Prepping for Halloween

This is Lulu's week off, and she's back to "normal" again now that she's back on Prednisone. Her foot has healed and she had her first grooming since she's started treatment at Healthy Spot. They made her fluffier than usual and kept her hair pretty long, so she's super soft and fuzzy.



The left side of her nose is starting to grow more fur now and the top of her muzzle has a few sprouts as well. The front of her lips are still pink and hairless.

I subjected the pups to their annual trying-on-of-the-Halloween-costumes and you can see they weren't all too happy. Here is Lulu (and Cora) in their Halloween outfits.

Quick Dr. Visit

It's been about a week since Lulu has started Cycle 3 of her chemotherapy and she's been experiencing some side effects. Starting last weekend she has been a bit sluggish (especially coming up the stairs) and pants a lot in exhaustion. Also she's lost her appetite, which is very unusual for her. She'll start her meal but have a hard time finishing, even after we've topped it off with some pumpkin (girl loves her fruit and veggies) or dried meat.

Also we learned our lesson with putting off her grooming. She has been biting at her paws (poor, itchy things) and must have bitten through the skin because one started to bleed and it looks infected. We took her in to see Dr. Turner today and the team was surprised to see her so shaggy.

Today's diagnosis:
• Stopping the Prednisone early may have affected Lulu's appetite and energy level. Starting today she is back on at 10mg 2x daily for three days, 10mg 1x daily for another three days, then back on to 10mg every other day.
• The doctor gave her an antibiotics injection to last her two weeks. Hopefully this will fight off that nasty infection on her foot. She is to soak it 2x daily for 5 minutes in a Chlorhexadine dilute and is back in the cone so she can't chew on her foot.
• Lulu's white blood cell count is normal so she is to continue on the Lomustine tomorrow.









The peach fuzz on the right side of her muzzle is slowly turning into fur and the left size now has some peach fuzz. Top of her nose, not so much. :( The pigmentation is starting to return too so you can see parts of her nose and top lip that is starting to match her bottom lip. When we take her out people have stopped asking about her nose -- I suppose she just looks like a "mature" dog now that has lost a bit of her fur. :P

Chemotherapy: Cycle 3

Lulu has incredibly fuzzy feet! We've been trying to scope out a new groomer in the area. Lulu and Cora have both been going to Paw House in Cypress since we've moved out here and Cora got a pretty bad allergic reaction the last time they gave her a bath so I'm hesitant to bring Lulu in. (Especially since her skin still looks so sensitive)

So in the meantime, Lulu has grown fuzzies all over, especially on her feet. Lulu also went in to start Cycle 3 of her chemotherapy today. She has run out of prednisone but the doctor said she doesn't need it anymore. Maybe now she'll shed her extra pounds?





A typical chemotherapy cycle (3 weeks) looks like this:
Evaluation with Dr. Turner
Vinblastine 10 x 0.1mg (chemotherapy by injection)
Catheterization, butterfly
CBC w/o differential
Blood Draw
Oral chemotherapy handling fee
Lomustine Cap 10 x 10mg (chemotherapy by oral capsule)
Recheck with Dr. Turner within 1 week
Recheck with RDVM within 1 week
CBC check within 1 week

Chemotherapy: Cycle 2

Lulu just finished cycle 2 (out of 3) of chemotherapy. She is doing well and back to her usual antics. How do we know she's back to normal?

• She yawns (audibly) in the mornings to ask for attention
• She scavenges for food when we are gone
• She's smiling again
• But most of all, she's her usual, lazy self



We've started taking her out more often now that most of the scabbing around her nose has fallen off. Her facial fur has started growing wild so it's a big contrast against the bare skin around her muzzle. We're just crossing our fingers and waiting for her fur to come back. (She's developed a little peach fuzz on one side :P)

Chemotherapy: Cycle 1

Lulu has just finished her first full cycle of chemotherapy and is taking a break this week. The skin around her muzzle is healing fast so we took this as an opportunity to give her a bath -- her first one in months! We had always been hesitant to give her a bath even though Dr. Lyons gave us the go ahead after she was done with radiotherapy. Lulu likes to rub her face all over the carpet after a bath and we didn't want to encourage too much irritation around her scabs.










So fresh and so clean!

Hungry Bear

Lulu is getting FAT. She has gained almost 3 pounds since she started her treatments. Apparently prednisone makes dogs unusually thirsty and persistently hungry which means that Lulu is always hungry, even after she eats.

She is always waiting for food. Here she is leading the pack in eying my mom's birthday cake.

Out and About

Now that Lulu's nose has dried up considerably, we're starting to take her out on outings. After being in the house for a couple of months straight she was excited to be outside.

We headed to The Camp in Costa Mesa for brunch. She barked a little more than usual and was very alert the entire time. (Mostly searching for birds) But she was happy! We're going to have to do a lot of retraining to get her to calm down in public areas, especially since her medicine makes her super anxious.





This week Lulu will be going back to see Dr. Turner for a quick CBC Test (Complete Blood Count) and her first dose of oral chemotherapy if all looks good.

Lulu's Medical Oncologist: Dr. Turner

Avenelle Turner, DVM, DACVIM (Oncology)

Veterinary Cancer Group's latest addition to the team of dedicated veterinary professionals is Board-Certified Oncologist Dr. Avenelle Turner. Dr. Turner received her DVM Degree from Colorado State University and completed her internship at Garden State Veterinary Specialists in Tinton Falls, New Jersey. She completed a three-year residency in Medical Oncology at Gulf Coast Veterinary Specialists in Houston, Texas. She was most recently practicing at a progressive multi-specialty practice in New York City for the past few years. Dr. Turner has extensive training in oncologic emergencies, clinical pathology, exotic animal oncology, and grief counseling. The focus of her approach to the practice of oncology is compassionate care and strengthening the human-animal bond. She has many personal interests including traveling abroad, reading, baking, and personal fitness. She is the proud parent of two tortoiseshell cats and a very long Dachshund named Sookie.

Starting Chemotherapy Treatments

Today we met Dr. Turner for the first time, Lulu's medical oncologist. Dr. Turner will be monitoring and administering Lulu's chemotherapy over the next couple of months. She's found the trick to befriending Lulu: feeding her constant treats as she conducts her physical exams.

She explained to us that Lulu will be doing three cycles of three weeks each to administer two different drugs. The first drug will be given by injection the first week, the second one orally the second week and on the third week Lulu will rest. At the end of the nine weeks, Lulu should be cancer free.




The scabbing around Lulu's nose has completely dried up and is starting to fall off. You can see that the new skin underneath the scabs is a very light pink color and very smooth. Her nose is also a very soft pink color but that should be darkening over the next couple of weeks. It seems very sensitive (like baby skin!) so I'm guessing it will toughen up over time too.

Still in the Cone

Poor Lulu. She keeps trying to scratch off the scabs but they are not ready so it makes her bleed even more. She has no more radiation treatments so hopefully it doesn't get any worse than this. I can't wait for everything to dry up -- makes me so sad to look at her!

Done with Radiation Therapy!

We had our last discharge appointment with Dr. Lyons today. She is done with radiation therapy! The worst is over. Dr. Lyons is confident that they got rid of all of the cancer cells in the muzzle and lymph node, though he did just a visual assessment. Apparently at this stage a cat scan won't do much to see what is leftover at the molecular level, so that's what chemotherapy is for.

Lulu already had a couple of milder doses of chemotherapy during her radiation therapy but now that she's done, the medical oncologist will step it up and give her the full doses. We meet with her next week!

The fur on the right side of her nose is getting dry and crusty. There are chunks that peel off at a time and I try to remind myself that it's normal. It just seems so much more harsh when it falls off with a huge chunk of fur attached to it. :P

Dry is Good

So I *think* Lulu is getting a little better today and starting to heal. The wetness is gone and her nose has started scabbing around the affected areas. The top of her nose is peeling and still very dry but I'm hoping all of this will heal and her skin (and fur!) will regenerate. She's been a little less persistent about rubbing her nose (maybe because it's much harder with this plastic cone) but was all sniffles through the night and morning.

I wish there was something topical I could put on her skin to help it heal faster but she just licks anything right off. Tomorrow we have a follow-up appointment with Dr. Lyons where we'll assess her progress as well as start the next dose of chemotherapy.

And yes, that is her prednisone pot belly. :)

A cone upgrade!

Lulu is building quite the collection of cones. She's upgraded to an extra-large... we needed one as long as we could find so that the tip of her nose can't reach anything she's trying to rub it against. This one is a little better for her to walk around in too, since she will have slightly better peripheral vision. Hopefully it doesn't bother her when she's sleeping.

And.... it got worse.

These pictures make me so sad but in the spirit of documentation, the posts shall go on!

Lulu was able to get a good scratch on the nose twice, and both times it ripped chunks of her fur off her muzzle. The growing raw and bloody areas plus these two open wounds are driving Lulu crazy and she is trying to rub her head on the wall, ground, anywhere she can, cone or not!

The soft cone is good for comfort but not great for preventing rubbing or scratching. Max is out shopping for a plastic cone. We need to do what we can to stop her from making the area worse. I keep reminding myself to be patient and that by this weekend she will start healing. *crosses fingers*

"It will get worse, before it gets better."

Oh, Lulu. This week the raw, tender area on Lulu's nose is getting bigger. It's irritating her even more now so she is back in the cone. When we don't watch her she tries to rub her nose against the wall since the cone prevents her from rubbing against the ground.

She is now on Tramadol (pain medication) 3x a day to keep her knocked out and pain-free for as much of the day as possible. The top of her nose is crusty and dry and the inside of her mouth is still raw and s-m-e-l-l-y. Fortunately she still has her appetite and is eating well. An ice cream a day, keeps the doctor away!

Last Day of Radiation

Today is Lulu's last day of radiation therapy. I thought I'd finally give you a peek into the place Lulu has to go to everyday! We start off at the parking lot at the roof of the building. As soon as Lulu sees the stairs she starts walking slowly and more hestitantly.

Here is the entrance to 9599... radiology on the left and cancer therapy on the right.

This is the wall of radiation graduates. Can't wait til next week when they will post Lulu's picture up!

Lulu hides under the chair as soon as she hears them calling for her.

And this is Swix, the cheerful gal that takes Lulu in and out of the radiation therapy room. Lulu likes her for one reason, and one reason only: she's the one that feeds her lunch when she wakes up!