The Fourth

At three weeks, I took Cas's blood again for All Pets to run a CBC. Assuming his numbers would be fine, I was not concerned with getting antibiotics from Davis ahead of time. The doctors had reduced his dose by 15%, after all.

I had to wait until Friday to get his CBC results, due to Thanksgiving.

Another drop off
It seems Cas is just really sensitive though, because his WBC was down again. This time, it was 770, even lower than the last time (when a dose reduced by 10% left him at 980). (Ugh.) So, I picked up a few days worth of Clavamox from All Pets* to get me through to weekend until I could speak with someone at Davis.

Monday, I spoke with Dr. Obrien at UC Davis about his numbers. She definitely wanted him on antibiotics; ideally he would have been on them since Wednesday or Thursday. I explained that he had been on them since Friday afternoon but that I they were about twice as expensive here. She said that since he'd been on them for a few days and his numbers were likely rebounding by now, I could discontinue them.

She also told me he was more anemic than before (i.e., his red blood cells were down too), so they would consider lowering his dose slightly more than last time. However, she also didn't want to lower it much, as a lower dose could affect efficacy.

Over the weekend, it started getting colder here. And drier. I assumed that's why Castor coughed periodically throughout Saturday night, but it worried me. To some extent, when treating cancer, I imagine anyone can get ensnared in the waiting game. Waiting for metastasis.


I wholeheartedly assume, stubbornly at times, that that will not happen to my boy. However, signs of even slight respiratory distress are not kind to me. Beyond that, he's more susceptible to infections while his WBC count is so low. That concerned me too.

He coughed a bit the following day, but by Sunday night he was back to normal. I told Dr. Obrien, but she didn't seem worried, especially after telling her how high his spirit and happy his attitude is.

It's quite amazing to me that he seems entirely unaffected by the chemotherapy, save the first evening, but on a cellular level, he's rather sensitive to it. Thankfully, it doesn't stop him from enjoying himself.

Obrien said we could take chest rads this week, if I wanted to, but she would be surprised to see anything after only 4 weeks. (The last set on November 4th was clear.) I told her I'd monitor him; she said to call her right away if anything worsened.

Thursday, December 2nd

Fortunately, Cas was back to normal. Nothing worsened. And we were back at Davis again.

A different drop off
This was a rather uneventful and short trip. We dropped him off and went to our mainstay of sustenance (veggie burger and garlic fries place). Shortly after getting to Mishka's for some work time, they called to say he was ready. It was very quick.

One thing I don't love about UC Davis so far, is that I feel, at times, that I'm inconveniencing the busy Docs. When I email Dr. Obrien questions, for instance, she answers them in a terse manner. While I prefer Dr. Cadille's responses though, Dr. Obrien does answer every question. I am confident that all the doctors and hospital technicians pay careful attention to his case and that he gets great care there.

When we picked up Cas, I asked to speak with Dr. Obrien. We chatted for a few minutes. After the team (that's awesome, btw!) discussed Castor's case, they decided to leave his dose alone. They didn't want the chemotherapy to become less effective. Rather than lower it, we would just put him on a prophylactic course of antibiotics at 3 weeks. This time, it's Baytril.

So, I can check his blood levels at 3 weeks again, but I don't have to. He'll be covered; we're assuming his WBC count will drop low again. And we'll continue, on course, in 4 more weeks.

Only two more to go!

They also listened to his lungs, per my request. She said they sound fine; he looks great. It's so wonderful to hear such good news. Castor is still doing extremely well! =)

He's such a goof too. Watch him telling the Big C to stay away:

*Note: After checking prices for Clavamox 375mg tablets at my old vet, also in SF, I was astonished by how much All Pets charged me. I knew Davis was ultra low, but two other hospitals in town, including SFVS, which is known to be pricey, charged $2.45 and $3.60 per pill. All Pets charged me $4.50 per pill! Outrageous, in my opinion. The "practice manager" said she'd look into the prices, at some point, but that right now, that was a "fair price." It is beyond me how that's a fair price for them, and another clinic about 5 miles away manages to sell the same meds from the same manufacturer at almost half the price. I called with a good attitude. I tried to be fair, explaining that I really love their clinic but was feeling rather upset about this price discrepancy between them and other local vets. I am not a happy customer now. Bad customer service. Bad manager. I never once felt that she was speaking from a service place, understanding place, or a friendly place. I felt like she was talking very carefully around the issue and not validating any of my feelings. Bad.

Castor almost has seconds

Thursday, September 30th

No second chemo yet
I took Castor for a blood test two weeks post-chemo to check on his white blood cell (WBC) count. The oncologists have to monitor the levels to make sure they don't drop too low. The normal range for a WBC count in the dog is around 6,000 to 17,000 leukocytes (a blood component by any other name would smell as ...well...bloody?) per microliter.

At Davis, they will not administer chemo drugs if the WBC count is below 2,000. If it's below 1,000, they put the animal on an antibiotic course to safeguard against any infections that might arise, given their low immunity.

Castor's CBC (complete blood count) was normal at the two week mark, so we went to Davis on the 30th for his second chemo treatment. Again, he was to get treatments every three weeks for a total of six treatments.

Rob, Robyn, and I dropped him off and ventured into the six-block area of downtown Davis to find sustenance. The plan was for the hospital to run a CBC prior to treatment, treat, and go home. It takes a couple to a few hours each time.

It was on the short side of that when a tech called to let me know Cas was done. Almost rhetorically, I asked, "so everything went fine?"

"No, we couldn't treat him today," he says.

"Ha ha," I thought. I do like smart asses, so I just chuckled. Just to make sure though, "are you kidding?"

"No, really. His white blood cells were too low to treat him today."

My heart sped up, and suddenly my fancy for garlicy fries vanished. (Poof!) And though I waited patiently for further explanation, the line was mute. It turns out he needed an invitation to provide further details. Odd.

After failing to be reassured Cas was alright, I decided to just speak with someone (else, preferably) in person. We finished eating in about 2 minutes and left for the hospital.

After speaking with someone (else - yay!) when I picked Cas up, I felt better. Apparently, some pets' counts dip down again around the three week mark. The tech explained that his body can uptake the chemo again from his kidneys as it's being processed causing that second dip in the numbers.

His WBC count was about 700, so they sent us home with Clavamox...again. =\ It doesn't seem to be worryingly abnormal. It just means he'll have to be on a once-every-four-weeks schedule. We would have to go for another visit next week.

Fortunately, we already had an appointment with the physical therapist the following Thursday. Unfortunately, Cas would have rather not visited with the oncology staff again. Oh, well. We've already agreed to roll with the punches, to expect the unexpected.

On the bright side, we learned more about chemotherapy and what to expect from Castor. I was also reminded of the power of support and solidarity.

Being there, wherever there is
In the waiting room, we met a couple with a beautiful mastiff, just diagnosed with Cancer. He had a seriously large tumor on his spleen. ("I've never seen a tumor that big with a dog still up and about," said the vet, clearly oblivious to the impact of her unnecessary candor.) Talking to them took me briefly back to the first day I found out about Castor's tumor.

I was grateful to be in a less hysterical, more familiar place. I found a place of acceptance, which allowed me to find a path of care and treatment. The optimism with which I managed to imbue Castor's and my path has made all the difference.

Still gently wafting his head in disbelief, the mastiff's friend said, "it's just not fair," after I told him why Castor was at the hospital. I could only smile and say, "it's so great that we get to help them through it though." Of course, despite my sincere gratitude, I could hardly keep my tears in their tear duct home.

Then, I decided to let them roll on down. There's nothing wrong with expressing these emotions. It's not about defeat or grief. It's all about love.

It was good to feel my love, feel their love, and share our burdens, if even for a few minutes. As Cas hopped out to me, wholly excited, full of love, and dragging the tech behind him, they both said, "that's the prettiest dane I've ever seen."

My thoughts and prayers are with them all. ♥