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.

Three down, three to go

I got to vet tech it up again the week before Castor's 3rd chemo appointment. Since Cas hates going to the vet so much, I decided it'd be really good for him if I could take his blood at home for his CBC. My wonderful vet clinic said they'd send it to the lab for me. So, Cas was spared a fearful trip, and I got to brush up on my tech skills. (Fun! I know it may sound weird, but I miss it.)

It went great. Cas is one of the best patients ever. The results this time were better, but not good enough to be sans antibiotics. This time his WBC count was just below 1,000. Oh well, we put him on the gold-priced Clavamox again, and waited for Thursday. He is still not having any noticeable side-effects from his treatments. He is perky, hungry, happy, and pooping like a champ. (That's right!)

Thursday, November 4th

One of the very best things about our trips to Davis is cuddling up with Cas in the car. In Auntie Robyn's Element, we get to nap in back, but this time Cas managed to snuggle up while I drove my car. Adorable Boy!

Another four weeks, another dose of carboplatin, but this time, Cas was up for chest rads too. Though my mantra is positive thinking our way to victory over this disease, I couldn't keep my nerves on board. I was anxious this visit. Only a bit though.

His CBC was normal as expected, so they gave him another treatment. This time, to try to avoid the big leukocyte drop, the doctor lowered his dose by 15% of the original.

She explained that since he barely dropped below 1,000, he shouldn't need antibiotics again. His numbers should hold above that with this further decrease in chemo. Sounds good to me since Clavamox is ridiculously expensive. Plus, I could do without shoving my hand into Castor's mouth twice daily.

We left him with the professionals and went to work at our favorite Davis coffee shop, Mishka's. I waited to here the (pretty) assuredly good news. He was only there for a few hours, and the tech called me to come back.

"He's ready to go home."

I usually appreciate brevity, but settle down there tech. "How were his chest rads?"

"The doctor can talk to you about them when you get here."

Lameriffic (not to be confused with lamériffic). Okay, well off we go.

Cas came loping out to us, and the Doctor soon after. And his chest...looks...GREAT! No lesions!!! Sweetness to the millionth power. She explained that everything looks great; he's a great patient, and so on.

Before we left she asked if we had any pictures or videos we could give to the surgeons. Apparently, they are so impressed with how well he gets around, because of his size (and eyesight, I imagine), that they want to have something to show other clients. That was the second best thing I'd heard all day.

Four more weeks until our next visit, and we'll check his lungs again at the 6th treatment, assuming all goes well until then.
I took Cas home, let him sleep it off. He is like a lump of bricks the night of chemo. He dreams like crazy, and I let him have 90% of my bed.

Despite his fatigue, he always eats dinner and always plays like a goof the next day.

I love this boy!

A little massage with his chemo

I know, I know. It's been a while since my last post. I know life just isn't the same without my (potentially lengthy) stories about Castor, but it's been one of those 3 weeks that is busy busy. I try to keep the actual dates posted before the stories though. (You're welcome. =P )

**OH, and I'll add pics and video to this later today.

Thursday, October 7th

And then, we were off to Davis again...weee!

To be honest, I don't mind our excursions. It's a whole day to be with the boy, to work casually from a cafe I don't spend enough time in to be sick of, and I get to take naps on the way home with Cas in Dabs's backseat.

Too bad Robyn has school this week. No napping for me, but Castor's getting what he needs. Plus, there's garlic fries waiting for me!

20 questions for the PT
We went first to Oncology to have a CBC done. This time, as expected, his levels were back to normal. After the blood test, we waited for our physical therapy appointment. He would have chemo administered afterward.

Jackie Woelz, the physical therapist, is very warm and very accessible. Every person I mentioned his physical therapy appointment to at Davis immediately replied, "Oh. Jackie's so great, isn't she?!" Indeed, she is.

We talked about his situation and our typical routines - diet, exercise, home set-up - for a long time before she assessed Castor. She let us stay in the courtyard just outside of her building the entire time. Castor loved that. He soaked up the sun while we chatted.

She started with one simple question. "What do you want to get from this visit or from physical therapy?"

I want to do whatever I can to help Castor stay as healthy as possible in his 3-legged body. For this visit, that means I want to figure out any exercises and stretching I can do to keep him flexible, strong, and sans pain. I mentioned that I wanted to be shown stretches to do for him each day to keep the range of motion in his joints ranging on.

I had a lot of questions for her. Like:

• What stretches should I do?
• Are the stairs okay to do as we have been?
• Should he have acupuncture?
• What about chiropractic adjustments?
• How long should I take him out to play and exercise?
• Isn't he cute in his harness...er, i mean, is this a good harness for lifting and assisting him?
• How do I know if he's too tired?
• How much should I limit his activity, if at all?
• Anything else I should know? (This is a good question in general. After all, they're the experts.)

I have the, perhaps annoying, tendency to cut vet professionals off a bit. It's just a consequence of my preparedness and research combined with my itty bitty amount of patience. They seem forgiving.

So, after minimal prompting I explained that yes, I had covered all of our slippery surfaces in the house. Yes, I raised his food and water. Yes, I had cut back and altered our pre-amp play time and walks.

Namely, no more urban hikes up and down the hills of our concrete neighborhood. We also don't typically hang out at the dog park for an hour. Most days, we go out to a grassy park in the morning for 30 minutes and in the afternoon/early evening for another 20-30 minutes. She was very pleased. Grassy ground? Check. More frequent, shorter trips out? Check.

It's not good for Cas now, as it wasn't as a giant breed puppy, to go out for "warrior weekends." He needs regular, moderate activity. And that's what he gets.

There is one sign to show me when his body's tired. She said to pay attention to the turnout in his rear leg. When his quad muscle is feeling fatigue, he may turn his paw out for support. That action locks his knee, which prevents his leg from buckling. However, it's dangerous for his knee. When that starts happening, it's time to go!

And getting out of the house? Fortunately, I had video on my phone to show her our trip down the stairs at home. I explained that though it sucked to have stairs at all, we were trying to minimize the impact on his joints and avoid and falling accidents by using both his Ruff Wear and Walk About harnesses.

She thought his trip down the stairs was great. (YAY!) She said it was really good that he dropped his head down so low, which would help keep him balanced and take weight out of his rear leg. It's really a result of his extremely poor vision. (Does he see at all now? I do not know. Not much, if any.)

She was familiar with and said the Ruff Wear harness was great, with one caveat. She didn't like the under part. Especially with a dog Castor's size, the slender straps that for the underside of the harness are not very supportive. I have worried that they dig into his (massive) chest. He sometimes makes an airy, grunty sound when we catch him as he hops out of the car, like the wind's being knocked out of him.

The other Ruff Wear model, the double back, has a full size underside, in the shape of the top. She recommended that, if possible, noticing however, that it is a bit heavier. She showed us one, and it's much heavier duty. I may invest in one, or she suggested I try altering his harness by attaching some heavy fabric to the bottom straps. A good excuse to practice sewing? Perhaps.

Walk, Stay, Sit, Lie
After all of the talking, Castor was ready for a rubdown. But first... We had him stand and walk to show Jackie how he do. She said he looked great!

He has great extension in his rear leg as he walk/hops. She examined his spine and said it was minimally curving with his new structure. It barely curves at the end to accommodate his new tripod posture. Upon running her thumbs down along his spine, she also didn't think he was in any notable pain.

She seemed very impressed with and happy about his physique and movement.

I explained that I was re-teaching him to do down dog (adho mukha svanasana). Thankfully, I taught him that last summer. I thought it'd be great for his shoulder movement. She agreed, though only because I explained that Rob supported his rear with the WalkAbout harness during his attempts. Cas is getting it; he can do almost anything for a carrot!

I also mentioned squats. Should I be having him sit and stand and sit and stand and... to build up his rear leg muscles. She was not keen on this idea. It's hard on his knee and his joints. She gave me a modified exercise though. Positioned behind Castor, she bent her knee on the ground under him. She had him sit on her thigh, which is halfway to the ground. Then stand. It's like people sitting down into a chair during physical therapy. Much better.

Massage me already!
Finally, (says Cas) we got him on his side. (Another command my smart boy knows ;-) ) I explained the stretching book I'd read along with some of the exercises. She was not familiar with it, but did recommend the book "Four Paws, Five Directions," for a guide on acupressure points. (HaHa! My mom's been suggesting that for more than a year now.)

To make a long story less long, she is more a fan of massaging than stretching dogs (and one would assume, cats, ferrets, and horses too). When she tried to, for instance, extend Castor's front leg (shoulder extension), he resisted her, big time. And my boy's strong!

Basically, if your animal patient resists, you can really hurt them. If I work on Cas for a while, just rubbing his muscles deeply, he relaxes a lot. Then I can usually stretch him for a while. She said the massaging part was plenty to keep his muscles supple and long.

So, I will not be stretching him, unless he asks for it. Instead, I'll be requesting a few down dogs after we get back in the house and his muscles are warm. Then at least once daily, I'll give him a good rubdown.

The most important muscles to keep supple are his triceps, trapeziuses, and his rear leg muscles. She also said I could gently to moderately draw my fingers or thumbs down along either side of his spine. NEVER on his spine.

And What Else?
She wholeheartedly recommended acupuncture. She has many clients who receive acupuncture and have had tremendous success with keeping up their energy, for example. She says she can guess by seeing them if they've just had a treatment or are in need of another.

She gave me the names of two people her clients have used for acupuncture, one in SF and one in Berkeley. There is someone who does home visits near Davis too, but that's not so pertinent to us. I will make an appointment with the SF doctor next week.

As above, she suggesting hitting acupressure points too. I was referred to the book mentioned above for that.


Castor and I get A+'s
Other than that, keep it up! That was her recommendation. He looks GREAT! I'm doing great! Everything is great! We will see her if and when he needs more help.

She said, "you both get A plusses." It was partly for assessment, and partly encouragement. Sweetness. I haven't had one of those since I started grad school.

FANTASTIC. We couldn't be more pleased. And grateful.

And just when he thought it was over...
And as if to reinforce Castor's love of Jackie, we took him to see the poking, prodding docs in the other building again. =\ We dropped him off for his chemo treatment.

We left for lunch. Fries! Yum.

We came back about an hour later. Thankfully, they were quick and on top of things.

He was given 90% of his initial dose. Hopefully, his WBC count would stay above 1,000 this time. I would have another CBC done in 3 weeks this time around. And they would see us next time.

Everyone says he looks great. Well, yeah he does. My little 3-legged rock star!

Playing with his kind

Saturday, October 2nd

We went to our first Bay Area Great Dane meet-up since Cas's surgery
the weekend after our non-chemo Davis trip. This was a joint meetup with the Sacramento group, so there were about 30 danes there! Cas was reunited with some of his Dane friends. Sweetness.

It was quite a trek for him to get up over the hill to the Dane's spot at Point Isabel, but he did it happily. He played a bit, stood a lot, and reveled in all the attention. It was a big workout for him, but he did great!

And we both (okay so me more than him) got to nap it off on the drive home.



I made him sit for a break in the middle. That way he could rest and I could make weird faces. Can you find the bed head in this picture? =P




He is gaining confidence every day, though he is a bit nervous when dogs are running fast near him. Last week on our morning park trip, two huskies were running around in huge circles when Cas decided to make his way toward me in the center of the park. Well, they ran right behind him, FAST, and Zoe ran right into his nub. (Zoe is an adorable husky who I can't help but think of as Hoshi in a Husky suit. Hoshi is my sweet grey kitty.)

He started yelping and crying and looking back at his hip. It was horrible. Absolutely horrible. I ran over and put his bum on my lap to take all the weight out of his back leg. He kept crying. About a minute later he was hopping tentatively around again.

He was fine. I think he was more scared than anything. He's still a tad trepidatious when dogs run crazy-style around him. Understandably so.


He has resumed his marking all over the park again, so I know that he's feeling like the big dog around here again. Just watch him show this stick who's boss.

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. ♥