Treatment day #8

We are about half way thru Tia's treatments and she is doing well.  They have continued with radiation despite the infection.  The tumor has not gotten any bigger since Monday, and the Doctor feels this is a good thing.  It means the antibiotic is working.  (Then why isn't it getting smaller?!)  No biopsy results yet, but they are hoping to have them by Friday so we can get Tia on a new antibiotic, if necessary.

Infection

Talked to Dr. Rosen last night.  She found that Tia had puss draining into her mouth from a small fistula.  She shaved a small area on the tumor, drew some fluid, and found it was the same as the puss in her mouth.  We are clearly dealing with an infection.  She said the lymph node enlargement is all related.  This is a relief in a sense, since she was a bit concerned that we might be dealing with another cancer.  Tia had been on antibiotics since before her abscessed teeth were removed on 10/5/09, but we took her off around Thanksgiving because there didn't seem to be a need for them.  Apparently we shouldn't have done that.  This infection is all related to the original issue.  Dr. Rosen explained that the center of a tumor is an empty area where bacteria love to congregate.  In order to know how best to treat the infection we need to know what type of bacteria we are dealing with.  She did a biopsy but we won't know the results for another week or so.  Once the results are back we'll know what bacteria is involved and which antibiotic will be best to fight it.  For now Tia has been put on an 'all purpose' antibiotic.  She is still receiving her regular radiation treatments, but there is a chance they might have to be suspended if the infection can't be controlled.  I'm really hoping the antibiotic helps control the infection so we can complete the radiation treatments. 

Second week of treatment begins today

Another early morning ride to NEVOG with Tia.  This time traffic was a little heavier.  We got there at around 7:35.  I met with Dr. Rosen and told her we thought Tia's tumor looked bigger.  She measured it, which she does each week, and confirmed that it is a bit bigger, but that it seems to be from fluid.  If the lump were hard it would mean that the tumor might be growing bigger.  The fluid could mean there is an infection.  Dr. Rosen also said the lymph node on the same side as the tumor is a bit enlarged.  This could also be from fluid.  She is going to biopsy both.  Results won't be back until probably tomorrow.  The type of tumor Tia has does not spread, so seeing the lymph node enlarged is a bit of a concern.  But come to think of it, the tumor site started getting bigger when we took Tia off the antibiotics, so maybe this is an infection.  Hopefully that's all it is.

It sure was nice to have Tia home for the weekend.  When we picked her up Friday night she seemed a bit indifferent towards us.  She was probably mad that we 'deserted' her there for the week.  She got over that pretty quickly, and was SO excited when we pulled in the driveway later that night.  She spent the weekend following us around everywhere, running around outside with her friend Silvi, making sheltie angels in the snow, eating as much as possible.  She even came with us to get the Christmas tree yesterday.  It'll be another quiet week without her, but Silvi is there to keep us company.  Brian is picking Tia up on Friday, when he comes home for his Christmas break.

Day 3

Spoke with Liz at NEVOG.  Tia is doing great, and they love her.  She said she is such a cute little girl.  They want to keep her!  (Yeah, like that's gonna happen.)  Liz said they have been feeding her twice a day, which is what she is used to.  First they treat her and then they feed her.  Today they treated the dog in the kennel next to her, and then fed him.  Tia was NOT happy that he was fed before her, and barked her displeasure.  I asked if she stamped her feet too, like a skunk does before it sprays, but she said no.  She sure is an expressive dog.  I am glad they are enjoying her, but I can't wait to pick her up after work on Friday!

First treatment update

I just got off the phone with Dr. Rosen.  Tia was still on the table but they were just in the process of waking her up.  She did fine.  I asked if they ended up radiating from above the head, down over the right eye and into the tumor.  She said yes, but that they also are hitting it from below, with a sharper angle up so that there is no exposure to the left eye.  This way they can hit as much of the tumor as possible.  I asked about how Tia's vision in the right eye will be affected.  She said the loss of vision will be gradual over the next 6 months to a year.  She will basically form a cataract over the eye which will result in a gradual loss of vision.  She mentioned that depending on the extent of the damage to the right eye, there may be surgery to correct the vision, but I doubt we will pursue that, provided she still has good vision in the left eye.  Animals adjust much better to handicaps than we do, and I am sure Tia will do so as well.  Dr. Rosen even mentioned that the loss of vision shouldn't be too much of a problem in the immediate future, and doing agility is still in the cards for Tia!  I asked her about the probability of an oral/nasal fistula forming.  She consulted with the other doctors and was told that the probability of one forming is pretty remote.  Because her tumor is one that will go away gradually it will allow the radiated tissues to heal, and therefore a fistula should not be an issue.  I was very relieved to hear that.

Tia's treatment begins

Got up at 4:45am today to drive Tia to NEVOG.  Tia knew something was up, because even when we go to dog shows we don't usually leave so early!  She didn't want to get in the car, but once in she curled up and slept the whole way.  I was jealous!  We arrived at NEVOG at about 7:20, having hit just a little traffic on the Mass Pike - early Boston rush hour, I guess.  The hospital doesn't open until 7:30am, so it really wasn't a very long wait.  While we waited I took another picture of Tia's tumor.  I really think it is bigger than ever, and am relieved that her treatment is about to get underway. 

Dr. Rosen was there and we had a chance to talk a bit.  She asked how Tia has been doing.  I told her that she is still her crazy, happy, active self, but that her sneezing has increased, and that yesterday I noticed she was licking her lips a lot, which is something new.  Dr. Rosen thinks this might be a sign that she has some pain, and they will put her on pain meds if necessary.  They showed me the kennel where Tia will be staying.  It is very spaceous.  Her bed fits in just fine, with plenty of room for her to walk around.  I hear that the radiology staff spends a lot of time with the "in-patients".  They get daily walk and play sessions.  Tia didn't seem too eager to stay though.  She kept jumping in the chairs in the waiting room.  I told them they should put one in her kennel!  I was asked what tricks she knows, so they can keep her alert and occupied when they have time.  Sounds to me like she will get lots of attention.  We went over feeding instructions.  Poor T will only get one meal a day because she needs to be fasted before each radiation session.  Her first radiation treatment will be this afternoon.  Dr. Rosen explained that the size of her tumor will likely not change until after her treatments have finished, and that it will get smaller over time.  It is nice to know what to expect.  We will miss Tia so much while she is at NEVOG, but we have been encouraged to call daily for updates, and of course she will be home over the weekends.  Luckily we have Silvi at home, so we won't be entirely "dogless".  Silvi belongs to Kim Lappen, and I 'borrowed' her to breed.  She has a litter of puppies due right around Christmas.  So along with eagerly awaiting the end of Tia's treatments on December 24th, we also get to watch for puppies!  It will be an interesting, busy time.

Keep thinking happy, positive thoughts for Tia's full recovery!  

Second visit to NEVOG

Yesterday's visit was a bit of a shock.  First they took a pre-anesthesia chest x-ray.  The results were clear so they proceeded to put Tia under for the CT scan.  That procedure went well, but the results were startling.     Tia's tumor is much bigger than they had anticipated, so unfortunately, surgical removal is out of the question.  With this type of aggressive tumor they need to take a much bigger margin around it in order to ensure that they get it all.  Because of the tumor's proximity to Tia's eye this really isn't possible.  The tumor has also eaten away at more bone than we thought.  Our only option at this point is to radiate.  The good thing is that Tia's tumor will not spread to other parts of her body, and the rate of success with radiation is 80 to 90%.  They should be able to shrink the tumor considerably, and give Tia another 2 to 4 years of quality life.  Since she is 11 years old now, that is a very reasonable expectation.  The bad thing is that she will certainly lose total vision in her right eye because of the radiation.  She will also lose another tooth.  There are other risks and side effects as well, such as a possible oral/nasal fistula.  We'll deal with them as they happen (or hopefully not!).  We will begin radiation on Monday, Dec 7th.  She will stay at the hospital weekdays for 3 weeks and her last treatment date will be Dec 24th.  Thanks to Stephen's help I have attached a copy of a couple of Tia's scans.  You can really see the size of the tumor.  Very scary!

Some people may question why we would spend such considerable funds to fight Tia's tumor.  It's pretty simple.  First, she is in excellent health now.  If you saw her she doesn't act any differently that usual.  She is active and happy, and eating like she always does.  In fact, she had the best Thanksgiving day of her life, since she was allowed to run loose in the house with all our guests, and anything that fell on the floor was hers.  (Not to mention all the turkey that Rick gave her later on when we were cleaning up!)  Secondly, I've known Tia since the minute she was born.  She has been my constant companion.  We have thoroughly enjoyed the sport of agility together, and built a bond that can't be ignored.  She makes me laugh all the time, no matter how "bad" a dog she is.  If dogs have a sense of humor, Tia has a huge one!  Tia has done so much for me in so many ways.  How can I ignore that??  Treating her tumor is the least we can do for her.

Wish us luck as we continue our journey.  Lets hope for a good outcome.