Well, we're all se for the surgery tomorrow. Pookie ad the thyroid scan yesterday, and unfornately he is not a candidate for radioidione therapy. It was a long shot, but I was still hoping he would...as I've heard great things about this therapy vs chemo, and we still have to consider the myelitis-we're not treating it as we should for now, as it involves supressing his immune system, and that was not an option before surgery and now we will have to consider that and how it will play with the chemo, if he gets that. We might have to treat one condition at a time.
I spoke with his surgeon today, and he said he was confident on his ability to remove it, but of course he warned me of the different possibilities.
I'm still researching all our treatment options, including holistics.
Arrived a little while ago from visiting Pookie. He is doing amazingly well. They removed the tumor with no complications, and when I saw him he was clearly stressed and not feeling well, but he was alert. The dr. said that all appears well, and that he'll probably release him tomorrow. They are agreesively treating his pain, so I'm not excessively concerned about it, although the Dr. did say it was not awfully painful.
The tumor, the size of a small plum, was sent to pathology to find out exactly what it is, what grade cancer it is, so we can better decide where to go from now. There is a big hope from me and his Dr. that by removing the tumor, it will also help the myelitis, because as they said the myeleitis could have resulted from his body and defeneses going on overdrive in response to the tumor, and with that threat gone, his own body could start to back down, stop attacking itself, and start healing.
So, for now my pookster has pulled through well through all of this, I just hope the recoivery goes well, he has some brusing along the incision, but all things considered it's minor.
Can't wait to get him home together, we've gone all out and fixed him up with a new bed, cushions for lounging around, new toys, and treats await him.
- I forgot to add, that he is not a candidate for radioidione therapy, his thyroid is not soaking out a lot of idione, so radioidione probably would not help. We'll have to see about post-opt treatments, but we'll take it one day at a time.
***Edited By: sandya on 10/10/2007 10:47:57 PM*** Reason: Forgot Something
I've had Pookie back since Thurs afternoon, but I took him back this afternoon because he wasn't eating and he went to the bathroom with some mild diaherra. They took off a pain patch that he had on and said that it would help increase his appetite, and they were right, as soon as we got home he started eating some cooked chicken and rice.
He has brusing a some swelling around the incision area, but we're applying warm compresses, so hopefully we'll start to feel better soon.
The Dr. also called me yesterday with the pathology results: looks like the cancer/tumor was contained in the capsule and had not bursted out, so by removing the tumor they had could taken the cancer out, however he did say that they could not rule out that individual cells had not broken out and were just to mircoscopic to view right now.
We have a recheck on the 25th and then we'll be able to talk about post-opt treatment like chemo, etc.
In the meantime, we're showering him with attention and reading up!
Pookie is recovering remarkably well. We're about 10 days post opt, and he get's his stiches removed this Thurs. His walking has improved since they removed the tumor, I haven't seen him limped at all since the surgery, so I'm hoping the tumor removal has helped the myelitis go down. We'll see what his vets say on Thursday, he has consults with his surgeon, neurologist, and oncologist.
Well, Pookie's got his stitches removed Thursday, the incision seems to be healing well, but we have 2 mainconcerns right now.
1) His prednisone has been reduced to half a tablet once a day (was on 2 half tabs a day for a month and now we're seeing some slight decline in his left side stability, he's slighly wobbly again. The nuerologist said that for right now, she still saw him remarkably improved from when she first saw him a month ago, and that we have to monitor him, and if he really starts to worsen (as far as leg stability and mobility goes) well have to reevaluate upping his dosage again.
The reason why his pred's being reduced (he's due to decrease again in another 3 weeks) is the chemo. Obviously chemo will destroy both good and bad cells, high predisone would supress his autoimmune system and could not be counterproductive with the chemo, so we have to treat his cervical myelitis conservatively right now.
We have a appt on Wed with his oncologist, and his neurologist said that they will all work together to secure the best treatment for him. Dr.Sullivan (neuro) said that the oncologist might be able to treat him with chemo that also treats encephalitis (the parent of myelitis, I need to research that more, I hope this helps both conditions. The Dr. think that if the myelitis was developed as a result of the cancer, now that the source has been removed his body will start to decrease it's defenses going on overdrive against his body and that will eliminate the myelitis, but there are no guarantees as we can't say for sure what came first; myeleitis or cancer, and if one caused the other.
He's also developed a weird cough/wheeze, hack attack when he eats or drinks mostly (sometimes it comes out of nowhere). Dr. said it might be some irratation from surgery but said none of the vascular was damaged from surgery, he said to watch it for a couple more days/week and let him know if it continues.
And he's developed another nasty habit, he wants to eat his poop. I don't know if it's the pred that has him constantly hungry and he's on a diet-but we have to be careful and make sure he's never alone with poop. Anyone ever had this problem?
Well, that's it for now until we meet Wed with the oncologist.
My suggestion would be to take him to a University hospital. Depending on where you live I'd be referring to the Univ of Penna. (East coast). Univ Calif West Coast, etc. This is not a problem for veterinarians to be guessing about and if they are experienced, fine; but if not, he needs a Univ. hospital.
They're not guessing on his conditions, they know he has cancer and they know he has myelitis.
The only thing of signigicant importance they can't quite pinpoint is which condition came first and whether one caused the other (hence, whether the cancer could have caused his immune system to over-respond and cause the myelitis).
There just isn't a single or mulitple batter of tests that could decipher that, one way we could tell is if the myelitis syptoms decease with time (reasonable time) without supressing his immune system, which we can't do right now because of the pending chemo.
I have confidence in the specialists (he's being treated at one of the most highly regarded specialty hospitals in California) that are working on him, he has a neurologist, surgeon, radiologist, oncologist, and his regular vets looking at everything. We're also looking at a Dr. who specializes in holistic therapies as well.
It's been a daunting 2-3 months, but we're making sure that he gets the best care, and best treatments for him.
But thanks for your advice, we had looked at a state univ before we found ASG.
Today we went for his first extended walk since the surgery and he did great, at one point he started to skip and want to run ahead of me to beat me back to the stairs that lead to our house, he hasn't done that in months! So, we're hopeful :}
So, it's been a while since I gave an update. Pookie is just a little over 1 month post surgery, and doing well. Unfortunately, we have determined that the myelitis and cancer were completly unrelated. They repeated the spinal tap 2 weeks ago, as his coordination was still off, and he had an elevated white bloof count of 12 when normal is 1.
So, we're supressing his immune system right now for about 3 months, and hopefully we'll get the myelitis in remission. As for the cancer, because the tumor was contained and completlly removed, plus, all the MRI and x-rays have come clear, the oncologist did not think that chemo was necessary, if I wanted to do it, she recommended 2-4 rounds. But, becase his myelitis did not resolve with the tumor removal, we decided to treat that versus the chemo.
But, for now he's doing well. He's active and running around again.
***Edited By: sandya on 11/25/2007 7:40:46 PM*** Reason: typos
Well, I'm back with an update. Unfortunately, the auto immune supression with the high dose of prednisone has not worked for Pookie. His myelitis seems to be a present as ever. The pred didn't do much but cause concerns with his liver, his belly was starting to extend too much for our comfort, so his neurologist said we will begin to taper him off of the pred and start a once a month dosage of lunesta a chemo-therapy agent, that will be low enough that will not produce any of the chemo effects, but will serve to lower his white blood count, which is sky high and causing his neuro disfunctions.
We have to have a ultrasound and labs done this Friday to rule out any underlying liver problems, before this dosage of lunesta is given to him as it can have unreversable advese effects on his liver.