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Groovy's Cancer Journey
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My favorite bandana
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February 10, 2005 - Surgery interrupted
Groovy will not be undergoing surgery. Instead, he will begin chemo immediately. The surgery consult was mindblowing. Several other small bumps were found on Groovy that contained some mast cells, and one area on him felt like a lot of very tiny bumps. I'm afraid this may mean his cancer is progressing more rapidly. Dr. Hedlund was concerned about doing the surgery for several reasons:
1. Groovy likes to lick and chew his incisions and sutures.
2. He has had an intolerance to morphine previously.
3. He could develop more lumps at any time since the cancer is already everywhere in his skin.
4.The surgery is likely to leave mast cells behind, which can cause decreased healing.
5. Since he has been on chemo previously, that increases his risk of having complications.
6. The area where sutures would be is one of high movement, and would put strain on the sutures & incision which could cause problems healing.
7. If the incision broke down, he would have an open wound and be at increased risk for infection.
8. A wound would mean he would have to wear an e-collar and could not run and play until he healed.
9. Groovy could not be given any more chemotherapy until he healed completely.
10. If he has surgery, there is a possibility that he may not heal at all!
The past 2 types of chemo did not work for him. There's one more to try. He'll most likely begin Vinblastine with Prednisone on Monday. If he progresses on that, then he can get in a clinical trial (experimental drug). If he progresses on that, no other drugs to try, nothing else to do except make sure he's a happy, pampered, comfortable boy. When it spreads internally to one of his organs, that's when he will get ill. I hope that it doesn't, but odds are that it will sooner or later. Screw sooner, hope for later. His 7th birthday is April 16, and I am hoping that he can celebrate it without being ill. Shhhh, he still does not know he is sick, he is romping in the yard as I write this.
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Live with intention, walk to the edge, play with abandon, choose with no regret, live as this is all there is.
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Excess on occasion is exhilarating; it prevents moderation from acquiring the deadening effect of a habit.
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February 14, 2005 update: Groovy's disease takes a turn for the weird
Groovy was tested for Urticaria Pigmentosa (a skin disorder in humans that is also very rare in dogs) today, and dermatology said they could not report that he definitely had this disease. His skin biopsies look a lot like UP, but Groovy himself does not look like a dog with UP. Groovy's mast cell disease is way weird (Mast cell disease can be anything from benign skin tumors to malignant systemic disease). Groovy has mast cell disease, but so far it is not in any other organ or lymph node, just his skin. Groovy has diffuse mast cell infiltrate in his skin along with discreet masses (tumors) that have been removed. There has been no systemic spread yet but there is a chance this disease could spread internally. But the risk of Groovy getting sick from chemotherapy (that he may not even need) is greater than the risk of systemic spread. He could have complications as a result of chemo, and it could also decrease his ability to fight off infection. One of his recent biopsy reports (from Sept. surgery) was different than the rest. It said that the masses were mast cell tumors but that there was diffuse infiltration of the skin with mast cells also - clusters of mast cells around the blood vessels within the "normal" skin distant to the mast cell tumors. We do not know why the mast cells are there (from cancer or from UP, or something else). Because of all these clusters of mast cells in his skin, we thought his mast cell disease had progressed throughout his skin, so he went on chemo last September because there was a concern that this disease may spread internally. He was then given a guarded to poor prognosis. He was staged completely at that time and there was no evidence of mast cell disease anywhere else but in his skin. The other side of this coin is that Groovy's disease may never spread internally, he may just keep getting new masses on his skin. In the recent months, Groovy has not behaved like a normal dog with mast cell tumor should. It should have spread by now - he should be ill by now. Groovy's latest mass was different from the previous masses too. It had lots of mast cells but no discreet tumor, which is strange. Then it was thought that Groovy may have UP, a rare skin disorder in dogs. Groovy is not fitting the normal mold for either disease. Most dogs diagnosed with diffuse mast cell disease die in a short period of time. The fact that Groovy is still feeling great is rare compared to other dogs. What we do know is that Groovy has a mast cell disease, but what that disease is, isn't clear. We're not sure Groovy has systemic mast cell tumor (cancer). He has had cancerous tumors removed previously. We're not sure if he definitely has UP. He's currently being treated for UP with benedryl and pepcid. If he gets new masses, he'll go on steroids (Prednisone). If it looks like he's going systemic, he'll go on chemo (Vinblastine) then. This is all way complicated, way confusing, way weird, but that's where we are today.
Next visit to the vet school is February 18 for restaging to see if there's any evidence of mast cell disease anywhere else besides his skin. If there is, he'll go on chemo, if there isn't we will be insanely ecstatic & grateful - until the next lump appears. So far this year, he has had new lumps every couple of weeks, so things are getting interesting...
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February 18, 2005 - Groovy restaged
Groovy was restaged today. No masses/lesions were found on the radiographs. Bloodwork was normal. Buffy coat showed no mast cells. Bone marrow aspirate showed no mast cells (his last 2 bone marrow aspirates showed lots of mast cells). Bone core biopsy pending. On the ultrasound and radiographs, his liver appeared to be rounded on the edges - ns it wasn't really enlarged all over, just slightly, sort of plump. Because of this, his liver will be aspirated next week at his recheck. What we know is that Groovy currently has a mast cell disease...it may be UP, it may be cancer (he's had 2 types of cancerous tumors removed previously), it may end up being systemic - or not. If it is cancer, it is not a cancer that has progressed enough to require chemo yet. Because his masses have been so different and weird, we just don't know yet what we are dealing with. Future masses will be aspirated, and if they are discreet tumors, they will be resected. If they are diffuse mast cells, he will go on steroids, and if more masses develop, then possibly chemo. He may go on steroids anyway next week, will have to see what happens at his appointment. Is he still considered terminal? We don't know. Will his prognosis improve if all is well with his liver next week? Don't know. Will post more when I know more. The fantastic news is this: as far as Groovy is concerned, there's nothing wrong with him.
Next appointment: February 23 for recheck & aspiration of liver...dig here for details
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Groovy's Cancer Journey
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