Another alternative

I found a new alternative medicine veterinarian for Cas (months ago!). I decided on Coastal Holistic in Pacifica, CA after a few referrals. We've been to about 6 acupuncture appointments there so far. I take him once a month; they advised treating him two weeks after his chemotherapy treatments.

The first vet we saw was Dr. DeLeeuw. I was recommended to see Dr. Molly Rice, but unfortunately, she was out of town and booked until early December. I didn't want to keep Cas waiting that long, so we took a chance on Dr. DeLeeuw.

She was very sweet, and I felt comfortable talking with her.

Starting with our next visit, we saw Dr. Rice. She likes to treat him with acupuncture followed by chiropractic adjustments.

Aside from that, I discussed alternative medicine options for Castor with Dr. Rice. She prefers to wait until her patients are finished with chemotherapy to use alternative medicine options (herbal chemo's).

So, we waited.

In the meantime, she had us give him probiotics (Jarro-Dophilus) and fish oil pills. She also helped us decide on a food - finally! We chose Orijin's Regional Red formula. It was the only non-raw food diet she would feed her pets. (I am not yet willing to deal with the time and costliness of a raw food diet. I also am unconvinced that it's orders of magnitude better than something like Orijin.) I think it's kinda awesome that it has wild boar in it. (Danes were bred to hunt them!)

She also reiterated what many others have said: Turmeric Rocks!! She said we can just sprinkle some on his food. Many believe it to have many, many fabulous healing properties, including protecting against cancer. Here's a 2007 Scientific American article, "Spice Healer," about the history of is medicinal use.

Cas really doesn't mind going to Coastal Holistic. It's quite amazing, given his usual trembly fear. It's probably all of the freeze-dried anchovies that Dr. Rice bribes...I mean gives him.

Cas finished chemo about three months ago. We just started him on a low dose of Artemisinin a couple of weeks ago. Her plan is to have him on it for a month and off for a month. So far he's handing it fine; it's such a small dose for him. Dr. Rice said she didn't want to change a lot with him, since he's doing so well. (YAY!)

She also highly recommended putting him on a blend of mushrooms. In fact, she said that is the number one thing she'd give him, and any pet for that matter. She says they help with many ailments and give amazing boosts to the immune system. I have not looked into support for those statements yet, but I plan to soon.

Specifically, she recommended he eat Corioles (a.k.a., "Turkey Tail") and a blend of Maitake and Reishi from gmushrooms.com. I may start him on some soon. Maybe.

I will say that my experiences with Coastal Holistic and Dr. Rice have been fantastic. More importantly, Castor has had great experiences (for vet trips, anyway). Dr. Rice has said, repeatedly, that she is so happy we do this for Castor BEFORE he has any major musculo/skeletal problems. She said she usually doesn't get to see animals until they are in bad shape, when there's limited help she can provide.

The acupuncture and/or chiropractic manipulations help his muscle and spine tremendously. If nothing else, it really eases pain and tension in his body. Rob and I massage him pretty regularly. Before our last visit, when I ran my thumbs down along side his spine, his back muscles twitched like crazytown. Right after his treatment: no more spasms. None. It's incredible how much it helps him.

Cas and I both fully recommend acupuncture (and chiropractic care), especially for beloved tripawds...as long as you find the right vet!


(Note: We never heard back from Dr. Fong about a refund. I've just let that go. He lost the best doggie patient ever.)

The best word ever, lately.

Cas had his 5th chemotherapy treatment on December 29th. Another typical treatment. I took him in on January 27th for his 6th and final treatment and the nerve-racking part: chest rads.

Considering metastases
I have made it something of a policy to not entertain thoughts of metastasis, but I found myself really nervous at his 5th visit. It probably had everything to do with a woman I met in the waiting room. As all do, she inquired about Cas, smiling and telling us how sweet he is. She was there with her dog for her 6th treatment. Osteosarcoma.

She said, "but they found it in her lungs." Still waiting to meet with the oncologist, she didn't yet know what her options were. She looked at me as though she missed being where I was 4 weeks prior. Also, as if I were going to be in her situation in another 4.

That day, as Cas was being treated, I spent my time researching lung metastases and options for treatment. I discovered such useful things as inhalant chemotherapy and pulmonary metastasectomies.

Did you know that a dog can survive with about 55% of normal lung capacity? They have 4 lung lobes on the right side and 2 on the left. In some instances of lung cancer, you can have whole or partial lung lobes removed, aka pulmonary metastasectomy.

In fact, I found a very interesting, seemingly good, though not "for dummies" (i.e., a bit jargony and technical) book, Small animal clinical oncology, by Stephen J. Withrow and E. Gregory MacEwan. (You can read some of it through its Google books preview.)



Needless to say (though perhaps I already have), I got a bit carried away by my fears. I was reassured by the UC Davis staff that I could wait to take chest rads until our next visit, so I took Cas home and tried to Ctrl-Z my concerns and sleep it off with the kitten. (Bed hogs!)




The Last (planned) Chemo Visit
The funny thing is that I wasn't nervous at all that day. Rob confessed that he was, and it was very mildly contagious. For the most part though, my nerves were dormant.

We dropped Cas off. The plan was to get chest rads and, if all was clear, administer his final dose of Carboplatin. They would call when he was ready to go.

After about 2 hours, I assumed that his lungs were normal. Otherwise, they would have called already. (Right??) About another hour passed, and the call came.

"Castor's ready to go home," a brief, yet loaded statement.

Dr. O'Brien came out to chat with me after I had Cas back, sitting in my lap.

(I exchanged emails with Dr. O'Brien the week prior where I complained about one of their tech's attitudes at visit 5 and told her I wanted time to chat about how to proceed at his next visit. She was extremely friendly, kind and apologetic about my experience with the tech. She was very approachable and had the sweetest things to say about Cas.)

She told me the good news, that his lungs had no sign of metastasis. (Woo hoo!) He had his 6th dose of chemo, and now, we would just need to check his lungs every 3-ish months.

I asked her if there were any other treatments I should consider. For example, another dane osteosarcoma survivor, Nova the Great, was put on a daily dose of Piroxicam and another chemo that she didn't continue using, due to sensitivity. Dr. O'Brien didn't think there was any evidence in the literature to support that route. She said there was nothing more to do, in her opinion.

She said we had already done the best for Castor. Now, we just keep enjoying our time together and come visit our old friends at Davis every few months. (YAY!)

As for symptoms of metastasis, I read that they can exhibit flu/cold symptoms. O'Brien said they can but might not. A recent client brought in her dog, saying "he just seems off." Indeed, in that case, it had spread to his lungs. She said that usually people will just sense that something's wrong.

(I am considering putting him on Artemesenin, but our alternative medicine vet, Dr. Rice, suggested we wait until his body has a break from the chemotherapy. We will talk about it at our acupuncture visit in early March. I'll post about it then.)

I can't express how happy I am that Cas doesn't have to have chemo anymore, that his lungs are clear, that he is happily, hoppily by my side every day. Though I enjoyed our Davis day trips together, I'm sure he'd much rather romp at the park and have me work next to him on our apartment floor. Sounds good to me too (we have a lot of comfy pillows).

The best thing I heard that day and in many, many days surrounding it was something O'Brien slipped in a tad nonchalantly. After she told me the results of his chest rads, she said, "so we consider him to be in a full remission now."

Remission.

The proverbial music to my ears.

Cas ♥ Treats!

A Noted Ampuversary

It was Castor's 5 month "ampuversary" today!
Woo Hoo!!

It's been a long 5 months; it really seems more like a year.


I feel like I've spent more quality time with Cas, more time really appreciating him since his surgery than I did at any time over the previous 6 years.


It really only took 2 months for him to be his usual, playful self. I remember the first time I saw him running on 3, chasing after a chocolate lab, trying to sound all ferocious. It was awesome.




I never thought he'd be running like this so soon:

I spent some time watching some videos of him as a quadruped the other day. The video that really took me back is probably not so exciting for you to watch, but it really stirs me up.

It's the day we left San Francisco for Santa Barbara. I took him to his park, Collingwood, as usual. It was our last walk home from the park, and I was weighed down by the finality of our departure. I wanted to capture his adorable prance, because I knew I'd never see it again.

It was pretty heavy as was, but I also had "Adia" stuck in my head. Some soundtrack for that morning. Jeez. Drama Queen, huh?

This is no sob story, though. In fact, I learned that Castor can prance on 3 legs. Happy Day!

It was weird, at first though, to see him walking around so casually in these videos. It really struck me how much more difficult it is for him to just walk around. Not that he knows that. You can't tell these non-humans that it's supposed to be hard. They just don't listen.

He's happy as ever. I honestly think that, aside from his puppyhood days on Summerland Beach, he's never been happier.

Shortly after watching him on 4, I saw his tripawd-ed-ness as strange for the first time.

It was one of the weirdest experiences, looking at him and just noticing the oddness of his stance. I saw that something was missing for the first time. This was the first time that I really noticed.


A breath later,
I left that fleeting moment outside of the dog park where I found it, and we went in to play.

And as with most days, it was the best part of mine.


Ever since that moment,
he's just been Cas again.


No more.


No less.

See how much we all love him:

Presence on the 25th

Okay, so I've become a bit of a knitting addict over the past year. It's true. This time of year, though provides a great reason to indulge in my addiction.

I made my mom this cute hat and scarf. The hat is from a pattern I bought, and I designed the scarf to match. My first cable project was a success. Yay! My mom loved them too. I still have to get pictures of her in them.
(Yes, I am posing funny. Good call. =P )


We all had a lovely time together on the Christmas. I am not religious, but it's wonderful to have a day to focus on gratitude for loved ones and to spend lots of quality time together. And since the 25th is already part of a tradition in that vein, I decided I'd go with it.

Plus, both from lack of funds and aversion to super-consumerism, our house managed to have a great balance of presents, goodies, and QT.

So, we had a few presents, some lovely lights, and made food all day. This chocolate candy cane cake (from Cook's Illustrated) is unbelievably moist, rich, and addictive. Thankfully, all the dairy and sugar hurts my belly if I eat more than a little. So, moderation wins this time!

We had a special house guest for the holidays too. Olivia, the (thank-the-lords potty trained!) persian. (I've had some bad uriney experiences with others of her breed.) She was a doll, and she learned to tolerate the kitteny advances of Hoshi pretty quickly.


I let Cas sleep in...okay, and myself. After all, I was up until 3am wrapping presents, though to be fair, I didn't start until 1-ish. Plus, most of that time was occupied with present - a Tartine bread book. (Aside: Tartine is the best bakery I've ever encountered. If you're in San Francisco, you MUST try it. Yes, you may spend some time in line. So worth it, though. We get bread from them every week. Yum!) I created a cute little carrying book cover using a Bi-Rite handle bag. (I bet you can't wait to see it unwrapped...)

I pretty much lost steam after that one, but luckily, there were only a couple more to wrap. A few for Cas and one for Hoshi, the kitty sis.

Cas sniffed out one of his gifts right away. Bully stick! Score!! (gross. I know, but he loves 'em.)

(The video's a bit long, but I know some of Cas's family wanna see every second. Really. It's not that I don't want to take the time to edit it. I don't know why you'd even think that. Ridiculous, really. Many people want to see all of this... Really. They will.)

Our dane meet-up group had a secret dane deer gift exchange, and Castor scored big time! A large, green box arrived a few days before Christmas, and we finally got to see what was filling it. OMG there were 1,000 toys inside. Cas's emotions ran the gambit - curiosity, excitement, boredom (as I struggled to detach all of them from the box), glee, and finally, overwhelm (see: right).

There were so many, after they were all freed up, he froze, eyes glazing over. Time for a break, it seemed.

So, I put them all away except for the fuzzy one that he just loves to nibble on. Nibble, nudge, nibble, nudge, ... ad nauseum.
=)

Hoshi's turn! We got her a cute little brown mouse that makes chirpy noises every time you tap it. She was less curious than I'd expect from a cat, but eventually she wrestled a bit with her new, chirpy friend/foe.


A week later, after assuming that she must have lost it, she reunited herself with it as I was trying to sleep. It turns out it was hiding just behind the head of my bed... Did I mention that it chirps incessantly? (Just listen to the soundtrack of the Castor video above.)


Anyway, she doesn't leave it alone now...unless of course, we hide it from her. (Wah ha ha.)




On to people presents. Well, Rob got some yarn, sweetness note cards, and, as I mentioned, an awesomely packaged bread book. ;-)





I got some Addi turbo knitting needles (yay!), a Mary Oliver poetry book (ahh...), and a "curiously awesome" Koi toy. It's a fish that lights up when in water. Think of it as a plastic, fish-shaped, color-changing, floating candle-replacement for a curiously awesome bath time experience. (It is pretty awesome.)


After all the cheer, toys, goodies, and way, way too much Aimee Mann and Sinatra Christmas songs (yes, possible), we all veg'd a bit. We watched Angel on the couch with Cas.

Afterward, he retired to the floor cushions next to his bed. It seems he likes variety. Even if that means scrunching into a tiny ball to experience it. He has tried to curl up on our little 16x16 couch cushions before. No joke. What a goof.

I had such a beautiful time. Even without snow! I hope you all experienced oodles of warmth, laughter, and color too. ♥

The best part of this holiday has been reconnecting with loved ones from afar and spending time with those here, especially Cas. I have never been so continuously grateful to have him in my life. Every day. That's the one great thing that's come of his battle with cancer...You know, the thing he beat the S out of, the thing that is G-O-N-E...

Oh, how I love this boy!

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.

An apology goes a long way

I have an update for the Or Alternatively... ordeal. After a round or two of phone tag with me, Rob was able to connect with Dr. Fong on the phone two weeks ago. (Yeah, I'm behind.) Rob told him of a couple of our concerns, explaining our overall unsatisfactory experience at his consult.

Basically, he told him we felt uncomfortable asking questions after several of mine were left unanswered and that he seemed to not be present. His response?

It was as good as it could have been. First, he apologized that we didn't have a good experience. Then he spent some time going over a few examples that Rob gave, including the giving of treats to Castor. He asked if Castor was okay after the visit. (Fortunately, he was.)

Before getting off the phone, he offered to speak with someone at SFVS about getting us reimbursed for some of the consult. He also provided Rob with his email address, offering to answer our questions by email if that was more comfortable for us. He did both of these things without prompting, which deserves to be noted.

Though I'm told there was a bit of defensiveness at first (who wouldn't be?), Dr. Fong validated our feelings, apologized, and offered solutions for us. That is good customer service. I will still take Castor to the new alternative veterinarian in Pacifica for future acupuncture, mostly because I still don't feel entirely confident that I will be fully able to communicate my needs to him. I really appreciate Dr. Fong's response, nonetheless. (I received terrible customer service from my regular vet in SF the same week, which made me appreciate his even more. More on that later.)

Maybe he was just having an "off" day when we came in, and maybe not. Either way, I have no complaints about how we left things. Hopefully, I can get better information from him via email. I might as well try.

Seeing double

I received a beautiful email from a woman, Shelly, introducing herself and her boy, Solomon, to me about 2 months ago. She had been an avid viewer of Cas's videos, as she was preparing for her boy to have an amputation. Cancer strikes again! (grrr...)

Solomon is an adorable fawn dane too. He lost his rear left leg exactly one week after Castor. (awww...) We decided to organize a 2-dog Tripawd Great Dane Meetup. (woo hoo!)

Thursday, November 18th

At 10 years old, he's getting along fabulously. Castor was his perky, prancing self too. It's so great to form communities around our special (danes), and now, even special-er (tripawd danes), beloved dogs.

They didn't play much together. Solomon was a tad nervous in a new environment, and Cas can't leave his rope alone some days. Still, it was great for us moms to chat about our challenges, our joys, and our gratitude for these amazing pups.

We didn't get great video footage of them playing; we were too busy enjoying ourselves. (Totally worth it!) Still, Cas is always ready to be photographed, it seems.

Though Shelly and Solomon have had a difficult time, first getting misleading (or at least incomplete) information about Solomon's condition in April, things are looking up now. Solomon's condition was reassessed after they moved to California in August. The oncologist in Berkeley recommended amputation, something Shelly originally thought impossible.

The great news is that Solomon actually had a different type of bone cancer, chondrosarcoma, one that they think surgery will cure. They keep checking the lungs for lesions, but the outlook is good. Great, huh?! Go Solomon!

I showed Shelly a few things Jackie, the PT, showed me, including muscle massages and how to strengthen Cas's back leg with modified squats so as not to hurt his knee. While we were there, might as well take a rest.

After the fun, I watched Solomon while Shelly brought the car closer to the entrance of the park. He was so worried. So was I! I kept worrying he would bump his head or trip over things, pacing back and forth. I forgot he and Cas aren't exactly the same. Solomon sees everything just fine. =)


Cas and I look forward to many more play dates with this sweetheart, who is so damn lucky to have such a dedicated mom.


Of course, her and I are luckiest.