The future of home drips

Jazz had another blood test today, to check ready for next week's Vincristine treatment (and Sharon reported that his lymph nodes are feeling normal).

I also had a chat on the phone with Fiona later about the practicalities of having him on the drip at home. Basically, it needs to be on a day when I'm not working, which means Sunday or Monday. Fiona's happy that he can go in for his treatment on a Saturday (which is a semi-normal working day for them anyway), as a) he's an undemanding patient, and b) I'm used to acting as veterinary nurse for vein raising to insert the canula, so they can just hook him up to the drip and add drugs as and when it's a little quieter. As to Sundays (if there's any problem with the canula), they expect to be there for at least an hour or two most Sunday mornings, so that's not really a big deal.

She'll also speak to Gerry about the overall drug protocol (originally, he'd been due to drop to a timetable of alternating weeks - one week on and one week off ALL the chemo drugs) after 8 weeks of once-weekly vincristine. However, we'll need to review this as we dropped to once-fortnightly vincristine a couple of weeks earlier than planned because of his stomach upset.

Accidents

Jazz has been having a few bladder "accidents" throught the night recently. Sometimes, rather than get us up, we come downstairs to find wet bedding rucked up in his crate. Of course, we don't know whether this is because he's just not asking us for some reason, or because he just loses bladder control and finds himself with a wet bed.

Proactive drip a success

Well, the proactive drip seems to have worked: we've had no sickness, and only very minor bowel looseness today. Hooray!

First day on the drip at home

Got out the doggy bag of drug vials, syringes, fluid bag and giving set, mircropore tape, wadding a vetwrap to put Jazz on his drip, and rigged up a frame over his crate (actually a folding coffee table stand, on end) to hang the bag from.

Had a bit of trouble getting the drip started, but got help over the phone from one of the nurses, and got it going by using one of the syringes to withdraw some fluid from the bag (via one port) and adding it (via the drugs port) at the other end. I had tagamet and metoclopramide to give him via the drip too.

He had a couple of times during the day when he got a bit agitated - as a response to one of these I took him out in the garden and sat with him for a bit, with his drip bag hanging from a tree branch. And obviously, he needs reasonably frequent attention to make sure he hasn't squashed or kinked the tube and stopped or drastically slowed the flow (which was to set at 1 drip per second).

Having been rather slow at times all day, so that I'd been wondering whether we'd get through it all before bed time, at the end of the day the bag suddenly ran out before he'd had his last dose of drugs, so I ended up taking him to the vet so they could administer them using their ad hoc fluids bag to flush them through. I also learned how to do a subcutaneous injection in case I need to administer other drugs in future.

It's clear that this probably isn't something that we can do for him when he's just got Andy with him (especially as Andy will be working), but we'll sort something out about that later.

Blood test OK, so Vincristine again

Jazz went in for his Vincristine injection and drip today, and Fiona has also agreed that we can try having him on a drip at home tomorrow, as he's such a good patient, and at least that means that he's spending another day less of his life at the vet. If there's a problem with the canula and I have to take him back in, then we haven't really lost anything anyway. We've got another week booked off work this week to get some work done on the new house, so will be able to find out whether this is a viable option longer term.

So, she's left the canula in his leg, and added anti-coagulent to stop it clogging up overnight, and I have been taught how to connect up and adjust the drip, and how to add drugs (tagamet and metoclopramide) to the drip etc., so we'll see how it goes tomorrow.

Recovered, and with new treatment plan

Called in to see how Jazz was, and he's a lot better (not quite as bouncy as last time he had the magic drip, but (according to veterinary nurse Debs) he offered a paw and was happy to eat, and he's not "depressed" like he was yesterday.

Unknown to each other (until they got together) Fiona and Helen both decided that he'd be better on Vincristine once a fortnight instead of once a week, as spending 2 days out of 7 in the vet on a drip isn't much fun. And I suggested that we should try putting him on a drip proactively the day after treatment (instead of leaving it until he feels awful 2 days afterwards) to see if that helps.

We're all off to Stratford on holiday today, so I'll get a blood test done while we're away, with results to go back to Fiona, ready for next treatment on Monday (which will be 1.5 weeks after the last one, but Mondays are easiest, and we should also be off next week to try the "day after" drip too).

Back into the vet for another drip

Jazz got me up at 6:45am to be sick. He was then sick again at 8:00am, so I took him back into the surgery to go back on the drip again, and once more they kept him overnight.

Vincristine again

After a couple of blood tests that showed white cell suppression, the latest one was OK, so Jazz has been in for another Vincristine injection (with half a day on a drip as well as is usual now).