It's been three months since Maggie's first near death experience (when she was first diagnosed with lymphoma and our canine cancer adventure began) and one month since she almost died the second time. This post has nothing to do with publishing or writing or Mara Dyer or anything but Maggie, really, but I get so many tweets and emails asking for updates (thank you!!!!) that I thought today would be a good day to do it, so skip away if animal medical shenanigans is not your thing.
But if it IS your thing, here's the timeline:
Oct. 17th, 11PM: Returned from Book Tour Part I. to find Maggie in awful shape; anemia, blood infection, grossly enlarged liver, overburdened kidneys. Immediately took her into the e-vet- she was diagnosed with
lymphoma hours later and the
Wisconsin Protocol was put into effect immediately. She made an amazing turn-around over 3 days and then went on outpatient weekly chemotherapy drugs and had an every 7.5 hour medication schedule. A test revealed her lymphoma to be the uglier of the two types (T-cell), but the oncologist thought there was hope, so I wanted to give Maggie a chance.
December 5th: Right before I planned to leave for Book Tour Part II, she started coughing.
December 6th: Sitter brought her to the vet and she was diagnosed with
megaesophagus. Still in remission from the lymphoma according to all of her bloodwork.
December 9th: Returned from Tour Part II. Maggie was hospitalized while I was away and was diagnosed with
laryngeal paralysis. Couldn't keep food or water down and became dehydrated; required
administration of 1300 mls of sub-cutaneous fluids daily.
December 12th: Became bladder incontinent at home, noticed third eyelid protrusion on her left eye.
December 13th: Tested for everything but couldn't find the source of her new problems (mega-e, lar par, incontinence or her eye).
December 14th: Hospitalization
December 15th: Still no answers
December 16th: Anesthetized for spinal tap
December 17th: Horrible reaction to spinal tap, debated euthenasia, emergency administration of Elspar (chemotherapy drug)
December 18th: MIRACULOUS turnaround: energetic and pain free, hungry, loving, and happy.
December 19th: Switched to CCNU (Lomoustine) for blood brain barrier treatment of her lymphoma, which moved into her spine but was in remission elsewhere. She was feeling awesome but still had the megaesophagus and laryngeal paralysis as well as the incontinence (requiring elevated hand feedings and many loads of laundry daily). CCNU killed her white blood cells, dropping them from 2000 (normal) to 107. Administered Neupogen ($700 per MILLILITER) which worked like liquid gold, as advertised, and brought her white blood cell count to 34,000.
December 20th - Partial CNS lymphoma remission achieved, no improvement with the megaesophagus, no improvement with the incontinence.
December 21st - through today: holding steady without any signs of aspiration pneumonia (the #1 leading cause of death in dogs with megaesophagus) and is clearly in remission from the lymphoma. Still requires the meds and the hand-feedings, but she is happy, hungry, and comfortable--her normal lazy self.
January 17th: After her second round of CCNU last week, we expected her white blood cell count to drop dramatically again but miraculously, it hasn't (she doesn't have the nickname "The Fighting Potato" for nothing). So we keep on keepin' on, like the
baby monkey.
Basically, the deal with her is that she has lymphoma, which, thanks to the CCNU is not killing her, and a second condition, megaesophagus, which also isn't killing her, but makes taking care of her really labor intensive. Below is our regimen:
7AM: 650 mls of sub-cutaneous lactated ringer solution (using an 18 guage needle) (megaesophagus)
9AM: Denamarin (hepatoxicity from the lymphoma or the drugs)
9:30AM: Cisapride (megaesophagus)
10AM: Keppra (epilepsy), Phenobarbital (epilepsy), Metoclopramide (megaesophagus), Prednisone (lymphoma), Prilosec (megaesophagus), Tylenol with Codeine (arthritis)
Hand-feeding #1 with 20 minutes of post-meal elevation
Laundry Load #1
3PM: Laundry Load #2
Handfeeding #2 with 20 minutes of post-meal elevation
5PM: Denamarin
5:30PM: Cisapride
6PM: Keppra (epilepsy), Phenobarbital (epilepsy), Metoclopramide
(megaesophagus), Prednisone (lymphoma), Prilosec (megaesophagus),
Tylenol with Codeine (arthritis)
Hand-feeding #3 with 20 minutes of post-meal elevation
6:10PM: 650 mls of sub-cutaneous lactated ringer solution (18 guage needle) (megaesophagus)
Laundry Load #3
1AM: Denamarin
1:30AM: Cisapride
2AM: Keppra (epilepsy), Phenobarbital (epilepsy), Metoclopramide
(megaesophagus), Prednisone (lymphoma), Prilosec (megaesophagus),
Tylenol with Codeine (arthritis)
Hand-feeding #4 with 20 minutes of post-meal elevation
Laundry Load #4
I sleep between 2:30AM and 7:00AM if Maggie will allow it and for a couple of hours during the day. Oddly, she tends to have a TON of energy these days (more than she's had in her entire life) and is always up for food so it's difficult to get more than a couple of hours of sleep at a time. But Maggie is family, and I could never give up on my family. And for all of you who are still talking about, writing about, recommending and buying MARA DYER when I go offline to take care of her? Thank you for not giving up on me.