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Jabba-Bear's Blog

Osteosarcoma: clinical trials and goofy smiles

Jabba-Bear's Blog

Remembering Jabba-bear

April 13th, 2013 · 6 Comments · memories, osteosarcoma

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It has been one week since Jabba-bear crossed the Rainbow Bridge.

We are slowly adjusting to life without him. Beyonce deeply misses her companion. Now, she can be found curled up in a tight ball on Jabba-bear’s side of the couch, her head pressed gently against his favorite arm rest where he used to perch, gazing out the front door,  paws dangling over the back of the couch.

Thank you for all of the love and support that you have sent our way over the past week. Thank you for sharing your touching stories with us; we were moved by the raw emotion in your words.

We felt that it was appropriate to honor Jabba-bear by sharing some of our favorite photos from the past 4 years. What follows is a small tribute to our sweet boy:

Jabba-bear name with halo-for blog

Jabba-bear the second time we met him (January 2009).

Jabba-bear at his birthplace (a farm in Yadkinville, NC) the second time we met him. 

Bear profile

Jabba-bear's first bath in his new home

Jabba-bear’s first bath in his new home

Jabba-bear on front porch after his first bath

Jabba-bear being cradled by his aunt Joanne after his bath

Jabba-bear as a baby, face in sam's hand-edited

Puppy  Jabba-bear keeping his mom company as she studied for Molecular Neuroscience

Jabba-bear keeping his mom company as she studied for a Molecular Neuroscience exam. He was such a good boy!

Jabba-bear liked to bite feet when he was a puppy (perhaps this was because his first "toy" was an old sandal that belonged to his mom).

Jabba-bear liked to bite feet when he was a puppy (perhaps this was because his first “toy” was an old sandal that belonged to his mom).

Sleeping Jabba-bear during the crate-training phase

Jabba-bear sleeping in his first bed during the crate-training phase. Note: This bed lasted about 2 weeks before he completely destroyed it…

Jabba-bear playing in his first snow

Jabba-bear playing in his first snow

Jabba-bear sleeping peacefully on his couch (which he much preferred to the crate!)

Jabba-bear sleeping peacefully on his couch, which he much preferred to the crate!

When Jabba-bear first met his older sister, Xena, the Italian Greyhound

When Jabba-bear first met his older sister, Xena, the Italian Greyhound, they were the same size. Xena, being older and wiser, was dominant to Jabba-bear. He quickly learned to play gently with her and was always good with small dogs.

Jabba's graduation from puppy school

Jabba-bear’s graduation from puppy school. Many thanks to his fantastic trainer, Geralyn Kelly!

Teenager Jabba-bear. He is still developing his classic "goofy smile".

Jabba-bear as a Teenager.  In this photo, he was still developing what would eventually become his classic “goofy smile”.

Licking his lips! Jabba-bear practicing the art of begging for more food.

Licking his lips! Jabba-bear practicing the art of begging for more food

Jabba-bear rocking sunglasses. What a cool dog! This photo was taken during his rebellious phase.

Jabba-bear rocking his mom’s sunglasses. What a cool dog! This photo was taken during his rebellious phase….clearly.

Jabba-bear demanding to drive his mom's V8 mustang convertible. He hopped into the driver's seat!

Jabba-bear demanding to drive his mom’s V8 mustang convertible. He hopped into the driver’s seat when she stepped out of the car to run a quick errand.

Jabba and his dad at the Blue Ridge Parkway.

Jabba and his dad at the Blue Ridge Parkway

Jababa and his mom at the Blue Ridge Parkway.

Jababa and his mom at the Blue Ridge Parkway

Father and son. Goofy smiles galore!

Father and son. Goofy smiles galore! 

Jabba in the backseat of his dad's car.

Jabba in the backseat of his dad’s car

Jabba-bear sporting a gorgeous sweater that his   maternal grandma bought him for Christmas.

Jabba-bear sporting a gorgeous sweater that his maternal grandma bought him for Christmas

Shortly after Jabba-bear's amputation (step 1 in his battle against osteosarcoma). All smiles, as usual.

This photo was taken shortly after Jabba-bear’s amputation (step 1 in his battle against osteosarcoma). As usual, he was all smiles!

After the amputation. Jabba-bear still keeping his mom company in her office as she studies.

After the amputation, Jabba-bear still kept his mom company in her office as she studied.

Yes-he may be wearing the "cone of shame", but have you ever seen such a ridiculously happy dog???

A couple of weeks after Jabba’s amputation, the incision site became infected, and we were forced to make him wear an E-collar. In this photo, yes-he may be wearing the “cone of shame”, but have you ever seen such a ridiculously happy dog???

Jabba-bear wearing cone, alseep on his couch

It was a big deal when Jabba-bear re-learned how to jump on the couch (post-amputation).

Eventually we put Jabba-bear in a T-shirt because he broke 2 "cones" (he was clumsy like his mom). in this photo, Jabba excitedly rushes to the door when he sees his maternal grandpawrents' car out front.

Eventually we put Jabba-bear in a T-shirt because he broke 2 “cones” (he was clumsy like his mom). In this photo, Jabba excitedly rushes to the door when he sees his maternal grandpawrents’ car out front.

Jabba-bear asleep on the floor at his maternal grandpawrents' house in Florida. He developed temporary vitiligo as a side-effect of the chemotherapy (notice his pink lips and  nose).

Jabba-bear asleep on the floor at his maternal grandpawrents’ house in Florida. He developed temporary vitiligo as a side-effect of the chemotherapy (notice his pink lips and nose).

Jabba-bear in August 2011.

Jabba-bear in August 2011

Jabba-bear after the Cure Search walk. You can see how he has adapted his sitting posture after the amputation.

Jabba-bear after the Cure Search walk. You can see how he has adapted his sitting posture after the amputation.

Happy Jabba-bear on his couch

Happy Jabba-bear on his couch

Jabba-bear on big chair

Close up of Jabba

Jabba-bear playing with his friend Mufasa while Beyonce sleeps in the background

Jabba-bear playing with his friend Mufasa while Beyonce sleeps in the background

Jabba-bear takes "studying with his mom" to a whole new level! He stole the book from her to learn more about the somatosensation.

In this photo, Jabba-bear takes “studying with his mom” to a whole new level! He stole the book from her to learn more about the sense of touch.

Jabba shows how much he loves neuroscience by devouring the jello brain mold his mom made for a school activity. Note: Jabba's mom was not intending to feed this to him; she was showing it to her sister and Jabba-bear jumped off the bed to chomp down on it.

Jabba shows how much he loves neuroscience by devouring the jello brain mold his mom made for a school activity. Note: Jabba’s mom was not intending to feed this to him; she was showing it to her sister, and Jabba-bear jumped off the bed to chomp down on it.

Jabba resting in a patch of sunlight in his backyard. He is finally able to enjoy the weather, after his first major haircut!

Jabba resting in a patch of sunlight in his backyard. He was finally able to enjoy the weather after his first major haircut! 

Jabba-bear and his "big" sister, Xena, looking out the window

Jabba-bear and his “big” sister, Xena, looking out the front door window

Jabba-bear on his perch

Jabba-bear on his perch

An "abstract" cartoon of Jabba-bear. Jabba's dad drew this on a dry erase board in the kitchen when Jabba was a teenager. After Jabba's amputation, we erased his back left leg.

An “abstract” cartoon of Jabba-bear. Jabba’s dad drew this on a dry erase board in the kitchen when Jabba was a teenager. After Jabba’s amputation, we erased his back left leg.

We miss you Jabba-bear! 

 

 

 


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An angel gets his wings

April 9th, 2013 · 11 Comments · euthanasia, metastatic lung cancer, osteosarcoma

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On Saturday, April 6th, Jabba-bear passed away peacefully at Oldtown Veterinary Hospital in the loving presence of his mom and dad.

Friday morning, we gave Jabba-bear a few doses of  Tramadol in hopes of alleviating some of his pain. It seemed to help quiet his labored breathing -he had been altering between healthy pants, small squeaks, and a honking sound that was reminiscent of a child with a very bad lung infection. You could hear a rattling sound in his lungs. Although he was clearly struggling, Jabba-bear was still very much aware of his surroundings. He still had a happy glean in his eye and would wag his tail in our presence, attempting to roll over for a belly-rub.  Later that day, we took Jabba-bear back to Reynolda Village for a short walk. It was a glorious day (a pleasant surprise considering the tumultuous, apocalyptic weather that we experienced on Thursday-snow, sleet, hail, rain, etc.).  Jabba-bear didn’t make it very far. He found a cool patch of ivy to lay in. We placed a blanket on the ground and sat with him for a while, petting him, allowing him to soak up the sun, while watching passersby with their pups. Jabba didn’t feel like making new friends that day, but he seemed to offer a knowing nod to the dogs as they walked past us.

Jabba-bear at Reynolda Village

Jabba-bear at Reynolda Village.

Jabba-bear at Reynolda Village-getting pet by his dad

Jabba-bear at Reynolda Village, close up

A close up of our beautiful boy.

Jabba-bear at Reynolda village, paws in my lap-edited

Soon, Jabba was ready to go back to the car. He loves the car, especially his dad’s fast BMW. We drove around town, stopping for pizza from 2 different restaurants. We ordered a total of 4 thick-crust pizza pies, smothered with cheese, bacon, and pepperoni (Jabba’s favorite). Then, Jabba’s dad went to the grocery store and bought cupcakes, donuts, bacon, turkey pepperoni, premium Nathan’s hot dogs, and sliced turkey (from the deli). That night, we decided to celebrate Jabba’s life by lifting the no-carb ban and allowing him to eat all the “junk food” he desired. When we got home, Jabba eagerly devoured 2 pieces of pizza and snacked for the rest of the night on various goodies.

After midnight, his breathing became extremely erratic. Jabba’s mom sat up next to him, placed her hands on his side and sang to him, whispering the words “quiet, quiet, quiet” while attempting to transfer all the loving, healing energy in her body to him, through her touch. As hokey as that may sound, it actually seemed to work. Jabba-bear soon fell asleep and started dreaming-his front two legs twitching periodically and his ears flicking with delight. Several times throughout the night, Jabba-bear sat up and cried out loud.  He was uncomfortable. Maybe it was all the pizza? At one point, he did let out an impressive belch before collapsing on his side, content, and falling back asleep.  By 5 AM, Jabba’s discomfort was wearing on both of us, and we called the emergency vet (Carolina Veterinary Specialists) to schedule his euthanasia. We told Beyonce to prepare herself to say “goodbye” to her brother. She responded by letting out a blood curling howl and then grabbing her lamb chop chew toy and throwing it in the air, settling next to Jabba’s head, with her paws on his front legs. As soon as we hung up the phone, Jabba-bear seemed to stabilize. After 10 minutes, we cancelled the appointment, deciding to try and “hold out” for Jabba’s primary vet (Oldtown Veterinary Hospital)-we had already scheduled an appointment for 9:20 AM on Saturday.  In an effort to distract ourselves from the impending doom that consumed us, we watched “All Dogs go to Heaven” on Netflix. When it finished, we still had nearly two hours until our appointment at Oldtown. Jabba seemed to be resting comfortably with his dad on the floor of the living room. We had surrounded him with pillows, propping him up until we found a position that allowed him to breathe more easily.

Shortly before it was time to leave for the vet, Jabba’s paternal grandpawrents arrived to say “goodbye” to their favorite grandson.  In the background, we played the Lion King soundtrack to comfort Jabba-bear (it was a trick that had worked in the past). At this point, we were all very emotional. Even though we were dreading this final moment, it also came as a relief since we knew that soon Jabba-bear would no longer be suffering. We fed Jabba-bear hot dogs for breakfast, and his dad cooked him half a package of thick bacon to feed to him in the car ride to the vet. Jabba savored every bite. On our way, we sang Hanunka Matata and I Just Can’t Wait to be King, and Jabba-bear stuck his head out the window, as he so loved to do. He closed his eyes and enjoyed some final good sniffs.

Jabba in car, looking serious-edited

Jabba-bear in the car, so serious.

Jabba-bear looking toward the light.

Looking toward the light.

Jabba-bear finally at peace.

Finally at peace.

Note: the above photos were taken the day before, during our trip around town. We thought they were symbolic of Jabba’s transition to heaven.

When we got to the vet, Jabba-bear let us know that he was ready to go. He normally rushes to hide behind a chair  (or in the corner)  when the vet-techs enter the room to take him to the back. On this day, he laid on the floor, gasping for air. He was not scared.  He just seemed tired of fighting. There was no question that we were doing the right thing. When the time came, they lifted Jabba-bear onto a table. He faced a painting on the wall- a well trodden path through the forest. It reminded us of our trip to Pilot Mountain. Perhaps Jabba could pass away thinking that he was back on the trail, climbing the mountain.  3 injections later (1 flush, 1 sedative, 1 dose of a pinkish euthanasia liquid), and Jabba-bear had passed. The staff at Oldtown were compassionate and completely professional. They helped ease the difficulty of the situation. We are, and always will be, extremely grateful to them.

Jabba's food bowl.

Jabba’s food bowl. His paternal grandpawrents placed this beautiful flower in his bowl while we were at the vet. It was a sweet touch.

Friday night was extremely difficult for us, but we were deeply touched by the incredible support that we received from so many of you in the Tripawds community. Thank you. 

Thank you, not only for your support, but also for taking the time to read our posts. Writing this blog over the past several weeks has been extremely cathartic for us.

We hope that you find value in what we have written about our journey with Jabba-bear. We are happy to answer any questions that you may have, now or at a later date.

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A fight well-fought

April 5th, 2013 · 8 Comments · metastatic lung cancer, osteosarcoma

It is with a heavy heart that we share this news: Jabba’s condition has taken a rapid turn for the worse. 

Yesterday morning (April 4th), while lying in bed, petting Jabba-bear, his mom noticed a lump inside his upper right lip.

We took him the vet in the afternoon, preparing ourselves to hear bad news, but hoping, nonetheless, that it would be a benign gum abscess (after all, Jabba-bear’s teeth were well over due for a cleaning). Later that evening, Jabba’s doctor called to confirm that it was, unfortunately, metastatic osteosarcoma; the  nodule  was emanating from his jaw bone, not his gum.  We were worried because the tumor literally appeared overnight, suggesting that it was quite aggressive.  Jabba’s doctor reassured us that against all odds, Jabba seemed to be doing fine; he was not showing any signs of pain.  However, she did warn us that his condition could turn on a dime. . . She said that the lump could stay the same size for a month or more, but if the cancer started to spread to his sinuses, she would have to recommend that we put him down. She reminded us that the goal was to preserve Jabba’s quality of life.  And we agreed.

After Jabba’s brush with death in January, we decided that we would seriously discuss his “end of life plan” if it became clear that he was no longer interested in food. If there is one thing that motivates Jabba-bear, it is food. . . of any sort (but pizza, peanut butter, and steak are his favorites!). This morning, Jabba didn’t get up for breakfast. When he heard the sound of kibble rattling inside Beyonce’s bowl, he slowly hobbled to the kitchen.  We filled his bowl with his Hill’s n/d Prescription diet and placed it in the bedroom, closing the door to give him privacy. We checked on him 10 minutes later, and he hadn’t touched the food, save to spread some of it around the bowl on the floor. We tried feeding Jabba by hand, while petting him. He ate a very small amount. We tried feeding him kibble, again by hand. He ate a few morsels.  We asked him if he wanted to go for a walk. He went to the door, but then laid down in the front yard, barely taking 10 steps. At this point, our hearts bursting with sadness, we began to have that dreaded talk about the logistics of Jabba’s euthanasia.

IMG_0364

Jabba-bear this morning (April 5, 2013). He has little to no appetite, and his energy level is very low.

We decided to give him one more day. We took him back to Reynolda Village and laid with him on a blanket, petting him as a cool breeze ran through his fur. Jabba’s dad took him for a car ride all around town, and Jabba made a valiant effort to stick his nose out the window for some good sniffs (he seemed to perk up a bit when we passed a shopping strip full of fast food joints). Tonight, we will have a pizza party, and we will spend the evening holding him, loving him, saying our goodbyes.

We don’t want Jabba-bear to suffer any more than he has already. He is now having a lot of trouble breathing. Every few breaths, he lets out a small cry, like he did the day after his lobectomy. It is absolutely gut wrenching to see him like this. His fight, although well-fought, might be drawing to an end.

We have an appointment scheduled with the vet for tomorrow morning. We are still not sure what will happen.

Thank you for all of your support during these difficult times. 

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Beyonce loves Jabba

April 5th, 2013 · 4 Comments · Uncategorized

Simply put. Beyonce adores Jabba-bear. Animals have amazing intuition. Over the past few weeks, Beyonce has grown closer and closer to Jabba-bear (both physically and emotionally). Several times we have seen her affectionately licking the incision site from his lobectomy. In our opinion, this action could serve one of two functions:  (1) she is trying to heal Jabba-bear, using her sweet saliva (which we half believe contains  “magical” regenerative compounds, since, despite being one of the clumsiest dogs in the world, Beyonce never gets hurt…EVER), or (2) she is attempting to remove Jabba’s cancer with her own bare teeth!

The following photographs illustrate Beyonce’s eternal affection for Jabba-bear (her hero):

Beyonce on Jabba 1-edited

Beyonce snuggling with Jabba-bear (he looks like a pillow)!

Beyonce resting comfortably on Jabba-bear                           (he looks like a pillow).

Beyonce couldn't be more at peace!

Beyonce couldn’t be more at peace! 

Beyonce curling up with Jabba-bear on the way back from Horizon's Dog Park

Beyonce curling up with Jabba-bear on the way to Horizon’s Dog Park (Saturday, March 30, 2013)

Jabba and Beyonce in car on way back from Horizons 1

After several hours of exercise, both Beyonce and Jabba were exhausted…but happy!

Jabba and Beyonce on way back from Horizons 3

As soon as the car started moving, Beyonce resumed her “normal” position of cuddling Jabba-bear.

 

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A sunny day at Reynolda Gardens

April 5th, 2013 · 3 Comments · lobectomy, metastatic lung cancer, osteosarcoma, recovery

On Friday March 15th, Jabba-bear went for a short drive across town to Reynolda Gardens, where he frolicked freely in the fields.

Jabba briefly explored the trails surrounding the Reynolda house, but he was more interested in meeting new friends (Reynolda Village is a popular dog-walking attraction). We laid down in the grass for a while and basked in the sunlight, enjoying every moment of the bright, beautiful weather. It was clear that Spring had finally arrived!

The following pictures highlight Jabba-bear at his finest:

Jabba-bear resting in the field in front of the Reynolda House.

Jabba-bear resting in the field in front of the Reynolda House.

Big Goofy Smile at Reynolda Gardens

Look at that Big Goofy Smile!

Jabba at Reynolda Gardens 2

Jabba at Reynolda Gardens 3

Jabba at Reynolda Gardens 5 (serious about food)

Did someone say the word “Treat“?

What a handsome profile.

What a handsome profile.

That afternoon, when we got home, Beyonce  welcomed Jabba-bear by licking his ears profusely (until they “stood up” on their own). We have to recognize that Beyonce has been extremely tolerant of all the extra attention Jabba-bear has been receiving over the past few weeks. She genuinely seems to understand what is happening to her beloved brother and best friend.

Jabba with Right Ear licked by Beyonce

Later that evening, Jabba’s breathing pattern became noticeably irregular. He seemed to be wheezing more than normal, gasping for air. But, we rationalized it as a side-effect from the lobectomy, telling ourselves that Jabba-bear was still adjusting to his smaller lung capacity. He still seemed eager to go for walks and to protect the neighborhood from the “evil” man in uniform who approaches the house each day with stacks of oddly shaped paper in his hands, leaving them in a box on the front porch. Disclaimer: the mailman is not evil by any means, but Jabba-bear has never taken a liking to him. As a result, the mailman probably thinks that Jabba is the Godzilla of dogs (a 180 pound guard dog that would rip his throat out if given the opportunity). I wonder what he would do if he realized that the source of the now familiar earth-shattering growl was really a 50 pound fur ball with 3 legs. . .

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Jabba starts metronomic therapy….again…

April 4th, 2013 · 4 Comments · lobectomy, metastatic lung cancer, metronomic chemotherapy, osteosarcoma, recovery

Three weeks after Jabba’s lobectomy to remove a large portion of his metastatic osteosarcoma, he was given a “bill of good health”, at least a temporary one. At this point, we decided to put Jabba back on metronomic therapy (i.e., frequent, low doses of chemotherapy) since he had tolerated it well for such a long time (almost 2 years!).

We started giving him cyclophosphamide (9 mg), the primary chemotherapy drug, first, since we still had a full bottle of it leftover from January. Note: Jabba’s doctors told us to withhold chemotherapy until he had sufficiently recovered from his surgery because these potent drugs that attack rapidly dividing cancer cells may prevent or limit wound healing (at the cellular level, the active ingredients in the pill cannot distinguish between a growing tumor and healthy tissue regeneration-it kills them both).

We debated putting Jabba-bear back on Palladia (50 mg) because of the sheer expense ($323.85 for 30 pills), but we eventually gave in and ordered the pills. Note: Jabba had previously been taking 70 mg of Palladia, but, since he lost a significant amount of weight prior to the lobectomy, we adjusted his dose accordingly. Although it should have been slightly higher (closer to 60 mg), we decided that we would start with the 50 mg capsule.

Because indigestion is one side effect of the metronomic therapy, Jabba-bear also receives 10 mg Pepcid or a generic anti-acid 2x daily. We still catch him eating grass occasionally though, which suggests that his stomach is not entirely settled.

In summary, Jabba-bear currently receives cyclophosphamaide and Palladia after breakfast on alternating days. He also takes 10-20 mg of Pepcid per day depending on his symptoms. In addition, Jabba-bear is still taking Prednisone (20 mg), which serves two purposes: (1) to help  reduce any residual swelling in his joints from the lobectomy and/or systemic inflammatory reaction to the metastatic osteosarcoma, and (2) to keep his temperature in the normal range (it is currently hovering in the high 102 degrees Fahrenheit).

As you can probably imagine, Jabba-bear has accumulated quite the extensive collection of drugs in his “medicine cabinet”. In addition to his metronomic therapy, he also has a stash of pain medicine (Tramadol), various antibiotics,  metronidazole (for diarrhea), heartworm medicine, flea medicine, etc.

Jabba-bear's medicine cabinet. Also shown in the above image is his thermometer which we used frequently to monitor his persistent fever and his jar of Royal Treats.

Jabba-bear’s medicine cabinet. Also shown in the above image is his thermometer which we used frequently to monitor his persistent fever and his jar of Royal Treats.

 Jabba-bear is very good about taking his medicine. We have a nice system worked out.  Every morning after breakfast, Jabba’s mom says, “time for your medicine, sweet prince”, and Jabba runs to the kitchen, drool spilling from his bottom lip, because to him, medicine = a tablespoon of peanut butter.

Jabba-bear medicine delivery system-edited

Jabba-bear’s drug delivery system. Peanut butter, disposable knife, and medicine!

The disposable, plastic knife is a good tool for delivering the chemotherapy drugs because it is not a good idea to touch them with your bare hands (as they are toxic!!!),  and the knife is not too sharp, so Jabba can successfully lick off the peanut butter without hurting himself.

Jabba getting his daily dose of medicine after breakfast.

Jabba getting his daily dose of medicine after breakfast. He gobbles it up with delight!

Overall, Jabba-bear seems to be doing pretty well on metronomic therapy.  However, it is important to acknowledge that we are fighting a losing battle. The metronomic therapy will not cure Jabba-bear. His metastatic disease is serious and quite aggressive. . . At best, this combination of medication will slow the progression of his cancer. Maybe it is working? Today marks 6 weeks since his lobectomy! We are blessed to have had him so long. We are not in denial about the gravity of Jabba-bear’s situation, and we recognize that the choices we made to prolong his life  may not be viable options for everyone (we have accumulated a significant amount of debt over the past 3 months). Nevertheless, we hope that some people may find this information useful. Thank you, once again, for your support.

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Jabba’s trip to Pilot Mountain

April 1st, 2013 · 2 Comments · lobectomy, metastatic lung cancer, osteosarcoma, recovery

When Jabba-bear was diagnosed with metastatic osteosarcoma, we vowed to do everything we could to ensure that whatever time we had left with him was well-spent. Unfortunately, doctors orders prevented us from doing anything really fun with Jabba for at least two weeks after his surgery (although we bent the rules a bit and took him on some very short walks since he begged for them). Once Jabba-bear was deemed healthy enough to resume normal activity, we promised to take him for daily walks (as long as he had enough energy), to schedule regular play dates with his friends, to give him as much steak and cheese as he wanted, to shower him with new plush toys (which would inevitably end up as a pile of shredded animal parts, loose thread, and  stuffing within seconds), and we promised to take him for weekly adventures so that he could live out his Bucket List.

Our first adventure occurred two days after Jabba-bear had the staples from his lobectomy removed (on Saturday, March 9th). Early that morning, we asked Jabba-bear if he wanted to go for a hike. He responded by initiating a very excited happy dance (i.e., rapid fire stomping of his two front legs: pitter patter, pitter patter, pitter patter), which we interpreted as a resounding, “YES!”. So, we decided to take Jabba to Pilot Mountain, where he could run free, off-leash and scale the mountain at his own pace.

Jabba-baar had a wonderful time at Pilot Mountain that day. He definitely exceeded our expectations. He must have hiked close to 2 miles (of his own volition); his endurance was remarkable. We were so happy to see him climbing the mountain, wandering off occasionally, but never straying to far from his pawrents, yet we recognized that this may be his last climb.

The following pictures and videos capture the fun that we shared on our trip to Pilot Mountain:

Jabba-bear smiling on his way to Pilot Mountain

Jabba-bear smiling on his way to Pilot Mountain.

Click on the image to view a video of Jabba-bear climbing Pilot Mountain.

Click on the above image to view a video of Jabba-bear climbing a trail Pilot Mountain.

Jabba resting happily on the first "leg" of the hike.

Jabba resting happily on the first “leg” of the hike.

Jabba-bear on "Pride Rock".

Jabba-bear on “Pride Rock”. 

Jabba and his dad perched on a ledge.

Jabba and his dad perched on a ledge.

Jabba getting a belly-rub from his mom during a break from his hike.

Jabba getting a back-rub from his mom during a break from his hike.

Jabba at an overlook near the summit. He posed in an effort to beg for some potato chips from a passerby who was snacking on lunch.

Jabba at an overlook near the summit. He posed with his best cute smile and begged for some potato chips from a passerby who was enjoying his lunch.

IMG_0278

Jabba near the peak, licking his nose.

Jabba near the peak, licking his nose.

Jabba-bear is all smiles near the end of his hike.

Jabba-bear is all smiles near the end of his hike.

Click on this image to view a short video of Jabba climbing stairs at Pilot Mountain.

Click on the above image to view a short video of Jabba climbing steep stairs at Pilot Mountain.

Jabba and his mom taking a break after a long climb.

Jabba and his mom taking a break after a long climb.

Jabba in the car on the way back home.

Jabba in the car on the way back home.

All tuckered out!

All tuckered out!

 

 

 

 

 

 

 

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Quick summary of last post

March 23rd, 2013 · 3 Comments · diet

I know the last post was extremely long and technical, so here is a summary of key points:

-Hill’s n/d prescription diet is the only commercial diet specifically formulated to both a)slow cancer growth and b) be palatable to dogs undergoing chemo

-We did not know about n/d until recently, despite Jabba having cancer for 2+ years, so you may have to take initiative to ask your vet. It also probably works better when given long term.

-Hill’s n/d is very expensive, running $180 a month for a 50 lb dog…

-But it is tasty! And supported by hard science.

-We are still working on it, but making a comparable home concoction of Hill’s n/d would be very difficult.

Please don’t hesitate with any questions or comments!

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Jabba Starts Hill’s Prescription Diet

March 23rd, 2013 · 1 Comment · diet

On Thursday, March 7th, Jabba-bear had his staples removed (from the intercostal split they performed during the lobectomy). The incision site looked fantastic! We were very impressed. That day, the prescription diet dog food that we ordered arrived at Oldtown Veterinary Hospital, and we fed it to Jabba for dinner.

Prescription diet dog food.   It is especially formulated for dogs undergoing chemotherapy.
Prescription diet dog food. It is specially formulated for dogs undergoing chemotherapy.

This  food is supposed to be ideal for dogs undergoing chemotherapy. Keep in mind that Jabba has been off cyclophosphamide for approximately 6 weeks (and he has been off of palladia since November 2012).

It was a little drier than we expected, but Jabba-bear devoured the entire can. When he finished, he licked his lips, wagged his tail, and looked up, drool spilling from his mouth onto the floor. He was adamantly begging  for more food! Happy to see our boy eating again, we gave him a little bit of his usual diet (Nutro Natural Choice).  Jabba-bear has eaten Natural dog food since he was 7 weeks old (when we officially adopted him). Once he outgrew the puppy food, he started eating Large Breed Adult food (Chicken, Whole Brown Rice, & Oatmeal Formula).  When Jabba lost his appetite in the middle of January, we tried feeding him the limited ingredient Sensitive Skin and Stomach line (Venison Meal & Whole Brown Rice). Initially, he seemed to like this food, but only if we spoon fed him. Beyonce, on the other hand, loves it!

For more information on Nutro Natural Choice products, see the following website: http://www.nutro.com/natural-dog-food/natural-choice-dog-food.aspx

The following paragraphs  summarize the research that Jabba’s dad did concerning the potential effectiveness of the Hill’s Prescription Diet:

Way back when, when Jabba was first diagnosed, we did a lot of reading about diets. Being grad students/budding scientists in biomedical fields, we are able to read and understand most scientific literature fairly well. There actually isn’t that much info out there, especially for dogs, but one thing that turned up was a ketogenic diet (very low carb/high protein/high fat), which was shown to be potentially effective in mice and human children with brain cancer. The logic is that cancer cells are heavily reliant on carbohydrates for energy, and are much less efficient at metabolizing ketone bodies, which was used instead of carbohydrates in organisms in a state of ketosis.

NCSU actually offers diet formulation services, which run $75 for commercial diet recommendations (I’ll come back to this, but LOL at them wanting $75 to tell you the name of a brand of dog food), and about $250 for homemade diet formulations. I had always planned to ask them about formulating a homemade ketogenic diet, but with our busy lives and Jabba doing so well for so long, sadly this never got done earlier.

Now, over two years later Jabba’s cancer has returned with a vengeance and with it the extreme motivation to do everything possible. So we did some more research and got in touch with NCSU. Here is the initial email exchange:

 

Hello,

Can the diet forumation service be used to formulate specific diets at the request of the client? Basically I am interested in formulating a ketogenic diet for my 4 year old dog with osteosarcoma. I am willing to pay the $231 fee for a ketogenic diet plan (or something based on the same principle), but I not interested in a standard homemade diet formulation. Is there a way to check with a veterinarian first if a) a ketogenic diet would be safe for my dog, and b) if NCSU CVM has experience and expertise in formulating this type of diet, and C) are there any other recommended specialty diets for dogs with cancer? Thank you very much.
—-
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Response:
Mr. Taylor –
  1. Yes an owner can directly request a homemade diet formulation. If you live outside of NC, the medical records for your dog must come from your local vet.
  2. Yes the formulations are done on an individual patient basis.
  3. A ketogenic diet can be formulated but it is very difficult to create ketosis in the dog and rarely indicated.
  4. If you wish to check our credentials, pls see http://www.cvm.ncsu.edu/vhc/vhwc/nutrition.
  5. There is a general suggested nutritional profile for cancer in general. A homemade diet can be formulated with that profile and there is one commercial product made with that formulation.

Please complete and return the attached request form to us and please request that a copy of the most pertinent medical records be sent to us by fax (919-513-6905) or email (best) (NCSUVetNutrition@gmail.com).

After receiving this info, we will email or call you if we have questions before sending the recommendations to you.

Thank you,
R Remilllard, PhD, DVM, DACVN

It was interesting to learn that ketosis is hard to produce in canines, I did not know that before, and it kind of rules out the idea of a ketogenic diet. At this point, a lot of googling had turned up Hill’s n/d prescription diet as the only commercial dog food specially formulated for dogs with cancer, so I assumed the commercial diet they mention in #5 was Hill’s n/d. I just asked  bluntly in a response email, and they confirmed it was Hill’s n/d (kindly without charging me $75), so that’s when we did some more research on Hill’s.

http://www.hillspet.com/products/pd-canine-nd-canine-canned.html

Hill’s n/d is pretty interesting because it is basically based on a single scientific paper from what I can tell. But I guess that is better than being based on nothing (which believe me, happens, there is a lot of snake oil out there)! It is a pretty good paper though; a double blind, randomized study, which is the gold standard as far as clinical trials go.

Hill’s (perhaps slightly biased) brochure which explains the paper and rational for the diet:

http://brf.vpweb.com/upload/Effect%20of%20fish%20oil%20arginine%20and%20doxorubicin%20chemotherapy%20on%20remission%20and%20survival%20time%20for%20dogs%20with%20lymphoma.pdf

In this packet, Hill’s makes the claim that “To achieve levels of omega-3 fatty acids found in Prescription Diet® Canine n/d®, typical pet foods need to be supplemented with 30 fish oil capsules per day for a 10-kg dog.”  Sure Hill’s, thats what you want us to think so we’ll buy your dog food, 2x  $3.50 cans/day for a 50 lb dog, dog food… right? Well lets look at the original paper this is based on to see if Hill’s is being honest.

Effect of Fish Oil, Arginine, and Doxorubicin
Chemotherapy on Remission and Survival Time for
Dogs with Lymphoma
A Double-Blind, Randomized Placebo-Controlled Study

http://www.catoils.net/v1/links/1916.pdf

Here is the breakdown of the nutritional content of the diet:

break down of fish oil fatty acids in experimental diet

break down of fish oil fatty acids in experimental diet

Fish oil contains fatty acids, and the main ones they focus on in this paper are EPA and DHA. These are rough calculations so please let me know if anyone sees a mistake. Most dog diet recommendations are based on calories, so we need to convert this to calories. Fat is 9kcal/g, CHO (carbs) and protein are 4kcal/g. So if we multiply this out, every kg of food has 2934 kcal from fat (326g x 9kcal), 1512 from protein (378g x 4kcal) and 864 from carbs (216g x 4 kcal). Total is 5958 calories. Jabba, being a mostly sedentary 50-60lb dog, needs 1200-1300 calories a day, 1200/5958/kcal = about 1/5 .

So we divide the EPA and DHA amount in grams by 1/5 to get roughly: 6 g EPA (c20:5) and 5g DHA (c22:6). These are present in fish oil at 300mg/200mg per pill, which would translate to 20-25pills per day (http://www.pureformulas.com/super-omega-3-gems-fish-oil-1000-mg-250-soft-gels-by-carlson-labs.html?CUSTOMTRACKING=CUSTOMTRACKING&CAWELAID=847734961&catargetid=1811371487&cagpspn=pla&gclid=CPrMn-TG5rUCFQ6EnQodwDYA0g#sthash.GYrwhU2W.dpbs)

CONCLUSION:  Hill’s claim of approximately 30 pills a day is pretty accurate. Damn. Not to mention the arginine which is not shown in these calculations but also present in Hill’s. I guess this is how they can charge $3.50 a can.  I am still looking into it, but there may be better sources of high yield liquid EPA/DHA that could be more cost effective and easier to implement (rather than shoving 30 pills down your dogs throat).

The rest of the paper shows a modest increase in survival times for dogs with lymphoma given the special fish oil/arginine diet:

surv curve

 

You can see that the average and max survival is substantially higher, although there is an overlap around the 25% survival mark, so it is anything but a guarantee. What is nice about this study,  and I want to re-emphasize, is that it is double blind/placebo controlled, so these results are pretty believable, even if the sample size is pretty small and the effect isn’t that huge.

Another interesting figure shows a very strong correlation between fatty acid concentration in the animals blood and survival time:

 

plasma c22 vs survival

Unfortunately it doesn’t really seem feasible to constantly measure your dogs DHA levels to see if the diet is working.

IN SUMMARY: the paper has pro’s and con’s (this is a different type of cancer, although the basic premise should work in different types of cancer), but overall I think it is enough to justify trying the diet and also Hill’s price.

I asked our family vet about Hill’s and she said she liked it but that at this point it probably wouldn’t do much to change Jabba’s outcome. We still felt it would be worth it to try, even if it just gave him a few extra good days.

Hill’s is specially formulated to be pallatable for dogs undergoing chemo, and Jabba definitely loves the taste. We did find one review that was a little dubious on the quality of the ingredients but oh well. Finally the cost: about $90/2 weeks so $180 a month. Yeah, not cheap. One other remark is that Jabba has definitely been gassier since starting Hill’s n/d!

In conclusion, Jabba-bear goes bonkers for the Hill’s Prescription Diet. He does his  “happy dance” around feeding time to signify that he is really ready to eat (he alternates lifting his two front legs and rapidly stomps on the wood floors, creating a “pitter patter, pitter patter, pitter patter” rhythm that resonates throughout the house).  This is one of Jabba’s most lovable qualities. He hadn’t “danced” in nearly 2 months.

Jabba and Beyonce begging for food.

Jabba and Beyonce begging for food.

Now, Jabba-bear is all smiles again!

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Jabba’s lobectomy

March 10th, 2013 · 9 Comments · lobectomy, metastatic lung cancer, metronomic chemotherapy, osteosarcoma

On Monday, February 18th,  Jabba-bear was admitted to Carolina Veterinary Specialists (CVS)  upon referral from his primary veterinarian (Oldtown Veterinary Hospital).  By that point, Jabba’s condition was critical. It was clear that  if we didn’t act fast, he would die…soon. That day, the doctors at CVS  performed an ultrasound of his abdomen, to try and visualize the mass in  his lung for a biopsy.

Jabba-bear at CVS during visiting hours. The small patch of  shaved skin on his side shows where the doctors attempted to do a blind biopsy of the mass in his lung (following the ultrasound).

Jabba-bear at CVS during visiting hours. The small patch of shaved skin on his side shows where the doctors attempted to do a blind biopsy of the mass in his lung (following the ultrasound).

Jabba-bear loves to push on our feet as we rub his belly! This was the most energetic he had been in 3 weeks. We felt that he was showing signs of improvement.

Jabba-bear loves to push on our feet as we rub his belly! This was the most energetic he had been in 3 weeks. We felt that he was showing signs of improvement.

This procedure was, in some ways, a gamble because lungs are ill-suited for ultrasonographic examination given that they are typically full of air (and ultrasound doesn’t work well through oxygen). As such, the doctors were unable to get a good look at the mass. The next viable option was lung surgery. As detailed in a previous post, Jabba-bear spent nearly one week at the “hotel” (CVS), receiving ample IV fluids and pain medicine, as he bravely withstood test after test after test. Eventually,  it was determined that Jabba was healthy enough to sustain surgery (no organ failure, no noticeable masses in his liver, etc.), although there was still some risk involved as Jabba-bear had been so sick for such a long time, and we were not sure what was causing his illness.  On Thursday, Februrary 20th, Jabba-bear had a lobectomy. Specifically, the surgeon removed the caudal lobe of Jabba’s left lung.

We were not allowed to visit Jabba-bear the day of his lobectomy, but we went to check on him Friday morning. This was a very difficult visit for us. As soon as the technician left us alone with Jabba, he starting crying…Loud, wailing, cries. We had never heard him make those sounds before. We didn’t know what those vocalizations meant. Was he in pain? Was he suffering? Was he yelling at us for putting him through yet another major surgery?  We felt helpless. We looked at each other and wondered if we had made the wrong decision. The technicians assured us that Jabba was not in pain, that he had spent the whole day resting comfortably (and quietly).  However, he was still not very interested in food.  We asked if we could try to feed him. The technician brought us quite a selection of wet and dry food. To our surprise,  Jabba-bear ate it all! This lifted our spirits. We stayed there petting Jabba-bear as long as possible, until it was time for him to go back on his IV fluids.

The next day, February 23rd, we checked Jabba-bear out of the “hotel”  and brought him home!

Jabba on the way home form the vet (after the lobectomy).

Jabba on the way home form the vet (after the lobectomy). The blue bandages covered the incision site.

Jabba-bear was happy to see the car. He had never been boarded before, and this was the longest he had ever gone without seeing his pawrents. When we got close home (turning onto our street), Jabba-bear perked up. He lifted his head, looked at the road, and started smiling!

The doctors sent us home with pain medicine (Tramadol) and steroids (Prednisone) and told us to limit Jabba’s physical activity for at least two weeks (no jumping, climbing stairs, running, etc.). We weren’t too worried about this since Jabba-bear is an extraordinarily lazy dog. Even though his sister, Beyonce, was waiting for him, we knew that they would be OK. Honestly, Jabba-bear and Beyonce do not interact much, save for the  occasional forced cuddling on Beyonce’s part.

We spent that whole day laying on the floor with Jabba-bear, scratching behind his ears, petting his backside….letting him know how proud of him we were. He is such a brave boy!

Jabba resting on his pillow. Beyonce give him a concerned look.

Jabba resting on his pillow. Beyonce giving him a concerned look.

By Sunday morning, Jabba-bear seemed to have improved significantly. His appetite had returned, and he seemed more energetic. Jabba kept rolling onto his back, begging for more belly rubs. As a result, he wiggled out of his bandage and exposed the incision site of his lobectomy. Although the below  picture might look gruesome, the incision site was neat and clean. We thought the doctors did an excellent job!

Jabba's incision site exposed!

Jabba’s incision site exposed! Beyonce stayed close to her brother, making sure he was OK.

We took Jabba-bear back to CVS to replace the bandages, since it was recommended that they remain on for one week.

Jabba's new threads!

Jabba’s new threads!

The following Thursday, Februray 28th, we took Jabba’s bandages off to allow the incision site to “breathe”. By this time, Jabba-bear had figured out how to jump on the couch again, and well….we let him.

Kisses from Beyonce.

Kisses from Beyonce.

Close look at the incision site.

Close look at the incision site.

There's that goofy smile again! (one week after the lobectomy)

There’s that goofy smile again! (one week after the lobectomy)

What a handsome boy! So serious.

What a handsome boy! So serious.

Brother and sister on the couch.

Brother and sister on the couch. Jabba loves to look out the front door.

Jabba's idea of resting comfortably.

Jabba’s idea of resting comfortably.

Lion-bear?

Lion-bear?

All things considering, Jabba-bear is doing very well. He started the high protein diet (Hill’s prescription) a few days ago, which we will write more about  soon.

He is no longer taking pain medicine, and he is tapering off the steroid treatment. We are still thinking about the next step for Jabba-bear (i.e., whether to put him back on cyclophosphamide and/or  palladia).

Thank you so much for all of your support over the past few weeks. 

 

 

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