Another blood test, and Cystitis 6 weeks on
Well, it's now 6 weeks since Jazz first got cystitis as a result of the first chemo treatment.
On a couple of days this week, he's given us some optimism by starting to behave a little more normally from time to time (such as chasing a ball a bit, and coming and sitting in front of us with "that look" when he's wanted to go out sometimes, instead of just lying there and panting), but I'm afraid to say that it hasn't been a steady improvement :-(
On the whole, things are pretty much the same - he seems in control of his bladder during the morning, but around midday the drips and leaks start, and that's usually our cue to start using the nappies for the rest of the day. He's still off his food too. On the good side, being in nappies does seem to help him get through the night - and the day, for that matter - with fewer trips outside.
We were back at the vet's for another blood test this morning. He weighed 23.7kg today.
His bladder still feels much the same as last week, i.e. better than it has been, but not noticeably better than last week. The lymph nodes are all reassuringly small though, so that's good news. I mentioned that he seems to be off his food now (he just doesn't want to eat much - he's not picking out the "good" bits and leaving the boring bits, or anything - he just doesn't get to the bottom of the bowl very often). Apparently, Prednisolone is an appetite stimulant (they're not quite sure how it works, but it acts on the brain somehow), and his dose was halved about a week and a half ago. This makes a lot of sense, as he was positively inhaling his food for a while, which is most unlike him. Fiona thinks it should settle down after a while, and he'll get back to his normal state (i.e. he'll eat as long as there's nothing more interesting going on). She did take his temperature again, just to check that there was no other obvious reason for him not to be eating, and once again it was spot on normal.
As to where we go from here with the chemotherapy, the Prednisolone and Leukeran should continue at the current dose (i.e. 4.5 and 2, respectively, every other day) until we get to 12 months from the first treatment. Assuming the blood tests don't dictate anything different, the Vincristine injections will continue once every 3 weeks for a while, and then perhaps drop to once every 4, again until we've been going for a year (i.e. until January 2006).
... and the cystitis WILL get better ... honest! Well, according to Fiona, anyway. If not, or if there seem to be any long-lasting effects, such as more permanent loss of bladder control, then she may need to start researching the effects of cystitis as a side-effect of the Cyclophosphamide in humans (on the grounds that it will have been used many thousands more times on humans than on animals, so there's more data to go on). I asked her about nappy rash, but she doesn't expect it to be a problem, mostly because modern nappies are pretty good at preventing it. If it does set in, then she's successfully used Sudocrem (i.e. the same stuff you use for babies) on dogs for other things before, or a bit of vaseline would also help. I've just ordered some canine Hygiene pants and pads from Pet Planet, to try instead of the home-made towel-and-elasticated-straps nappy arrangement. We'll see if they're any easier to use.
Meanwhile, Fiona obviously really has a bit of a soft spot for Jazz. For no particular good reason, she gave him a cuddle and a kiss today. I'm sure that's not normal behaviour for a vet!
We have booked an appointment for his next Vincristine injection on Thursday evening. Fiona will call when she gets the blood test results in the next day or two, to either confirm that we should come for the injection, or suggest someting else, according to the results. We'll also need to get some more Leukeran and Prednisolone this week (which I forgot to mention this morning, but did mention last week).
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