Kesey had his third round of chemo two weeks ago (carboplatin again).  No real issues with it.  The internist at our local vet administered the chemo and we still really, really like him.  Kesey gets acupunture once/month now and I think that’s the schedule we’ll continue with.

We saw the internist for some bloodwork and x-rays yesterday, b/c Kesey has been coughing and hacking and breathing heavily.  It looks like he has an infection.  His temperature was a little high.  So, we’ll start him on antibiotics today.  Yesterday was the first time we’ve had to ask for a quote before moving forward with the tests.  What a terrible feeling…and we’re not even three months in.  We’ve used up all of the funds allowed through our pet insurance, so we need to be more careful about costs now.  The insurance only paid 70% to begin with, but that made it much easier to not worry too much about expenses.  Looking back, I should have been more careful with spending in the beginning – we saw three oncologists, got a number of opinions, etc, and it was expensive, but in the end we felt confident about the decisions we were making…now we just need to figure out how to fund those decisions.  I’m sure it will work out, but I don’t like that cost is becoming such a factor in our decision making process.  We’re already stressing out about Kesey’s fourth, and final, round of chemo.

The good news is that Kesey’s lungs look good other than the infection.  And he really is doing quite well.  He eats like a champ, gets excited to see new people, and is generally happy.

Yesterday after the vet, we went to pick up G from his grammie and grampie and G walked up and gave Kesey a hug and said “how’s my good buddy…you going to be oookay Kesey.”   He wasn’t questioning, but trying to reassure Kesey.  G just doesn’t know to use “you’re” instead of “you.”

Our internist says he plans to get in touch with Dr. Sivula at Dancing Paws…he seems genuinely interested in holistic treatment and that makes us very happy.

Kesey has been falling more than I would like recently.  His front leg just kind of falls out from under him sometimes, and then I see his face hit the ground.  It’s very, very hard to see, and makes me sad.  That said, we continue moving forward and we’ve been taking more and more walks.  The other day I had G in the stroller, and Kesey on leash and we were walking up the street, when I noticed that a random, unknown Lab mix was following us.  It seriously freaked me out, b/c Kesey is rather defenseless and I had both him and G and myself to keep safe.  I was probably overreacting when I called L to come and pick us up, but I didn’t want to take any chances.  Plus I’ve seen that look Kesey gets when he feels at all threatened…I guess “defeated” is a good way to describe it.  I guess that’s to be expected, but it’s hard to see our very courageous and strong pup feeling sad.

We’ve known all along that Dr. Sporer’s office works with an internist who can administer chemo and advise us. We just felt that we needed to work with an oncologist.  Now that we’ve met some oncologists and been to Medvet for one chemo treatment, we feel fairly confident that we have learned what we need to know about the treatments.  And we’re not in love with any of the oncologists, so we decided it would be in Kesey’s best interest to have future chemo treatments done in Dr. Sporer’s office.  As a first step, we met with the internist and introduced him to Kesey.  We actually really like this doctor.  He recommended carboplatin for treatment, and said he would not use adria.  Thank goodness…b/c we are just pretty freaked out by the adria.  He also said that Kesey seems to be doing very well. I asked him how he feels about us using holistic treatments in conjunction with chemo and he said that he thinks people do not use holistic enough and he’s so happy we feel so strongly in favor of it.  What a relief to hear him say this!  Another question I asked him was if a tech will stay with Kesey the entire time he’s receiving the chemo, and he said absolutely yes and that he also stays with Kesey the entire time.  Awesome.  At Medvet, it’s a tech who stays with him, no vet.  I should note that we had no problems with Medvet, we just didn’t feel any real attachment to the practice and we weren’t willing to give up holistic options as we were told we would need to do.  We love that there is a dedicated cancer center and that the office is spacious and bright, but as far as Kesey’s care and comfort, we trust Dr. Sporer more than anyone else and we know that if we go with her office, we’ll have her, Jess and the internist all looking out for our special guy.  And I know Kesey will be comforted by Dr. Sporer’s and Jess’ presence.  And we’ll be about five minutes away from home…make the treatments less stressful for all of us.

So we have an appointment to see Dr. Sivula for acupuncture Monday.  They are opening early to fit us in.  Such amazing people there!  Hopefully the acupuncture will help build up Kesey’s immunities.  And then we have chemo Tuesday.  I am not looking forward to the chemo, but again, it is only after extensive research and soul searching that we are making the decision to continue the treatment.  One dose does virutally nothing to help.  Two doses should help to lengthen his life.  And four doses is the max we will do.  There’s a chance, however, that we’ll stop after two.

I don’t think I’ve shared the website for the dehydrated raw food we’ve been giving Kesey.  It was recommended by Dr. Sivula, and we LOVE it.  We feed Force from Honest Kitchen, and Kesey cannot get enough of it.  Franklin and Millie drool over it too, but they don’t get much b/c we just don’t have the budget to feed all three of them this.  For Kesey, I usually mix in some chicken breast, cottage cheese, fish oil, and his acidophilus.  He gobbles it up.  I feel very guilty giving Franklin and Millie boring, dry kibble.  Maybe I can find a way to feed them Force for one of their daily meals.  Franklin has sensitive skin and a sensitive stomach, so I know it would be very good for him.  Currently, Kesey gets Evo dry in the morning (b/c we bought a large bag and needed to use it up), and then his special Force combo dinner.  I’d like to switch Millie and Franklin to Orijen, a dry food I’ve really come to love, for breakfast and a Force combo for dinner, while feeding Kesey a mix of homemade and Force.  Just need to play with our budget a bit.

Aren’t those two adorable?  Franklin has always liked to snuggle up as closely as possible to Kesey.  Kesey doesn’t seem to mind, or if he does, he doesn’t ever say so.  Sometimes Franklin tries this with Millie, but she likes a lot of personal space, so she doesn’t let Franklin stay close for too long.  I don’t know what Franklin’s going to do without Kesey.  I guess I don’t know what any of us are going to do without Kesey.

Yesterday we went to see Dr. Sivula and Kesey got some acupuncture.  He seems to enjoy it.  All went well there and we continue to love that office and everyone in it.  We saw some other pups using the underwater treadmill, and I am excited for Kesey to get his chance in there once he builds his immunity back up.

Early today we took Kesey to see Jess (Dr. Sporer wasn’t in) for some bloodwork.  Awesome Jess came out to our car with a tech and they did the blood draw right there.  Jess hopped right in to cuddle with Kesey – the back of our car is official dog space and filled with dog hair covered blankets and covered in dried on doggie drool.  I’m not sure I’d get in back there, so this is just further evidence of how awesome Jess is and how she’ll do anything for Kesey.  We didn’t want to take him inside the clinic b/c today is the day his white blood cell count should reach it’s low point.  And today’s blood test will tell us just how low that count is.

Yesterday, Dr. Sivula told us that he thinks Kesey looks terrific and that he seems to be handling the chemo very well.  I tend to agree.  It was a rough couple of days, but Kesey is back to his happy, easy going, food motivated self again now.  We talked with Dr. Sivula about options for future chemo, and I think he helped L and I to come to the conclusion that Kesey would be best suited for treatment at our local vet…Dr. Sporer’s office.  There is no oncologist there, but they have an internist who comes to the office for things like this.  Kesey is so comfortable there and I would be sure to schedule his treatment on days that Dr. Sporer and Jess are there to provide just a little extra comfort (to both me and Kesey).  Ultimately, this makes the most sense.  I struggle with moving to an internist rather than an oncologist, but the fact is that we know we want to use Carboplatin only.  I’m not interested in adria at all.  And we know we want as few treatments as possible…a maximum of four…and we know what we need to do for follow-up care, so I think b/c we’ve met with so many oncologists and done so much research, we really just need someone who will administer the drugs, communicate effectively with Dr. Sporer, and agree to allow us to use holistic treatments in conjunction with chemo.  So, this all makes sense to me.  Now, I just have to talk with the internist and make sure he’s on board with all of these things.

This morning, he woke up with a gooey, yucky eye infection.  We took him to the vet.  Our regular staff wasn’t there since it’s a Saturday.  I had hoped they might be able to examine his eye in our car, but we had to take him in one of the exam rooms.  We actually had to take him in once, then were told it would be quite a while, so best to take him back to the car, then we took him in again about 30 minutes later.  I felt awfully anxious the entire time, b/c I don’t want Kesey to have an eye infection, b/c his immunity is low b/c of something we did to him, and b/c now he’s being exposed to all of these other diseases/infections.  Hopefully this will be the worst thing we have to deal with.

New deck – just lattice needs replacing now.  I’m excited to share that Kesey is navigating the new stairs very well!  He’s slow moving, but he can get up and down w/out much trouble at all.  L and my dad are so awesome for building the stairs for him.

Kesey enjoying the lower deck now that he can happily use the new stairs.

This afternoon we all spent some time outside together.  We aren’t using the dog pool right now, so Franklin decided he might like to cool off in G’s sand and water table.  He’s not the brightest dog (by far), but he is the funniest.

Frankin: “Think we can jump up there and get in?”

On another note, last night I hosted a Pampered Chef party to benefit the Humane Ohio campaign to “Raise the Roof.” I planned this before I knew Kesey would be having chemo this week.  I was a little worried about all of the commotion, but all seemed to go well.  If anyone needs Pampered Chef products, let me know.  I have info about a really great raffle that raises funds for Humane Ohio if you might be interested in that.  And if anyone wants to host their own party to benefit Humane Ohio, let me know that too!

Yesterday I saw Len with this pencil sticking out from his ear.  I couldn’t help laughing.  He said “it’s a carpenter’s pencil,” and seemed just a little embarrassed.  I asked him if it came free with the wood purchases, and it didn’t.  He literally bought this to use on the deck remodel.  I think he even sharpened it using a knife.  It’s really quite adorable.

Deck’s looking a lot better, isn’t it?  The stairs are so nice.  L still has some work to do – adding the railings to the stairs, doing something about that awful lattice on the bottom, and finishing the railing on the upper deck, but I’m so happy with the progress.  We’ll also add some no-slip something or other to the stairs to make it easier for Kesey to use them.  And it’s hard to see b/c of the sunlight when I took the photo, but there are these really cool beams on top of the deck, and we’ll use those to hold some kind of fabric to create some shade.  My dad has been a huge help with the entire project, but I’m really proud of L’s skills too and I love him so much for getting this project done so quickly for Kesey.

So, we show up at Medvet, meet with the oncologist, talk thru options.  She recommends a combo treatment of adriamycine and carobplatin.  Adria can effect Kesey’s heart.  He’ll need to take antibiotics b/c it will kill so many white blood cells.  When we take him for his follow up blood work w/Dr. Sporer, we need to run him in quickly and leave right away so he doesn’t pick up any disease at in the vet office.  The more she talks about this treatment, the more sick I begin to feel and I wish we could all just leave.  So, the recommendation is adria yesterday, come back in two weeks for carbo, come back in three weeks for adria, back in two weeks for carbo, and continue this until we’ve had a total of six treatments.  In total, this would stretch out for more than four months.  Ugh…hating the idea more and more.  The oncologist in Akron recommended 3-4 treatments of carbo only, each three weeks apart.  Now that we’d worked so hard to go to medvet b/c we liked the overall office so much better, I’m wishing we were doing carbo only and wishing we were in Akron.  Also, this doctor does not want to work with holistic meds and tells us not to use any of them.  Why didn’t I ask about this before???  Why am I so unable to make a decision and feel good about it?

G is with us in the exam room and he and I ended up leaving b/c he would not stop talking and if we left at least L could pay attention to what the doctor was saying.

So appointment ends and L, G and I leave Kesey there for his adria treatment.  L and I feel literally sick and so sad and so full of regret already.  We meet some favorite friends, Anand and Madey, for dinner at Northstar.   As we pull in, my phone rings.  Kesey’s ECG showed an irregular heartbeat and after running it by the resident cardiologist, the oncologist decided using adria would be too risky.  They recommend a full cardio work up (but cannot do it until another day) and meanwhile recommend starting with carbo.  Feeling even more sick now b/c Kesey’s heart has something wrong, and now we’re poisoning his body with chemo.  I do feel a tiny sense of relief is using carbo instead of adria though.  At least this will give us the option of having future treatments in Akron…if the Akron doc will see us since we started somewhere else.  And poor Dr. Sporer worked so hard to get us in to the Columbus doc, but I think/hope she’ll understand if we want to change the plan.

So we finish dinner and go to pick up Kesey.  He seems okay.  L and I are sad.  We decide to drive home rather than stay overnight.  Kesey needs a good night of sleep and we’d all rather be home.  When we got home, Kesey wouldn’t even stand up to get out of the car.  L got him up finally.  We came inside, gave him a little food and all went to sleep.

L and I have not slept in the same bed since Kesey’s diagnosis.  L sleeps on the first floor with Kesey.  I sleep on the second floor with G.  L said Franklin slept snuggled up close to Kesey all night.  I love Franklin for that.

This morning Kesey ate some canned food and he just went outside to lie on the deck.  I think this is a good sign.  Still,  I’m worried about him.  I’ll be home working all day, so will be close by to keep an eye on him.  L’s heading out to get some things including the rubber gloves we have to wear when handling Kesey’s nausea meds.  Seriously…we have to wear rubber gloves.  I can only imagine what that means about the way the meds will affect Kesey.

So to reiterate, cancer and chemo suck.  And I will clearly never be okay wtih any decisions we are making.  But I do hope that Kesey gets thru this okay and then we can decide on next steps.  I think what I do know for sure is that we will find a way to incorporate holistic care into whatever we are doing.  I’m just not okay leaving that out entirely.

Dr. Sporer seemed a bit alarmed at waiting until next Thursday too, but also hated to see us not be able to go for treatment where we were all most comfortable.  She made a quick call to Medvet and worked her magic to get us in tomorrow!  Awesome.  While she was on the phone, Jess was giving Kesey a bath.  I am so grateful for both of these amazing people.  Kesey smells so good and has to feel so much better.  We are admittedly not frequent dog bathers.  I mean they might get four baths a year max, but Kesey hasn’t had a bath yet this summer, and he really needed it.  I just feel better putting him through chemo feeling as good as he possibly can going into it.

We left with instructions from both Jess and Dr. Sporer to call and let them know how things go tomorrow.

We’ll stay in Columbus tomorrow night and hopefully see some friends for dinner, and we’ll definitely have to make a Pattycake run.  I’ll be super anxious until we know Kesey handled the chemo okay, but I have to tell myself that it’s all going to go well.

I have a call in to Dr. Sivula b/c I really want to get some “next step” advice from him.  I have all of these holistic treatments in the kitchen, but am not sure how to use them in conjunction with chemo.  He is leaving town tomorrow and we won’t see him again until July 14th, so I hope to talk with him before he leaves.  If we aren’t able to get in touch with him, Dr. R from CA should be back in town relatively soon, so we can hopefully talk with her about combining holistic with chemo.

I need to remember to ask about heartworm prevention too, b/c Kesey didn’t get it at all in June and now I think we’ll need to wait until after chemo.  I always forget to ask about this one for some reason.

As I type, L is outside building the deck.  The steps are done and the rest will come together soon.  It’s going to be awesome…just hope Kesey agrees!

His smile is back.

As I’ve mentioned, Kesey had never turned down food in his life, so his refusal to eat throughout the past two weeks had us very concerned.  We took him off his antibiotic and he is nearly back to normal…he’s even eating kibble!  He does still leave a few bits of food in his bowl, so that’s strange, but he’s eating at least as much as he was pre-amputation.  We’ve been feeding him a mix of different grain free canned foods, Evo kibble, dehydrated raw, and homemade foods including chicken breast, cottage cheese and eggs.

Friday, my mom and I stopped to check out the grain free options at the Clipper Cottage (my parent’s Cocker, Zoe, has her hair styled there).  They had a wide variety of options, including some I had not seen elsewhere, Orijen and Taste of the Wild.  They also had some canned tripe, which I’d read no dog would refuse, so I picked up a can of that.  Now that I’ve read more about what it is, I’m totally disguted by it and am not sure I’d buy it again.  Also on the shelves, were dog treats made from Tripe.  I brought a few samples home and Kesey devoured them.  He did not eat the other sample treats I brought for him.  Clipper Cottage was awesome b/c they had so many free samples…we will be trying lots of new foods in the coming days.

L is building new stairs on our deck as well as doing some general improvements b/c the entire deck is quite unsightly.  Our backyard is inaccessible from our house without use of the deck, which is elevated about 5 feet off the ground.  The current stairs are kind of rickety (and terribly ugly) anyway, so this was a project that’s been needing done.  L’s making the stairs much wider and longer, closing them in, and in general just trying to create a way for Kesey to reach the backyard.  If Kesey can’t use the new and improved stairs, we’ll continue taking him out front, but it would be nice to avoid that and it would be nice for Kesey to feel a little more “normal” too.  Today my dad and L worked on the stairs most of the day.  The new ones should be ready to go tomorrow.

Kesey hung out in the backyard with us all day today.  He seemed very happy to spend time under his favorite tree.  Later this afternoon, Kesey and I went for a short walk – about 10 minutes round trip.  Kesey definitely had a little spring in his step, but he tires quickly.

Here’s another shot of his incision site…looking good, isn’t it?  I expect the remaining staples will come our when we see Dr. Sporer Tuesday.

Okay…so Jess takes us to the exam room after stopping at the scale.  Kesey has lost nearly 10 pounds since before the amputation.  Not good.  We spend some time talking with Dr. Sporer and Jess and Dr. Sporer says she thinks Kesey looks great.  She said the incision site is looking very good, but not ready to remove the last of the staples yet.  She was clearly not thrilled about the discontinuation of the antibiotics, but she does understand that time is kind of important if we’re going to do chemo.  She gave us a topical antibiotic to use instead, and we were all happy with that.

I asked about the groomers at the vet office – it’s one of those full service practices with vets, grooming, boarding, 24 hour care.  Dr. Sporer said she and Jess would be happy to give Kesey a bath for us.  How awesome is that?  I’m not comfortable doing this for Kesey b/c I don’t want him to fall and I’m nervous about his incision site.  But he needs a bath and I know he’ll feel better if he has one.  And he loves Jess and Dr. Sporer, so if Jess does this for him, with a bit of assistance from Dr. S. if needed, it’s honestly perfect.   They have a great non-slip tub and can do this safely and I know Kesey will enjoy the time with them.  We did take them each a bag of treats from Heidi’s as a general thank you for being so awesome, so that may have had something to do with them making this amazing offer, but I think they would have offered anyway, b/c they seem to love Kesey so much.

So, we talked with Dr. Sporer about chemo and how impossible we were finding it to make a decision.  I said that one of things I’m really struggling with is that we amputate Kesey’s leg and I feel like b/c of that, maybe we really should consider chemo, b/c I want it to be worth it for him.  She made me feel so good b/c she said that if we had not amputated, we would likely have been taking about whether or not to euthanize him yesterday rather than whether or not to do chemo.  I knew we were making the right decision with amputation, but it’s hard to not have doubts sometimes, so this was very helpful to know.  She said OSA is incredibly aggressive and the pain is unbearable, so we had to amputate.  I agree.  So we talked about chemo and she recommended doing it.  I could tell she was trying to be careful to not cross that professional line and get too personal, but it’s easy to see that this has become personal with the five of us who were in that exam room (me, L, Jess, Dr. Sporer, and Kesey).  We all connect very well and we all have Kesey’s best interest as top priority.  So, Dr. Sporer said that it’s certainly our decision, but if Kesey were her dog, she’d do chemo.  I have to say that hearing this from Dr. Sivula and Dr. Sporer has us leaning HEAVILY toward giving it a try.  I just felt such a connection to both of these vets and I feel like they really connected with Kesey too.  I trust them both and I like that one is holistic and one is traditional and they both had the sense that Kesey would be okay with chemo.

The one thing truly holding me back is our conversation with Dr. R. on Monday.  She made such a good point about Kesey not handling the surgery and antibiotic well and what sign that might be of how he would handle chemo.  That makes a lot of sense to me, and it makes me feel very cautious.  This is definitely not a decision we will make lightly.  But I am coming to think that overall we do not want any regrets.  We can try chemo once and if Kesey has a bad reaction, that’s it, we’ll never ever do it again.  But if we never try and he leaves us in a few months, I think we will have tremendous guilt and will regret not giving him the chance.  So, right now I’m in the process of deciding between Medvet and our local oncolgist.  I’m leaning toward Medvet – even though it seems crazy – but I just felt so much better there and so did Kesey.  Need to find out how many treatments they recommend and how long in between, etc.

Oh…important note: Dr. Sivula told us about another grain free food from Wellness.  It’s called Core, and I picked some up for Kesey.  He has had it twice now, and both times gobbled down the entire can!  I’m sure this is a combo of the nux vomica, acidophilus, acupuncture and discontinuation of the antibiotic, but he does not gobble the Evo at all, so I’ll be picking up more Core today as well as some more chicken breast – hopefully pre-cooked.   Things seem to be looking up.