Wednesday, April 22, 2009

Unstitched

Today Chandler had his follow-up with Dr. Rocha and received the second of the four vaccinations for melanoma. Dr. Rocha was very pleased with how Chandler was post-operation. I told him that we re having trouble keeping him from wrestling with Riley and that he is eating like a horse.*

After the quick once over, Dr. Rocha took Chandler downstairs (they have a huge space downstairs for all the work beyond a simple check-up) to get his vaccination and his stitches removed. A few minutes later, Heather (the Onocology resident) brought Chandler back upstairs vaccinated and stitch-free. Without the stitches, he looks even better.

It was rough waiting for him while he was downstairs. Not because I was worried like the last time I had to wait there (that seems so long ago), but because I heard some other pet-parents sniffling and tearing up. I am a very empathetic person (shock, I know) and being around that was hard. I knew exactly how they were feeling.

Chandler goes back in 2 weeks for his next vaccination and then again 2 weeks after that.

*Chandler WAS eating like a horse when we were giving him wet food. Now that he is back on kibble, he is none too happy. When he gets hungry, he'll eat.

Monday, April 20, 2009

Improvement

Chandler is doing unbelievably better. It is almost as if the surgery never happened. If his face weren't half shaved and he could hold it longer before having to go outside, it would be like nothing happened. He is eating like a horse. I know some of that is because he is getting squishy food rather than kibble, but he is seemingly always hungry. For those of you who know Chandler, you know he is a pick eater and can often go a day or more without eating. He spent a lot of time outside yesterday. He even walked, without prompting or encouraging, to the lower level of the back yard. Prior to the surgery, he didn't do that.

I could not be happier about his progress. He is off his antibiotics and one of is pain pills. We are also weening him off his final pain pill. Tomorrow should be his last day on it.

Thursday, April 16, 2009

"HEY!!!-- Break It Up, Break It Up!!!!"

That's what I heard Michael screaming this morning as Chandler instigated a bit of rough-housing play with Riley. That's right- not the other way around. Clearly Mr. Yorkie-turned-Chinese-Crested is feeling much better, and we couldn't be more thrilled. Still-- lots of wound healing to go and suture removal isn't until next Wednesday, so we need him to stay nice and calm-- no jumping or rough-housing. And the weather is spectacular here and going to be so for the next few day, so try to keep him from chasing squirels and such in the yard... this should be our only problem with him, right?

I just got off the phone with Dr. Rocha (Oncologist)and we reviewed Chandler's final pathology report of (totally benign) fibrosis in the urinary bladder- so that's nothing to treat. We also reviewed the pathology of the tumor and affected lymph node in the neck which were very positive for malignant melanoma, but also significant for a clear margin on both; implying that the whole cancer plus a small bit of the healthy surrounding tissue is out. We like to have clear margins in medicine because that implies that you got the whole tumor and a perimeter of healthy looking tissue that might not be healthy. Meaning, even though that perimeter looks normal the cancer may have spread into those cells on a microscopic level, but not to an extent that we can see it. Given the very fast and high rate of spread with malignant melanoma, this is how it comes back over and over again, and how it spreads to other organs/tissues so quickly.

Normally they like to get a 2 cm margin. However in oral cancers (even in larger breeds) that's anatomically restricted. In Chandler, they got a 3-4 mm margin. Still, because the adjacent lymph node is affected, he's an advanced Stage II. Dr. Rocha said that Chemotherapy is off the table and it doesn't work in dogs in melanoma.

So he presented us with the following options:

1) Do nothing at all. Avergage survival would be 3-6 more months with likely mets to the lymph nodes and/or lung.

2) Continue with the oral melanoma vaccine only (i.e., no radiation therapy.) Chandler received the first vaccine at surgery and will get the 2nd one next week. He will get two more, thereafter, for a total of 4 vaccines every 2 week. Then, assuming he responds and is well, he will continue with 6 month "boosters". Most dogs who respond will survive between 6 months and 1 yr on this. However, it's important to realize that not all dogs respond to this vaccine therapy.

3) Vaccine therapy with radiation of the primary oral site and radiation of the adjacent lymph node chain. At a cost of $8,000 - $9,000, raditaion will administered in 18 individual week day treatments (he gets Saturday and Sundays off). Statistically, this increases survival (if the dogs responds) to between 1 - 1 1/2 years. How it works? Well, Chandler will start to feel a burn at the end of week 1 and this will intensify progressively through weeks 2 and 3. The burn from the lymph nodes is said to be akin to a bad sunburn with local sensitivity and not much else. However, the oral burn, while better tolerated in larger breed dogs, is very poorly tolerated in small/toy breeds, like Chandler. Dr. Rocha said that by week two of therapy, expect a period of a minimum of 2 but (more likely) up to 4 wks of debilitating pain. This often results in the need to place a feeding tube as the dog can no longer swallow and it's agonizing. Often, they need to place it via the stomach as an NG (nasogastric) tube is physcially too irritating to the dog to tolerate going down into the stomach. I have to say, I really, really, REALLY pressed him for his opinion. He said that, in his experience, owners who have opted for oral radiation often are left (in the end) questioning, "Why did I put my baby through that?" I said, "Really?" And he said, "In my opinion, radiation of the oral cavity in small dogs is ethically highly questionable."

4) Vaccine therapy with radiation the adjacent lymph node chain, ONLY. Also the same cost of $8,000 - $9,000, raditaion is administered in same pattern of 18 individual week day treatments. This works the same as above-- just feels like a really bad sunburn and the skin needs to be tended with moisturizer, but it has NO EFFECT on appetite, level of activity or alertness, and even little dogs handle it well. If this works, it can potentially take hi survival to "better than 1 year", provided the non-irradiated primary oral tumor doesn't regrow (since we're not irradiating it.) Otherwise, that one spreads and then we're back in the 6 months range.

So... quite the questions here. Assuming the astronomical cost of this weren't a factor, it all seems like a big crap shoot in a 14 year old dog. We certainly have a LOT to talk about.

ONE MORE THING: We're putting this out here to help ourselves and others. We're trying to share information, in part, with the hope that someone else, somewhere else, someday whose beloved little angel also gets this horrible disease will have a resource into the present day treatment options and though process of pet-parents who are struggling with difficult issues. Michael and I request that you respect our privacy and not post opinons about treatment. This is a very personal process for us and our family and we need to come up with our own answers and options. Thank you.

Wednesday, April 15, 2009

The Best News!

Dr. Kyles called this evening. He got the results from the pathologist. The mass in Chandler's bladder appeared to be just a fibrous mass, no evidence of a tumor. And even better news is that the report showed clear margins around the oral melanoma he removed. In other words, Dr. Kyles got the ENTIRE tumor out of Chandler.

Tomorrow we'll talk to Dr. Rocha and decided if we need to proceed with radiation at all.

This is the absolute best report we could have gotten.

I am beyond relieved. I didn't realize how tense I was about this until I spoke to Dr. Kyles. I feel like a massive weight is lifted. And that I felt that way when we brought him home only shows how completely flattened I was at the start of this episode. So Chandler had the bladder surgery for nothing, but I am happy we did it to make sure there was nothing there.

Leaps and Bounds

Chandler is getting better every day. It is amazing how quickly he is bouncing back.

Yesterday I had him with me in my office while I was working. One second he was in his bed, the next I looked and he was gone. The little monster had actually gone back downstairs on his own. And during one of his walks, he went up the stairs into the house on his own.

Last night I slept on the couch just in case again. I am happy to report that Chandler slept through the entire night. He didn't even use the pee-pee pad in his pen. YAY!!!

Tuesday, April 14, 2009

P.O.D. # 3

Chandler did very well on post-op day #3. He's getting a bit more comfortable with the idea of peeing on the wee-wee pads, though he's so well house-broken that he still whines and struggles with it before allowing himself to do this. I came home late from work on Monday night and so we all had short, little time together on the couch. We caught up on In Treatment on HBO On Demand, and then I nodded off on the couch, as I often do. It was nice having us all there together on the couch... Michael took a video of it:

video

Then we took Riley and Phoebe out for their night walks and it was my night to sleep downstairs with Chandler. Michael needed to catch up on a GOOD night's sleep. Chandler started off whining so I put a wee-wee pad on the couch and let him lay on it, with me. He fell asleep immediately. I was trying to fall asleep but his snoring was kind of loud. Also, I was afraid he'd do (what he's been doing lately) which is to suddenly wake up and literally jump up. We have to grab him when he does this to stop him from falling off the couch! So I took pillows from the other couch and lined the floor next to the couch we were on with them and then wee-wee pads, just in case he jumped off. So now we had the "barrier" for his protection. Still, I was dozing and knew I needed to actually sleep. I figured that if I took him now, at midnight, he'd pee, poop and if I returned him to a dark room into his crate, he'd just fall asleep. And that's what happened. YAY! I had a hard time falling and staying asleep--- I'm a little too long/tall for the couch. So I tossed and turned until 3:30 when Chandler started to really get fussy. As soon as the whining started, I took him outside for another peeing session, put him back in bed and then started to fall asleep myself, finally, at 4 AM.

That's when, from upstairs, I could hear Riley. Riley started crying all night. He's still a puppy, so we have to let him cry and try to fall back asleep and not think he's gonna be able to wake us up when he wants something. When we got up at 6 this morning, it turns out that Riley wanted water... poor baby. Oh well.

Most importantly, it's Tuesday morning, P.O.D. # 4 now, and Chandler is doing even better than before. I have full confidence in his recovery from the surgeries.

Monday, April 13, 2009

Update

I spoke to Dr. Rocha, the oncologist today. We need to wait until the pathology reports come back on the tumor, lymph node and bladder mass before determining what to do next for Chandler. Radiation will have no effect on the bladder mass if it is cancerous, it will only be for the melanoma. However, before we can even begin that, the wound has to heal completely, so at least 10 days to 2 weeks.

Ethan and I were prepared to cancel our pending vacation because of Chandler's health. If starting the radiation when we were gone would make a difference in his prognosis, it would have been a no brainer. But, Dr. Rocha said that we could start it when we return without it hampering his recovery.

Weekend Video

It's a day or two late, but I can't seem to make my FLIP video camera work with the MACs at home (GRRR!) So I'm uploading this at my office. Hopefully, this will work so you can watch how he progressed over the course of the weekend! YAY!
video

First Night Home

Last night was Chandler's first night home since the surgery.

We kept him penned up most of the evening, so Phoebe and Riley wouldn't get too into his business. Every time he made a sound, Phoebe ran to the pen to make sure he was OK. It was sweet how concerned she was for him. But between him whining, Phoebe growling and Riley being a puppy, it was exhausting. We finally let him sit on the couch with us and the seemd to calm him down. He slept a bit, ate a nice size dinner and slept some more.

Unfortunately, we need to keep him penned up at night, so he doesn't pee on the floor. As he doesn't like being penned up, I decided to sleep in the den with him. We went out for a last relief walk around 11:30. Chandler went right to bed with no fussing. Around 3:45, he woke up and stared whining. We went out, he did his business and then back to bed. He slept until 6:30, when I got his brother and sister up to go out.

All in all, a pretty easy over night. I slept more deeply than I have in a week. Deep enough to dream and feel refreshed when I woke up. It just feels so good having him home.

Sunday, April 12, 2009

Vaccine

I've mentioned that Chandler is starting a vaccine therapy for his cancer. I know we usually think of a vaccine as something to prevent a disease, that you get before you contract the disease. However, there is a canine melanoma vaccine for dogs who have had melanoma. It is a series of 4 shots spaced 2 weeks apart. For more information on the vaccine, go here.

He's Home!

We brought Chandler home today.

We called the hospital at 9:00 this morning and talked to the doctor on duty. She told us she had checked Chandler over and he seemed to be doing very well. They were starting to reduce his pain meds in the IV so we could likely take him home. She added that she thought some of his crying was about being in the cage. She assured us that when we got there, we would go into a room with Chandler and assess for ourselves his pain level.

We got to the hospital around 1:45. We were led into a room and after a minute, JoJo, the nurse on duty, brought in Chandler. He looked so much better. We put him on the ground and let him explore the room. Not a single yelp from him. So, we knew he was good to go. We took him upstairs to wait for his discharge papers and medications. He started to cry a little, so I took him outside. He was soo happy to have fresh air and walk around. He peed and then calmed down.

On the drive home, Chandler fell asleep in my lap. I think he and I both needed that. Now he is home and resting in a penned off area. Phoebe and Riley were so excited to see him. And of course Phoebe went into nurse mode. Everytime Chandler would make a noise, she rushed over to make sure he was OK.

It feels so good to have him home and our family complete again. Tomorrow I will find out when he sould start radiation and the details on the program. But for now, I am just enjoying having Chandler back. Medicine only can do so much, now it is all about love.

Saturday, April 11, 2009

Third Visit

At 8:00, Ethan called the vet to check on Chandler. Clarence, the night nurse, told him that he tried to feed Chandler, but that he didn't eat anything. Ethan and I decided to see if we could get him to eat. We hopped in the car with some freshly made food, courtesy of daddy Ethan (ground up chicken, rice, sweet potatoes, carrots and peas) and headed back into the city.

When we got to the vet, Chandler was actually pretty quiet. He got a little worked up when he saw us, but nowhere nearly as bad as this afternoon. Clarence told us that Chandler had been pretty quiet for a while, and when he got wound up, Clarence let him out of the cage to walk around a bit. Chandler peed on the floor apparently, but being out of the cage helped calm him down.

Unfortunately, Chandler didn't eat that much. He took a few small bites, but not nearly what he did this afternoon. But he laid down in my lap and slept for a minute or two. It felt wonderful. Ethan and I were there for about 20 minutes and the decided to let Chandler rest more. When we put him back in the cage, he didn't get too worked up. And he was actually quiet when we walked out of the patient care room.

Tomorrow he should be coming home. Hopefully when they taper his pain meds tomorrow he can tolerate it. We know he will have some pain, but right now it seems as if a lot of the crying is about being caged up.

Quick Thank You

I just want to thank everyone for respecting our wishes and not calling for status reports. It is hard enough being in the middle of it, but to have to rehash it over and over is really horrible. The love and support we are getting from everyone is amazing and so appreciated. Not having to go over the medical issues repeatedly is even better.

So, thank you all. Please keep the good thoughts coming. And of course we will keep you all posted on what happens next.

Michael's afternoon visit

After work today I went into the city to meet Ethan at the veterinary hospital. I had already seen the photos of Chandler, so I was somewhat prepared. I cannot explain both the relief and sadness I felt at seeing Chandler. He was making a sound like I have never heard him make before, almost like a dying goose. Ethan showed me how to pick up him so as not to contact the surgery sites. I picked him up and sat down on a stool with him. It felt so good just to have my baby in my arms. I couldn't cuddle him and squeeze him like I wanted to, but holding him was amazing.

Chandler hadn't eaten anything since 10:00 Thursday night, so we needed to get him to eat. Ethan tried giving him baby food this morning, but he didn't take it. I put some of the baby food on my finger and Chandler readily licked it off. He ate several tablespoons of food this way. And now with the food in his stomach, they could give him more pain medication. Shortly after eating, Chandler started making that sound again, so we put him back in his cage as we knew he had to urinate. He definitely didn't want to. I think the pain he is feeling is from the bladder surgery and right now, peeing is very uncomfortable for him. There was a little blood in his urine, but we were expecting that. Once he finished I put him back on my lap. He was quiet for a few moments and put his head down on my hand.

We stayed with him for a few more minutes and then left as he was getting a little fussy again and we wanted him to rest. As we were leaving he started with the sound again. Ethan saw I was getting upset and told me to wait a sec. Once we were out of sight, Chandler quieted down.

It is such a relief to see him being active. However, I want him home. And still I know, he needs to be there. Once his pain is managed, then we can get him home. I miss him so much, but I know he's coming home soon. I want it to be a few days from now already so that he is over the hump with the healing and the pain. Seeing him all bruised and shaved is so hard. What is even harder for me is knowing that Chandler was not in any pain when we brought him in and now he is. I know what we did is for the best, but seeing him like this is so difficult. In my mind, he is thinking things like, "why did my daddy leave me here?" "why did he let them do this to me?" "does he not love me anymore?" I know that is not happening, but I still feel like it is. I just want him to know how much we love him and that we did this because we love him.

The best part of today though, was that I got him to eat. You cannot understand the joy I felt knowing that I got him to eat. This is going to help him so much. And it helped me as well. I feel like I did something to help him and heal him. It got rid of some of the helplessness I had been feeling. It gave me such comfort to feed him. And I like to think it gave him comfort too, having his daddy there taking care of him.

Ethan told me what a stark contrast it was between this morning and this afternoon. I am so thankful that Ethan took charge this morning. What a long week this has been.

Post-Op Day 1 (P.O.D. 1) Ethan's AM Visit

I was on the train on my way in to see Chandler before heading to the office (need to catch up on work that piled up this week) when Michael called me to say that Dr. Kyles called to say Chandler was up, well and looked like he might even be able to go home tonight. Only thing, they're having trouble getting him to eat. So, on my way up 9th Avenue, I stopped off to get a Chicken-flavored baby food for Chandler, since he usually can't resist that stuff.

As they brought me downstairs to the inpatient unit (what an ENROMOUS HOSPITAL and unit, btw...) I heard this awful sound of crying. I thought it was Chandler and when I turned the corner and saw him, it was! He looked so horrible. Shaved for surgery, sutures everywhere, blood-tinged urine stains on the wee-wee pad... he looked as bad as I've ever seen a dog. He recognized me immediately and ran up to the front of the cage and the crying and the noises started to get louder and faster. This was very upsetting. After some attempts at licking me and such, he started to try and escape the cage. I decided that first I'd try to feed him. He was interested in the food as I was preparing it and taking it out of the jar but he wouldn't eat it. I put a little on my finger and he took the tiniest few licks but ran away and yelped each time. I assumed that meant that it hurt him to swallow it (there are incisions IN the mouth, too) so I abandoned that approach.

Next, I asked the handler if I could learn how to lift him and have him sit on my lap. This was not as easy as it should be for an 8 lb dog. Especially with him squirming and freaking out as he was. Eventually I got the hang of it and got him to lay on my lap, but it's hard for him to get comfy because his belly incision can't get on my lap and his neck incision shouldn't be on my arm. I digress...

The crying got worse and worse and I asked the handlers if this was going on all day/night? They said, "Yeah" as if it were normal. I said, "Well, I know him and this is PAIN!" They tried to talk me out of it, but I was having NONE OF IT! I said to her, "No offense to you, but please page Dr. Kyles and ask him to come in here RIGHT NOW!" So they did and Dr. Kyles arrived.

He was very matter-of-fact and said that he thought this was pretty reasonable for post-op day 1 and that Chandler could go home tonight if I wanted. I must have looked at him like he had three heads because he said, "What's wrong?" I politely voiced my concern that this is not normal for Chandler. Even when he gets whiny after sedation and such, it's NEVER like this. This is no anxiety or agitation... this is the sound of P A I N and we need to do something about this, NOW. He said that Chandler was getting 3 mg/kg of IV Fentanyl last night and this morning he looked good so, in anticipation of his discharge later today, they started to taper it down a few hours ago to 1.5 mg/kg. I said, "Maybe this is the issue? You've lowered his pain meds and now he's in pain again?" Dr. Kyles seemed skeptical at first but looked him over and then agreed and said he could definitely bring the Fentanyl back up but that would mean no coming home tonight.

I was torn and wanted to talk to Michael about this but there was no cellphone signal there and no landline in that room. I didn't want to leave Chandler after just getting there, but I wanted another opinion- MICHAEL'S. I asked Dr. Kyles, "If this were your dog, what would you do?" He said he couldn't answer that for me. Lovely. Okay, Dr. Ciment, you're on your own.

I thought it through and asked Dr. Kyles, "Okay, so let's say I bring him home and he has pain- what do I do? He won't let anything in his mouth, and I can't just shove a pain pill down his throat like you can with most dogs... will I be injecting him?" And, of course he said I wouldn't. "That's the challenge here" Dr. Kyles told me. The flip side of this is that, we KNOW he'd be more comfortable at home, resting in his own bed, in his own space, etc... so this was not a straight forward decision. In the end, we decided that we'd take the pain meds back up and let Chandler stay another day & night. Nothing will be comforting about home if he's in intractable pain.

I watched them up the meds on the IV infusion pump and Chandler slowly started to calm down. I gave him some Reiki. Then, I left him and now am back at the office, hoping that I, too, can calm down.

I'm planning to head back up at 1:30-2-ish and will visit again, this time with Michael. I'm hoping to see a very different little man-- one in less pain and more comfy.

Next update- mid afternoon.





Saturday Morning

I got a call at 9:30 from Dr. Kyles. He had rounded on Chandler and told me that Chandler was doing very well and could come home this afternoon. Ethan was there at 10:00 to visit while I was working. I am going to head in this afternoon when I am done at 1:00. After his visit, Ethan called me. Looks like Chandler will be there tonight as well. Ethan's post to follow.

Friday, April 10, 2009

9 PM UPDATE FROM THE ICU

Chandler is resting comfortably. He was a little fussy before but they upped the pain meds and he's quiet, relaxed, comfortable and sleeping. They tried to give him some (wet) food because, after all, it has been a day, but he wasn't really interested. We're not concerned-- under the best of normal circumstances, he's fussy about food.

Most importantly- he's breathing on his own, resting, on fluids, he peed on his own (YAY! Bladder is working) and he's comfortable.

I think we just might get some sleep tonight.

Finally...

He's Out of Surgery!!!

Dr. Kyles just called. Chandler is out of surgery and waking up already. They were able to remove the entire tumor in his mouth and the malignant lymph node as well. They couldn't excise a large margin around the tumor as Chandler's mouth is so small and the location of the tumor would have required removing bone from his jaw. So, he'll get a little radiation once his mouth is all healed. They couldn't close the entire wound as there was not enough tissue, so it will take a little time.

As for his bladder, the mass did not appear to be cancerous. They will have a path report on it soon, but Dr. Kyles is very confident it is nothing serious.

Chandler also started on the vaccine therapy today. He'll get 3 more injections at 2 week intervals.

I cannot say how happy I am. There just aren't words for it. I am shaking as I type this. This is the best news we could have gotten. My baby is fine. He will be at the hospital over night and then tomorrow we will see if he can come home or will he need one more night there. Much will depend on his pain level. But those of you who know Chandler, know he does not show pain that often. So it will require some serious scrutiny. Honestly, as much as I want him home, if we feel he needs another night in the hospital, he'll come home Sunday instead.

He is such an amazing dog. Everyone who meets him thinks he is only 10 years old or a puppy. I know the exercise he got walking around our old neighborhood in St. Louis gave him a great start. I mean he kept up with a greyhound and a golden retriever on 1.5-2 mile walks. He is a strong being.

Thank you all for your love, support and positive thoughts. I know that all of that helped tremendously.

Big Day Today

Today we brought Chandler in to meet with Dr. Kyles. On our way in, I called the CT Scan facility and made sure they faxed the report over to Dr. Kyles so if everything checked out, Chandler could have surgery today.

The fax arrived while we were waiting for our appointment (because of the holidays there was no traffic getting in to NYC today and we made it in very quickly). We had the receptionist make a copy for us so we could review it. Overall it was really good news. We already knew about the tumor in Chandler's mouth and lymph nodes. The big question was the mass in his bladder. The report was inconclusive, so hopefully when they go in, they will see it is not cancerous. But back to the oral tumor. The good news here is that there is no evidence of it going into the bone and it is operable. The only issue is that because of the location, they may not be able to excise the entire thing or get a clear margin. But Chandler is a candidate for the new vaccine therapy, so even if some of the cancer is left, it isn't as bad as if it they couldn't remove any of it.

The CT scan showed a few other areas of interest, but not cancer related. Chandler has some kidney issues showing possible early stages of kidney disease. However, this is easily treated with medication.

After talking with Dr. Kyles, we decided to proceed with the surgery today. So, after filling out the necessary paperwork, we handed Chandler off to the Vet Tech and said "see you soon." This is so not "good bye." We do not yet know what time Chandler is going under the knife today. They had a few emergency cases come , but we know at the latest it would be in the afternoon.

Following the surgery, Chandler will have to spend at least one night in the surgery center. He may come home tomorrow, but it will depend on how he is doing. We expect him home no later than Sunday.

I cannot tell you the relief I feel. Yes, I am scared, nervous, and anxious about my baby having surgery today. However, now that we know what we are dealing with, a treatment plan will be set up very soon and best of all, the melanoma is being removed. The waiting was horrible these past few days. Now we are just waiting to find out that he is out of surgery. Poor Chandler had to go three days in a row without breakfast. Today he was looking from me to his plate, almost demanding food. I felt so horrible not feeding him. As smart as he is, he doesn't understand the no eating before surgery rule. I brought food and treats with me to vet just in case he didn't have surgery today so I could feed him immediately. Serious mix of emotions happening now, but I feel like I can breathe again. I even have my appetite back. That pit in my stomach feeling is gone. And of course I hate that Chandler isn't home right now, but he needs the surgery. This is the first time in 14 years when I am home at night and Chandler isn't here. I've never slept in my home when he wasn't here.

This afteroon, Riley tried to snuggle against Phoebe the way he does with Chandler, but she wasn't having it. I wonder if they realize he is not home. It is going to be hard keeping Riley away from him when he comes home, but Chandler will need to rest.

Please keep the positive thoughts coming. Remember we aren't fighting anything. We are improving, helping and restoring.

Thursday, April 9, 2009

Update

Dr. Rocha called to say he didn't get the CT report and that the fine needle aspiration of Chandler's bladder was "non-diagnostic." He added that he is off tomorrow. So, even if the report came in tomorrow, nothing would happen until Monday at the earliest. But we scheduled an appointment to meet with the surgeon tomorrow at 10a.m. Very frustrating. And we want this out of him ASAP, letting it go until Tuesday is not acceptable.

Ethan sprang into action on this and called Chandler's regular vet to run interference. I just got a call from the specialist's office. Chandler is on the books for tomorrow. So, as long as they don't get too many emergency cases coming in tonight/tomorrow morning, Chandler will have surgery tomorrow to reduce the mass in his bladder and removed the mouth tumor and lymph node. Dr. Mlekoday is the best vet bar none. This is also predicated on the results of the CT, but we will have that tomorrow as well.

WOW! I am happy this is going to happen sooner rather than later, but at the same time I am scared. I get nervous enough when he gets knocked out for dental. This is major surgery! My baby is being cut open. I know it is to help him, but that doesn't lessen the anxiety for me. The parade of horribles is going through my head. Please everyone put out good thoughts about Chandler being fine, coming through the surgery with no problems, and his health being improved. And of course if for some reason it cannot happen tomorrow I will be disappointed, as long as it is because they got booked up. So good thoughts everyone.

CT Scan

Today's CT scan went well. We don't have the results yet, but the doctor said she was able to get good, clear images. Chandler handled it like a pro. He walked out to the car on his own, no need for a carry. Often after anesthesia he is loopy for a while. Not this time. Start to finish was less than 1.5 hours. If anyone needs to get his or her fur-kid an MRI, CT Scan or radiation, I cannot recommend Veterinary MRI and Radiotherapy Center of New Jersey highly enough. Everyone there is amazing and they take care of the owners as well as the pets. Now we are just waiting to hear from Dr. Rocha.

Why This Blog and What the Title Means

First a little background. 3 weeks ago I found a lump in Chandler's mouth. At his annual check-up/predental vet appointment I pointed it out to Dr. Mlekoday (Chandler's doctor) and she said she would check it and biopsy it at his dental the following week. This past Monday we got the news that Chandler has malignant melanoma in his mouth. Needless to say, this was devastating news. Ethan got us the first available appointment with an oncologist recommened by Dr. M., Dr. Rocha at Veterinary Specialists in NYC. We met with Dr. Rocha, yesterday, Wednesday. During the examination, Dr. Rocha gave Chandler a battery of tests. Chandler was very cooperative and he did not have to get sedated for the x-rays or ultra sounds. That was good news as it meant we would be able to leave around 1:00. However, Chandler's bladder was not full so they could not get a clear image of it and we had to wait for him to fill up. Finally by 2:30 he was full. Unfortunately, the ultrasound showed a mass in his bladder. They did a fine needle aspiration of the mass, along with the lymph node under the tumor in his mouth to find out what we are dealing with.

The lymph node showed some metastisis, but the paraspinal nodes around Chandler's bladder are clear. So, we did get some good news. Dr. Rocha believes the bladder tumor is unrelated to the melanoma. Today we are off to get a CT scan of Chandler's mouth and abdomen so we know better how to treat him.

So why this blog? Well, all of our friends want to know what is going on with Mr. Chandler. However, having to repeat the news over and over is very painful and I would rather have one central location to give everything we know at once. We truly appreciate everyone's concern and support. But I just cannot keep telling everyone separately. Calls and emails to express support and to see how we are doing are always welcome, but for any questions on the status of things medically, we have this blog.

What the title means. Ever since he was a puppy, Chandler has made this trilling sound to greet his friends. I have never heard another dog do this. But everyone who heard it laughed and knew they were loved and welcomed by Chandler. So what better way to let visitors to this blog know they are welcome than with this sound that is the essence of Chandler. With that, welcome to Chandler's Trill.