for breakfast and when we came home, he was foaming and anxious.  Gave him cerenia and we was back to normal after a half hour.  We LOVE Cerenia.
  • Carboplatin 6 doses 4/14/16-8/26/16.  We used antibiotics and antidiarrheals during this treatment to manage side effects (white blood cell count was low, etc)
  • September 26th, 2016:  Started Rapamycin (Sirolimus).  We are firmly of the opinion that THIS medication was what kept Eider alive and well, for so long.  This is a VERY interesting drug and Eider remained on it until he passed away.  So, it was given alongside various chemotherapies.  Please ask your vet about this medication and use it, if you can afford it.  If you can’t afford it, sell something and then afford it.
  • Sometime in December of 2016, Eider went for a re-stage and two nodules were seen in his lungs.  AU was pretty sure that the cancer had reappeared (metastasized) in his lungs.  We opted to monitor closely for any further changes.  Thankfully, we went for a very long time with little to no change!
  • September 2017:  the lung nodules had grown a bit and increased in number, so AU began a chemo regimen using Doxorubicin.  He had 6 treatments and in…
  • December 2017: He finished the Dox. chemo and we discussed a maintenance plan of Cyclophosphamide and Piroxicam, but did not begin that yet.
  • February 2018: Lung mets are still stable, but Eider had developed pretty severe reflux from these powerful medications.  So, we began using Famotidine (for people) and this helped a ton!  He was able to begin the new regimen.
  • February 2018-November 2018: Eider remained on:
    • Cyclophosphamide
    • Piroxicam
    • Famotidine
    • Rapamycin
  • December 2018: Due to some fairly minor changes in his lung mets, the vets wanted to try Palladia.  This was a total disaster.  We ended up at an emergency vet at 2 in the morning, after Eider’s blood pressure went so high he was shaking violently and couldn’t sleep and looked completely wild.  I was actually somewhat opposed to Palladia, but I’m not a doctor, so we went for it.  That was not a good fit for him.  Please note: every dog is different.  So, please don’t avoid this medication just because it didn’t work for us.  The oncology resident at that time recommended at “medication vacation” after the palladia failure. So, he went for two whole weeks with NOTHING.  I have to say… it felt really nice to give him this break.
  • February – July 2019: We began/followed a new regimen:
    • Chloramucil
    • Quellin
    • Rapamycin
    • Prilosec (instead of famotidine, as that didn’t seem to be helping his reflux as well)
    • Sucralfate (for the damage due to reflux)
      • PLEASE NOTE: Do NOT give this medication (aka Carafate) within 2 hours-before or after-chemotherapies or other medications.  It can bind to other medications and prevent them from being effective.  We did not know this and went for a few weeks of giving it twice a day with other meds.  It is hard not to beat ourselves up over this error.
  • Throughout the first half of 2019, Eider had checkups with xrays every 2 months.  His disease always progressed, but it was quite slow and he was consistently asymptomatic, so we were all very happy despite the looming reality.
  • In July of this year, AU felt that the regimen wasn’t quite cutting it anymore.  So, we opted to add IV Zoledronate on a monthly basis.  This was an addition to the regimen listed above with another change to his NSAID.  We swapped out the Quellin for Deracoxib, instead.  This seemed to be much easier on him.
  • July – Early November 2019: We moved to monthly Zoledrenate treatments and xrays.  We knew the mets were growing/multiplying, but he was still a wild child.  Great attitude, great appetite and plenty of energy.
  • November 2019: we noticed his tolerance for activity change pretty quickly.  He was getting out of breath.  We knew what was happening, so we opted to decrease activity and try to keep him calm.  AU supported this and we all sortof knew that things were slowing down.
  • December 6th, 2019: Eider had his monthly checkup at Auburn.  He was still doing really well.  He didn’t want to calm down, but we all agreed that exercise was just not in the cards, since his breathing seemed labored if he was over-excited.  They did not do x-rays.  I never asked them about this…we just sortof “knew” that it wasn’t needed.   We went ahead and scheduled his next appointment for January 17th, 2020.  I never thought it wouldn’t happen.
  • December 13th, 2019: Eider started to have a funny-sounding cough.  We weren’t sure what it was and it didn’t seem too bad.  We watched him closely over the weekend.
  • December 16th, 2019: The cough was more frequent and I could hear a faint crackle in his chest… and almost a quiet “whistle”.  Like wind through pine trees.  We both felt we were in trouble.  I called Auburn and they called in Trazedone and Cough Tabs to our local vet.
  • For the rest of the week, he would have short coughing spells, usually after going outside or getting too excited.  But, they would subside.  The medications helped a little, but we knew something was up.
  • Saturday, December 22nd, 2019:He began to posture (like the Sphinx) and seemed less comfortable.  The coughing was more severe and frequent.  He was not himself.  That night, he had a coughing spell that just wouldn’t end.  His heart was racing and he looked frightened.  There is no other way to describe it.  He crossed the Rainbow Bridge that evening, in our arms, with the gentle support of our local vet, Dr. Eiland and his fiance (who is a veterinary nurse).

This timeline may seem jam-packed with intimidating information.  However, if you “zoom out”, you will notice that there are huge chunks of time where the only action was just a check-up here and there.  From May of 2016 through December of 2019, we simply changed medications and kept an eye on things.  These were great years.  We grew as a couple and there were miracles abounding.  I can’t wait to tell you all about it, in later posts.  I will also share some information about how we fed Eider and different products we used that were helpful.  I have tons of pictures and videos too, at various stages.  So, if you hear the word “hemipelvectomy”, don’t be scared.  Little Eider proved you wrong already.  😉

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