Thank you Oldtown Veterinary Hospital!

When we began Jabba-bear’s battle with osteosarcoma, his primary doctor, Oldtown Veterinary Hospital (http://www.oldtownvet.com/), gave him a very special gift: a guardian angel charm for his collar. He loved this charm so much! One day the charm broke off his collar, but we have  kept it on a shelf next to his bed. Every day we look at it, and we are reminded of how lucky we are to have Jabba-bear in our lives. He has made it this far largely because of the outstanding care that he has received from the doctors and staff at Oldtown Veterinary Hospital.  We are incredibly grateful to them for all that they have done, especially over the past 2 years.  Jabba-bear’s osteosarcoma has been an unusual and difficult case to treat. Nevertheless, Jabba-bear continues to persevere…throughout it all, his goofy smile continues to warm the hearts of everyone he meets.

Guardian angel charm for dog collar. Protect this dog (back).
Guardian angel charm for dog collar. Protect this dog (back).

This is an example of a personalized appointment reminder that Oldtown courteously sends out. We thought this was such a beautiful card that we’ve saved it on the “Jabba-bear” side of the refrigerator (above his food bowl).

A reminder that Jabba-bear had a heart worm antigen detection test   scheduled for January 2012.

For Jabba-bear’s 1 year Ampuversary, Oldtown sent us a celebratory card! It was very kind of them, especially considering that Jabba-bear had spent most of that year seeing doctors at North Carolina State University College of Veterinary Medicine (as part of the OSA clinical trial).

The card that Oldtown sent Jabba-bear to celebrate his 1 year Ampuversary!
The card that Oldtown sent Jabba-bear to celebrate his 1 year Ampuversary!

Thank you Oldtown Veterinary Hospital! 

Recap. Advice appreciated.

Just a quick recap of the previous post since its LONG!

-Jabba’s x-ray was clear nearly two years after amputation (January 4th, 2013). During this entire period he was on metronomic cyclophosphamide, and for most of the second year he was on Palladia (70mg). He had come off of Palladia for financial reasons in November 2012.

-a few weeks after this x-ray, Jabba became sick with fever, lethargy, loss of appetite, pU/pD (excessive thirst and urination), arthritis, and eye discharge.

-these symptoms were initially suspected to be pneumonia, along with the sudden appearance of a large mass in his lungs.

-surgical removal of the mass and biopsy confirmed it was osteosarcoma, which had also spread to his lymph nodes. Cancer can cause the symptoms we saw by triggering a generalized, hyperactive immune response (i.e., paraneoplastic syndrome). For more information on this syndrome,  see http://en.wikipedia.org/wiki/Paraneoplastic_syndrome.

-steroids and removal of the mass have controlled the symptoms for now.

For anyone who was been at this stage, what do you recommend? Do we put him back on metronomic therapy? High-dose infusion chemo? Or just treats?

It’s a cough…It’s pneumonia…It’s metastatic osteosarcoma

Here is the update that we have so wanted to avoid writing. . .

As mentioned in a previous post, Jabba had an X-ray shortly before his 2 year ampuversary (Jan 4th) showing that against all odds, his lungs were still clear – save for a small nodule that had not changed size or appearance in the year since it had first become visible. We were beginning to think he may have actually beaten cancer!

A few weeks later, Jabba began showing signs of illness: he was drinking a lot, peeing in the house (more than usual) and he started developing eye boogers. At first, we weren’t too phased by this, as the symptoms were mild. However one night it became obvious Jabba was very sick: his eyes were red, his nose very warm, and he was hardly moving. We took him to the emergency vet fearing some kind of organ failure. We spent the bare minimum to rule out kidney failure (a $30 test), and planned on taking him to his family vet the next morning (in an interesting side note, the ER vet who saw Jabba was actually the former intern who first saw Jabba at NCSU 2 years ago, what a small world!). Here is the report from the ER:

Presenting Illness : Jabba Bear presented for evaluation of increased thirst and urination that was first noticed three
days ago, as well as lethargy, mild coughing and redness of his eyes with mucoid ocular discharge that was noticed
today. Jabba has a history of osteosarcoma of the left hind leg that was diagnosed approximately 2 years ago. Jabba
underwent an amputation and a course of chemotherapy. After the initial chemotherapy was completed, Jabba was
started on metronomic therapy consisting of cyclophosphamide, piroxicam and palladia. Since November of 2012, the
metronomic therapy was decreased to cyclophosphamide only. During the course of Jabba’s treatment he has had
several episodes of lower urinary tract signs which have been diagnosed as both sterile hemorrhagic cystitis and urinary
tract infections (based on culture). In November of 2011, Jabba completed the course of the OSA study he had been
enrolled in at NCSU CVM and radiographs taken at that time revealed a single possible nodule, repeat radiographs taken
(most recently in December of 2012) revealed that the nodule had not grown. Since Sunday, his owners report that his
water intake has been significantly increased and he has needed to go outside to urinate approximately every 2 hours
and has been producing a large amount of urine each time.

Exam: Wt. 56.8lb, T 104.9, HR 144, RR 24, MM/CRT p<2
EENT – corneas clear OU; mild mucoid ocular discharge; mild scleral erythema; no nasal discharge; ears clean AU; no
abnormalities on limited oral examination; throat palpates normally
PLN – all peripheral lymph nodes palpate soft, small and symmetric
CVR – no murmurs or arrhythmias noted; femoral pulse strong; normal lung sounds ausculted over all fields
MSI – ambulatory x3 with no lameness noted; adequate, symmetrical muscling; no pain on palpation of long bones;
haircoat healthy; integument intact; no evidence of ectoparasites
GI/UG – no pain on abdominal palpation; no masses or organomegaly noted; neutered; no abnormalities on rectal
N – BAR, appropriate mentation; no CN or proprioceptive deficits noted; full neuro examination not performed

Assessment:
1) Fever
2) PU/PD
3) Ocular discharge and redness

SWO – explained that while the PU/PD could not be easily tied to the other symptoms noted, it was probably the most
significant symptom and would be the initial focus of diagnostics. Discussed causes of PU/PD including renal
insufficiency, diabetes mellitis/insipidus, Cushing’s, Addison’s, pyelonephritis, hypercalcemia, hepatic insufficiency, etc..
Recommended CBC/Chem/L/UA and thoracic radiographs. Despite recheck thoracic radiographs being performed
relatively recently, new cough and possible pathology warrants rechecking. CBC/Chem/L/UA best way to determine
cause of PU/PD. Owners expressed financial constraints and inquired about waiting to have Jabba evaluated with
primary veterinarian in the morning; explained that without knowing the cause, I could not give them a prognosis.
Recommended checking BUN/Cre at a minimum to r/o renal insufficiency, if renal values are normal, would still

Presented: 01-29-13, 8:12p

recommend additional diagnostics, but other differentials would be less critical to treat immediately. Owners approved
BUN/Cre only.

Treatment:
1) BUN/Cre – within normal limits (BUN 11, nl 7-27; Cre 1.3, nl 0.5-1.8)

SWO – renal values within normal limits which makes primary renal insufficiency and other kidney problems such as
pyelonephritis unlikely. Cannot ruleout other causes of PU/PD as previously discussed. Other causes are still significant,
but renal insufficiency would be the most critical to treat immediately. Owners declined additional diagnostics and will
monitor at home overnight with a plan to follow up with their primary veterinarian in the morning. Discussed starting
antibiotics due to fever, would not recommend starting at this point without a better understanding of the cause if they
are planning to pursue additional diagnostics in the morning. Recommend monitoring at home overnight and bringing
back if any new developments or worsening symptoms, otherwise follow up with primary veterinarian in the morning
for additional diagnostics.

Client Instructions:
As we discussed, there are numerous causes of increased thirst and urination and we cannot determine the cause of
Jabba Bear’s symptoms at this point without performing additional diagnostics. We checked Jabba’s renal values which
were normal and this rules out some of the more important causes, however, additional diagnostics to further evaluate
these causes was declined tonight in favor of monitoring at home and following up with your primary veterinarian in the
morning. As such, please keep a close eye on Jabba Bear over night and do not hesitate to call or bring him back to
AESFC if you have any concerns about how he is doing at home.

Please follow up with your primary veterinarian tomorrow morning to discuss additional diagnostic and treatment
options.

The treatment Jabba Bear received today was based on assessment of the presenting signs and diagnostic procedures
that were performed. Keep in mind that there can be complications that develop due to changes in the existing
condition or presence of underlying condition not apparent at the time of the treatment which can be severe or even
fatal.

So Jabba did not have kidney failure, and the next morning we took him to his family vet. His Dr. told us she suspected an infection, which would explain his fever and PU/PD (medical term for drinking and peeing a lot). An x-ray showed a mass in his lung, which the vet suspected was pneumonia. After all, his lungs were clear less than a month before, and this large, singular mass did not look like the typical presentation of osteosarcoma (many small mets). Jabba was prescribed antibiotics and we went home happy, thinking “at least he only has pneumonia!”

Jabba X-ray for blog 1.30.13
Note: In the above image, Left and Right are reversed. We have delineated the boundaries of the suspected infection in Jabba’s left lung. For a comparison, the red dot in Jabba’s right lung highlights the first suspicious lung met that appeared in early  2012, but remained constant for over one year.

Once Jabba was diagnosed with pneumonia, we decided to stop his metronomic chemotherapy (9 mg cyclophosphamide every other day), in an effort to improve his ability to beat what we thought was an opportunistic  infection. After all, Jabba-bear had been immunosuppressed for 2 years.

Unfortunately, after two weeks and several different antibiotics, Jabba’s fever and lethargy did not subside, his appetite became almost non existent, and he had lost a significant amount of weight.  A second X-ray showed the mass had remained relatively stable. We should emphasize that Jabba-bear’s primary doctor did not suspect that the mass was metastatic lung cancer for several reasons:

(1) The apparent physical characteristics of the mass were less consistent with metastatic osteosarcoma  (normally characterized by an abundance of small lesions throughout the lung, like the original suspicious lung met highlighted in the above X-ray, not one large well-defined mass in the caudal most portion of the lung).

(2) The mass appeared suddenly (sometime between 1.4.13 and 1.30.13). If this were metastatic disease, we would have expected to see at least a hint of it early in January. Whatever this was had gone from 0-60 in a blink of an eye.

(3) The mass had not changed much in size or shape in a week and a half (see the below X-ray).  The only noticeable difference between the X-rays on 1.30.13 and 2.11.13 was that the boundaries of the mass were slightly thicker at the later time point, possibly reflecting the development of an abscess around the infection site.  If this were metastatic lung cancer, it was clearly aggressive. . . meaning that we would have expected it to grow significantly in the time between these two images. And, it did not.

Jabba X-ray for blog 2.11.13
Again, we have delineated the boundaries of the mass in Jabba’s left lung. 12 days after it first appeared on X-ray film, it is approximately the same size (about the size of a golf ball).

Because this supposed infection was antibiotic-resistant, we opted for a tracheal wash, which would capture whatever bacteria was causing the infection, and allow for tests to see which antibiotics would be effective against it. After 5 longs days, the results came back: there was no bacteria in Jabba’s lungs. At this point, Jabba’s fever had been hovering in the 104 range for over a week. It was time to consider the possibility that Jabba’s condition was more serious than we anticipated. Therefore, we were referred to a specialty vet: Carolina Veterinary Specialists (CVS).

Being an emergency and  “referral only” vet, the attitude at CVS was a little different than what we were used to dealing with, but they came highly recommended. During our consultation, the doctor told us that she had reviewed Jabba’s X-rays (shown above) and was quite convinced that Jabba had lung cancer. The question was whether or not it was metastatic disease. This distinction is important. If it were a primary lung tumor (i.e., unrelated to Jabba-bear’s osteosarcoma) then there was a relatively good chance that removing the tumor would “cure” Jabba’s condition and that he could live a long(er) life. If, however, it were metastatic osteosarcoma, then there would be little that we could do besides love what little time we have left with him. Upon physical examination of Jabba, the vet confirmed another symptom that we had suspected but were unsure about: Jabba’s joints were swollen, which was a form of arthritis caused by systemic inflammation. The vet determined that the first step in diagnosing Jabba was to try and biopsy the mass in his lung using a needle and ultrasound. This was unsuccessful. Surgery to remove and biopsy the mass was presented as the only feasible option; or euthanasia. We were not given very much time to mull over the decision, being told in effect “this is very urgent.” At this point, the CVS vet was “highly suspicious” that the mass in Jabba’s lung was cancer, the logic being that cancer can cause an systemic immune response than can create fever and arthritis, etc. But, hearing the words of Jabba’s primary vet in our ears, we held out hope that this may in fact still be something else, and opted for surgery.

Before surgery, Jabba needed blood work to see if he was healthy enough to sustain the potentially  invasive surgical procedure. We were informed that his blood tests showed evidence of liver failure, so again the option was more expensive tests, or euthanasia. An ultrasound of the liver showed no overt tumors present, so at the advice of the vet we had a bile acid tests done to examine liver function, and a joint tap to confirm the cause of his arthritis (I am still not sure the point of this test before surgery, but at this point we are in so deep, what the hell). Two days later the test results came back showing that Jabba’s liver was functioning well, so he was deemed fit to undergo surgery immediately. At this point he had been staying at the hospital for 3 nights, and receiving IV fluid to help lower his fever. The vet also put him on steroids to lower the fever, something she had been reluctant to do as if it was an infection, steroids would make it worse. The surgery was to be laproscopic (small incision and guided with a scope), but we agreed to allow them to make a larger incision and open the ribs if need be.

The next morning we got a call saying his fever was down in the 100’s, and he would be going to surgery soon, but also that the mass appeared larger upon x-ray. We should expect a call in about four hours. Two hours later we got a call from the vet, saying the mass was too large to remove without damaging the lung, and if we still wanted them to take some for biopsy. We were devastated, but told them to go ahead. An hour later, the surgeon (different from the vet) called and told us that, while he had gone for the larger incision and intercostal split, he had in fact removed the entire lobe of that lung, and gotten the entire mass. Suddenly hope came back, although the surgeon also informed us that there were suspicious looking lymph nodes near Jabba’s heart, which he also biopsied. The biopsy results would be back in a few days. We weren’t allowed to visit Jabba that night (we had been twice a day every day that week), but went to visit the next day and took him home the day after that (now Saturday, he had been at CVS since Monday).

Jabba's X-ray just before surgery
Jabba’s X-ray just before surgery. The surgeon informed us that the mass was about the size of a baseball. Given its size and location, the surgeon believed that it had been growing for more than 6 months. . .

The good news is that Jabba is doing well after surgery (now almost two weeks ago)! The bad news is that the biopsy results confirmed this was highly aggressive osteosarcoma, which was present in his lymph nodes. Here is the biopsy report:

Histopathology, Full Written Report
Biopsy
DESCRIPTION/MICROSCOPIC FINDINGS/COMMENTS:Microscopic Description:
Sections of a lung mass are examined on 3 slides. There is a
partially delineated neoplasm within pulmonary parenchyma composed of
ovoid to fusiform or occasionally stellate mesenchymal cells forming
broad interlacing bundles and trabecular arrays. The cells form thin
trabecula of osteoid and a few cell are entrapped with osteocytic
lacuna. The cells have pleomorphic hyperchromatic nuclei with coarse
chromatin stippling. There is a high mitotic rate. Several smaller
nodules are dispersed in the adjacent pulmonary parenchyma.
Sections of lymph node are examined. Nodal architecture is
effaced by the same type of neoplastic cells described above.Microscopic Findings:
Osteosarcoma, multifocal, lung, lymph node.Comment:
The osteosarcoma has metastasized to the lung and lymph node. The
prognosis for metastatic osteosarcoma is poor.
So, that’s where we are now. Jabba will have his surgical staples taken out in a day or two. He is generally doing well, even going for a long walk the other day and dragging us to see his friend down the street. Either the removal of the mass or the steroids are managing his symptoms well for now. His energy level is not what it used to be, and he is still tender from the surgery and/or arthritis, but his appetite is back and most important, he seems happy.
We know that we put Jabba-bear through a lot over the past month, but we were trying to save his life. We believed that our miracle dog had, against all odds, beat osteosarcoma. We couldn’t bear to “let him die” from pneumonia when he had survived bone cancer. We celebrated his 2 year Ampuversary and we have cherished every day since. Although we should have expected that Jabba’s disease would, at some point,  metastasize, we were not fully prepared for this news. We are all still fighting this horrible disease.
There are still options to consider, which we welcome opinion and insight on. Jabba has been off his metronomic therapy for a while: cyclophosphamide for a month, and palladia for several months. We may soon put him back on one or both. Another option we are resistant too, but have not completely ruled out, is going back to the stronger, infusion style chemotherapy. Also he will start on a commercial diet soon recommended for dogs with cancer (Hill’s n/d, I will write more about this soon).

Introducing Beyonce (and other fun things)

Before we discuss the events of the past two weeks, we think it is appropriate to mention a few important highlights of 2012.

In January 2012, Jabba-bear’s mom adopted a greyhound named Beyonce Knowles. She raced on the Celebrity Track in Florida (hence her name), but she wasn’t very fast. This lead to her having a relatively short racing career. Beyonce was described by the kennel as a “DIVA”. She was a little wild, jumpy, and playful. The owner of the kennel called her Bouncy Beyonce. Basically, she was different from the rest of the greyhounds and a lot to handle. We (Jabba’s pawrents) thought it would be good for him to have a playmate, so the fact that Miss Beyonce Knowles was energetic was actually a major attraction for us. Before finalizing the adoption, we took Jabba to meet Beyonce. Jabba-bear was the first non-greyhound that Beyonce had ever seen. To prepare for the meeting, and since we didn’t know how she would react to Jabba, Beyonce wore a muzzle. When she saw him, her pupils dilated and she had a whole body reaction. She lunged at Jabba-bear (as if she wanted to attack him). Jabba calmly approached Beyonce, looked her in the eyes, put his face next to her muzzle, and let out a deep, authoritative growl to let her know that he was the alpha dog. After that was established, they played together for nearly an hour. Two months later, Beyonce came to live with Jabba-bear. The delay was due to the fact that she tested positive for heartworm and needed to be treated (and kept quiet) for a couple of months before she could resume normal activity.

Jabba and Beyonce's first walk together in Winston-Salem, NC.
Jabba and Beyonce’s first walk together in Winston-Salem, NC.

First walk together

Beyonce quickly made herself comfortable in Jabba’s house. As soon as she moved in, her wild side dissipated, and she became quite calm. Perhaps Jabba-bear set the tone for the house. In any case, Beyonce turned out to to be just as lazy as Jabba-bear.

Queen Beyonce asleep in her new home.
Queen Beyonce asleep in her new home

Beyonce adores Jabba-bear (although we still are not quite sure how he feels about her).

Shortly after she moved in, Beyonce started curling up with Jabba-bear, wrapping herself around his body, nuzzling the site of his amputation. It was almost as if she knew that something was missing.

Beyonce loves her tripod brother.
Beyonce loves her tripawd brother
Beyonce holding onto Jabba's "stump"
Beyonce holding onto Jabba’s “stump”

Beyonce sleeping with Jabba

If she had it her way, she would do everything with him.

Two peas in a pod
Two peas in a pod (looking out the window)

Beyonce does demand a lot of attention (she really is a DIVA), but she is a sweet, loving dog. And she certainly is cute!

Beyonce on couch-sweet face

Overall, the last two years of Jabba’s life have been wonderful. He had many great days and his smile touched the hearts of everyone he met (people and pups alike).

These are some photo’s from the dog party Jabba had to honor his 3rd year:

All of Jabba's best friends were able to attend his birthday party.
All of Jabba’s best friends were able to attend his birthday party.

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Other dogs using Jabba's ramp! They love it
Other dogs using Jabba’s ramp! They loved it
Jabba and Yeshua.
Jabba and Yeshua
Jabba  and Yeshua when he was a puppy.
Puppy Jabba and Yeshua (3 years ago)
Jabba-bear and his friend Bear about to enjoy his 3rd birthday cake
Jabba-bear and his friend Bear about to make a wish and enjoy some cake!

The following photos illustrate some of the other good times that we had:

Jabba-bear attended a CureSearch walk in the Spring. He made a lot of children happy that day.

Jabba after the CureSearch walk for children's cancer
Jabba after the CureSearch walk for children’s cancer

Jabba-bear went as Yoda for Halloween!

Yoda-bear
Yoda-bear

A father’s love for his dog:

Jabba-bear cuddling with his dad.
What sweet boys!

Picture 083

IMG-20111001-00006

3 dogs!
Beyonce can never resist a good group hug!

Some of Jabba’s great poses on his couch(es):

What a sophisticated pup!
What a sophisticated pup!
Upside down Jabba!
Upside down Jabba!
Who could say "no" to that face?
Who could say “no” to that face?

Jabba’s Two Year Ampuversary

This is a little late, and we have a lot to share right now, but first let’s start off with good news: Jabba made it to his two-year Ampuversary (January 21st, 2013) with no sign of cancer in his lungs! He celebrated his Ampuversary by going for a run (nearly 2 miles!). It was a wonderful, wonderful day. . .

But, let’s back up a little bit. A little over one year ago (January 13th, 2012), Jabba-bear completed a 50-week osteosarcoma study at North Carolina State College of Veterinary Medicine (co-sponsored by Ohio State University). During this time, Jabba-bear received metronomic chemotherapy in the form of low doses of cyclophosphamide and piroxicam, every other day. Shortly after completing the study (February 10th, 2012), we received a phone call informing us that there appeared to be a small (5 mm) metastatic tumor in Jabba’s right lung. The prognosis was bleak, and the referring veterinarian told us to prepare to say “goodbye” to Jabba-bear. When we asked how much time to expect to share with him, they told us that Jabba-bear would not make it to November. We were devastated by this news, but we vowed to do everything in our power to ensure that Jabba-bear would have the best chance possible of beating the odds. The doctor recognized our devotion to our beloved pet, and appreciated the fact that we were gradate students (i.e., of limited financial resources), and despite the fact that the clinical trial had ended (and we were “encouraged” by the study coordinators to discontinue the metronomic therapy in order to better gauge the effectiveness of the near year of treatment), she recommended that we try supplementing Jabba-bear’s medicine regimen with Palladia (an FDA approved drug for the treatment of advanced mast cell tumors in dogs, which was the other drug in the clinical trial-it was two drugs [cyclophosphamide and piroxicam] or three [cyclophosphamide, piroxicam, and palladia]). So Jabba was given free Palladia for several months. We actually didn’t realize we were getting it for free until we tried to re-fill his prescription in November 2012 and were informed we had only been paying shipping ($25), and that the actual cost of Palladia was closer to $170 a month. Unfortunately due to financial restrictions we made the decision to take Jabba off of Palladia at this time. All year, we had been dreading the arrival of November. . .recognizing that after November, Jabba-bear would be on “borrowed time”. However, November came, and Jabba-bear surprised us by hiking 6 miles up and down Pilot Mountain one cold Saturday morning. We took him there off-leash, and he had a fantastic time scaling the mountain, periodically glancing back at us mere two legged creatures who were lagging behind. He had so much life in him!

Throughout 2012 we periodically had Jabba’s lungs X-rayed, always holding our breath and bracing for bad news. But miraculously his lungs were always clear, save for the small “met” that never moved or changed in size. Finally in January 2013, it was beginning to look like Jabba had beat cancer, and that the small met was not in fact cancer. Attached are two pictures of his xray showing the small “met” (red arrow), in January 2012, and one year later in 2013.

jabba xray 2012

jabba xray 2013

We should add that shortly after Jabba-bear began taking Palladia, he started having complications with his renal system. He seemed to be incontinent, and was urinating in the house every couple of hours. Then, came the blood. At first there were only a few drops of blood in his urine, but it worsened over time. Our local vet treated Jabba for a urinary tract infection (UTI), but he didn’t respond very well to any antibiotic that we tried (there were at least 4 of them). This went on for a couple of months, with seemingly weekly checkups at the vet and test after test after test (e.g., urinalysis, ultrasounds of his bladder, complete blood counts, etc.). Jabba is the “mystery” dog. Nothing about him has every been “textbook” easy to diagnosis. One day the urinalysis would be riddled with bacteria, and the next, it was completely clear. An ultrasound of Jabba’s bladder showed some nodules (bumps), which may have been due to cystitis (urinary bladder inflammation). Nevertheless, Jabba-bear didn’t have any of these complications (side-effects) in the year that he was taking only cyclophosphamide and piroxicam. Therefore, we decided to discontinue the piroxicam and keep Jabba on the cyclophosphamide and palladia drug cocktail, (since both drugs are used in the treatment of cancer in dogs). This seemed to do the trick. Jabba’s bladder problems dissipated and we had many good months. In October of 2012, Jabba had a small flareup of his bladder. This cleared up pretty quickly, and all was “forgotten”….until we went to refill his palladia (long, complicated story, involving a doctor who did us a huge favor out of the goodness of her heart-needless to say that we are very grateful to her!). Jabba-bear had a chest X-ray on December 5th, 2012, which showed that the suspicious lung met hadn’t changed at all since February 2012. It was barely large enough to be detected on the X-ray (we were told that the mass must be at least 4 mm to be quantified). We were encouraged by this finding, since Jabba-bear was off palladia (receiving only cyclophosphamide on alternating days), but decided that we would hold out another month before allowing ourselves to really celebrate. As such, Jabba-bear had another X-ray on January 4th, 2013 (shown above). Miraculously, the lung “met” looked identical to the day it was first detected (in February 2012). At this point, our veterinarian told us the good news: that little spot on the X-ray was probably not a real lung met! She said that we couldn’t technically say that Jabba-bear was “cured” for another year (3 years after the initiation of treatment), but she had a good feeling about him. And we did too. Our little mystery, miracle, tripawd dog!

On the way home from the vet
On the way home from the vet
Jabba-bear in costume as a Scotsman (Christmas 2012, Punta Gorda Florida).
Jabba-bear in costume as a Scotsman (Christmas 2012, Punta Gorda Florida).
Jabba and his mom at the  vet in January 2013
Jabba and his mom at the vet in January 2013

Update

No new pictures, but just as an update Jabba is doing quite well and has now passed his 8 month ampuversary with no sign of metastasis in his lungs! Go Jabba! Also that bald spot on his butt has finally filled back in, hopefully we will post pictures of this soon.

Jabba starts metronomic therapy

This was back in April, sorry for the delay but at least we still have the pictures. Jabba started his metronimic therapy regimen which involves low does of cyclophosphamide and piroxicam every other day. This dose and frequency is supposed to prevent angiogenesis, thus preventing a metastasized tumor from being able to take hold and grow (presumably in the lungs).  We met some other dogs in the trial that morning, though they were still there for the high dose chemo (Jabba was the first in this study!). One lady, the owned of the Irish Wolfhound made the trip all the way from Washington DC. It is good to see people so committed! Interestingly, we noticed the Wolfhound’s front leg was amputated mid-bone, and apparently is being fit for a prosthesis, something new they are doing at NCSU CVM.

Later that day Jabba stayed at his grandparents house and played this his big sister Xena the Italian Greyhound:

Updates- halfway done with chemo

Jabba has had 2 of his 4 “high dose” chemotherapy treatments at North Carolina State College of Veterinary Medicine. He has these every 3 weeks for 4 months. He needs a complete blood count every week to make sure he is handling it alright. We had a small scare when in the 2nd week his neutropil level was low, and there was a chance if it got lower he would have to stop. Luckily next week it was back to normal.

Some fur finally starting to regrow after 2 months.
We were a bit worried about a persistant discoloration on his stomach on the side of the amputation (purplish color compared to healthy pink on the other side). But the vet is not concerned.
Jabba at the vet for his weekly cbc.