Scruffy is getting the Madison-Wisconsin Protocol (25 weeks total)
Week 1: CBC, Vincristine IV, Asparaginase (Elspar) SQ, Prednisone PO
Week 2: CBC, Cyclophosphamide (Cytoxan IV, Furosemide (Lasix) IV, Prednisone PO
Week 3: CBC, Vincristine IV, Prednisone PO
Comes Week 4, at which point there's a problem to be solved: Scruffy's kidneys are not doing well. The Week 4 drug - Doxorubicin (Adria) IV, Diphenhydramine IM, and Prednisone PO is very hard on kidneys. I didn't retain all of the discussion with the oncologist, but it appears that, if we don't use the Doxorubicin, then we're no longer doing the Madison-Wisconsin Protocol. And he named another Protocol - I want to say "CHOP", although I'm not sure that's right.
Week 4 also includes "CBC, ECG, *ECHO" as well. Dr. E said that he thought it might be a good choice to do another ultrasound next week, to see if there has been any change in the tumors that would indicate that the treatment is having a positive effect. I don't know what *ECHO is. I have another paper they gave me that is a description of a variety of chemotherapy options; maybe it's listed in there.
Week 5: CBC - blood work only.
Week 6: CBC, Vincristine IV
and so on, alternating the 3 drugs. Six months of treatment, when the life expectancy they gave us for "successful treatment" was four to twelve months........
The only good thing about all this so far is that there appear to have been NO side effects or reactions to the chemo at all. Scruffy was in the hospital for the first dose of vincristine, but I did see him the next day, and aside from the trauma of hospitalization and catheterization and chemo and not eating....... Well, he didn't look good, but he was responsive, and he actually ate a little bit for the first time in more than two days. The second treatment, also no side effects. I do think that he's mildly nauseated generally, and have been giving him Zofran (ondansetron) every 12 hours since he came home on Jan. 23. He's eating fairly enthusiastically - I have only given him cyproheptadine twice in the last week and a half; it seems to make him hyper, and he was eating adequately without it. Peeing and pooping appear to be normal, also.
Sadly, the steroids (dexamethasone IV, then prednisone pills) immediately raised his glucose level. When he came home, I got ketodiastix and started checking his urine. (He's not nearly as regular as he was in the old days!) Always above the renal threshold, which for him seemed to be around 180. So, on Monday, Jan. 30, I started him on Levemir again. (Day 1392 of his being OTJ, which breaks my heart. Everything breaks my heart these days....) Tiniest little dose - under the zero line - seems to have a significant effect. And whatever I remember from four years ago - which isn't much, apparently - I don't know that it will apply now. Because now, in addition to the cancer, he's got daily fluids added to the mix. Today, for example, (recorded in his spreadsheet, linked on the righthand column) he started out at 258. I'm pretty sure there was virtually no insulin in the shot I gave him the night before, hence 258. I gave him another "under the zero line" shot this morning, and he apparently dropped most of the day - he didn't appear to have started back up until +12, and was only at 119. I don't think I can risk shooting that low without any idea how he's going to do. Maybe this method won't work so well with Lev, which needs patient, stable dosing, but given the other circumstances we have to deal with, I don't see that it can be helped. Every hour that he spends under 180 is a plus for his kidneys.
Week 1: CBC, Vincristine IV, Asparaginase (Elspar) SQ, Prednisone PO
Week 2: CBC, Cyclophosphamide (Cytoxan IV, Furosemide (Lasix) IV, Prednisone PO
Week 3: CBC, Vincristine IV, Prednisone PO
Comes Week 4, at which point there's a problem to be solved: Scruffy's kidneys are not doing well. The Week 4 drug - Doxorubicin (Adria) IV, Diphenhydramine IM, and Prednisone PO is very hard on kidneys. I didn't retain all of the discussion with the oncologist, but it appears that, if we don't use the Doxorubicin, then we're no longer doing the Madison-Wisconsin Protocol. And he named another Protocol - I want to say "CHOP", although I'm not sure that's right.
Week 4 also includes "CBC, ECG, *ECHO" as well. Dr. E said that he thought it might be a good choice to do another ultrasound next week, to see if there has been any change in the tumors that would indicate that the treatment is having a positive effect. I don't know what *ECHO is. I have another paper they gave me that is a description of a variety of chemotherapy options; maybe it's listed in there.
Week 5: CBC - blood work only.
Week 6: CBC, Vincristine IV
and so on, alternating the 3 drugs. Six months of treatment, when the life expectancy they gave us for "successful treatment" was four to twelve months........
The only good thing about all this so far is that there appear to have been NO side effects or reactions to the chemo at all. Scruffy was in the hospital for the first dose of vincristine, but I did see him the next day, and aside from the trauma of hospitalization and catheterization and chemo and not eating....... Well, he didn't look good, but he was responsive, and he actually ate a little bit for the first time in more than two days. The second treatment, also no side effects. I do think that he's mildly nauseated generally, and have been giving him Zofran (ondansetron) every 12 hours since he came home on Jan. 23. He's eating fairly enthusiastically - I have only given him cyproheptadine twice in the last week and a half; it seems to make him hyper, and he was eating adequately without it. Peeing and pooping appear to be normal, also.
Sadly, the steroids (dexamethasone IV, then prednisone pills) immediately raised his glucose level. When he came home, I got ketodiastix and started checking his urine. (He's not nearly as regular as he was in the old days!) Always above the renal threshold, which for him seemed to be around 180. So, on Monday, Jan. 30, I started him on Levemir again. (Day 1392 of his being OTJ, which breaks my heart. Everything breaks my heart these days....) Tiniest little dose - under the zero line - seems to have a significant effect. And whatever I remember from four years ago - which isn't much, apparently - I don't know that it will apply now. Because now, in addition to the cancer, he's got daily fluids added to the mix. Today, for example, (recorded in his spreadsheet, linked on the righthand column) he started out at 258. I'm pretty sure there was virtually no insulin in the shot I gave him the night before, hence 258. I gave him another "under the zero line" shot this morning, and he apparently dropped most of the day - he didn't appear to have started back up until +12, and was only at 119. I don't think I can risk shooting that low without any idea how he's going to do. Maybe this method won't work so well with Lev, which needs patient, stable dosing, but given the other circumstances we have to deal with, I don't see that it can be helped. Every hour that he spends under 180 is a plus for his kidneys.
2 comments:
Hi, I have reached your blog through Google - one of my cats has brown spots in her eye and I was searching up on eye diseases. (I want to be prepared before the vet)
What you and your cat have to go through is terrible. My heart goes out to you. I was so impressed with your dedication and determination to make him happy. I used to know someone who decided to put their cat down because of its old age and it started to pee all over. It takes a lot of money and time to care for a troubled cat. Some think it is kinder to put the cat down but I am not sure if that's always true...
May the Lord bless you two. All the best.
Lynda sorry all this is going on ..wonderful dedication and love ...sendings hugs and strength . Sam and missy
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